Copyright Sociological Research Online, 2003

Chris Phillipson (2003) 'Globalisation and the Future of Ageing: Developing a Critical Gerontology'
Sociological Research Online, vol. 8, no. 4, <http://www.socresonline.org.uk/8/4/phillipson.html>

Abstract

Debates on globalisation have become an important area within the social sciences. The purpose of this chapter is to extend this discussion to the study of ageing and in particular the field of critical gerontology. Some of the concerns here include issues around inequality and social divisions running through the life course. These are being changed and influenced in new ways by the political and economic changes associated with globalisation. The argument of the paper is that globalisation brings forth a new set of actors and institutions influencing the social construction of public policy for old age. Some of the themes covered in this paper include the rise of transnational bodies such as the World Bank and the World Trade Organisation, problems affecting people in the developing world, the acceleration of global migration in various forms, and changes in the nature of citizenship and citizen-rights. The chapter concludes by setting out the case for an 'age- sensitive' globalisation that can provide an effective challenge to new forms of inequality and exclusion.

Keywords:

Critical Gerontology; Globalisation; International Governmental Organisations; Risk Society

Introduction

1.1

This paper reviews the challenge for an ageing society created by the rise of globalisation. Globalisation, defined here as the process whereby nation-states are influenced (and sometimes undermined) by trans-national actors ( Beck, 2001), has become an influential force in shaping responses to population ageing. Growing old has, itself, become relocated within a trans-national context, with international organisations (such as the World Bank and International Monetary Fund) and cross-border migrations, creating new conditions and environments for older people. This paper explores how globalisation creates new agendas for social theory and for social policy and ageing.

1.2

Globalisation, it is argued, has produced a distinctive stage in the social history of ageing, with a growing tension between nation state-based solutions (and anxieties) about growing old and those formulated by global actors and institutions. Ageing can no longer be viewed as a 'national' problem or issue but one that affects trans-national agencies and communities. Local or national interpretations of ageing had some meaning in a world where states were in control of their own destiny. They also carried force where social policies were being designed with the aim or aspiration of levelling inequalities, and where citizenship was still largely a national affair (and where there was some degree of confidence over what constituted 'national borders'). The crisis affecting each of these areas, largely set in motion by different aspects of globalisation, is now posing acute challenges for ageing in the twenty-first century. This paper focuses upon the new policy discourse associated with global ageing, and the implications this carries for constructing social theory and social policy.

The New Global Environment

2.1

Social theory in gerontology brings together a variety of intellectual streams, reflecting in rough measure shifts in sociological perspectives over the past 50 years. Over the past decade, one particular strand - critical gerontology - has been especially prominent, although this approach itself follows a number of paths, reflecting contributions from feminism, work in the humanities, and neo-Marxist political economy (Cole et al., 1993; Arber & Ginn, 1996; Phillipson, 1998; Minkler & Estes, 1999). The critical elements in this gerontology centre around three main areas: first, from political economy comes awareness of the structural pressures and constraints affecting older people, with an emphasis on divisions associated with class, gender and ethnicity (Estes et al., 2001). Second, from both a humanistic as well as a biographically orientated gerontology, comes a focus on meaning in old age and the insecurities that can affect daily routines and relationships. Third, from all three perspectives comes a focus on the issue of empowerment, whether through the transformation of society or the development of new rituals and symbols to facilitate changes through the life course (Kaminsky, 1993).

2.2

Central to the approach taken by critical gerontology is the idea of ageing as a socially constructed event (Vincent, 2003). In respect of political economy, this is seen to reflect the role of elements such as the state and economy in influencing the experience of ageing. In relation to the humanities, the role of the individual actively constructing his or her world is emphasised, with biographical perspectives highlighting the interplay between self and society (Keynon, 1996). The idea of lives as socially constructed is perhaps the key theme of critical gerontology, with different points of emphasis depending on the approach taken.

