With the greying of populations in many nations around the globe, aging highlights important issues relevant to discussions on health and social policy reform. As Canada moves forward in strengthening its aging policy, there is an opportunity to examine aging-related policies from international perspectives and consider their application to the Canadian setting.
The Making of Ageing Policy: Theory and Practice in Europe, edited by Rune Ervik and Tord S. Lindén, provides a comprehensive overview and discussion of ideas to address challenges and opportunities for the aging population. This discussion involves labour and social policy at both national and international levels. Its eleven chapters address defining and operationalizing: aging policy, paradigms of policy ideas in response to aging, competing international and national policies, and theoretical perspectives on institutional and ideological approaches to the study of aging policies. In addition, key tensions in aging and social policy between the burden of dependency and opportunities of longevity are identified. Throughout the book, description focuses on how paradigms such as productive aging and active aging dominate aging policy. The authors also identify a lack of normative and institutional analyses. They address the latter through an examination of the value basis and justifications of aging policy.
Overall, the book is well written and explores key policies around aging populations. The book does a superior job of exploring various paradigms in aging (e.g., productive, active) and the influence they have on policy in the areas of pension management, health, and long-term care. Various theoretical concepts are explored in the first half of the book with applied examples explored in the latter portion of the book. There is a greater focus on the labour portion of social policy, with some attention to general health care and more to long-term care. Some of the content can be advanced for more casual readers of political science but overall, the general themes and findings are quite clear. The book will appeal to a wide audience, especially persons interested in health and aging policy from a systems perspective.
The first chapter of this book begins by exploring various statistics characterizing the aging population while highlighting the need for increased years of healthy life expectancy, and recognizing that seniors themselves are not a homogeneous group. There is an introduction to the evolution of the “idea” of aging itself that takes the reader from disengagement to successful and active aging. A summary of subsequent chapters is also included.
Active aging is the focus of the second chapter, which reflects the need for partnerships between citizens and society, with the aim of a comprehensive, non-coercive, and reflective approach. An in-depth foundational background is provided on the concept, demonstrating its birth and evolution, and is followed by a discussion of its implications for policy.
The third chapter compares aging policies set out by the European Union (EU), the Organisation for Economic Co-operation and Development (OECD), and the World Health Organization (WHO) and highlights an overall lack of consensus.
Older-adult non-government organizations (NGOs) and their limited relevance and power are explored in chapter four, including an example from Ireland examining the inclusion of NGOs in policy development from the perspective of both politicians and public servants.
Chapter five includes descriptions of pension reform in four EU countries (Norway, Denmark, Germany, and United Kingdom) and examines the challenges (costs) and potential/implemented solutions (i.e., longer stay in workforce, pensions linked to dependency ratio).
An example of active aging in Poland is explored in chapter six and includes social insurance, social assistance, and privatization in our understanding of active aging, where ultimately, economic issues are viewed as more important than aging issues (i.e., more as productive aging with an economic focus than active aging with a whole person focus).
In chapter seven, activation aging is a concept presented as a middle ground between active aging (focus on staying healthy, employed longer and fully participating in community and political processes) and productive aging (focus on economic aspects such as costs and decreased contribution). In the example provided from Germany, there is a focus on tightening the link between benefits and labour force participation, recalibration of programs and institutional integration. Ultimately the activation middle ground is found lacking, as there is greater focus on productive aging than active aging.
Paradigms and ideas are explored in greater detail in chapter eight and examination of framing issues in a way to get public acceptance of potentially unpopular welfare policy reforms to address an aging population. A United Kingdom example, with a liberal welfare model (i.e., limited public responsibility for welfare), highlights conflict between increased needs for service and the promise of cost saving; a Norwegian example, with Nordic welfare model (i.e., strong public responsibility for welfare), focuses on the struggle for sustainability of the welfare state in the context of demographic change. Both of these examples highlight the focus on the economic burden perspective (productive aging) and non-economic related aspects of aging are secondary.
Chapter nine links the political paradigms and histories in Italy and Poland, in relation to long-term care and the labour market, highlighting the links between political cultures (Mediterranean vs. post-socialist types of welfare states) and resulting policies (cost focus on institutions vs. care allowances).
There is also discussion in chapter ten around fiscal responsibility for funding long-term care: society, families, or the individual. Three systems (Norway, United Kingdom, and Germany) are examined and funding strategies and solutions (e.g., a universal tax-funded model, a family centred/insurance-based model, and a hybrid of the two) are compared and contrasted. The final chapter reviews the key themes as introduced in the first chapter and how these topics were explored in subsequent chapters.
The Making of Ageing Policy provides a useful and well-written exploration of key labour and social policies related to aging populations through dominant paradigms. A real strength of this book is that it provides both theoretical and applied information for the reader. While the book has a European emphasis, the theoretical components (such as active aging and activation) are highly transferable to other settings, such as Canada, as they present different ‘views’ on an aging population that can be applied via policy in any first world country. The applied examples from European countries are also of use to Canadian readers as a result of the grounding in political culture (e.g., attitudes or beliefs that guide a political system) that is provided. The book is fitting for both academics interested in policy as well as for policy makers looking at foreign aging policies that may be transferable to Canada.
