Dædalus coming up in Dædalus: Dædalus on the humanities Patricia Meyer Spacks, Steven Marcus, Andrew Delbanco, Pauline Yu, Gerald Early, Anthony Grafton, Thomas Crow, Jack Journal of the American Academy of Arts & Sciences Balkin & Sanford Levinson, and Dag½nn Follesdal & Michael L. Friedman Winter 2006
on body in mind Antonio & Hanna Damasio, Jerry Fodor, Carol Gilligan, Gerald Winter 2006: on aging Edelman, Jorie Graham, Raymond Dolan, Arne Öhman, Mark on Chris Wilson The century ahead 5 aging Johnson, Jacques d’Amboise, and William E. Connolly Henry J. Aaron Longer life spans: boon or burden? 9 Sarah Harper Mature societies 20 on identity Akeel Bilgrami, Wendy Doniger, Amartya Sen, Stephen Greenblatt, Paul B. Baltes Human dignity & the limits of life 32 Kwame Anthony Appiah, Sydney Shoemaker, Joseph Koerner, Susan Green½eld, David A. Hollinger, Claudio Lomnitz, Carol Linda Partridge Of worms, mice & men 40 Rovane, Todd E. Feinberg, Ian Hacking, and Courtney Jung Hillard Kaplan The life course of a foraging species 48 Dennis J. Selkoe Deciphering Alzheimer’s disease 58 on nonviolence William H. McNeill, Adam Michnik, Jonathan Schell, James Carroll, Caleb E. Finch Aging, inflammation & the body electric 68 & violence Breyten Breytenbach, Mark Juergensmeyer, Steven LeBlanc, James Kenneth Clark The artist grows old 77 Blight, Cindy Ness, Neil L. Whitehead, and Mia Bloom Jagadeesh Gokhale & Kent Smetters Social Security & the aging of America 91 on sex Joan Roughgarden, Terry Castle, Steven Marcus, Claudia Goldin, Lisa F. Berkman Brian Charlesworth, Elizabeth Benedict, Wendy Doniger, Lawrence & M. Maria Glymour How society shapes life spans 105 Cohen, Anne Fausto-Sterling, Catharine MacKinnon, Tim Birkhead, and Margo Jefferson poetry Charles Wright Last Supper 115
on capitalism Joyce Appleby, John C. Bogle, Lucian Bebchuk, Robert W. Fogel, ½ction Ree Davis I kneel before you 116 & democracy Jerry Z. Muller, Peter Bernstein, Richard Epstein, Benjamin M. Friedman, John Dunn, and Robin Blackburn dialogue Daniel Bell & Wolf Lepenies on society & sociology past & present 120 on life Anthony Kenny, Thomas Laqueur, Shai Lavi, Lorraine Daston, Paul Rabinow, Michael S. Gazzaniga, Robert George, Robert J. Richards, notes Jeri Laber on torture 124 and others Robert F. Nagel on the decline of federalism 127
plus poetry by Peg Boyers, Kevin Carrizo di Camillo, John Kinsella, letters on compromised work, poetry for nonpoets &c. 131 Charles Simic, Lawrence Dugan &c.; ½ction by Adam Braver, Dorian Gossy &c.; and notes by Michael Cook, Norbert Schwarz, Joel F. Handler, William B. Quandt, William Galston, Richard Morris, Robert J. Sharer &c. U.S. $13; www.amacad.org FOUNDED 1780
Inside front cover: A picture of progressive de- mentia, using a silver-stained section of the amygdala of the brain from a sixty-nine-year-old man with a nine-year history of the disease. In this image, darkly stained neuro½brillary tangles occupy much of the cytoplasm of selected pyra- midal neurons, in contrast to the golden brown cytoplasm of numerous adjacent cytologically normal neurons. In the center, a senile plaque, consisting of a large compacted deposit of extra- cellular amyloid, is intimately surrounded by a halo of dilated, structurally abnormal (dystro- phic) neurites–represented by the squiggly dark brown pro½les. See Dennis J. Selkoe on The aging mind: deciphering Alzheimer’s disease & its antecedents, pages 58–67: “The process of brain aging can contribute to the development of a clinically noticeable dementing illness, but aging by itself appears to be insuf½cient to cause the illness.” Image courtesy of Dennis J. Selkoe. James Miller, Editor of Dædalus
Phyllis S. Bendell, Managing Editor and Director of Publications
Esther Yoo, Assistant Editor
Contributing Editors: Robert S. Boynton, D. Graham Burnett, Peter Pesic, Danny Postel
Board of editors
Steven Marcus, Editor of the Academy
Russell Banks, Fiction Adviser
Rosanna Warren, Poetry Adviser
Joyce Appleby (u.s. history, ucla), Stanley Hoffmann (government, Harvard), Donald Kennedy (environmental science, Stanford), Martha C. Nussbaum (law and philosophy, Chicago), Neil J. Smelser (sociology, Berkeley), Steven Weinberg (physics, University of Texas at Austin); ex of½cio: Patricia Meyer Spacks (President of the Academy), Leslie Cohen Berlowitz (Chief Executive Of½cer)
Editorial advisers
Daniel Bell (sociology, Harvard), Michael Boudin (law, u.s. Court of Appeals), Wendy Doniger (religion, Chicago), Howard Gardner (education, Harvard), Clifford Geertz (anthropology, Institute for Advanced Study), Carol Gluck (Asian history, Columbia), Stephen Greenblatt (English, Harvard), Thomas Laqueur (European history, Berkeley), Alan Lightman (English and physics, mit), Steven Pinker (psychology, Harvard), Diane Ravitch (education, nyu), Amartya Sen (economics, Harvard), Richard Shweder (human development, Chicago), Frank Wilczek (physics, mit)
Announcement
Correction: In the Fall 2005 issue, “50 years,” acknowledgment should have been made of Stephen R. Graubard, the editor who assigned and edited all but one of the essays that were reprinted in that issue.
Dædalus is designed by Alvin Eisenman Dædalus
Journal of the American Academy of Arts & Sciences
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Dædalus was founded in 1955 and established as a quarterly in 1958. The journal’s namesake was renowned in ancient Greece as an inventor, scientist, and unriddler of riddles. Its emblem, a maze seen from above, symbolizes the aspiration of its founders to “lift each of us above his cell in the labyrinth of learning in order that he may see the entire structure as if from above, where each separate part loses its comfortable separateness.” The American Academy of Arts & Sciences, like its journal, brings together distinguished individuals from every ½eld of human endeavor. It was chartered in 1780 as a forum “to cultivate every art and science which may tend to advance the interest, honour, dignity, and happiness of a free, independent, and virtuous people.” Now in its third century, the Academy, with its more than four thousand elected members, continues to provide intellectual leadership to meet the critical challenges facing our world. Dædalus Winter 2006 Subscription rates: Electronic only for non- Issued as Volume 135, Number 1 member individuals–$38; institutions–$86. Canadians add 7% gst. Print and electronic © 2006 by the American Academy for nonmember individuals–$42; institu- of Arts & Sciences tions–$96. Canadians add 7% gst. Outside The artist grows old the United States and Canada add $20 for © 1972 by Cambridge University Press postage and handling. Prices subject to change Measuring Social Security’s ½nancial outlook without notice. within an aging society © 2006 by Jagadeesh Gokhale Institutional subscriptions are on a volume- & Kent Smetters year basis. All other subscriptions begin with Last Supper the next available issue. © 2006 by Charles Wright Single issues: current issues–$13; back issues I kneel before you for individuals–$13; back issues for institu- © 2006 by Ree Davis tions–$26. Outside the United States and On society & sociology past & present Canada add $5 per issue for postage and han- © 2006 by Wolf Lepenies dling. Prices subject to change without notice. Editorial of½ces: Dædalus, Norton’s Woods, Claims for missing issues will be honored free 136 Irving Street, Cambridge ma 02138. of charge if made within three months of the Phone: 617 491 2600. Fax: 617 576 5088. publication date of the issue. Claims may be Email: [email protected]. submitted to [email protected]. Mem- Library of Congress Catalog No. 12-30299 bers of the American Academy please direct all questions and claims to [email protected]. isbn 0-87724-053-1 Advertising and mailing-list inquiries may be Dædalus publishes by invitation only and as- addressed to Marketing Department, mit sumes no responsibility for unsolicited manu- Press Journals, 238 Main Street, Suite 500, scripts. The views expressed are those of the Cambridge ma 02142. Phone: 617 253 2866. author of each article, and not necessarily of Fax: 617 258 5028. Email: journals-info@ the American Academy of Arts & Sciences. mit.edu. Dædalus (issn 0011-5266; e-issn 1548-6192) Permission to photocopy articles for internal is published quarterly (winter, spring, summer, or personal use is granted by the copyright fall) by The mit Press, Cambridge ma 02142, owner for users registered with the Copyright for the American Academy of Arts & Sciences. Clearance Center (ccc) Transactional Report- An electronic full-text version of Dædalus is ing Service, provided that the per copy fee available from The mit Press. Subscription of $10 per article is paid directly to the ccc, and address changes should be addressed to 222 Rosewood Drive, Danvers ma 01923. The mit Press Journals, 238 Main Street, Suite 500, fee code for users of the Transactional Report- Cambridge ma 02142. Phone: 617 253 2889. ing Service is 0011-5266/06. Address all other Fax: 617 577 1545. Email: journals-orders@ inquiries to the Subsidiary Rights Manager, mit.edu. mit Press Journals, 238 Main Street, Suite 500, Printed in the United States of America by Cambridge ma 02142. Phone: 617 253 2864. Cadmus Professional Communications, Fax: 617 258 5028. Email: journals-rights@ Science Press Division, 300 West Chestnut mit.edu. Street, Ephrata pa 17522. The typeface is Cycles, designed by Sumner Postmaster: Send address changes to Dædalus, Stone at the Stone Type Foundry of Guinda 238 Main Street, Suite 500, Cambridge ma ca ma . Each size of Cycles has been separately 02142. Periodicals postage paid at Boston designed in the tradition of metal types. and at additional mailing of½ces.
Newsstand distribution by Ingram Periodicals Inc., 18 Ingram Blvd., La Vergne tn 37086. Phone: 800 627 6247. Chris Wilson
The century ahead
The twentieth century was, above all Population growth was so characteris- else, a century of population growth; tic of the recent past that we tend to re- the twenty-½rst century will be a cen- gard it as the norm. However, for most tury of aging. Between 1900 and 2000 of human history the long-run rate of the world’s population quadrupled, population growth has been very close from around 1.5 billion to over 6 billion. to zero. From the biblical Adam and Eve, Most of this increase occurred after it would have taken only thirty-two dou- World War II. At present, it seems un- blings of the population to reach over 8 likely that the population will grow by billion. At the rate of population growth more than about a further 50 percent. seen in the 1960s and early 1970s–over 2 The most plausible forecasts see a pop- percent a year, implying a doubling time ulation numbering between 9 and 10 of around thirty years–and given that billion by about 2050, with stability or the gap between generations is also usu- decline in total population thereafter. ally about thirty years, such an increase However, the population at older could have taken place inside a millenni- ages will increase far more quickly in um. Even James Ussher’s 1650 estimate the coming century than in the last. In- of October 23, 4004 b.c. as the date of deed, the end of population growth and creation implies we have been around its replacement by aging are logically re- much longer than that. And since Homo lated. All rapidly growing populations sapiens actually emerged one hundred are young. If each birth cohort is larger and ½fty thousand or so years ago, the than the one before, there will always be rate of growth has obviously been close plenty of young people. to zero. Similarly, extrapolating the growth Chris Wilson is a staff member of the World Pop- rates of the recent past into the future ulation Program at the International Institute for soon yields logically impossible ½gures. Applied Systems Analysis in Laxenberg, Austria. Ansley Coale once calculated that a One of Europe’s most widely cited demographers, growth rate of 2 percent a year sustained he is currently researching the causes and conse- for ½ve thousand years would lead to the quences of global demographic convergence. sheer volume of human beings exceed- ing that of the solar system. © 2006 by the American Academy of Arts The absence of growth is a necessary & Sciences but not suf½cient condition for aging;
Dædalus Winter 2006 5 Chris we also need long life expectancy. In tury, and for a few especially well-doc- Wilson populations before the modern medi- umented cases, as far back as the late on aging cal era, relatively few people survived 1700s. For Japan and the United States to reach three score years and ten. Thus, detailed information dates back to the population aging is a novelty requiring early twentieth century. What these sta- both long lives and a low growth rate tistics reveal is both simple and striking. (i.e., low fertility). Though rare in the There has been an enormous reduction past, these conditions are now becoming in mortality, with life expectancy for the the norm around the world. two sexes combined now approaching, or even exceeding, eighty in most devel- When demographers try to under- oped countries. Even more remarkably, stand the determinants of aging, they this progress has been very regular for use one of social science’s great general- many decades. Jim Oeppen and James izing models: the demographic transi- Vaupel have shown, for example, that tion. When a population modernizes, the trend in “best-practice” life expec- it undergoes, along with many other tancy (i.e., the country with the lon- aspects of development, a set of inter- gest life expectancy in each year) has connected changes called the demo- been linear for more than 150 years.1 graphic transition. According to this In each decade the “state of the art” has model, every population at some point increased about 2.5 years. Moreover, al- has high fertility (mostly between four though there has been some variation at and six children per woman) and low the national level, most developed coun- life expectancy (mostly between twenty- tries have demonstrated strongly linear ½ve and forty years). With the spread trends in life expectancy for the whole of of modern medicine and public health, the twentieth century. mortality improves; as family planning Paradoxically, although this trend has and contraceptive use become the norm, been evident in mortality statistics for fertility falls. Usually life expectancy many decades, it is only in the last few rises ½rst, with a delay before fertility years that it has been recognized. De- declines. This difference in timing leads mographers, actuaries, and others con- to substantial population growth before cerned with forecasting mortality had the two processes come back into bal- always hitherto assumed that life expec- ance. tancy was approaching some asymptot- This process of transition began in the ic limit and would thus level off in the late eighteenth and nineteenth centuries near future. But if there is some biologi- in Europe, the United States, and the cal limit to extending longevity, there is other neo-Europes; it became a global no sign of it yet. As Oeppen and Vaupel phenomenon after World War II. Today, point out, estimates of the maximum more than half of the world’s people live possible life expectancy made through- in places where fertility is at or below out the twentieth century were, on aver- the level needed for long-run intergener- age, surpassed within ½ve years of being ational replacement (about 2.1 children made. This consistent error is of more per woman), and global life expectancy than purely academic interest–pension- is approaching seventy years. Trends in mortality can be followed in 1 Jim Oeppen and James W. Vaupel, “Broken considerable detail for many European Limits to Life Expectancy,” Science 296 (2002): countries from the mid-nineteenth cen- 1030–1031.
