Global Aging: Key Implications for U.S. Foreign Policy and Federal Agencies

What GAO Found Many countries, including the U.S., are experiencing an increase in both the number and the proportion of older adults in their populations. According to the World Health Organization, the share of the global population aged 60 and over is expected to more than double from one billion in 2020 to 2.1 billion by 2050. As countries experiencing population aging take steps to address the domestic effects, experts told GAO that global population aging may also affect the U.S. GAO identified three broad U.S. foreign policy interests that may be affected by aging abroad: national security, economic competitiveness, and global health and humanitarian assistance (see figure). Effects of Global Aging on U.S. Foreign Policy Interests GAO identified several key implications of global aging populations for the U.S. by interviewing experts and conducting a literature review. For example, U.S. national security interests may be affected as allies spend more on healthcare for their aging populations, likely resulting in fewer available resources for defense spending. U.S. economic interests may also be affected by shrinking labor pools abroad, which could affect labor force competition and worldwide migration patterns. Lastly, global health interests may be influenced by the prevalence of chronic disease in aging populations. As a result, U.S. global health priorities may have to be adapted to the health-related risks and vulnerabilities faced by aging populations. The Departments of Defense (DOD), Health and Human Services (HHS), and State have some efforts that indirectly address the implications of global aging. These agencies produce research and data, engage with partner nations, and provide health and humanitarian assistance. State’s regional bureaus train younger populations in other countries to replace skills lost when older individuals leave the workforce. Additionally, HHS researches the effects of aging and age-related conditions on populations both domestically and abroad. However, U.S. agencies do not provide foreign assistance that specifically addresses the needs of older populations, according to agency officials. Why GAO Did This Study According to the United Nations, population aging is occurring at an unprecedented pace and is poised to become one of the most significant social transformations of the twenty-first century. As the populations of partners and adversaries age, the U.S. may be affected by this trend. Stakeholders have increasingly identified global aging abroad as a potential strategic challenge for the U.S. Understanding the changes associated with global aging and their potential effects, including consequences for U.S. fiscal policy, may help inform U.S. strategic priorities and goals. GAO was asked to examine the U.S. foreign policy implications of global aging and how U.S. agencies are considering these implications in their programming. This report examines (1) the implications of aging populations worldwide on U.S. foreign policy interests; and (2) U.S. agencies’ efforts to identify and address the implications of aging populations worldwide on U.S. interests. To address these objectives, GAO interviewed experts and conducted a literature review to identify the implications of aging populations worldwide on U.S. foreign policy interests. GAO selected experts from academia and nongovernmental organizations to represent a balance of views. To identify agency efforts to address global aging, GAO reviewed relevant agency documents, policy guidance, and program documentation. GAO also spoke with officials at DOD, HHS, and State. GAO selected these agencies based on their roles in foreign assistance programming and policy development relevant to demographic change. For more information, contact Chelsa Kenney at kenneyc@gao.gov.

Global Aging: Key Implications for U.S. Foreign Policy and Federal Agencies

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