When our most precious and hard fought for successes give rise to yet more challenges life is revealing its Sisyphean character. We work as hard as we can to roll a rock up a hill only to have it crush us on the way down. The stones that threatens us this time are two of our global civilization’s greatest successes- the fact that children born are now very likely to live into old age and the fact that we have stretched out this old age itself so that many, many more people are living into ages where in the past the vast majority of their peers would be dead. These two demographic revolutions when combined form the basis of what I am calling the Longevity Crisis. Let’s take infant mortality first.
The changes in the pattern of infant mortality rates from 1900 until today is quite simply astounding. In the US a child born at the beginning of the 20th century had a 10% chance of dying before the age of 1. In some cities the rate of infant deaths was as high as 30%. By the end of the 20th century this rate of infant deaths had declined by over 90%. For all of human history up until very recently families that wanted children needed to shoot for high numbers. Many of their children would likely die before they had even learned to speak. More would likely die before reaching age 5.
As late as 1920, 30% of Americans still worked on farms which gave additional impetus to have large families. This combined with the lack of effective birth control (“the pill” wasn’t widely available until 1960) meant that average household size was large- around 4 children- though this was down from the average of seven children per household in the 1800s.
Everything about this story leads to the outcome that the number of children born per woman eventually shrinks. The compression has already happened almost everywhere and in some places such as East Asia including China, Japan and South Korea and in Europe it is happening much faster than in others.
Ultimately in terms of the sustainability of our species this decline in the birth rate is a very good thing. Demographics, however, is like a cruise ship- it is hard to turn. In the lag time the world’s population is exploding as societies are able to save the lives of children but continue to have nearly as many of them. We are living through the turning. As this incredibly cool video graphic from the Economist shows it took humanity roughly 250,000 years to reach 1 billion of us in 1900, but thereafter the rate of growth skyrocketed. There was only a little over a century between our first billion and second billion. 40 years later in 1960 we numbered 3 billion. Only 14 years after that we reached the 4 billion mark and the time between adding another billion would shorten to about a mere dozen years with 5 billion reached in 1987, 6 billion following 12 years later in 1999, and 7 billion a dozen after that in 2011.
Thankfully, the rate of population growth is slowing. It will take us 14 years to pass the 8 billion mark and 20-25 years to reach what will perhaps be the peak of human population during this era- 9 billion in 2050. Though comforting we shouldn’t necessarily be sanguine in light of this fact- we are still on track to add to the world the equivalent of another China and Europe by the middle of the century. Certainly, these people will, with justice, hanker after a middle class lifestyle putting enormous pressures on the global environment. Add to that the effects of climate change and it seems we are entering a very dangerous and narrow chute through which humanity must pass.
Making the chute even narrower will be the fact that the transition from a high birth rate to a low one is occurring under equally unprecedented conditions regarding human longevity. As pointed out by Ted C. Fishman in his Shock of Grey a person born in 1900 had an average life expectancy of 49 years. By 2000 we had turned that into almost 77 years diligently increasing the average human lifespan by between 1.5 and 2.7 years per decade. (p.14)
It needs to be stressed here, however, that the vast majority of these gains in life expectancy are the result not of keeping the old alive, though we have gotten much better at that, then making sure children survive. The fact that many less children die today skews the average life expectancy upward. These were relatively “easy” gains technically speaking and involved public investments as much as anything else: better sanitation, clean drinking water, routine vaccinations, diet and antibiotics.
Fishman has a neat way of giving us perspective on what the achievement of 80 year longevity means for our species by putting it in terms of life years. At merely the same rate of longevity increase as we have today the world’s population in 2050 will have lived around 500 billion years more than had they be born in 1900! (p.14) That number, 500 billion, not only reveals the extent of the environmental challenges we face, but gives us an idea of the depth of human experience and creativity we might gain. Our longevity and numbers seem to add time to the universe itself.
If you want a jaw-dropping visualization of humanity’s demographic rollercoaster, not to mention a humbling perspective of your own existence within the warp and woof of being and not being, you can get little better than World Births and Deaths in Real-Timea real time simulation of reported human births and deaths created by software developer Brad Lyon.
Aside from the sheer environmental impact of what in the near future will be our increasing human numbers there is the question of how we deal with the transition to what are in essence old societies. Take a rapidly aging country such as Japan. By 2050 Fishman sees the percentage of the Japanese population over age 65 to be a jaw dropping 40%. (p. 145) The dependency ratio, that is the ratio that measures the number of workers per dependent children and elderly is expected to reach 1:1. We have never seen a dependency ratio like that, and Japan isn’t even the worst. Cities such as Shanghai are projected to have a percentage people of over 65 as high as 60%. As a result of its draconian 1 child policy China faces the real danger of growing old before it gets rich.
In Europe too we are seeing the emergence of elderly societies. Fishman again captures the problem quite well writing of Europe where no country is getting proportionally younger and in the worst of the lot, Spain, especially:
Translate the numbers into an estimate of how many people need help with their basic needs, and Spain begins to look like a country that is literally handicapped. Unless medical advances deliver millions of people from infirmities they are now destined for, one out of every six to eight Spaniards will need help with walking, going to the toilet, or doing some other activity that we take for granted until it becomes too difficult. (114)
When transhumanists and their opponents debate the former’s wish lists of medical and technological breakthroughs: radically increased healthy longevity, regenerative medicine, cognitive enhancements, cyborg technologies, advanced AI and robotics the dispute is normally centered around the question of human enhancement and the empowerment of healthy individuals. My guess is that in the long run, however, the development and deployment of these technologies will have occurred not in the interests of the minority of healthy individuals that want them, but because without the use of such technologies societies will simply cease to be functional.