6 Dædalus Winter 2006 and health-care systems have been fund- cades. The origins of the health crisis The century ed on the basis of large underestimates under Communism and its persistence ahead of the number of elderly people in the in Russia, Ukraine, and the other post- future. Soviet states is a matter of heated de- The linearity of the upward climb in bate in both the scienti½c and general life expectancy has occurred in spite of literature. Whatever the cause, the cri- the fact that very different age groups sis serves as a warning against unqual- and causes of death have been involved i½ed Panglossian optimism. Likewise, in different eras. Before World War II, the emergence of hiv/aids and the almost all progress took place in reduc- associated reemergence of tuberculosis ing infectious diseases, with the biggest make clear that all future estimates of impact for infants and children. In con- improvement in public health must take trast, today much of the improvement into account the potential for severe re- is concentrated at old ages. Perhaps versals. the best analogy for these remarkable changes is to be found in models of eco- Overall, however, the last half-centu- nomic growth. Just as modern theory ry has seen unprecedented convergence hypothesizes the existence of an endoge- in mortality patterns around the world. nous rate of growth that is in some sense While rich countries still lead in life built into our economic system, so too expectancy, the gap between these lead- there may be an endogenous rate of im- ers and most developing countries has provement in health, as measured by life shrunk substantially. In fact, there has expectancy. In any event, we have every been more convergence in demography reason to expect that continued increas- than in any other aspect of moderniza- es in the average length of life will aug- tion. For example, consider Latin Amer- ment population aging. ica as a whole, where the United Nations There are, of course, exceptions to this estimates current life expectancy is sev- optimistic picture. In the Soviet Union enty-two years, and gdp per head (ad- and its client states in Eastern and Cen- justed for inflation and other factors) tral Europe, life expectancy stagnated is below $4,000, according to the Orga- from the 1960s until the end of Com- nization for Economic Cooperation and munism. It then worsened still further Development. Now consider the United in many cases, in the immediate after- States. Life expectancy in the United math of revolution. In Russia and many States was seventy-two years as recent- of the post-Soviet states it remains low, ly as the early 1970s. In contrast, the U.S. especially for men. Male life expectan- gdp per head exceeded $4,000 by 1900. cy in Russia today is roughly the same Latin America is a century behind the as it was in 1950: about sixty years. To United States in income growth, but on- put this stagnation into perspective, the ly thirty to thirty-½ve years behind in life equivalent ½gure for the United States expectancy. We can make similar com- has increased since 1950 by almost ten parisons for most developing countries. years from sixty-six to seventy-six. And though the gaps in educational at- In the post-Communist countries fur- tainment or urbanization are somewhat ther west, however, the last decade has smaller than in gdp per head, none of seen rapid improvements; life expec- the other conventional quantitative in- tancy there will likely converge to levels dices of development has converged as seen in Western Europe within a few de- rapidly as demography.
Dædalus Winter 2006 7 Chris In recent decades there has also been a There is also a sense in which aging Wilson striking convergence in fertility, which can be ‘locked in’ as part of a country’s on aging has declined rapidly in most countries. demographic regime through a form More than half of the world’s popula- of negative momentum. For example, tion now lives in countries or regions in in Southern Europe, the large number which fertility is below the level needed of baby boomers moving through the for intergenerational replacement.2 In childbearing ages has disguised the very most of Southern Europe (including low fertility rate of recent decades. The Italy and Spain) and in most of Central largest age groups at present are those and Eastern Europe, the total fertility ages 25 to 39. In the coming decades, rate (the number of children born per however, the much smaller cohorts woman) is below 1.3. Similar values are born since the mid-1980s will be in the now seen in Japan, South Korea, and reproductive ages. Unless these cohorts many of the more developed parts of (currently ages 0 to 19) have much high- China. Even some countries that might er fertility than their parents, the num- seem unlikely candidates have experi- ber of births in countries such as Italy enced rapid fertility decline. In Iran, and Spain will shrink even more rapid- for example, fertility fell from over six ly in the future than it has so far. In con- children per woman to just over two trast, the United States and other coun- between the mid-1980s and mid-1990s. tries in which fertility has stabilized at In contrast, fertility in the United States close to the replacement level (in Eu- has seemed to defy gravity, staying close rope, they include France and the Nor- to or even above the replacement level dic countries) will face much less severe for the last two decades. Among the de- challenges from demographic disrup- veloping countries in which fertility is tion. now lower than in the United States are The future is always uncertain to China, Brazil, Thailand, and Tunisia. If some degree, but when trends have the trends of the last twenty-½ve years been so clear and so consistent for de- continue for another decade or so, the cades, they form a solid basis for pre- U.S. fertility level will be well above the diction. It is very close to certain that median for the human population as a aging will be one of the de½ning global whole. phenomena in the twenty-½rst centu- The very speed of fertility decline in ry. The ways in which societies choose many countries will produce an exagger- to adapt to this new reality will test the ated form of aging. While aging is an in- old adage that “demography is destiny.” evitable and global phenomenon, coun- Fatalism, however, is uncalled for–to tries in which fertility has fallen rapidly a substantial degree we can still choose will experience a form of ‘super aging’ our future. However, demography does in the middle decades of this century. impose strong constraints on the range The baby boom cohorts of Southern of feasible options. Taking these con- Europe or the pretransition cohorts in straints into account is the basis for in- China are very large compared to those formed reactions to the challenges posed that followed, and their getting old will by aging. greatly exacerbate any problems that ag- ing generates. 2 Chris Wilson, “Fertility Below Replacement Level,” Science 304 (2004): 207–209.
8 Dædalus Winter 2006 Henry J. Aaron
Longer life spans: boon or burden?
‘Aging angst’ has become a booming slope to immortality, with all its seduc- industry among scholars. For example, tive and corrosive effects. the ethicist Leon Kass and others argue Meanwhile, on a societal level, econo- that, on a personal level, increasing lon- mists like Laurence Kotlikoff and Scott gevity may deprive life of its savor and Burns worry that the growing percent- undermine the quest to achieve. Kass age of the elderly in the population por- states, “If you push those [mortality] tends economic calamity: limits back, if those limits become out of Let your mind wander toward the future. sight, we are not inclined to build cathe- Move, slowly, to the year 2030 . . . . What drals or write the B Minor Mass, or write do you see? You see a country [the Unit- Shakespeare’s sonnets and things of that ed States] whose collective population is sort.”1 Kass never says how much of an older than that in Florida today. You see a increase in longevity is too much, only country where walkers outnumber stroll- that if science were able to slow aging, ers. You see a country with twice as many it would put humankind on a slippery retirees, but only 15 percent more workers to support them. You see a country with Henry J. Aaron is Bruce and Virginia MacLaury large numbers of impoverished elderly Senior Fellow at The Brookings Institution. Co- citizens languishing in understaffed, over- author of “Countdown to Reform: The Great crowded, substandard nursing homes. Social Security Debate” (with Robert D. Reis- You see a government in desperate trou- chauer, 2001) and “Can We Say No? The Chal- ble. It’s raising taxes sky high, drastically lenge of Rationing Health Care” (with Melissa cutting retirement and health bene½ts, Cox and William B. Schwartz, 2005), he is cur- slashing defense, education, and other rently researching Medicare reform. He has also critical spending, and borrowing far be- written and coedited many volumes, including 1 Transcript of interview of Leon Kass by Mor- “Agenda for the Nation” (2003) and “Coping ton Kondracke,
Dædalus Winter 2006 9 Henry J. yond its capacity to repay. It’s also print- longevity means an older population. Aaron ing tons of money to ‘meet’ its bills. You on Keynes had only half the story: in the aging see major tax evasion, high and rising long run we will, indeed, all be dead, but rates of inflation, a growing underground with rising longevity we will be old ½rst. economy, a rapidly depreciating currency, and more people exiting than entering the Despite a widespread desire to pro- country. They are leaving because they’re long life, the human species for millen- sure things will get still worse. nia made no progress toward ful½lling What is going on here? it. Even tiny increases in longevity sus- The prospect of living long lives, with tained over the numberless generations physical and mental capacities intact, of human existence would have resulted has long occupied the human imagina- in life spans far greater than any now ob- tion. To be sure, the ability to slow or served. Instead, until the modern eco- prevent the onset of serious illnesses nomic era, few infants lived to experi- and even aging may create risks. But ence what now would be called old age. the harm that may result if something Nearly all of the current extension is done to excess does not require forgo- of life spans is a by-product of rising in- ing the good that results from doing the comes–the result of the Industrial Rev- same thing in moderation. George Will olution and the science that produced illustrates this in his case for therapeutic it. Before the Industrial Revolution, the cloning: elderly formed a small fraction of the population because people died young Life . . . is lived on a slippery slope: taxation and birth rates were high.3 In no Euro- could become con½scation; police could pean nation did as much as 5 percent become gestapos. But the bene½ts from of the population reach age 65 until the taxation and police make us willing to middle of the nineteenth century; in wager that our judgment can stop slides none did 10 percent of the population down dangerous slopes.2 reach age 65 until after 1930. Now, pro- Warnings that a growing elderly popu- jections indicate that by the year 2050 lation threatens national well-being are more than 20 percent of the population of a different character, but are also odd. will exceed age 65 in most developed nations, and in several the proportion Population aging can be delayed if birth 4 rates remain high and the population will approach or exceed 30 percent. continues to expand. Until population Visions of the United States as a na- stabilizes, increasing longevity can coex- tion of doddering codgers notwithstand- ist with a stable, low fraction of the pop- ing, the U.S. population is projected to ulation that is elderly. Of course, unlim- 3 Paradoxically, famine, which reduces life ex- ited population growth creates problems pectancy, could increase the proportion of the of its own. It evokes specters of ‘stand- population that is elderly because it also causes ing room only,’ natural resource exhaus- birth rates to fall. For analogous reasons so tion, environmental degradation, and could emigration of the young. –at least for poor nations–inescapable 4 U.N. projections indicate that more than poverty. Of course, population growth 35 percent of the population in Japan and Ita- must end. When it does, increased ly will be over age 65. According to U.N. pro- jections, 20.9 percent of the population in the 2 George Will, “Column,” The Washington Post, United States will be over age 65, the lowest August 4, 2005. proportion among developed nations.
10 Dædalus Winter 2006 remain among the youngest in the devel- ate serious social and economic chal- Longer life oped world because of its relatively high lenges if the years of extended life are spans: boon or burden? birth and immigration rates. Although ones of mental and physical in½rmity; the proportion of the U.S. population but prospective medical advances prom- over age 65 will rise from 12.3 percent in ise treatments and, possibly, cures for 2005 to 20.6 percent in 2050, the labor conditions that produce physical and force will grow, not shrink, by 29 percent mental decline. For the most part, the over that period. In sharp contrast, the increase in life expectancy made possi- proportion of the Japanese population ble by rising incomes, improved public over age 65 is already 19.7 percent and health, and medical advances is a mon- is projected to rise to 35.9 percent by umental achievement. In the United 2050. The Organization for Economic States, population aging, like the post– Cooperation and Development projects World War II baby boom, will doubtless that the Japanese labor force will shrink require some quite signi½cant economic by more than one-third between 2005 and social adjustments, but the adjust- and 2050.5 ments are straightforward and require So, if one embraces a dismal vision no more than honest political leader- of the demographic future in the Unit- ship. ed States, then one must tremble at the I shall begin this survey by recalling truly unspeakable prospects confront- what growing old meant to previous ing France, Germany, Japan, and Italy. generations in the United States and In fact, it’s hard to ½gure out where juxtapose a realistic image of what be- Americans, who according to Kotlikoff coming old will mean for our children and Burns will be fleeing their wreck of and grandchildren. I shall then outline a nation, would actually go. Those who the genuine economic problems that see population aging as a source of col- increasing longevity and population lective calamity need to explain why the aging will raise and the steps that will achievement of sustained economic ad- be necessary to deal with them. vance and the deferral of death and of physical and mental decline–all age-old A scrim of forgetfulness shields us goals of human striving–is a global ca- from the rather ugly reality of growing lamity. old in the America of just a few genera- To be sure, extended life expectancy tions past. Let us draw back that curtain will pose a variety of challenges. In all to examine what growing old meant for developed nations, public budgets bear the generations born in 1860, 1890, and more of the cost of care and support for 1930.6 the elderly than for children. Population The 1860 cohort was born in a nation aging will therefore tend to push up tax that still treated slavery as a constitu- rates. Increased longevity could also cre- tional right. A quarter of those born in 1860 died before turning age 20, half be- 5 Thai Than Dang, Pablo Antolin, and Howard fore reaching age 65. Living conditions Oxley, “Fiscal Implications of Ageing: Projec- and public sanitation were appalling by tions of Age-Related Spending,” Organization today’s standards: few houses had in- for Economic Cooperation and Development, door plumbing, and few cities had mu- Economics Department Papers No. 305, Sep- nicipal water and sewer systems. Sur- tember 19, 2001. The Japanese labor force is projected to decline on average by 0.9 percent- age points annually from 2000 to 2050. 6 Aaron and Reischauer, Countdown to Reform.