2.3

At the same time, critical gerontology is itself flanked on the one side by the continuing importance of mainstream sociological perspectives (e.g. symbolic interactionism and exchange theory), and on the other side by a new perspective on the role of older people as cultural innovators, and bearers of new life-styles. This latter approach has called into question many of the preoccupations of social gerontology, in particular its concern with the excessive power of the state, with problems of poverty, and with the alienation of older people. Gilleard & Higgs (2000:23) make this point as follows:

Orthodox social gerontology has treated later life as if it were constituted by inventories of social need and social exclusion. This is not how older people live and experience their lives. The growth of retirement as a third age - a potential crown of life - has been constructed primarily in terms of leisure and self-fulfilment. While these practices may be most fully enacted by a relatively small section of the population of older people, culturally this group represents the aspirations of many, whether or not they are able to realize such a lifestyle.

2.4

The argument developed in this paper is that while an appreciation of new lifestyles and consumerism in old age is certainly vital, the 'traditional' concern of gerontologists with social exclusion and social inequality remains difficult to avoid (Scharf et al., 2001; Agulnik et al., 2002). Moreover, the evidence to date is that critical gerontology - especially in its manifestation as political economy - will be crucial in providing explanations of new divisions operating within and across age groups. These divisions reflect an external environment that has brought radical changes to the lives of older people. Old age has been progressively displaced from the institutional framework created by retirement and the welfare state, and the associated idea of the generational contract. In its place have come multiple work-endings, the creation of welfare as a risk rather than a collective right, and the possibility of inter-generational conflict (Phillipson, 1998). In sum, growing old is part of what theorists such as Beck (1992) and Giddens (1991) have termed the 'post- traditional society'. Increasingly, old age is reconstructed as a phase in life negotiated by the individual, rather than an experience controlled by and developed through mass institutions such as the welfare state.

2.5

But these developments can also be viewed as part of a new political economy shaping the lives of present and future older people. The change here has been variously analysed as a move from 'organised' to disorganised capitalism', to a shift from 'simple' to 'reflexive modernity', or to the transformation from 'Fordist' to 'post-Fordist economies' (Lash & Urry, 1987; Phillipson, 1998). Essentially, this concerns the change from the mass institutions which defined the first phase of ageing, to the more individualized structures - privatised pensions, privatised health and social care, targeted forms of social protection - which increasingly inform the second (Blackburn, 2002).

2.6

This new period of ageing is further defined by another influential characteristic, namely, its location within a globalised world where transnational actors and communities are major players in a reconfigured political economy. In Global Transformations, David Held and his colleagues (Held 1999: 45) set the scene as follows:

Today, virtually all nation-states have gradually become enmeshed in and functionally part of a larger pattern of global transformations and global flows...Transnational networks and relations have developed across virtually all areas of human activity. Goods, capital, people, knowledge, communications and weapons, as well as crime, pollutants, fashions and beliefs, rapidly move across territorial boundaries... Far from this being a world of 'discrete civilisations' or simply an international order of states, it has become a fundamentally interconnected global order, marked by intense patterns of exchange, as well as by clear patterns of power, hierarchy and unevenness.

2.7

This transformed political economy is underscored by the emergence of a more aggressive form of capitalism, one contrasted with the more controlled and regulated capitalism of the 1950s and 1960s. Hutton (2000: 9-10) describes the essential features of this 'turbo-capitalism', as follows:

Its overriding objective is to serve the interests of property owners and shareholders, and it has a firm belief, effectively an ideological one, that all obstacles to do that - regulation, controls, trade unions, taxation, public ownership, etc - are unjustified and should be removed. Its ideology is that shareholder value must be maximised, that labour markets should be 'flexible' and that capital should be free to invest and disinvest in countries at will... It's a very febrile capitalism, but for all that and its short-termism it has been a very effective transmission agent for the new technologies and for creating the new global industries and markets. It's a tool both of job generation and of great inequality.

2.8

The next section of this paper assesses in more detail the impact of global change upon the lives of older people, beginning first with the involvement of international bodies in the field of pension provision.

