Extra Time: 10 Lessons for an Ageing Society - How to Live Longer and Live Better. Camilla Cavendish

a national Fertility Day, with talks up and down the country, she was met with outraged counter-demonstrations. Women marched through the streets carrying placards reading ‘siamo in attesa’:³⁶ a play on the Italian for ‘we’re expecting’, which also translates as ‘we’re waiting’. Waiting for jobs, waiting for affordable childcare, and waiting for equality. Many Italian women still lose their jobs when they get pregnant; one in four is sacked within a year of having her first child.³⁷ Romance is not entirely dead, but the birth rate is in trouble when women need to work but don’t have equality.

      Germany has similarly high rates of childlessness to Italy. But in Europe’s prosperous heart, this has less to do with money worries. ‘In the days of “Kinder, Küche, Kirche” [“Children, Kitchen, Church”] it was natural to have children,’ I’m told by Dr Jan Kessler, a paediatrician in Munich. ‘But that’s old-fashioned to a generation which wants to keep its options open. They want to study; they want a good career; it’s never really a good time to have a child.’

      Women are enjoying success, and don’t always want to deal with old-fashioned views of motherhood. ‘No one minds me having a career,’ one married academic told me. ‘But I would get a lot of flak if I left a child in a crèche.’ Some German women fear being labelled as Rabenmütter, ‘raven mothers’, if they dare to combine work and motherhood. This appalling image, of ravens as carrion-eaters who neglect their young, seems to weigh heavily on some women, who are in any case not certain whether they want children.

The German government gives generous parental leave and has massively expanded day care. It now spends almost three times as much on benefits to families as it spends on defence.³⁸ (The UK spends about 1.3 times more.³⁹) The reforms were led by Ursula von der Leyen, a government minister and mother of seven, who subsidised paternity leave and declared that men should be responsible for half of the childcare. And the birth rate has nudged up a little, with the help of immigrants. To keep pace, the Federal Statistical Office has estimated that the country would need half a million immigrants every year until 2040. That seems unlikely, given the backlash which followed Angela Merkel’s opening the borders to around a million refugees in 2015.

      The birth rate is higher in Britain, where part-time working and maternity benefits are routine. That’s partly because of high levels of immigration: 28 per cent of live births in the UK are to foreign-born women,⁴⁰ though foreign-born people make up about 14 per cent of the population.

      We are also breeding a nation of only children. Almost half of British families now contain only one child. It’s not clear how much of that is deliberate. In polls, Brits say their ideal family is just over two children, but the birth rate is 1.76.

      Sarah Davies, a teacher, was in her mid-thirties when she plucked up the courage to ask her long-term boyfriend to settle down. He dumped her. Now, she wonders if she’s left it too late. ‘No one will fancy me if I look desperate,’ she says gloomily, staring at a dating site. Ms Davies is not one of those mythical creatures regularly accused by the UK press of ignorantly frittering away their fertility. She’s been muffling the ticking of her biological clock for years, fearing men are on a different timetable. ‘They’ve got no incentive,’ she reflects. ‘If I was a man, I’d probably focus on my career too, and not want to be hamstrung by a baby till I’d made it.’ A lack of suitable partners may explain recent increases in the numbers of single women seeking IVF, and why birth rates for women over 40 are at their highest level since 1949.⁴¹ That seems more likely than the idea that highly capable career women, who stick to every other timetable, somehow ‘forgot’ to have kids.

      Is Life Expectancy Stalling?

      Galloping increases in life expectancy have recently slowed dramatically in the UK, and to a lesser extent in Germany, Sweden and the Netherlands. This has surprised actuaries. Some blame it on government cuts to public services, although those were not uniform in those countries.⁴² Others believe it has more to do with a slowdown in the incredible progress we have made against heart attacks and stroke.

      Life expectancy at birth grew substantially during the twentieth century, because we were reducing deaths among infants and children: but life expectancy from the age of 65 barely budged. Between 1970 and 2011, however, older people saw a dramatic change: life expectancy at 65 increased 20 times as fast as in the previous century. The main reason? A massive drop in deaths from heart attack and stroke, driven by people giving up cigarettes.

      Since 2011, progress has slowed. ‘It’s possible we have gone back to the time before 2000, when life expectancy improvement was more gradual,’ says Gordon Aitken, insurance analyst at RBC Capital Markets. ‘From 2000 to 2010, we saw the wealthier getting healthier. But it’s hard to keep reducing deaths from cardiovascular diseases at the same rate. And obesity and diabetes are on the rise.’

      There is no consensus on how the change affects different socio-economic groups. One data set suggests that the ‘Comfortable’ are unaffected, and that the losses are among the ‘Hard-Pressed’. Another suggests that all groups are seeing a slowdown in improvement.⁴³

      While these differences are of enormous importance to insurers, because they affect annuity payouts, they are less crucial for the rest of us. Mr Aitken explains that the chance of dying in 2018, for example, didn’t increase from the previous year. What has happened is that the forecasts for growth were too optimistic. A 65-year-old man in the UK is now expected to live to 86.5, while a 65-year-old woman is expected to reach 88.4.

      Sub-Saharan Africa: The Young of the Future

      Sub-Saharan Africa finds itself in a demographic bind of a different sort. Its population is expected to quadruple to 4 billion people by 2100,⁴⁴ with Nigeria overtaking America as the world’s third most populous country. There is much excitement at the prospect of youth burgeoning as the old world shrinks. Tanzanian President John Magufuli has claimed he sees no need for birth control, insisting a high fertility rate will boost his country’s economy.⁴⁵

      Sadly, he may be mistaken. The great leaps forward made by the Asian Tiger economies came from the so-called ‘demographic dividend’: of rapid growth in working-age populations, enabling those countries to grow fast and invest, followed by sharp subsequent falls in the birth rate which boosted the skills base, because parents with fewer children could invest more in educating each one.

      Sub-Saharan Africa is on a different path, of continuing population growth with no demographic dividend in sight. Its per capita income is growing slowly, and its many willing hands may not be able to find work, if they remain at low skill levels. Add to that the likely strains on the environment and infrastructure, and Mr Magufuli may come to change his mind.

      The Paradox of Living Longer, But Not Being Fertile for Longer

      Falling birth rates must be good news for a planet whose natural resources have been stretched to the limit by humans. And they reflect a welcome next step in the liberation of women. Almost everywhere outside sub-Saharan Africa, women are throwing off the shackles of their traditional roles. Lower infant mortality has made it safer to have smaller families. The hold of religion is waning. More women are pursuing careers. At the same time, job insecurity and the high cost of living, especially in cities where the jobs are, has left many couples fearing they can’t afford children.

      Some worried governments have resorted to bribery. The Polish Ministry of Health put out a terrible video, encouraging the population to ‘multiply like rabbits’.⁴⁶ Norway, Sweden, Denmark, France, Germany and Russia pay ‘baby bonuses’. Some of these schemes have had limited success: France and Sweden have the highest birth rates in Europe. But not all women want to be treated like prize cows. A Danish government video, urging women to ‘Do It for Denmark’, missed the point: that many women don’t want children, and others can’t find a good father.

      It may be that the post-war baby boom was unusual. Today’s combination of greater career opportunities for women, and increased financial pressures, may be returning us to an era when people did not get married, or have children, until they felt they could afford it. Some may leave it too late as a result. Others will feel liberated