Dædalus Winter 2006 11 Henry J. gery was uncommon and dangerous be- intervene when the 1860 cohort was 69- Aaron cause surgical technique was primitive years-old. By 1932, a quarter of the work on aging and anesthesia was dangerous. Inocula- force was unemployed. The elderly were tions were uncommon. Childhood dis- more likely than the young to lose their eases winnowed the young, and pneu- jobs and less likely to ½nd new ones. Pro- monia was known as the ‘widow’s tracted unemployment, bank failures, friend.’ plunging stock prices, and collapsing By current standards, the 1860 cohort real-estate values destroyed the savings was a nation of educational dropouts, of those in the middle and working although the United States led the world classes who had scrimped and saved for in mass education. Out of every hundred retirement. Private charities were over- students who started primary school, whelmed, and public charity dried up seventy ½nished, twelve completed high as state and municipal tax collections school, and three graduated from col- plummeted. Only a few Civil War vet- lege. Economic growth was rapid but erans and their widows received small uneven. The U.S. economy underwent pensions; otherwise, private pensions thirteen economic contractions between were rare. The ½rst Social Security 1885 and 1925; many were catastrophic check was not paid until the 1860 co- by modern standards. Output fell 7 per- hort reached age 80, and few were eligi- cent following the 1893 panic, 8 percent ble for bene½ts. For the one-third of the during the 1907–1908 depression, and 1860 cohort who survived to their sixty- 6 percent on the eve of World War I. ninth birthdays, the ½nal years were gen- Since World War II, output has never erally grim. fallen more than 3.7 percent in any re- cession. America’s 1890 cohort also lived Women gave birth to an average of through boom and bust. World War I more than ½ve children. The backbreak- ended a recession. With peace came ing job of caring for children, husbands, another recession; unemployment brothers, sisters, and parents in a world reached 12 percent. The 1920s brought without washing machines, vacuum boom, except on the farm. The year cleaners, refrigerators, or dishwashers 1929 ushered in twelve years that blight- was borne, typically by women, until ed what should have been this cohort’s death and lightened only as family mem- prime earning years. Too old to ½ght bers died or moved away. Once married, in World War II, the men of the 1890 few white women worked outside the cohort worked to support their sons home. Those who worked for pay al- at the front. Women left home for the most invariably performed menial tasks. paid labor force, freed from traditional Many women, especially African Ameri- jobs as secretaries, teachers, social work- can women, were domestics. ers, and nurses, to become machinists Old age was not a passage to a ‘new and assembly-line operatives. mode of living,’ but a continuation of Like its forebears, the 1890 cohort what life had been when one was young. suffered high rates of infant mortality. Three-quarters of men born in 1860 and Although this cohort bene½ted from still alive at age 65 continued to work steady, if undramatic, improvements for pay until death, disability, or eco- in health and education, more than nomic catastrophe intervened. Such a one-third of 20-year-old women and catastrophe–the Great Depression–did two-½fths of 20-year-old men did not
12 Dædalus Winter 2006 live to see their sixty-½fth birthdays. thirds of surviving men from the 1890 Longer life Eighty percent of unmarried elderly cohort were still working at age 65, near- spans: boon or burden? women and half of unmarried elderly ly half at age 70, and 30 percent at age 75. men had been widowed. Four-½fths More than one-third had incomes below of this cohort ½nished primary school, of½cial poverty thresholds. one-fourth graduated from high school, but only one in twenty earned a college The 2.6 million American children degree. born in 1930 enjoyed advantages un- When this cohort reached age 65 in the available to previous generations. Near- mid-1950s, fewer than half had health ly all ½nished primary school. Seven in insurance. Coverage was often uncertain ten graduated from high school. Part- because insurers could raise premiums ly because of the G.I. Bill for Korean sharply or refuse to renew coverage of War veterans, one man in ½ve and one those whose health had begun to dete- woman in nine graduated from college. riorate. Because health expenses of the Women no longer automatically with- elderly, even when adjusted for inflation, drew from the labor force after mar- were less than one-tenth of what they riage; those who did often reentered are today, medical outlays were a threat when still young. Just over one-third only for the minority who became seri- worked outside the home when they ously ill. But in one of the most striking were age 30, but three-½fths did at age social changes of the late twentieth cen- 50, and two-½fths still worked for pay tury, a spell in a nursing home became at age 60. common. By the late 1970s, roughly a If the educational achievements of quarter of the 1890 cohort survivors the 1930 cohort were striking, the eco- were residing in nursing homes. nomic advances were breathtaking. Congress passed the Social Security Between the end of World War II and Act of 1935, subsequently increasing the mid-1970s, output per person more bene½ts and extending coverage in 1939 than doubled. At the start of their work- and again in 1950. Because of these liber- ing lives, members of the 1930 cohort alizations, members of the 1890 cohort earned hourly wages three times higher received bene½ts far greater than the than members of the 1890 cohort had earmarked payroll taxes they and their earned in their ½rst jobs. By the time the employers had paid. Still, bene½ts were 1930 cohort turned age 65, their average modest–only about 32 percent of tax- earnings had risen by another one-third. able earnings of full-time covered work- Post–World War II recessions, though ers. And since roughly half of U.S. jobs numerous, were shallow compared with were not covered until the 1950 legisla- the economic paroxysms of earlier eras. tion broadened coverage, many mem- Furthermore, unemployment compen- bers of the 1890 cohort did not receive sation, also created by the Social Securi- bene½ts at all. Furthermore, private pen- ty Act of 1935, cushioned the shock for sions covered only about a quarter of those who did lose jobs–for up to six members of the 1890 cohort. Even work- months in normal times and even lon- ers who were covered typically received ger during recessions. meager bene½ts because most had not Higher incomes, medical advances, worked long enough under these plans and improved working conditions com- to have earned meaningful bene½ts. bined to boost life expectancy for the With insuf½cient income to retire, two- 1930 cohort. Two-thirds of men and over
Dædalus Winter 2006 13 Henry J. three-quarters of women born in 1930 merica’s 1960 cohort was better edu- Aaron A on lived to celebrate their sixty-½fth birth- cated than any of its forebears. Only one aging days. Four-½fths of 65-year-old men and in eight dropped out of high school. Half three-½fths of 65-year-old women still attended college and nearly one-fourth lived with a spouse. earned a bachelor’s degree. The fraction As they approached retirement age in of the 1960 cohort with postbaccalaure- the mid-1990s, members of the 1930 co- ate education matched the share of the hort had options and resources few of 1860 cohort who had completed high their parents had enjoyed. Most had as- school. But not all advanced at the same sets that provided substantial ½nancial pace. African Americans were only two- security. Social Security bene½ts, aver- thirds as likely as whites to earn a college aging $8,500 a year for individuals and degree, and barely half of Hispanics $12,000 for couples, were fully protected completed high school. against erosion by inflation. One-third Even if the earnings of men with little of the 1930 cohort received private pen- education grew more slowly than their sions, although the amounts were mod- parents’ pay had, the 1960 cohort earned est–a median of less than $7,000 a year. more on their ½rst jobs than their par- Further, more than four in ½ve mem- ents had three decades earlier. The jobs bers of the 1930 cohort owned their ½lled by members of the 1960 cohort own homes at retirement. Most had also required less brawn and more brain bene½ted from the postwar real-estate than had jobs in the past. Three-½fths boom that tripled the real value of own- of men and 90 percent of women in the er-occupied housing between 1950 and 1960 cohort worked in white-collar or 1995. The 1930 cohort also had better service-sector jobs. Still, roughly one- protection against medical costs than quarter of men and a small but growing ever before. Medicare, enacted in 1965, fraction of women worked as craftsmen, provided basic health insurance cover- mechanics, miners, machine operators, age for the elderly and the disabled while laborers, truck drivers, or in other phys- eight in ten also had supplementary cov- ically strenuous jobs that become in- erage. creasing dif½cult to perform as one ages. Increasingly workers retired years be- Women were better educated, worked fore they died. One-third of men in the more hours, stayed in the labor force 1930 cohort stopped working before age with fewer interruptions, and earned 62, two-thirds before age 65. Average much more than women had previously. living standards approximated those of As a result, more will be entitled to their younger adults. Averages, however, con- own private pensions and to Social Secu- cealed large disparities: only 4.3 percent rity based on their earnings rather than of elderly couples were poor in 1996, their husbands’. compared to 18 percent of elderly single Members of the 1960 cohort have told men, 20 percent of elderly single wom- pollsters that they hope to retire earlier en, and 36 percent of elderly single Afri- than have past generations. Unfortu- can American women. Whatever the fu- nately, they have done little to prepare ture holds for the ½nal years of the 1930 economically for that event. By 2000, cohort, its circumstances represent a only 31 percent of those born between revolutionary improvement over the 1954 and 1964 had nonhousing assets experiences of their predecessors. worth more than $100,000, and 49 per- cent had accumulated less than $50,000,
14 Dædalus Winter 2006 a sum that would support an annuity of cutbacks in publicly ½nanced pension Longer life less than $4,000 a year. In their failure and health bene½ts. Out-of-pocket spans: boon or burden? to save, the 1960 cohort differ little from medical expenditures may discourage their forebears, who began to save, if older people from leaving primary at all, only in their forties and ½fties. jobs as soon as they now do or from Members of the 1960 cohort may ½nd withdrawing from the labor force com- it even harder to save when they reach pletely. those ages, though, because many mar- ried late and deferred childbearing. As Undeterred by the demonstrated in- a result, many will face tuition bills and capacity of even the brightest people to other costs of childrearing until late in anticipate future conditions or events, their lives. many claim to see clearly into the dis- On the bright side, more members tant future. David Cutler, a Harvard pro- of the 1960 cohort will have more size- fessor and dean, once spoke disparaging- able pensions than previous genera- ly of “spreadsheet policy analysis,” the tions. The declining fraction of employ- extraordinary disposition of some ana- ees with pensions tied to previous earn- lysts to take seriously the mindless ex- ings, so-called de½ned-bene½t plans, trapolation of unreliable assumptions will ½nd them more secure than in the decades or even centuries into the fu- past because the Employee Retirement ture. What should be clear to all who try Income Security Act of 1974 set vesting to anticipate the implications of popula- rules and the Pension Bene½t Guaranty tion aging for today’s and tomorrow’s Corporation guarantees all or much of newborns is that only a few things are promised pensions. On the other hand, clear. the massive shift to pensions whose One, the proportion of the population value depends on the market price of that is elderly will increase. This trend is stocks and other assets, so-called de- almost certain because the large cohorts ½ned-contribution plans, means that of baby boomers who will start reaching the pensions of the 1960 cohort will age 65 in 2008 are already alive. Almost face the risk of losing value just when as certain is that tomorrow’s elderly, like they are needed. If the pensions are not today’s, will be mostly women. Of those converted into annuities, these risks will over age 65, 58 percent are female; of persist even after bene½ts are being paid. those over age 85, 69 percent are female. More than previous cohorts, members Female life expectancy exceeds male life of the 1960 cohort will also confront the expectancy by about ½ve years. As wom- possibility that they will outlive their as- en are also typically younger than their sets. One-½fth of men who reach age 65 husbands, women are more likely to out- are projected to be alive at age 90, and live their husbands and can anticipate half of women alive at age 65 are expect- about ten years of widowhood.7 It is al- ed to live past their eighty-seventh birth- so likely that life expectancy will con- days. If members of the 1960 cohort retire 7 The Social Security Administration estimates when they say they will, those who reach that among couples in which the husband is 65 retirement age will spend an average of and the wife is 63, 54 percent of women and 45 percent of men will outlive their spouses by roughly one-third of their adult lives in a year or more (the remainder will die in the retirement. But retirement patterns may same year). Women will outlive their husbands change as rising budgetary costs force by an average of 10.84 years; widowers will out-
Dædalus Winter 2006 15 Henry J. tinue to increase, though by how much Subject to these uncertainties, the na- Aaron 8 on remains highly uncertain. However, a tion of 2050 is quite likely to be richer aging drop in longevity, caused by widespread and better educated than its forebears, obesity or a global pandemic that sci- even if the rate at which longevity in- ence is unable to control, is not out of creases slows. Growth of per capita in- the question. come will continue as the fruits of in- In any event, the physical and men- formation technology, such as data tal condition of the elderly during these processing that abets advances in mo- added years counts more than the mere lecular biology, continue to spread.10 number of years added to the human According to estimates by Kevin Mur- life span.9 A nation swarming with dod- phy and Robert Topel, the welfare gain dering seniors incapable of working or from increased longevity between 1970 even of caring for themselves would face and 2000 was worth about as much as nasty challenges. On the other hand, a all economic growth over that period.11 nation replete with mentally and physi- Factors other than advances in health cally active elders who might even delay care contributed to this increase, of retirement a few years would enjoy an course. But improvements in the treat- extraordinary economic and social op- ment of heart attacks and reductions portunity. The speed and character of in the number of low– birth weight in- advances in medical knowledge give rea- fants yielded bene½ts worth about six son for optimism, if not for con½dence, and ½ve times the added cost of medi- that increased longevity will lengthen cal care respectively.12 And eliminating life, not prolong dying. Understanding half the deaths from heart disease or and controlling the processes that un- cancer would produce bene½ts greater derlie Alzheimer’s disease and other than annual gdp to current and future forms of senile dementia and arthritis Americans. Moreover, these estimates are within the reach of medical science. make no speci½c allowance for enhance- ments in the quality of life that would result from better medical care. live their wives by an average of 9.75 years. Per- sonal communication from Stephen Goss, chief actuary of the Social Security Administration. 10 J. Bradford DeLong, Claudia Goldin, and Lawrence F. Katz, “Sustaining U.S. Economic 8 James Vaupel thinks that today’s newborns Growth,” in Agenda for the Nation, ed. Henry will typically live into the next century. Other J. Aaron, James Lindsay, and Pietro Nivola demographers simply extrapolate trends of the (Washington, D.C.: Brookings Institution more or less recent past and predict that life ex- Press, 2003), 17–60. pectancy will continue to increase one or two years with each passing decade. Jay Olshansky 11 Kevin M. Murphy and Robert H. Topel and various colleagues worry that obesity, pan- place the gain from increased longevity at $3.2 demics, or other events will reverse the increase trillion a year. gdp rose from just over $1 tril- in life expectancy. lion in 1970 to just over $9 trillion in 2000. See Kevin M. Murphy and Robert H. Topel, “The 9 Alexander M. Capron, “Ethical Aspects of Value of Health and Longevity,” The National Major Increases in Life Span and Life Expec- Bureau of Economic Research, Working Paper tancy,” and Margaret Battin, “Comments,” in 11405, June 2005. Henry J. Aaron and William B. Schwartz, Cop- ing with Methuselah: The Impact of Molecular 12 David M. Cutler and Mark C. McClellan, Biology on Medicine and Society (Washington, “Is Technological Change in Medicine Worth D.C.: Brookings Institution Press, 2004), It?” Health Affairs 20 (5) (September/October 198–234, 235–246. 2001): 11–29.