Global Institutions and Support for Older People

3.1

Globalisation, it may be argued, exerts unequal and highly stratified effects on the lives of older people (Yeates, 2001; Vincent, 2003). In the developed world, the magnitude and absolute size of expenditure on programmes for older people has made these the first to be targeted with financial cuts (just as older people were one of the first beneficiaries of the welfare state). In less developed countries, older people (women especially) have been amongst those most affected by the privatization of health care, and the burden of debt repayments to the World Bank and the IMF (Estes & Phillipson, 2002). Additionally, globalization as a process that stimulates population movement and migration may also produce changes that disrupt the lives of older people (Papastergiadis, 2001). And one must not forget either that they may comprise up to one-third of refugees in conflict and emergency situations - a figure which was estimated at over 53 million older people worldwide in 2000 but will almost certainly have grown since (Help Age International, 2000).

3.2

But older people have also been affected by the way in which inter-governmental Organisations (IGOs) feed into what Estes et al. (2001) identify as the 'crisis construction and crisis management' of policies for the elderly. Bob Deacon (2000) argues that globalization generates a global discourse within and among global actors on the future of national and supranational social policy. The most obvious example has been in the area of policies for pensions. Yeates (2001), for example, has observed that both the World Bank and the International Monetary Fund (IMF) have been at the forefront of attempts to foster a political climate conducive to limiting state welfare and promoting, instead, private and voluntary initiatives. The report of the World Bank (1994) Averting the Old Age Crisis has been influential in making the case for multi- pillar pension systems, and in particular for a second pillar built around private, non-redistributive, defined contribution pension plans. Holtzman (1997), in a paper outlining a World Bank perspective on pension reform, has argued for reducing state pay-as-you-go (PAYG) schemes to a minimal role of basic pension provision. This position has influenced both national governments and transnational bodies, such as the International Labour Organisation (ILO), with the latter now conceding to the World Bank's position with their advocacy of a mean-tested first pension, the promotion of an extended role for individualized and capitalized private pensions, and the call for Organisation for Economic Co- operation and Development (OECD) member countries to raise the age of retirement (OECD, 2001).

3.3

In Deacon's (2000) terms, this debate amounts to a significant global discourse about pension provision and retirement ages, but one which has largely excluded perspectives which might suggest an enlarged role for the state, and those which might question the stability and cost effectiveness of private schemes. The International Labour Organisation (ILO) (Gillion, 2000) concluded that investing in financial markets is an uncertain and volatile business: that under present pension plans people may save up to 30 per cent more than they need, which would reduce their spending during their working life; or they may save 30 per cent too little - which would severely cut their spending in retirement.

3.4

Add in the crippling administrative charges associated with the running of private schemes, and the advocacy of market-based provision hardly seems as persuasive as most IGOs have been keen to suggest (Minns, 2001; Blackburn, 2002). John Vincent suggests that the view that population ageing represents a 'demographic time bomb' is constructed by those with a particular way of seeing the world. He goes on to conclude (Vincent, 2003:86) that:

The function of such arguments is to create a sense of inevitability and scientific certainty that public pension provision will fail. In so far as this strategy succeeds it creates a self-fulfilling prophecy. If people believe the 'experts' who say publicly sponsored PAYG systems cannot be sustained, they are more likely to act in ways that mean they are unsustainable in practice. Certainly, in Britain and elsewhere in Europe, the state pension is an extremely popular institution. To have it removed or curtailed creates massive opposition. Only by demoralising the population with the belief that it is demographically unsustainable has room for the private financiers been created and a mass pensions market formed.

3.5

But while the impact of IGOs on the pensions debate is reasonably well-known, their influence regarding questions concerning the broad field of health and social services - especially as they relate to older people - is less well understood. Increasingly, the social infrastructure of welfare states is being targeted as a major area of opportunity for global investors. The World Bank has expressed the belief that the public sector is less efficient in managing new infrastructure activities and that the time 'has come for private actors to provide what were once assumed to be public services' (Whitfield, http://www.centr e.public.org.uk/briefings/pfi). This view has been strongly endorsed by a variety of multinational companies, especially in their work with the World Trade Organisation (WTO). The WTO enforces more than twenty separate international agreements, using international trade tribunals that adjudicate disputes. Such agreements include the General Agreement on Trade in Services (GATS), the first multilateral legally enforceable agreement covering banking, insurance, financial services and related areas.