For our survival not as individuals, but as a society, we desperately need technologies and medical breakthroughs that keep the elderly functional and contributing for as long as possible. We need a major investment in regenerative technology, and major research into arresting especially neurological decline. We need cheap and effective exoskeletons that will allow the elderly to retain mobility well past their 65th year, and robots to do much of the work we may no longer be fit to do. The deployment of such technologies will need to be global because the Longevity Crisis is global and will hit especially hard those societies which remain poor.
We also need to avoid losing the gains in longevity we have made in the past century.
If you’re in the mood to be freaked out there’s nothing better than this recent Frontline documentary Hunting the Nightmare Bacteria. To bring up my oft quoted Orgel’s Second Rule “Evolution is cleverer than you are” as shown in this documentary bacteria who are the true lords of the earth are busy outsmarting us. Our overuse of antibiotics and our obsessive compulsive craziness for things like antibacterial dish soap is threatening us with a surge of resistant bacteria that could reveal our seeming defeat of communicable diseases in the last century- which has added to our numbers of both young and old- tragically temporary.
It was this defeat over communicable diseases that transformed death into primarily an experience of the old whereas in all ages prior it was terrifying precisely because of its randomness and especially its impact on the young- a thief in the night- the Grim Reaper and his scathe.
We might also eat our way into shorter longevity. Quoted by Fishman, one of the top thinkers on longevity outthere- S. Jay Olshansky- thinks that today’s generation of diabetic children have a good chance of living shorter lives than their parents. (205)In the West we haven’t seen that since the late Middle Ages when longevity declined by a decade from 48 to 38 years.
As Olshansky points out in his The Quest for Immortality: Science at the Frontiers of Aging simply continuing the trend of increasing longevity we have now is likely to prove difficult.
… adding 80 years to the life of an 80- year- old person is far more difficult than adding 80 years to the life of an infant. The implications for life expectancy are obvious. As life expectancy climbs beyond its current level (80 and older) death rates must fall at a progressively faster pace to achieve even small gains in life expectancy.
This is the stark reality of entropy in the life table. Increasing life expectancy in a population already long-lived is like walking up a hill of increasing slope while carrying a stone of increasing mass.
Gains in life expectancy are already slowing and entropy in the life table ensures that gains in the future will be even slower. (p. 87)
Olshansky is especially well known for popularizing the idea of the “longevity dividend”. He wants us to focus our medical research on finding ways to slow biological aging. Olshansky does not see this refocusing as a means to transhumanist ends- neither radical longevity let alone biological immortality strike him as realistic goals, and one might add as did Kevin LeGradure launching off the recent Pew survey on the subject that the goal of radical longevity is not one the public is hankering for in any case.
Rather, what Olshansky wants us to do is find ways to slow aging so that we can compress the time frame in which human beings suffer terminal illnesses. Longevity isn’t the goal here, but the delay of chronic and debilitating diseases many of the elderly are under current conditions doomed to suffer. Increased average lifespan is a secondary effect. For those interested primarily in increased longevity the promise of shortening the length of frightening and devastating illnesses such as Alzheimer’s is a potentially politically broadening selling point for increased public funding for longevity related research. Indeed, our very success in holding off death in the middle aged and those in their 60s and 70s demands, on grounds of compassion, that we attempt to compress the timeframe in which people suffer the new types of very emotionally and physically painful diseases of aging that our success has inadvertently created.
As noted, we have been extremely effective at rolling back the death of children from threats such as infectious diseases. We are also extremely effective at saving the middle-aged, say a 59 year old who suffers a heart attack. Yet, the sisyphean nature of reality always manages to strike back. A person saved while a child by antibiotics or as an adult through heart surgery- threats to life that would have killed the person quickly- has the chance now of dying from Alzheimer’s diseases an extremely crippling and expensive condition that might take a decade or more to result in death.
Alzheimer’s is especially frightening- not merely for the way it robs the individual of their identity and is therefore one of the most tragic of diseases both for the sufferer and her loved ones, but because of the scale of the disease. Olshansky predicts that on current trends the US will have 16 million Alzheimer’s sufferers by 2050. That’s over 3 million more people than live in my beloved Pennsylvania or as many people as there are in the country of Australia.
The longevity gains we had in the past were largely the result of investments in public health. It was our devotion to one another as fellow citizens and human beings that gave us the miracle of hundreds of billions of more human life years. When as they should be these are years of love and wonder, insight and creativity, and, we can hope -wisdom.
Ensuring that the majority of us can remain healthy and productive with our increased years will require perhaps even greater public investments, many of them in technologies transhumanists have long held dear. Above all, continuing the gains we have had in longevity by both avoiding going backward and increasing longevity will take both shoring up our public health capacities so that we can avoid the return of pandemic killers. (The most galling effect of the recent blockheaded government shutdown was that it compromised the essential work of the CDC in preparing for a potentially devastating flu outbreak.) As the Frontline documentary points out public sector investment is necessary to deal with issues such as bacteriological infection because the market does not find research into necessities such as new antibiotics profitable.
The very complexity of the problem of figuring out how to slow the process of aging going forward will likewise demand massive public investments into areas little touched by today’s medical researchers refocusing our efforts on understanding the underlying mechanisms of aging rather than just trying to come up with cures for specific diseases. At the same time we will have to ensure we fully support the development of the young or society will have poisoned itself at the root, along with ensuring that the benefits of medical and technological advances are shared both within our societies and globally. We can make it through the Longevity Crisis and beyond but only if we do so in the spirit of a supportive family- young, old and in the space between.