16 Dædalus Winter 2006 It is possible that future advances may tainment, or computation, however. In- Longer life not bring bene½ts as large as those of stead, as other, less satisfying forms of spans: boon or burden? past innovations. The twenty-½rst cen- consumption gave way to the new tech- tury has a tough act to follow: the twen- nologies, people celebrated the improve- tieth century saw massive reductions in ment in living standards. infant and childhood mortality, the in- So also demand for medical treat- troduction of arti½cial joints and ct ments has dramatically increased as and mri scans, and the virtual elimina- medical advances have improved the tion of broad classes of infectious dis- chances for bene½cial outcomes while eases. But this century has opened aus- reducing the price of achieving these piciously with the sequencing of the outcomes. Largely because of such ad- human genome, an event that may re- vances, total U.S. spending on health veal the fundamental processes of par- care multiplied more than ninefold ticular illnesses and of biological aging and tripled as a share of gdp between and senescence and heralds the possi- 1960 and 2003. There is every reason to bility of individualized medicine, where expect future medical advances to add treatments are tailored to the speci½c bi- to age-adjusted, per capita spending on ological characteristics of each person. health care. Population aging will ampli- Even if the twenty-½rst century does fy this growth, but advances in medical not live up to the more overheated ex- technology are likely to remain the prin- pectations of some observers, there is cipal force driving up health-care spend- good reason to hope that Alzheimer’s ing.13 disease, diabetes, and some forms of If health-care spending were to con- cancer will become curable or even pre- tinue growing at the same rate as in ventable. These improvements will be the past half century, about 2.5 percent- costly, however. In fact, they are likely age points a year faster than the growth to be so expensive that they will force of per capita income, the fraction of extremely dif½cult and divisive politi- income devoted to health care would cal choices and economic tradeoffs. But reach 33.6 percent in 2030 and 36.1 per- technical advance will be a cruel tease if cent in 2040. Increases in health-care few can afford it. spending would claim half of income growth by 2022 and all of it by 2051. If Total spending on the products made Medicare and Medicaid spending were possible by scienti½c revolutions typi- to rise at the same rate, outlays on these cally increases, even as the prices of two programs alone would rise from 4.2 these products fall. The automobile, the percent of gdp in 2005 to 11.5 percent airplane, television, and the computer by 2030, and 16.1 percent by 2040.14 For reduced the price of moving a person or a ton of merchandise a mile, of hearing 13 Per capita health-care spending rises until an opera or seeing a drama, and of car- patients are in their eighties and then it actual- rying out an arithmetic computation. At ly falls. the same time, they raised total spending on these activities because they raised 14 Henry J. Aaron and Jack Meyer, “Health,” in the standards of quality, thus increasing Restoring Fiscal Sanity: The Long-term Challenge, ed. Alice Rivlin and Isabel Sawhill (Washing- the quantities that people demanded. No ton, D.C.: Brookings Institution Press, 2005). one bewailed the growth in the share of These projections are taken from the Congres- income devoted to transportation, enter- sional Budget Of½ce.
Dædalus Winter 2006 17 Henry J. purposes of comparison, all income and Even if maturity brings certain com- Aaron payroll taxes combined will comprise 16 pensations and opportunities,16 no one on aging percent of gdp in 2006. welcomes the loss of physical and men- These projections suggest that taxes, tal capacities associated with aging. But premiums, and cost sharing will have to the problems that aging individuals face increase and that coverage will have to is not the cause of ‘aging angst.’ Rath- be restricted. A more dif½cult problem er, it stems from a sense that a large in- arises from the fact that most health crease in the fraction of people who are care is consumed during episodes of ill- ‘old’ will make life much less attractive ness when total spending is so high that for the young. The fear is that the el- any adequate insurance plan will cover derly will be economically inactive and all, or nearly all, costs at the margin. In otherwise unproductive, that they will this situation, patients have economic not have saved enough during their eco- incentives to seek, and conventionally nomically active years to provide for reimbursed providers have every incen- themselves during their inactive years, tive to assure that patients receive, all and thus, that they will impose crushing care however high the cost or low the tax burdens on the declining fraction of bene½t. the population who are economically Health-care rationing curbs such active. high-cost, low-bene½t care for well- It is certainly possible for nations to insured patients. Most people and all bring calamity on themselves through politicians recoil now at the prospect mismanaged policies, as the histories of health-care rationing. This reaction of Argentina throughout the twentieth is misplaced because such rationing century, most of Africa after the end of would improve welfare by redirecting colonial rule, and the Russian empire resources from uses that produce ben- under communism clearly attest. But we e½ts smaller than cost and make them can manage the problems of population available for services that produce ben- aging easily. To do so, American policy- e½ts greater than cost. Whether the na- makers need to keep a few basic facts tion can ration health care accurately in mind. First, apart from borrowing and fairly, though, is far from certain, or lending from foreigners, all national but trends in health care indicate that consumption comes from currently pro- a national debate about health-care ra- duced goods and services. How that con- tioning is inescapable.15 sumption is divided between the eco- Even with higher cost sharing and nomically active and inactive depends well-designed rationing, Americans– on the relative size of these two groups and citizens of all other advanced na- and their relative living standards. Sec- tions–are going to end up paying far ond, consumption by the economically more than they now do for health care. inactive can be ½nanced either by their Population aging will intensify this own past savings or by current taxes on trend. the economically active. Third, past sav- ings are responsible for today’s capital
15 Henry J. Aaron, William B. Schwartz, and 16 George E. Vaillant, Aging Well: Surprising Melissa Cox, Can We Say No: The Challenge of Guideposts to a Happier Life from the Landmark Rationing Health Care (Washington, D.C.: Harvard Study of Adult Development (Boston: Brookings Institution Press, 2005). Little, Brown, 2002).
18 Dædalus Winter 2006 stock, which influences today’s produc- product of a monumentally bene½cial Longer life tive capacity. Finally, past savings also achievement–increased longevity–and spans: boon or burden? can be used to support today’s elderly. an inevitability–declining birth rates. The lesson of these simple economic Longer life spans will doubtless create relations is straightforward. Americans some problems. But as the old saying can prepare now to meet the macroeco- goes: Consider the alternative. nomic ‘challenge’ of aging by insisting on public policies to promote high na- tional saving. That will add to tomor- row’s productive capacity. High saving would also reduce borrowing from abroad, which generates debts to for- eigners that tomorrow’s active work- ers will have to either repay or pay debt service. Yet recent economic policy has moved resolutely in the direction of encourag- ing consumption with permanent tax cuts. Recent discussions of pension re- form have also lacked explicit proposals to encourage future generations of work- ers to delay retirement, which would re- duce pension claims. By extending drug coverage to the elderly and disabled, Congress has further committed the nation to providing a needed bene½t but failed to pay for it, thereby increas- ing borrowing and deepening the fu- ture ½scal challenges of population ag- ing. Measured over the next seventy-½ve years, the Medicare Modernization Act will also add to federal borrowing an amount nearly twice the projected short- fall in Social Security. Thus, current poli- cy has aggravated, rather than ameliorat- ed, the ½scal problems of population ag- ing.
The ½rst step in dealing with the ‘ag- ing problem’ is to avoid public policies that enlarge it. The second step is to recognize that the U.S. ‘aging problem’ is among the smallest in the developed world. The third step is to recognize that although population aging will pre- sent some ½scal challenges, it is the by-
Dædalus Winter 2006 19 Sarah Harper
Mature societies: planning for our future selves
As the new millennium begins, the thirds of the world’s older population world is entering into demographic ma- already resides in developing countries, turity. Western Europe now has more with the absolute numbers of older peo- people over age 60 than under age 15. ple in these regions projected to double Asia will follow by the year 2040, the to just under a billion within twenty- Americas shortly after. But while West- ½ve years and increase to 2 billion by ern Europe took more than a century the middle of the century. The majori- to go through this demographic transi- ty of these individuals are already born. tion, Asia will move through it in less Indeed, we are tomorrow’s elderly. than twenty-½ve years. By 2050, more We are not talking here about the so- people globally will be over age 50 than called age wave. Many people mistaken- under age 15. ly believe that population aging is solely The extent of population aging is truly the result of the baby boom generation staggering. By 2030, nearly half of West- moving its way up the population pyra- ern Europe’s population will be over age mid. Rather, demographic maturing is 50, with a life expectancy at 50 of anoth- a global trend that heralds long-term er forty years. That is, half of this pop- shifts in individual and societal behav- ulation will be between 50 and 100, a ior–changes that are likely to restruc- quarter over 65, and 15 percent over 75. ture societies for much of the foresee- Yet, in terms of numbers, it is to the able future. developing world we must look. Two- Powering this maturing trend, in real- ity, are dramatic declines in fertility and Sarah Harper is director of the Oxford Institute increases in the normal life span. By the of Aging at the University of Oxford. The editor mid-1980s, most Western-style countries of “Families in Ageing Societies” (2004), she has were experiencing historically low fer- also authored “Ageing Societies: Myths, Chal- tility levels. Initially, calendar measures lenges and Opportunities” (2005) and many ar- of fertility indicated a plateau in repro- ticles. Harper currently serves as editor of “Gen- duction during the 1930s and 1940s– erations Review,” the journal of the British Society what we consider the end of the classi- of Gerontology. cal demographic transition–before a further drop to levels signi½cantly be- © 2006 by the American Academy of Arts low replacement level occurred. How- & Sciences ever, generational measures reveal that
20 Dædalus Winter 2006 fertility levels had been continuously brother had a life expectancy of forty- Mature declining, even through the end of the four years; his great-grandson now has societies transition. one of seventy-one. There is thus evi- Perhaps fundamental norms regarding dence of a rectangulization of the life the desirability of having many children curve in the West, with a growing per- changed radically, or perhaps the eco- centage of the population reaching out nomic structure of modern societies re- toward the current maximum life span. duced the need to bear a lot of children. The eventual convergence of the max- In any case, low fertility seems to be a imum and normal life spans should be characteristic of postindustrial societies: seen as a great success. For most individ- fertility in Europe, for example, remains uals born in a society to reach the natu- below the replacement level of 2.1, de- ral limit to human life in good health spite increases in some countries toward and with few frailties is a major achieve- the end of the twentieth century. Most ment for any society. To accomplish this strikingly, the past two decades have al- on a global level would be the achieve- so seen a steady fall in fertility in Asia ment of civilization. For then we would and Latin America. Total fertility rate, have conquered poverty, disease, famine, the number of children a woman of re- and war. productive age will bear in her lifetime, We have already felt the impact of has now dropped to 1.4 in Hong Kong, the factors associated with demograph- 1.5 in Singapore, and 1.8 in Korea, Tai- ic aging–falling fertility and mortality, wan, and Thailand. Sri Lanka and Chile and increasing longevity–and those stand at 2.1 and Brazil at 2.3. contributing to it–advances in living While maximum life span has re- standards, education, public health, mained more or less constant, twen- and medicine. But population aging tieth-century social, economic, and promises to influence decision making medical innovations have also enabled even more in the new century and at more people to achieve the maximum every level–individual, national, and life span. Until very recently, for exam- international. The social, economic, ple, the second longest-lived person was and political areas that this shift may born in 1701, with a life span of 113 years. affect include: the labor market, saving During the same period, however, the and consumption patterns, family and number of British centurions alive at any household structure, social interaction one time was in the hundreds. This ½- and networks, demand for health and gure has now increased to some thirteen welfare services, supply of housing and thousand, with eighty-seven thousand transportation, leisure and community predicted by 2050. Between now and behavior, and even geopolitical order. 2050, the number of centurions in Japan Thus, individuals and governments, in will also rise, from twenty-eight thou- both developed and developing coun- sand to 1 million. Currently, the world tries, must understand the reality of has two hundred and sixty-½ve thousand population aging in order to plan socie- centurions; by 2050, it will have 3.8 mil- tal frameworks and policies appropriate lion. Overall, life expectancy has im- for the demographic challenges and op- proved. In 1880, a female baby in Europe portunities ahead. could expect to live to age 47; her great- granddaughter born one hundred years Currently, the demographic burden hy- later can expect to live to 78. Her baby pothesis dominates public rhetoric. This
Dædalus Winter 2006 21 Sarah hypothesis focuses on four pervasive that is, the proportion of the population Harper myths. The ½rst sees Western health- aged 65 and over–responsible, along on aging care systems folding under the strain with income, lifestyle characteristics, of caring for growing numbers of older and environmental factors.3 people. The second myth fears the ratio Part of the reason for the false rhet- of workers to retirees will become so oric lies with the methodologies used lopsided that many Western economies in some research studies.4 Often, these will collapse. The third envisions fami- studies simply calculate how much lies as loose, multigenerational collec- health care people at each age use.5 tions of individuals, experiencing more These current patterns are then applied emotional strain, as fewer children are to the demographics of an aging popu- available to take care of elderly parents. lation to forecast the effects of changing Finally, the fourth mistakenly believes demographics on the cost of health care. that aging is a feature of the developed The results imply that age contributes world alone, with little relevance to de- between 0.3 and 0.8 percent of annual veloping countries. expenditure growth.6 But this simplis- An aging population naturally raises tic way of assessing age-cost effects ig- concern about increasing health- and nores the fact that the amounts of health social-care costs.1 U.S. forecasts, for ex- care utilized by different age groups al- ample, show health-care costs account- so change over time. In fact, a number ing for almost 33 percent of gdp by of studies have revealed that health-care 2030.2 However, as George Leeson expenditures are concentrated in the pe- points out, a number of cross-national riod immediately prior to death.7 Thus, studies have considered the determi- nants of health-care costs, but only one 3 Leeson, “The Demographics and Econom- has found population age structure– ics of uk Health and Social Care for Older Adults.”
1 G. W. Leeson, “The Demographics and Eco- 4 S. Petrou, J. Henderson, T. Roberts, and nomics of uk Health and Social Care for Older M.-A. Martin, “Recent Economic Evaluations Adults” (Oxford Institute of Aging, University of Antenatal Screening: A Systematic Review of Oxford, 2004),
22 Dædalus Winter 2006 as we postpone death to later and later caused in part through a sharp growth Mature ages, the health-care costs associated in real spending on pensions.10 Yet, as societies with preceding ages should grow lighter. with many studies of the effects of pop- Within the United States, in particular, ulation aging, these studies rely on cur- the growing elderly population portends rent dependency ratios and retirement especially large increases in health-care rates,11 rather than acknowledging that costs because of both the Medicaid and these measures are period- and cohort- Medicare programs. Currently, Medi- speci½c and can therefore change. Dal- care provides almost universal coverage mer Hoskins, Secretary-General of the of hospital and physician expenses to International Social Security Associa- those over age 65, while Medicaid pro- tion, stresses that instead of focusing vides medical care to eligible persons of on the ‘burden’ of the aging, we must all ages, as well as nursing home expens- pay attention to the rising number of es for the elderly. But the United States persons who are able to work but made spends a lot on health care in general. In prematurely inactive.12 Indeed, as with addition, it shifts the payment for health health-care costs, it is not demographic care from private to public sources at age aging per se, but current policy frame- 65.8 Thus, the fault for the feared Medi- works, that are liable. The continued care crisis lies not so much with the in- commitment by many governments creasing numbers of old people, especial- to generous public pensions with high ly since forecasts show a long-term de- replacement rates both facilitates and cline in U.S. disability rates.9 Instead, encourages retirement at or before age the responsibility belongs to rising per 65, despite evidence of increased lon- capita health-care expenditures in a poli- gevity.13 cy framework that makes these a public liability. 10 Leeson, “The Demographics and Eco- nomics of uk Health and Social Care for Likewise, the aging of populations al- oecd so inspires fear of serious ½scal issues, Older Adults”; , “Ageing and Income: Financial Resources and Retirement in 9 oecd Countries” (Paris: Organization for Columbia,” Age and Ageing 29 (3) (2000): 249– Economic Cooperation and Development, 253; C. O’Neill et al., “Age and Proximity to 2001); R. Lee and S. Tuljapurkar, “Population Death as Predictors of gdp Care Costs: Re- Forecasting for Fiscal Planning,” in A. J. Auer- sults from a Study of Nursing Home Patients,” bach and R. Lee, eds., Demographic Change and Health Economics 9 (8) (2000): 733–738. Fiscal Policy (Cambridge: Cambridge Universi- ty Press, 2000); European Commission, “Pub- 8 B. Bosworth and G. T. Burtless, eds., Aging lic Finances in emu–2002,” European Economy Societies: The Global Dimension (Washington, no. 3 (Luxembourg: Of½ce for Of½cial Publica- D.C.: Brookings Institution Press, 1998). tions of the European Communities, 2002).