3.6

Barlow & Clarke (2001: 84) note that the current round of GATS negotiations has put, 'every single social service on the table and is only the first of many rounds whose ultimate goal is the full commercialization of all services'. Indeed, the WTO has itself called upon Member governments to, 'reconsider the breadth and depth of their commitments on health and social services' (cited in Yeates, 2001: 74). This will almost certainly place enormous pressure on countries to move further in the opening-up of public services to competition from global (and especially US) corporate providers. Pollock & Price (2000: 95) argue that:

To extend rights of access for private firms, the WTO, with the backing of powerful trading blocs, multinational corporations, and US and European governments, is attempting to use regulatory reform to challenge limitations on private sector involvement. But this amounts to a challenge which lies at the heart of social welfare systems in Europe. The new criteria proposed at the WTO threaten some of the key mechanisms that allow governments to guarantee health care for their populations by requiring governments to demonstrate that their pursuit of social policy goals are least restrictive and least costly to trade.

Globalisation and Older People in Developing Countries

4.1

But whilst the new global discourse is re-shaping welfare states in the developed world, its impact on developing countries has proved to be even more dramatic (Polivka, 2001). Already the majority of the world's population of older people (61 per cent, or 355 million) live in poorer countries. This proportion will increase to nearly 70 percent by 2025. For many countries, however, population ageing has been accompanied by reductions in per capita income and declining living standards. Epstein (2001) notes that between 1950 and the late 1970s, life expectancy increased by least 10 per cent in every developing country in the world, or on average by about 15 years. However, at the beginning of the twenty- first century, life expectancy remains below fifty in more than ten developing countries, and since 1970 has actually fallen, or has barely risen in a number of African countries (WHO, 2000). The AIDS epidemic is certainly a major factor here, but development loans requiring the privatization of health care have also had a devastating impact. Epstein (2001) reports, for example, that by the mid- 1990s the African continent was transferring four times more in debt repayment than it spent on health or education. More generally, Help Age International (2000: 8) argue that:

[O]lder people's poverty is still not a core concern in the social, economic and ethical debates of our time. Their right to development is routinely denied, with ageing seen as a minority interest or case for special pleading. Poverty and social exclusion remain the main stumbling blocks to the realisation of the human rights of older people worldwide.

4.2

Elderly people are also affected in different ways by inequalities in the global distribution of income. Income inequalities, within and between countries and regions, may create a number of pressures upon older people, increasing the risk of poverty but also disrupting social networks as younger people abandon rural areas for cities, or attempt long distance migrations to wealthier regions or countries. Wade (2001) summarises data indicating that incomes became markedly more unequal in the period from the late 1980s to the early 1990s. He reports one study which found the share of world income going to the poorest 10 per cent of the world's population falling by over a quarter, whereas the share of the richest 10 per cent rose by 8 per cent. Wade (The Economist, April 28^th, 2001, pp.93-97) comments here that:

It is remarkable how unconcerned the World Bank, the IMF and global organisations are about these trends. The Bank's World Development Report for 2000 even said that rising income inequality ''should not be seen as negative''… Such lack of attention shows that to call these world organisations is misleading. They may be world bodies in the sense that almost all states are members, but they think in state-centric rather than global ways.

4.3

This argument raises important issues about the limitations of global institutions in their attempts to respond to population ageing. Two points might be made here: first, about the nature of what Amartya Sen (2000) refers to as the 'global architecture' represented by economic institutions such as the IMF, World Bank and OECD; and second, the democratic deficit of globalisation and possible responses to this. On the first point, we need to question whether arrangements derived from the Bretton Wood Conference, following the Second World War, really provide an adequate response to the social changes (notably in relation to demography) that have unfolded in the intervening period. Sen (The Observer, 25 June, 2000) makes the point that:

The world was, in fact, very different in the forties, when the bulk of Asia and Africa was still under colonial rule of one kind or another, when the tolerance of insecurity and of poverty was much greater…and when there was little understanding of the huge global prospects of democracy, economic development and human rights in the world.

4.4

And we might also add when concerns about the social and economic impact of population ageing had yet to appear on a world stage. Institutions apart, it is also clear that the neo-liberal consensus operating within globalisation has undermined effective responses to many of the social and economic problems facing older people (Scholte, 2000). Indeed, neo-liberalism, as practised by dominant organisations such as the IMF and WB, has often intensified the difficulties facing elderly people: for example, with pressures to privatize core public services; economic restructuring; and cuts to pensions (Estes & Phillipson, 2002).

Developing Gerontology for the Twenty-first Century: Social Policy and Social Theory in a Global Age

5.1

The analysis developed thus far suggests that critical gerontology will have a major role to play in understanding new forms of structural inequality affecting the lives of older people. In terms of the construction of social policy, this point may be illustrated in three ways: firstly, through the influence of globalisation on issues relating to citizenship and public policy; secondly, via the impact of global governance on the lives of older people; thirdly, in the political changes needed to involve older people and relevant NGOs in the development of a global social policy.

5.2

On the first point, globalisation brings forth a new set of actors and institutions influencing the social construction of public policy for old age. To take one example, the increasing power of global finance and private trans-national bodies, raises significant issues about the nature of citizenship, and associated rights to health and social care, in old age. In the period of welfare state reconstruction, rights were defined and negotiated through various forms of nation state-based social policy (although it is important to emphasise the dominance of the USA via the Bretton Woods system). Globalisation, however, transfers citizenship issues to a trans-national stage, this process being driven by a combination of the power of inter-governmental structures, the influence of multinational corporations, and the pressures of population movement and migration. Alongside these developments come provocative questions about the nature of citizen- rights, and the determinants of the 'life chances' available to members of the global society-older people in particular.

5.3

Drawing on the work of Bauman (2001) and Beck (2001), it might also be argued that rights, in the period of late modernity, have become more fragmented as well as individualised. Certainly, the risks associated with ageing are relatively unchanged - the threat of poverty, the need for long-term care, the likelihood of serious illness. What has changed, as Bauman (2001) argues in a more general context, is that the duty and the necessity to cope with these issues has been transferred to individual families (women carers in particular) and individual older people (notably in respect of financing for old age). The new social construction (and contradiction) of ageing is, on the one hand, the focus upon growing old as a global problem and issue and, on the other, the individualisation of the various risks attached to the life course.

5.4

This development suggests an important role for social gerontological theory, as well as social policy in combining macro- and micro-social perspectives, with new approaches required to understand how global processes may reshape the institutions and experiences with which ageing is associated. In this regard, it will be important to move beyond what Hagestad and Dannefer (2001) view as an undue attention in gerontology on individual ageing. The reasons for this focus they cite as: firstly, late modernity's emphasis on individuals and their agency; secondly, the medicalization of old age; and, thirdly, strong pressures from problem-orientated professions and politicians. Hagestad & Dannefer (2001:15) conclude that: 'The costs of the microfocus [have been the] significant… hamper[ing of] our ability to address the aging society in the context of global economic and technological change.'

5.5

The second major issue to be addressed concerns that of global governance and its impact on ageing. This development introduces us to the undoubted complexities of globalisation and its influence on daily life. The negative effects are well-known: corporations that appear to trample over the rights and needs of individuals and communities; IGOs that put debt repayment before maintaining or improving schemes of social protection; and forms of crisis construction that emphasise the costs associated with ageing populations (Hutton & Giddens, 2000). Ramesh Mishra (1999: 130) summarises these aspects as follows:

The main problem [appears to be] that those conditions and social forces which made national welfare states possible, e.g. the existence of a state with legitimate authority for rule-making and rule-enforcement, electoral competition and representative government, strong industrial action and protest movements threatening the economic and social stability of nations, nationalism and nation-building imperatives, are unavailable at the international-level. Moreover, globalisation is disempowering citizens within the nation-state as far as social rights are concerned, without providing them with any leverage globally. At the same time, trans-national corporations and the global marketplace have been empowered, hugely, through financial deregulation and capital mobility

5.6

Yet the contrary trends are also important and require analysis in the framing and development of social theory and social policy in relation to ageing. Deacon (2000: 13), for example, notes what appears to be the emergence of a 'new politics of global social responsibility'. He writes:

Orthodox economic liberalism and inhumane structural adjustment appear to be giving way to a concern on the part of the [World Bank] and the IMF with the social consequences of globalization. International development assistance is concerned to focus on social development. United Nations agencies are increasingly troubled by the negative social consequences of globalization…[there is a shift] away from a politics of liberalism to a global politics of social concern.