9 K. G. Manton, L. S. Corder, and E. Stallard, 11 oecd, ”Ageing and Income.” “Chronic Disability Trends in Elderly United States Populations: 1982–1994,” Proceedings of 12 D. Hoskins, “Thinking About Ageing Is- the National Academy of Science 94 (1997): 2593– sues,” International Social Security Review 55 (1) 2598; V. A. Freedman and L. G. Martin, “Un- (2002): 13–20. derstanding Trends in Functional Limitations Among Older Americans,” American Journal of 13 P. S. Heller, Who Will Pay?: Coping with Ag- Public Health 88 (10) (1998): 1457–1462; Lee- ing Societies, Climate Change, and Other Long- son, “The Demographics and Economics of Term Fiscal Challenges (Washington, D.C.: In- uk Health and Social Care for Older Adults.” ternational Monetary Fund, 2003).
Dædalus Winter 2006 23 Sarah Changing these policy frameworks retain more of their own workers. Fur- Harper will involve combating the perception ther, many predict that countries like on aging that the elderly are economically inac- China themselves will attract highly tive, both as producers and consumers. skilled labor, especially in the growing Laboratory-based research suggests the and valuable it sector.16 decline in physical and mental activity The elderly are also thought to con- between ages 20 and 70 is negligible; sume less, perpetuating anxiety that in general, variations within age groups population aging will result in slower far exceed those between age groups.14 economic growth. However, the longer Despite this evidence, considerable individuals work, the more likely it is data indicate that negative perceptions their consumption rates and patterns of older workers are still partially re- will also change. Currently, those over sponsible for prompting early retire- 50 spend primarily on leisure activities ment.15 rather than on consumer goods. But Given the apparent increase in healthy consumer goods obviously have a limit- life expectancy for current older cohorts, ed life span, and as people live longer, older men and women should be able to they will need to replace what they pur- remain economically active longer. In- chased in their twenties and thirties. dustrialized countries may, therefore, Ensuring older workers a place in the burden themselves with their unwilling- labor pool would enable them to con- ness to adapt ½scal and social policies to sume more later in life. Again, changing changing social and cultural attributes. preconceived notions of older cohorts Despite an increasingly tight labor mar- and their economic behavior is the key ket in many developed countries, em- to capitalizing upon the potential of ployers have reacted very slowly to this. population aging. In fact, many have thus far relied on im- migration as the panacea for falling birth The possibility that families will un- rates. However, this movement of Asian dergo more strain is also ever present and Eastern European migrants into in discussions about population aging. Western labor markets is hardly sustain- These arguments suggest that increas- able, as economic growth in the source ing longevity means greater numbers of countries will allow these countries to older people requiring care, at the same time that declining fertility is shrinking the reservoir of family members avail- 14 C. P. Bird and T. D. Fisher, “Thirty Years Later: Attitudes Toward the Employment of able to care for the old. This places pres- Older Workers,” Journal of Applied Psychology sure on the middle-aged to cope with 71 (1984): 515–517. both dependent children and aging par- ents. 15 C. S. Forte and C. L. Hansvick, “Applicant Rather than the demise of the family, Age as a Subjective Employability Factor: A however, more heterogeneous forms Study of Workers Over and Under Age Fifty,” Journal of Employment Counselling 36 (1) (1999): of family are emerging from the reality 24–34; E. M. Crimmins, Y. Saito, and S. L. of population aging. These alternative Reynolds, “Further Evidence on Recent Trends structures include multigenerational in the Prevalence and Incidence of Disability Among Older Americans from Two Sources: The lsoa and the nhis,” Journal of Gerontol- ogy Series B: Psychological Sciences and Social Sci- 16 D. Arkless, “2005 Manpower Presentation to ences 52B (1997): S59–71. ibm,” Paris, October 2005.
24 Dædalus Winter 2006 relationships and members not form- reporting both increased contact with Mature erly de½ned as kin.17 Naturally, these family members and a signi½cantly more societies new family arrangements are generat- positive view of the family as a support- ing questions about each person’s role ive institution.20 in the intergenerational transmission of social and economic resources and each As pressing as the concerns of aging person’s responsibility for taking care of in developed countries are, developing dependent adults. Extensive work in the countries face the greatest challenge. In United States and Europe has revealed a forty-½ve years, three-quarters of the 2 high level of social and economic trans- billion elderly people in the world will fers despite signi½cant changes in fami- live in developing countries. Currently, ly structure.18 For example, Vern Bengt- Africa has 40 million people over age 60, son’s study shows that while members Latin America and the Caribbean have of Generation X were more likely to have 41 million, and the Asia-Paci½c region grown up in a home with divorced par- has 600 million. Moreover, these coun- ents, a full-time working mother, and tries are aging very quickly: it will take, fewer than two siblings, intergenera- on average, twenty-three to twenty-four tional influences remain strong. In fact, years for the elderly to go from compris- alternative and multigenerational fami- ing 7 to 14 percent of the population lies are performing the functions of nu- in many developing countries, a jump clear families where necessary. that took 115 years for France to achieve. Cross-sectional work in Europe has Worse, the elderly in developing coun- also demonstrated at least an intention tries will probably not be the active, on the part of middle-aged children healthy retired but frail, dependent eld- to take care of older kin. Data from ers. France, for example, show that despite Older people are among the poorest the government’s fears of a breakdown in every developing country. With the in family solidarity, 80 percent of mid- lowest levels of income, education, and dle-aged children said they would eith- literacy, they lack savings, assets, and er provide housing for needy parents land; have few skills or capital to invest and in-laws or care for them in their in productive activity; and have very own homes.19 Scandinavian research limited access to jobs, pensions, or oth- has also highlighted the importance of er bene½ts. In fact, many developing kinship within a modern welfare state, countries have yet to establish even min- imal social insurance schemes. Health- 17 V. L. Bengtson, “Beyond the Nuclear Fami- care provision, for example, will pose a ly: The Increasing Importance of Multigenera- real challenge. With the epidemiological tional Bonds,” Journal of Marriage and the Family transition now underway globally, the 63 (2001): 1–16. emphasis is shifting from infectious and 18 G. W. Leeson, “Changing Patterns of Con- parasitic diseases to chronic and degen- tact with and Attitudes to the Family in Den- erative diseases. The World Health Re- mark,” Journal of Intergenerational Relationships port 2003 identi½ed cardiovascular dis- (forthcoming). ease and lung cancer as two new major global epidemics–brought on not only 19 J. Chwalow, A. Bagnall, C. Baudoin, and by environmental factors such as smok- F. Elgrably, “France,” in I. Philp, ed., Family Care of Older People in Europe (Amsterdam: ios Press, 2001), 27–48. 20 Leeson, “Changing Patterns.”
Dædalus Winter 2006 25 Sarah ing and diets high in saturated fat, but oped systems tend to exclude large sec- Harper also because individuals are now living tions of the work force.23 on aging long enough to develop those diseases. Even so, it would be foolhardy to ig- Though commonly perceived as a West- nore the urgency of developing insti- ern disease, cardiovascular disease is tutions and policies appropriate for a now taking more lives in developing world that will have 1 billion older adults countries than in the developed world. within the next twenty-½ve years. But since most health-care systems in these regions are struggling to address As the baby boom generation moves acute diseases, including hiv/aids through old age and dies, and if cur- and tropical diseases, and tackle infant, rent low rates of fertility and mortali- child, and maternal mortality, they have ty continue, most developed countries no spare resources to develop much and some less developed countries will needed preventative public-health pro- probably become fully mature, ‘age grams, let alone long-term care strate- symmetric’ societies over the next few gies. decades. These societies will be histor- The second large area of real concern ically unique in both their demograph- is material security. Most people in less ic pro½le and their promise of long, developed countries have no prospect healthy lives for many individuals.24 of a secure and sustainable income in Governments have the ½rst two de- their old age. Few, even among workers, cades of the twenty-½rst century to receive any public bene½ts. In contrast develop frameworks for these mature to the 84 percent of those over age 60 societies. in oecd countries who receive a pen- Currently, three broad approaches sion, under 20 percent in many Latin exist. Governments can introduce ame- American countries, under 10 percent liorative policies and simply wait to see in Southeast Asia, and under 5 percent what happens when a more age-sym- in parts of sub-Saharan Africa do.21 metric population arrives; they can Not only is political impetus missing, attempt to manipulate population struc- but substantial practical obstacles stand in the way of extending formal insur- Earthscan, 1999), 82–97; International Social ance coverage to workers in both rural Security Association, “Report of the Asian Re- and informal sectors. These range from gional Round Table, Meeting on Social Secu- lack of adequate record keeping iden- rity Protection of the Rural Population in De- tifying the appropriate recipients to veloping Countries” (Kuala Lumpur: Interna- tional Social Security Association, 1980). the logistics of actually delivering bene- ½ts.22 Even countries with more devel- 23 U.S. Social Security Administration, “So- cial Security Programs Throughout the World,” Research Report no. 65 (Washington, D.C.: 21 World Bank, “Averting the Old Age Cri- U.S. Social Security Administration, Of½ce of sis: Policies to Protect the Old and Promote Policy, Of½ce of Research, Evaluation, and Sta- Growth,” World Bank Policy Research Report tistics, 1997). (Oxford: Oxford University Press, 1994). 24 Currently, there are concerns about child 22 J. H. Schulz, “Economic Security in Old and adolescent obesity and diabetes. Given the Age: A Family-Government Partnership,” in ability to prolong life, a fall in healthy life ex- J. Randel, T. German, and D. Ewing, eds., The pectancy, rather than in life expectancy itself, Ageing and Development Report: Poverty, Inde- is possible. This may mean the growth of a pendence and the World’s Older People (London: frailer, more disabled older population.
26 Dædalus Winter 2006 tures through increased fertility or im- luctant to hire older workers.26 Until Mature migration; or they can explore and take the middle of last century, however, an societies advantage of the many opportunities a age-integrated workforce was consid- mature population offers. Governments ered a versatile workforce,27 and ample should pursue the latter approach and evidence pointed to the valuable contri- seize the chance to harness the experi- butions that older workers made to eco- ence, expertise, and creativity of older nomic activity.28 It was widely acknowl- people. edged that while capacity changed with Rather than de½ning themselves only age, one could overcome this through by their demography, societies that take retraining and adaptations in the work the latter approach will bene½t from the environment.29 Such evidence is all the possibility of age integration, or more more abundant today.30 Even within the interaction between successive cohorts. manufacturing sector, where concern This potential to utilize the capabilities that older workers are not as productive of such a large spectrum of cohorts, in is highest, research shows those aged 55 different stages of the life course, is un- and older are as productive as those aged precedented. Moreover, integration 35 to 54, and more productive than those could be a consistent and relatively sta- under 35.31 bilizing force within societies as they 26 Princeton University Conference on Dis- mature. However, these bene½ts will crimination in Labor Markets, Discrimination in only accrue if those influencing our Labor Markets, ed. O. Ashenfelter and A. Rees governments and economies today turn (Princeton, N.J.: Princeton University Press, from fearing such a future and work to- 1973); L. A. Bennington and R. Wein, “Anti- ward creating the framework for tomor- discrimination Legislation in Australia: Fair, Effective, Ef½cient or Irrelevant?” Internation- row’s mature societies. Such a frame- al Journal of Manpower 21 (1) (2000): 21–33. work would include banning age dis- criminatory practices; encouraging age- 27 E. Belbin, “Methods of Training Older integrated behavior; and fully recogniz- Workers,” Ergonomics 1 (1958): 207–211. ing the eventual frailty, and ½nality, of 28 S. Harper and P. Thane, “The Consolida- old age. tion of ‘Old Age’ as a Phase of Life, 1945– 1965,” in M. Jefferys, ed., Growing Old in the As Matilda Riley argued some thir- Twentieth Century (London: Routledge, 1989), ty years ago, the removal of structural 43–61. age barriers, such as those to work and 29 A. T. Welford, Ageing and Human Skill education, is essential to an age-inte- (London: Oxford University Press, 1958); grated workplace–where age does not E. L. Meier and E. Kerr, “Capabilities of Mid- constrain entry, progress, and exit;25 dle-Aged and Older Workers: A Survey of the and individuals of different ages inter- Literature,” Industrial Gerontology (Summer act within the same set of structures 1976): 147–155. or roles. Unfortunately, even in those 30 T. Warr, “Age and Employment,” in H. C. countries with anti–age discrimination Triandis, M. D. Dunnette, and L. M. Hough, legislation, employers are generally re- eds., Handbook of Industrial and Organizational Psychology, vol. 4, 2nd ed. (Palo Alto, Calif.: Consulting Psychologists Press, 1994), 485–550. 25 M. W. Riley, “Age Strata in Social Systems,” in R. H. Binstock and E. Shanas, eds., The Hand- 31 J. Hellerstein, D. Neumark, and K. Troske, book of Aging and the Social Sciences, 2nd ed. “Wages, Productivity and Worker Character- (New York: Van Nostrand Reinhold, 1976). istics: Evidence from Plant Level Production
Dædalus Winter 2006 27 Sarah Besides general reluctance on the part historical shift. In the United States, Harper of employers to hire older workers, there for example, nearly one-½fth of all chil- on aging is also evidence that institutional sup- dren born in 1900 were orphans before port for age-structured careers has stag- reaching age 18. In contrast, more than nated.32 Fewer jobs provide increasing two-thirds of those born in 2000 will rewards and security for longer tenure. still have both sets of grandparents at Instead, more variable and flexible pat- 18.35 Similarly, at age 30, one-½fth of terns of career progression and termi- the 1900 cohort had a living grandpar- nation have become the norm. Indeed, ent; three-quarters of those born in younger cohorts, currently in early and 2000 will have at least one living grand- mid-life, are already growing accus- parent at 30. The age-integrated family, tomed to a less rigid labor market with with members stretching from birth greater access to part-time and flexible to well into their eighties and nineties, working patterns as well as the need to appears to be a growing phenomenon in continually update skills.33 many Western societies. Bengtson even While the workplace is still slow to suggests that in terms of providing sup- move toward more age-inclusive frame- port across the life course, multigenera- works, some examples exist. The Nor- tional bonds are becoming more impor- wegian model, for one, lays out the key tant than nuclear family ties for many elements of a long-term strategy for fa- Americans.36 cilitating an integrated workforce. These These multigenerational families have elements include a ½nancial incentive wider policy implications. Despite what and bene½t system that encourages the considerable public rhetoric predicted, retention of older workers, more flex- wars between the generations have not ible working patterns, continual training erupted. Younger cohorts have not risen and education, and increased dialogue up to protest policies that bene½t older between employers and employees. adults, even if these policies seem count- er to their own interests. Anne Foner Another development of mature soci- offers two reasons why people of work- eties is the multigenerational, or ‘bean ing age in the United States favor pro- pole,’ family. It is estimated that three- grams that bene½t older people. First, quarters of all adults will become grand- parents.34 This represents a considerable ent Role,” Generations 20 (1) (1996): 17–23; D. Dench, J. Ogg, and K. Thomson, “The Role Functions and Wage Equations,” Journal of La- of Grandparents,” in R. Jowell, J. Curtice, A. bor Economics 17 (3) (1999): 409–446. Park, and K. Thomson, eds., British Social Atti- tudes: The 16th Report (Aldershot: Ashgate, in 32 K. Loscocco, “Age Integration as a Solution association with the National Center for Social to Work-Family Conflict,” Gerontologist 40 (3) Research, 1999). (2000): 292–300. 35 P. Uhlenberg, “Intergenerational Support 33 D. Gallie, Equal Opportunities for Women and in Sri Lanka,” in T. K. Hareven, ed., Aging and Men in Europe?: Eurobarometer 44.3: Results of Generational Relations: Life-Course and Cross-Cul- an Opinion Survey (Luxembourg: Of½ce for Of- tural Perspectives (New York: Aldine de Gruyter, ½cial Publications of the European Communi- 1996). ties, 1998). 36 Bengtson, “Beyond the Nuclear Family: The 34 R. Giarrusso, M. Silverstein, and V. L. Beng- Increasing Importance of Multigenerational tson, “Family Complexities and the Grandpar- Bonds.”