5.7

In similar vein, Mishra (1999: 130) observes the increasing momentum behind the move towards global governance and reform of existing IGOs, with increasing pressure to make bodies such as the World Bank and IMF more democratic and accountable for their actions.

5.8

At the same time, the ability of corporations or other organisations to evade their responsibilities may be constrained by different forms of trans- national governance. For example, taking the European context, avoidance by successive UK governments of age discrimination legislation has finally been challenged by a European Union directive outlawing discrimination in the workplace on grounds of age, race, disability or sexual orientation. Similarly, national legislation following the European Convention on Human Rights, also has the potential to be used to challenge age discrimination in areas such as service provision and employment, as well as fundamental issues relating to the right to life, the right not to be subject to inhumane treatment, and the right to a fair hearing. Both examples illustrate the way in which international law may be used to challenge discrimination against older people. They further illustrate the need for new approaches to theorising about age that can integrate the continuing power and influence of the nation-state, with the countervailing powers of global institutions.

5.9

As has been suggested at different points in this paper, ageing must be viewed as a global phenomenon, one transforming developing - as much as developed - countries. But we need to be clearer about the way in which global institutions and global governance might be used to promote the needs and rights of older citizens. The task here must be to construct new theories about the nature of citizenship in the light of the more fluid borders surrounding nation-states. The extent to which these developments lead to the emergence of a 'global community' and 'global citizenship', such as that outlined by John Urry (2000) is unclear. The important question, however, is whether older people are advantaged or disadvantaged by the spread of mobile communities along with more varied forms of citizenship, an issues which can only be settled by the application and development of social theory.

5.10

Finally, it will be especially important, given the pressures associated with globalisation, to engage older people and their organisations with the debate launched by national governments and IGOs about the future of pension provision and health and social care services. Thus far, older people and their representative organisations can claim only limited influence on the major debates about population ageing launched by the World Bank and similar organisations. The case that needs to be made is for an 'age-sensitive' globalisation in which older people have greater influence in key international forums. The key dimensions to this might include:

• Auditing the activities of key IGOs in respect of their activities on ageing issues;
• Building an age dimension into development policies and strategies;
• Promoting ageing organisations as major players alongside existing multilateral agencies;
• Strengthening the age dimension in human rights legislation;
• Encouraging older people's organisations to play a prominent role in the network of groups and forums which comprise global civil society.

5.11

This is an important agenda, and one that is being only partially addressed in the United Nations, the WHO and related organisations. The aspiration of these bodies to encourage the empowerment of older people, and to achieve what the World Health Organisation (2001) define as 'active ageing', will surely fail unless global inequalities are tackled in a systematic way, and most notably those which reduce the life chances of those in less developed countries and in poorer communities of the developed world.

Conclusion

6.1

The aim of this paper has been to review the implications for older people of the social and economic changes associated with globalisation. In addition to its direct economic and social policy implications, globalisation may be said to have major consequences for gerontological theory and social policy. First, globalisation re-emphasises the importance of a macro- level focus within the field of ageing. Dominant global institutions - the World Bank, the World Trade Organisation, the International Monetary Fund - have established distinctive views and policies about the causes, characteristics and consequences, of population ageing. The approach taken by these organisations raises significant issues for theories concerning public policy in old age, and in particular attempts to understand the interaction between local, nation state, and global organisations, and their relative influence on the social construction of ageing. Second, gerontological social theory and social policy must also acknowledge the activities of supranational bodies in debates on the nature of citizenship. Traditionally, ageing has been theorised within the context of the borders of nation states. In the twenty-first century, however, there will be greater fluidity and mobility within and across societies, illustrated by the rise of different kinds of trans-national communities. Theorising about what it means to grow old within this social context is certainly a major priority for understanding new social relations and social patterns of ageing.

6.2

Finally, older people will be faced with the challenge of securing their identity within the context of the uncertainty and risks characteristic of late modernity. Globalisation undoubtedly adds a further dimension to the nature of such risks and the different way in which they are expressed throughout the life course. Exploring the lives of older people as active participants in this new global environment will be a major challenge for critical gerontology in the twenty-first century.

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