28 Dædalus Winter 2006 younger people have a stake in protect- er adults. The possibility for increased Mature ing public programs for older adults be- interaction between successive genera- societies cause these programs relieve them of tions, which arises from population ag- ½nancial responsibility for the elderly ing, thus impacts society as well as fami- people in their own families. Second, lies. younger adults wish to preserve these programs for their own old age.37 It is clear that during the last quarter Of more importance than these self- of the twentieth century, the early re- interested motives, however, is how tirement of healthy, active adults had these policies are mediated within kin- profound implications for societal pre- ship roles and relationships.38 While conceptions, and ultimately the de½ni- public programs operate at the national tion, of men and women in their ½fties level, most people actually experience and early sixties. In fact, the notion of them at the individual, family, or com- the ‘Third Age,’ which Peter Laslett munity level. Age-integrated families conceived as commencing during an in- naturally advance opportunities for dividual’s sixties as he or she withdrew younger people to have contact with from full-time employment, is now seen and knowledge of their older relatives. as beginning at 50. Or even as the Third Through these intimate intergenera- Age Foundation boldly asserts in a re- tional relationships, older people are cent uk report: “Older people is the no longer the other. Thus, even though term used for the purposes of this report individuals do not directly bene½t from to refer to those aged 40-plus.” Given age-friendly policies, these policies feel that individuals at 40 can expect to live rewarding because their relatives, with ½fty more years, are we really to believe whom they have affective intergenera- that two-thirds of the adult population tional ties, are bene½ting. are now ‘old’? Also, younger people may well re- Yet, particularly in Western societies, ceive direct or indirect bene½ts from ½nancial and other services are now la- these programs. The entitlements for beling those over 50 as the ‘older’ con- older adults that these programs dis- sumer group; communities are building pense at the macro level often result in special housing for those over 50; and a circulation of bene½ts from older to governments in many countries are even younger family members. The relative providing pensions to individuals from ½nancial security afforded the old by age 50. At least one uk local authority public programs permits them to con- now allocates social services for the eld- tribute to their children and grandchil- erly to those age 50 and older on the dren. So rather than parents becoming grounds that this is politically correct. rich at the expense of the young, the And many in the sales sector say that young bene½t both directly and indirect- identifying a late-life product as one ly from the public funds received by old- “for those in their ½fties” is a good sales technique, as the older consumer will 37 A. Foner, “Age Integration or Age Conflict be more likely to purchase a product ap- as Society Ages?” Gerontologist 40 (3) (2000): parently targeted at those some twenty 272–276. years younger. However, the social, cul- 38 S. Harper, Ageing Societies: Myths, Challenges tural, and economic dynamics driving and Opportunities (London: Hodder Arnold, this are not necessarily good for the in- 2005). dividual.
Dædalus Winter 2006 29 Sarah Female menopause, which usually be- period, the acceptance of death as a Harper gins around age 50, was the original ra- natural part of the human condition, on aging tionale for making age 50 the transition which could enrich and inform all life, into old age. Men came to be included was slowly replaced by the view that in this transition because of the often willpower and scienti½c knowledge associated, though never causally associ- could postpone physical decline inde½- ated, change of roles and relationships nitely. By the middle of the twentieth that occurred around that age. The eco- century, scienti½c responsibility had nomic bene½t of early retirement was completely trumped personal responsi- also partially responsible for including bility: modern science, having discov- men. However, with the aging of life ered the ‘problem’ of old age, resolved transitions–the delay in ½nishing full- to solve it.40 As Cole remarked, “Un- time education, forming stable adult able to infuse decay, dependence, and unions, and becoming a parent–most death with moral and spiritual signi½- individuals in their ½fties are still active cance, our culture dreams of abolishing parents, partners, and contributors to biological aging.”41 community and economic life, as they This dream has conjured up a notion were when they were in their thirties of the body not based on human experi- and forties. ence. Since we do not see in½rmity as a Indeed, given the multiplicity of roles common experience of all stages of hu- and diversity of life-course experiences, man life that is then expanded in later most individuals will spend much of life, the frailty of the old sets them apart their adulthood moving back and forth from the young. among a spectrum of responsibilities As societies age, it is important that with no sense of an abrupt transition at we recognize the full potential length of 50. One woman in her ½fties, for exam- active adulthood and enable most indi- ple, seamlessly shifted between being viduals to contribute as long as they are a granddaughter and grandmother, par- able. However, it is equally important ent and child, worker and caregiver, and that we then accept a period, brief or wife. Another, the wife of a U.S. senator, long, of morbidity and disability at the had her last child naturally at 51. Though end of our lives as the reality of old age. pregnant and nursing, she was eligible Then, societies can redirect resources for old people’s housing; in England, she to those elders in real need, ensuring would have been targeted for social serv- accommodation and ½nancial, social, ices and considered to be in her Third and health-care services, regardless of Age. chronological age. This is the reality– In our eagerness to claim that we have old age as an integral part of adulthood. reached later life, we have created an ‘age’ that starts at 50 and may continue for nearly half a lifetime. As a result, we marginalize the reality of true old age– 40 W. A. Achenbaum, Old Age in the New Land: the increasing frailty and approach of The American Experience Since 1790 (Baltimore: death that comes to the very old. His- Johns Hopkins University Press, 1979); T. R. torians Thomas Cole and W. Andrew Cole, The Journey of Life: A Cultural History of Ageing in America (Cambridge: Cambridge Uni- Achenbaum have suggested that this versity Press, 1992), 129. process of marginalization began in the nineteenth century. During this 41 Cole, The Journey of Life.
30 Dædalus Winter 2006 Most developed countries began the Mature twentieth century with populations that societies aged from one old for every ten young, to one old for every two young by the late 1980s, to one old for every young person by the early years of the twenty- ½rst century. Developing countries saw a dramatic increase in absolute numbers of older people, moving from a few mil- lion to nearly a billion in that time. Eu- rope also saw three months of life expec- tancy added at birth every year. The speed and magnitude of these changes are unprecedented, and their full implications are dif½cult to grasp. Laslett talked of a cultural lag, in which society has yet to catch up with the cur- rent reality of population aging. Riley speaks of a structural lag, whereby in- stitutions have yet to adapt. It is clear that there is also an individual lag, whereby people have yet to readdress their life-course activities in light of their signi½cantly increased potential for long life. As mature societies develop, we must be wary of confounding age with cohort and life course, implying that those in later life must consistently act in certain ways because of their age. While age- integrated mature societies may display certain characteristics because of their demographic pro½le, we must also ac- knowledge the complexities of cohort and period effects: each cohort brings with it speci½c life dimensions, dynam- ics, and histories; and each time period introduces particular institutional and structural contexts. All mature societies now have the exciting possibility of age integration. Mature societies are not those that have large numbers and pro- portions of old people; they are societies in which people live longer.
Dædalus Winter 2006 31 Paul B. Baltes
Facing our limits: human dignity in the very old
An ancient Greek myth captures a di- see a growing number of Tithonuses– lemma that still faces us today. The god- very old and frail people, bereft of mind, dess of the Dawn, Eos, persuades Zeus body, and human dignity. to make her earthly lover Tithonus im- The Janus face of aging becomes ap- mortal. But she forgets to ask Zeus to parent when we compare what, pursu- preserve the health and vitality of her ant to earlier work by Bernice Neugarten lover. As a result, though Tithonus lives and Peter Laslett, my colleagues and I on and on, his body and mind begin to have called the ‘Third’ and ‘Fourth Age’ 2 fail. Finally, and with pain in her heart, of the human life span. These are dy- Eos moves her former lover into a sepa- namic and heuristic concepts, approxi- rate chamber where he lives forever out mations that change with time and ex- of sight. hibit large individual variations. Cur- Like Eos in the myth, some scholars rently, in developed countries, the Third now entertain the prospect of an inde- Age begins, on average, at about age 60; terminate, if not ‘limitless,’ human life the Fourth Age generally starts around span.1 But should this dream become a age 80. reality, still other students of aging fore- In recent decades, a powerful coalition of gerontological scientists, policymak- ers, and social-technological advances Paul B. Baltes, a Foreign Honorary Member of the American Academy since 1991, is director at 1 J. Oeppen and J. W. Vaupel, “Broken Limits the Max Planck Institute for Human Develop- to Life Expectancy,” Science 296 (5570) (May 10, ment in Berlin and Distinguished Professor of 2002): 1029–1031. Psychology at the University of Virginia. He is also vice president of the German Academy of 2 P. B. Baltes, “On the Incomplete Architec- ture of Human Ontogeny: Selection, Optimi- Natural Sciences Leopoldina. Baltes codirected zation, and Compensation as Foundation of the Berlin Aging Study and coedited the “Interna- Developmental Theory,” American Psychologist tional Encyclopedia of the Social and Behavioral 52 (4) (April 1997): 366–380; P. B. Baltes and Sciences” (with Neil Smelser, 2001). He is cur- K. U. Mayer, eds., The Berlin Aging Study: Aging rently leading the Max Planck International Re- from 70 to 100 (New York: Cambridge Universi- ty Press, 1999); P. B. Baltes and J. Smith, “New search Network on Aging. Frontiers in the Future of Aging: From Success- ful Aging of the Young Old to the Dilemmas of © 2006 by the American Academy of Arts the Fourth Age,” Gerontology 49 (2) (March/ & Sciences April 2003): 123–135.
32 Dædalus Winter 2006 has contributed to major increases in tain its productivity when a growing Human longevity and improvements in the qual- proportion of its labor force population, dignity in the ity of life for individuals in the Third because of its older age, is less ½t for in- very old Age.3 But theoretical and empirical evi- novative labor and productivity? dence suggests that further improve- ment may become more dif½cult as In industrialized countries over the last more and more people reach the Fourth century, we have witnessed truly aston- Age. These oldest-old are manifesting ishing increases in average life expectan- a new level of biocultural incomplete- cy, from about forty-½ve years in 1900 ness, vulnerability, and unpredictability to close to eighty years in 2000. Of spe- in their everyday behavior–testing the cial importance is new evidence that life limits of human functioning as well as expectancy is increasing in the older as of science and policy. well as younger age ranges.4 Thirty years After offering some of the scienti½c ago, an 80-year-old would live, on aver- evidence for this contrast between the age, another four years; today, an 80- Third and the Fourth Age, I shall sketch year-old can expect to live longer for some of its implications, not only for double that time. If this upward trend the individual but also for societies. De- in life expectancy continues more or pending on characteristics such as aver- less linearly, nearly half the people born age age and age distribution, countries today–especially women–could theo- will differ in productivity and health retically reach an age close to 100. costs. Indeed, a population’s age distri- While certain genes play a key role bution may even affect how much mon- in determining the life spans of human ey a country has available for interna- beings, genetic factors by themselves tional developmental aid. cannot explain this rapid increase in Thus, it is not surprising that debates life expectancy in the twentieth centu- over the future of aging differ in marked ry. Changes in the human genome occur ways, for instance, in the United States gradually, over much longer periods of and in Germany. Because a much larger time than a century. Rather, better living proportion of Germany is elderly, and conditions have been primarily respon- because of the added problem of lower sible for the recent increase in human rates of fertility, German scholars and life expectancy. These technological, so- policymakers have been forced to face cial, and cultural changes have permitted some hard questions: How can a society fuller utilization of the plasticity built distribute scarce educational and med- into the human genome. ical resources justly among people at all As more people live to older ages, stages of life? How can a society main- they are demonstrating remarkable po- tential. Researchers at the Max Planck Institute for Human Development have 3 P. B. Baltes and M. M. Baltes, eds., Successful found that people in their sixties and Aging: Perspectives from the Behavioral Sciences (New York: Cambridge University Press, 1990); seventies still possess considerable in- Baltes and Mayer, eds., The Berlin Aging Study; tellectual and cognitive resources. Of M. W. Riley, R. L. Kahn, and A. Foner, Age and course, intelligence is not a single, ho- Structural Lag: Society’s Failure to Provide Mean- mogeneous capacity, and not all aspects ingful Opportunities in Work, Family, and Leisure of intelligence in the elderly show posi- (New York: J. Wiley, 1994); J. W. Rowe and R. L. Kahn, “Human Aging: Usual and Success- ful,” Science 237 (4811) (July 10, 1987): 143–149. 4 Oeppen and Vaupel, “Broken Limits.”
Dædalus Winter 2006 33 Paul B. tive changes–but some do. On one as our minds lose their basic poten- Baltes hand, the mechanics of the mind, like tial for peak performance in the basic on aging computer hardware, dictate the sheer mechanics of the mind, we can concen- speed and accuracy with which it pro- trate our efforts in areas where we have cesses information. This capability– already achieved mastery and where which is also key to learning–grows ‘new’ learning is not the most critical rapidly during childhood, but begins component. to wane in early adulthood. On the oth- In the same vein, many older adults er hand, intelligence also includes a kind evince heightened emotional intelli- of ‘crystallized’ pragmatics, which, like gence and interpersonal social cogni- computer software, reflects culture-spe- tion.7 Indeed, wisdom, often considered ci½c knowledge such as language, pro- the peak of human excellence in mind fessional skills, and practical reasoning and character, is one of the elderly’s about human affairs.5 most impressive potential characteris- Older adults can retain and even im- tics.8 It goes without saying that simply prove the crystallized pragmatics of the growing old is not enough to become mind, provided they do not suffer from wise. However, with life experience and brain disorders. This is especially true the necessary personal qualities and pat- for those bodies of pragmatic knowledge terns of thought, adults in their sixties that individuals cultivate.6 Thus, even and seventies often address problems requiring wisdom extremely well. The positive aspects of experience 5 P. B. Baltes, U. M. Staudinger, and U. Linden- are also evident in certain areas of pro- berger, “Lifespan Psychology: Theory and Ap- fessional expertise. Older composers plication to Intellectual Functioning,” Annual Review of Psychology 50 (1999): 471–507; R. B. and conductors, for instance, are often Cattell, Abilities: Their Structure, Growth, and Ac- among the best in their ½elds. As long as tion (Boston: Houghton Mifflin, 1971); F. I. M. an aged person remains professionally Craik and T. A. Salthouse, eds., The Handbook active, unaffected by speci½c age-associ- of Aging and Cognition, 2nd ed. (Hillsdale, N.J.: ated illnesses such as stroke, and works Erlbaum, 2000); S.-C. Li et al., “Lifespan in an area where the pragmatics rather Transformations in the Couplings of Mental Abilities and Underlying Cognitive Processes,” than the mechanics reign, age often has Psychological Science 15 (3) (2004): 155–163; little or no effect on specialized profes- P. A. Reuter-Lorenz, “New Visions of the Ag- sional knowledge. ing Mind and Brain,” Trends in Cognitive Sci- ences 6 (9) (September 1, 2002): 394–400; K. W. Schaie, Developmental Influences on Adult 7 L. G. Aspinwall and U. M. Staudinger, eds., Intelligence: The Seattle Longitudinal Study (New A Psychology of Human Strengths: Fundamental York: Oxford University Press, 2005); P. C. Questions and Future Directions for a Positive Psy- Stern and L. L. Carstensen, The Aging Mind: chology (Washington, D.C.: American Psycho- Opportunities in Cognitive Research (Washing- logical Association, 2003); B. T. Hess and F. ton, D.C.: National Academy Press, 2000). Blanchard-Fields, eds., Social Cognition and Ag- ing (London: Academic Press, 1999). 6 Baltes and Baltes, eds., Successful Aging; R. T. Krampe and P. B. Baltes, “Intelligence as Adap- 8 P. B. Baltes and U. M. Staudinger, “Wisdom: tive Resource Development and Resource Al- A Metaheuristic (Pragmatic) to Orchestrate location: A New Look Through the Lenses of Mind and Virtue Toward Excellence,” American soc and Expertise,” in R. J. Sternberg and Psychologist 55 (1) (2000): 122–136; R. J. Stern- E. L. Grigorenko, eds., The Psychology of Abil- berg and J. Jordan, eds., A Handbook of Wisdom: ities, Competencies, and Expertise (New York: Psychological Perspectives (New York: Cambridge Cambridge University Press, 2003), 31–69. University Press, 2005).
34 Dædalus Winter 2006 The elderly are also amazingly well- in the fast movements than he was actu- Human equipped to adapt and stay positive de- ally able to–an example of compensa- dignity in the spite the increasing restrictiveness of tion. People who apply selection, opti- very old their activities and physical abilities. In mization, and compensation as behav- fact, many older people claim they feel ioral strategies feel better about them- just as healthy as younger people, even selves and go further in life, especially though–objectively speaking–they are when the mechanics of mind and body not. Often, their ability to establish new start to decay, as they inevitably do in standards of comparison makes this feel- old age. ing possible. For example, after people Gerontologists and policymakers are survive a heart attack, they are likely to thrilled with these pieces of good news. compare themselves to others who have However, not everyone–particularly died.9 not the very old people themselves– This ‘adaptive self-plasticity’ has posi- share this optimism. After all, why is it tive effects on well-being. It also corre- that most people don’t want to be old? sponds to the theory of selective opti- Why do people always want to be a bit mization with compensation, developed younger than they actually are as they at the Max Planck Institute for Human grow older? And why does the discrep- Development.10 According to this theo- ancy between actual age and desired age ry, people at all ages of life engage in se- increase dramatically as we reach our lection, optimization, and compensa- seventies, eighties, and nineties? Nine- tion. However, in older people, the mas- ty-year-olds in Berlin, for instance, said tery of these skills can become a ½ne art, they would have liked to stay, on aver- as in the case of the pianist Arthur Ru- age, between the ages 65 and 70. binstein. At 80, Rubinstein was asked how he Late in his life, the Italian philosopher managed to still give such excellent con- Norberto Bobbio coined the phrase certs. Over the course of several inter- “happy gerontologists,”11 suggesting views, he offered three reasons. First, that some aging researchers were so op- he played fewer pieces–an example of timistic because they had not yet taken selection. Second, he practiced these a proper look at the older-old. But since pieces more often–an example of opti- then, a number of gerontologists have in mization. Finally, he played slow move- fact shifted their focus from the ‘young- ments more slowly, to make it appear as old’ to the ‘oldest-old.’ In the Berlin Ag- though he were playing the piano faster ing Study, for example, more than ½fty medical experts, psychologists, sociol- 9 J. Heckhausen and J. Krueger, “Developmen- ogists, and economists repeatedly as- tal Expectations for the Self and Most Other sessed over a period of ten years approx- People: Age Grading in Three Functions of So- imately ½ve hundred older people rang- cial Comparison,” Developmental Psychology 29 ing in age from 70 to 100.12 (3) (May 1993): 539–548. The results con½rmed what Bobbio 10 Baltes and Baltes, eds., Successful Aging; had suggested: Although some of the A. M. Freund and P. B. Baltes, “Life-Manage- ment Strategies of Selection, Optimization, 11 N. Bobbio, Old Age and Other Essays (Cam- and Compensation: Measurement by Self- bridge: Polity Press, 2001). Report and Construct Validity,” Journal of Personality and Social Psychology 82 (4) (April 12 Baltes and Mayer, eds., The Berlin Aging 2002): 642–662. Study.
Dædalus Winter 2006 35 Paul B. older-old remain very agile and emo- For instance, compared to people in the Baltes tionally well-off, their numbers begin Third Age, almost ½ve times as many on aging to dwindle as they grow older. Physical people over 85 suffer from chronic im- and mental capacities increasingly di- pairments and exhibit low functional minish the older someone gets, clearly scores across a wide range of physical, contradicting the belief that today’s eld- cognitive, and social indicators.15 These erly are necessarily spared the negative data con½rm that life’s journey tends aspects of aging. to take a turn for the worse as one reach- Aside from deteriorating health, sen- es, and even exceeds, the biological lim- sory systems, and bodily strength, one its of human adaptability. The fact that of the ½rst things to decline markedly the physical and mental capabilities of in the oldest ages is the capacity to learn. same-age old people have improved sub- Experiments where subjects must learn stantially in recent years can at best buff- a new memory enhancement technique er the negative effects of old age, but demonstrate this: whereas the young- not eliminate the basic trend. In other old tend to do very well, many people words, the magnitude of the aging effect over 85 are unable to learn the technique is much larger than that of historical im- unless it is simpli½ed in major ways.13 In provement. the Fourth Age, even people considered The dramatic increase in dementia mentally ½t for their age have dif½culty makes the losses of the Fourth Age par- learning especially if the concepts are ticularly visible. According to the Ber- complex. lin Aging Study and other studies, less Moreover, people in the Fourth Age than 5 percent of 70-year-olds suffer have a more fragile self-image than from some form of dementia, including younger-old people. In the oldest-old, Alzheimer’s.16 But this percentage in- self-regulatory adaptability diminishes, creases to 10 to 15 percent of 80-year- largely because the gap between the de- olds and to about 50 percent of 90- to sired and the real becomes too large in 100-year-olds. Currently, no scienti½c scope and magnitude. When the Fourth evidence seems to indicate a ‘historical Age is reached, indicators of well-being cohort effect’ for Alzheimer’s-induced such as life satisfaction, social integra- dementia–that is, a shift toward later tion, a positive attitude toward life, and ages. aging satisfaction start to fall as a whole. Dementia, especially Alzheimer’s dis- When looking at the whole of human ease, leads to a gradual deterioration in functioning, the evidence for sizeable many basic human characteristics, in- losses in the Fourth Age is impressive.14 cluding intentionality, independence, identity, and social integration. These 13 R. Kliegl, J. Smith, and P. B. Baltes, “On the characteristics play a key role in de½ning Locus and Process of Magni½cation of Age Dif- human dignity and allowing individuals ferences During Mnemonic Training,” Develop- mental Psychology 26 (6) (1990): 894–904; T. Singer, U. Lindenberger, and P. B. Baltes, “Plas- Gerontology: Psychological Sciences 57 (6) (No- ticity of Memory for New Learning in Very vember 2002): 471–473. Old Age: A Story of Major Loss?” Psychology and Aging 18 (2) (June 2003): 306–317. 15 Baltes and Smith, “New Frontiers.”
14 J. Smith et al., “Two-Wave Longitudinal 16 H. Helmchen et al., “Psychiatric Illnesses in Findings from the Berlin Aging Study: Intro- Old Age,” in Baltes and Mayer, eds., The Berlin duction to a Collection of Articles,” Journal of Aging Study, 167–196.
36 Dædalus Winter 2006 to exercise autonomously their ‘human ever, without a doubt, one of the core Human rights.’ questions gerontology faces today is to dignity in the We are now faced with a new chal- what extent further scienti½c develop- very old lenge: to conserve human dignity in the ments can offer new insights and ways later years of life. In the Fourth Age, ger- to ameliorate the biological de½cits of ontology’s leitmotif, “Add more life to the Fourth Age. Theoretically, of course, years, not more years to life,” seems to the advent of new forms of biotechnolo- have met a new barrier. This barrier has gy gives us hope of genetically altering its roots in our evolutionary past.17 the biogenetically ‘incomplete’ architec- ture of the life course to make it more Up until the present time, biological amenable to cultural and psychological evolution operated by selecting and op- influences. However, based on present- timizing the reproductive abilities of hu- day evidence, such speculations also put mans during early adulthood. As a con- us on shaky ground–not only because of sequence of this primary focus on repro- the unpredictable effects of genetic engi- ductive ½tness, there was little opportu- neering, but also because of the ethical- nity for improving the genome for the religious debate on human nature. older ages of modern times. Not surpris- Because of the complexity of the hu- ingly, therefore, the self-preserving reg- man genome, any attempt to intervene ulatory mechanisms of the human ge- in this system risks producing undesir- nome deteriorate with age. These bio- able side effects. Moreover, a multitude genetic losses of human aging are less of biogenetic factors, including their obvious in the Third Age because cul- interaction with numerous behavioral ture- and technology-based improve- and environmental parameters, influ- ments have been successful in compen- ences the aging process and many of its sating for this evolution-based de½cit. associated diseases. An increasing num- These genome-based de½cits, more ber of random effects are also a part of conspicuous and prevalent in the Fourth the story. This makes gene therapy more Age, limit the countervailing effective- complicated for these diseases than for ness of cultural factors, including edu- ‘simpler’ monogenetic diseases. Though cation and medicine. Older people, in gene therapy currently holds a lot of general, need much more practice than promise for treating monogenetic dis- young people to achieve similar progress eases, these kinds of diseases are demo- in a cognitive task. Moreover, the num- graphically less signi½cant, affecting on- ber of illnesses increases. Multimorbid- ly a small fraction of the aging popula- ity and general losses across the board tion. become hallmarks of the oldest ages.18 Many biomedical scientists agree that Is this but a transitory state? Scientists knowing the genetic factors involved should be careful with predictions. How- in the aging process does not automati- cally mean that a quick and standardized means of ‘arti½cially’ perfecting the bio- 17 Baltes, “On the Incomplete Architecture of genetic architecture of the aging process Human Ontogeny”; C. E. Finch, Longevity, Se- is available. These factors are simply too nescence, and the Genome (Chicago: University complex and often differ from individu- of Chicago Press, 1990). al to individual. Nonetheless, it seems 18 Baltes and Mayer, eds., The Berlin Aging fair to argue that in the long term only Study; Baltes and Smith, “New Frontiers.” biomedicine has a chance of truly trans-
Dædalus Winter 2006 37 Paul B. forming old age into a Belle Époque. Be- oldest-old, researchers focused on im- Baltes cause of the reduced scope of biological proving quality of life worry about the on aging potential, improved environmental con- associated increase in the gap between ditions and age-friendly behavioral strat- longevity and vitality. egies alone will not suf½ce. That the situation is not hopeless is illustrated in the “compression of mor- For the younger-old, those in the Third bidity model” articulated by Fries.20 Age, the prospects seem bright. With It proceeds from the assumption that new approaches involving various meth- there is a ‘current’ biological limit to ods of biocultural co-construction,19 life span, around eighty-½ve to ninety with systematic efforts at optimizing the years. With that assumption, science strengths of older individuals, with new and society could take increasing the aging-friendly institutional structures, quality of life rather than the quantity with innovative efforts at developing of life more seriously. One way to do so conceptions of productivity that extend would be by compressing major events beyond the narrow sense of economic of illness into the few years preceding productivity, modern societies have the natural ‘biological’ death. Such a stra- potential to create a better future for tegy allows people to maintain their hu- the younger of the older ages and there- man dignity longer without necessarily by empower individuals to become ‘suc- extending life span. cessful agers.’ And because of large in- In my view of the evidence, Fries’ vi- dividual variability in the genome and sion still seems a realistic alternative. culture, it is also likely that we will con- Though only when we move to an aver- tinue to witness outstanding individual age life expectancy of eighty-½ve to success stories in the oldest ages as well. ninety years will we know if it is truly For most of the older-old, however, possible. Using this model as a frame- the prospects are not so bright. From work along with the newest evidence my point of view, “Hope with a mourn- on the dysfunctional states of the old- ing band” may be the motto best suited est-old, I suggest that we tone down to this situation. How to combine lon- our quest to extend longevity in favor gevity with a high quality of life and hu- of raising the quality of life within the man dignity in the oldest ages is the new present frame of life expectancy. And frontier. As demographers celebrate even if there is no maximum biological each month gained in the lives of the limit to life, such a limit can still become
19 P. B. Baltes, P. A. Reuter-Lorenz, and F. Rösler, eds., Lifespan Development and the Brain: 20 J. F. Fries, “Aging, Natural Death, and the The Perspective of Biocultural Co-Constructivism Compression of Morbidity,” New England Jour- (New York: Cambridge University Press, forth- nal of Medicine 303 (3) (July 7, 1980): 130–135; coming); E. Jablonka and M. J. Lamb, Evolu- J. F. Fries, “The Compression of Morbidity: tion in Four Dimensions: Genetic, Epigenetic, Be- Near or Far?” Milbank Memorial Fund Quarterly havioral, and Symbolic Variation in the History of 67 (2) (1989): 208–232; J. F. Fries, “Measuring Life (Cambridge, Mass.: mit Press, 2005); S.-C. and Monitoring Success in Compressing Mor- Li, “Biocultural Orchestration of Developmen- bidity,” Annals of Internal Medicine 139 (5 [Part tal Plasticity Across Levels: The Interplay of 2]) (September 2, 2003): 455–459; J.-M. Robine Biology and Culture in Shaping the Mind and and J.-P. Michel, “Looking Forward to a Gener- Behavior Across the Lifespan,” Psychological al Theory on Population Aging,” The Journals of Bulletin 129 (2003): 171–194; Riley, Kahn, and Gerontology Series A: Biological Sciences and Medi- Foner, Age and Structural Lag. cal Sciences 59 (2004): M590–M597.
38 Dædalus Winter 2006 a part of our decision making as self-di- from about 45 to 55. Experimental aging Human rected individuals. research on cognitive plasticity clearly dignity in the Besides begging the question of more demonstrates the considerable negative very old quantity versus better quality of life in and rather immutable effects of age on the oldest ages, this new frontier will al- the speed and accuracy of information so intensify debate over the meaning of processing and the potential to learn life, forms of death and dying, and the new skills and knowledge, especially at impact that investing scarce resources high levels of expertise. Also, the older in increasing life span will have on oth- we get, the more the body calls on cog- er sectors of society. Though these are nitive resources–for instance, when beyond the scope of this essay, it is im- keeping one’s balance or thinking while portant to discuss at least the last issue walking on uneven terrain.21 This ‘mort- briefly in order to place human aging in gaging of the mind’ by the body leaves a larger societal and global context. Too less of our mind available for mental ac- often aging researchers and policy ana- tivities of the usual kind. lysts overlook the implications of indi- We humans are inherently curious vidual and population aging for the dis- and committed to living long and well, tribution of resources. if not for eternity. Yet, even as homo For instance, to what degree does the faber22 allows us to grow older and older, growing investment into extending and we must consider the scienti½c evidence supporting the lives of the elderly limit that indicates a developmental limit to the resources available for improving human life in the oldest ages and accept the lives of children and youth, or for that “less may be more.” reducing the gap between the rich and Hesiod is said to have expressed a sim- the poor? Also, are we hampering glob- ilar thought: “If one chooses the right al progress by allocating an increasing- half, half may be more than the whole.” ly larger share of our resources to keep- ing the oldest in our own industrialized country alive rather than helping devel- oping countries? For a gerontologist, these are questions that do not win the approval of most of his peers. However, I believe these are the kinds of questions that will increasingly shape scienti½c and public discourse about individual and population aging in the twenty-½rst century. Countries such as Germany–where increasing longevity and low fertility rates will result in a disproportionately older population within the next ½fty 21 U. Lindenberger, M. Marsiske, and P. B. years–must also consider the effect of Baltes, “Memorizing While Walking: Increase population aging on their national pro- in Dual-Task Costs from Young Adulthood to ductivity and global competitiveness. Old Age,” Psychology and Aging 15 (3) (Septem- ber 2000): 417–436. Such societies are likely to experience a reduction in their potential for innova- 22 J. Mittelstraß, “Science and Culture,” Euro- tion, as the average age of workers grows pean Review 4 (1996): 293–300.
Dædalus Winter 2006 39 Linda Partridge
Of worms, mice & men: altering rates of aging
The word ‘aging’ has very different im- over time, after puberty. This is the sense plications for wine and women. Matters in which I will use the word ‘aging’ in can improve or deteriorate over time, this essay, as the intrinsic decay in func- and the everyday usage of the term can tion that sets the ultimate limit to life cover either situation. span. In the natural world things tend to At ½rst sight, aging does not require get worse over the course of adulthood. any special explanation. Machines wear In mammals and birds, for instance, out and fail, so why not living things many long-term ½eld studies have re- too? Aging does indeed involve accu- vealed that both likelihood of survival mulation of damage. The molecules and production of offspring decline lat- that make up bodies acquire lesions, as er in life. There are exceptions, to be do whole cells and tissues. Decrements sure. Especially where animals start to in the ability to run or to solve problems procreate before they are fully grown, as quickly, for example, reflect this accu- is the case in many ½sh, chances of sur- mulation of damage. vival and fecundity can improve over at If this were the whole story, then we least part of adulthood. would expect similar organisms to age But in the organism in which most at roughly similar rates, but they do not. people are really interested, humans, For instance, bats and monkeys are pe- there is a clear deterioration in function culiarly long-lived mammals for their body size; birds, in general, also live Linda Partridge is Weldon Professor of Biome- much longer than comparably sized try and bbsrc Professorial Fellow at Univers- mammals. These differences persist in ity College London. The author of numerous ar- captivity and are thus properties of the ticles and the editor of several books, Partridge species rather than of the individual life- has researched the genetics of ½tness-related style. The rate at which organisms age traits, with a particular interest in life histories can, therefore, evolve. By changing the and aging. Currently, she is working on under- rate at which unrepaired damage accu- standing how dietary restriction and mutations mulates with time, certain biological in the insulin or insulin-like growth factor signal- processes are able to influence the rate ing pathway extend life span. of intrinsic decline. It is the activity of these processes that can change during © 2006 by the American Academy of Arts evolution. & Sciences
40 Dædalus Winter 2006 Considering its genetic basis and evo- young. These late-acting, deleterious Of worms, lutionary change, aging has some very mutations can therefore cause aging. mice & men: altering odd characteristics. It is unconditional- In addition, aging can evolve as a side rates of ly deleterious; yet, as far as we know, no effect of earlier success. If a mutation aging genes have evolved to directly cause ac- bene½ts the young, perhaps by making cumulation of damage, lowered fertility, them more fecund, natural selection and death. Earlier ideas that the aging can act in its favor, even at the price of a of individuals could be bene½cial to the higher subsequent rate of aging. Again, species, by removing the old to make death by natural hazards means that way for the young, are now very large- more of the mutation’s bearers will sur- ly discredited. If aging itself is a disad- vive to gain the early bene½ts than to vantage, then it cannot evolve by nat- show the elevated rate of aging. ural selection in its favor and must in- In either case, whether as a side ef- stead evolve as a side effect of some- fect of mutation pressure or of earlier thing else. reproductive bene½ts, the intrinsic rate Several of the intellectual giants of of aging seems to evolve according to theoretical populations genetics and a the level of external hazard. In an en- large amount of empirical research in vironment where external risks mini- the laboratory and the ½eld have pro- mize the likelihood of survival beyond duced quite a clear picture of the two age 10, natural selection will not elimi- routes through which aging can evolve. nate a mutation that causes problems First, it can appear as a side effect of for 11-year-olds from the population. mutation pressure, in a process known However, if the external hazards ame- as mutation accumulation. Sporadic al- liorate so that survival to age 14 becomes terations to the genetic material trans- routine, then natural selection against mitted from one generation to the next the mutation will become stronger. can often cause genetic diseases. Some We therefore expect to ½nd slow-ag- of these diseases, however, become man- ing creatures in less hazardous environ- ifest only as the bearer of the mutation ments. This is roughly what we observe gets older, as in the case of Huntington’s in nature. Species that are well protected disease. The later in life that the muta- such as tortoises and turtles, species that tion’s bad effects appear, the greater can fly such as birds and bats, and mam- the mutation’s chance of reproduction mals that live in trees instead of on the because external hazards such as infec- ground are all capable of longer lives. tions, predators, and accidents will Aging involves change in the organ- cause attrition of the bearers of the mu- ism with time, which has often led peo- tation and not all of them will survive ple to think that it is a process like de- long enough to express its effects. Nat- velopment or growth. Our evolutionary ural selection therefore acts more weak- understanding of aging says otherwise. ly to remove these later-acting muta- Aging evolves in response to extrinsic tions from the population. The balance hazard, with more rapid aging arising between the occurrence of mutations in more dangerous environments, as a and their removal from the population side effect of accumulating more muta- by natural selection is hence shifted; lat- tions that either affect an organism lat- er-acting mutations can achieve a high- er in life or cause more intense early re- er frequency in the population than can production. Aging is therefore not a pro- equivalent mutations that also affect the grammed process like development or
Dædalus Winter 2006 41 Linda growth, with a well-orchestrated hier- cause of various public-health measures Partridge archy of genetic control ensuring that such as improved sanitation and hygiene on aging the right things happen in the right and a great reduction in the impact of place and at the right time to make a infectious diseases. These increases in well-formed organism. The genes that survival have affected all age groups. affect aging did not evolve to control it; Thus not only average life expectancy therefore it is a much more haphazard but also the longevity of the oldest seg- and variable kind of process. In humans, ment of the population has increased. the sorts of damage that accumulate Furthermore, there is no sign that the are very distinct in different parts of the upward swings in survival rates are slow- body, and the rate at which these forms ing down for any age group, which sug- of damage accumulate can vary greatly gests that there is no impending limit to between individuals. People develop dif- maximum human life span. Such a limit ferent problems from each other as they may exist, but at the moment we cannot age, and they die of diverse causes. Be- see what it is. cause aging is such a complex process, it People of all ages are certainly healthi- probably involves a large variety of par- er than they used to be, although the ap- allel processes. Therefore, many rather proaching wave of obesity in the young, than few genes likely influence aging. if unchecked, may counter this trend. Aging’s complexity has long colored But is the improvement in health the re- scienti½c and medical attitudes toward sult of the slowing of the aging process it. Scientists have tended to assume that itself? The ½gures suggest not. If we de- aging is too dif½cult and intractable a ½ne a population’s death rate as deaths trait for experimental analysis. Although per thousand in a year, then this rate in- aging is the major risk factor for multi- creases with chronological age–aging. ple diseases, including major killers such Were aging checked, we would see a de- as cancer, circulatory disease, and neu- cline in this latter rate, say over ten-year rodegeneration, the medical community blocks of time, but we do not. Rather, treats these diseases separately rather survival at all ages has increased, with than as different manifestations of a sin- no evidence of a slow down in the rate gle, underlying aging process. Aging is of aging itself. Human death rates tend seen as inevitable, too complicated to to be somewhat elevated at birth, fall do anything about, and best treated by to a minimum around the age of puber- piecemeal intervention into its undesir- ty, and start to rise steadily thereafter. able manifestations. This pattern has remained unchanged over the one and a half centuries during Tempering pessimism about the pros- which life expectancy has lengthened, pects for intervening in the aging pro- and the rate of increase in death rates cess are the dramatic improvements in after puberty has not declined. Health health during aging that have occurred during aging is better, but the underly- in industrialized human societies world- ing aging process seems to have eluded wide. The rate of aging certainly has a modi½cation. There is good news and genetic and evolutionary basis, but life bad. span can vary depending upon the envi- As a result of longer life expectancy, ronment encountered. Beginning in the industrialized societies face many chal- mid-nineteenth century, survival rates lenges, particularly for health-care sys- have risen steadily, probably mainly be- tems. Although older people are now
42 Dædalus Winter 2006 healthier, health-care demand is steadily like growth factor signaling pathways of Of worms, growing as more people reach the older mammals. mice & men: altering ages at which aging-related health prob- These ½ndings were fascinating. They rates of lems occur. This provides strong motiva- revealed that adult life span could be un- aging tion for the biomedical community to der simple genetic control, and that a undertake scienti½c research that will signaling pathway more familiar for its ameliorate the impact of aging-related effects on the regulation of blood sugar disease and disability. In recent years, and growth in mammals could also af- the discovery that mutations in single fect life span in a lowly invertebrate. genes can greatly lengthen healthy life However, the full implications of these span in experimental animals has galva- ½ndings took some time to become ap- nized research into the mechanisms of parent. For starters, the long life of the aging. This has come as a surprise to mutant adult worms was probably sim- many, and it has opened up new vistas ply a reexpression in the adult of the in our understanding of how healthy life traits that make for long life in dauer lar- span is controlled. vae. If this were true, then the ½ndings would unlikely to be of any relevance to The process of discovering the single mammals, which do not have dauer lar- gene mutations that extend life span vae or their equivalent. Furthermore, it started with a tiny roundworm called was quite unclear how this insulin-like Caenorhabditis elegans. It was in the con- pathway could have any bearing on life text of studies of these worms’ develop- span. ment that the ½rst mutation came to There matters rested for some years light. Before becoming reproductive until an insulin-like signaling pathway adults, the worms can take two differ- came to light in another invertebrate ent developmental routes. If conditions inhabitant of research laboratories, are good, they grow straight through to the fruit fly Drosophila. Again, the ini- adulthood and start reproducing. If, on tial discovery occurred during studies the other hand, the worms are crowded of development rather than of aging. or short of food, they arrest their devel- This insulin-like signaling pathway con- opment and form a dauer larva. Dauer trols growth in the pre-adult period. If larvae stop feeding, store fat, resist var- the activity of the pathway is elevated, ious environmental stresses, and are growth rate and the size of the adult are very long-lived. Because of these char- increased. Conversely, lesions in com- acteristics, they can sit out hard times ponents of the pathway result in dwarf and resume normal development when adult flies. Because of this work, scien- conditions ease. Initially, work on dauer tists were able to make mutations in development produced mutations in several genes that encode components single genes that caused the develop- of the pathway and measure the effect ing worms to form dauers even under on adult life span. Some of these mu- good conditions. Different, weaker mu- tations did indeed increase life span. tations in these same genes, however, The results for Drosophila were also in- made the adult worm long-lived. And teresting, for instance, in showing that one of these mutations turned out to be lesions in the pathway seemed to in- in a gene that encoded a part of a signal- crease life span much more in females ing pathway that was clearly similar in than in males and to impair the fecundi- its evolution to the insulin and insulin- ty of females.
Dædalus Winter 2006 43 Linda But the ½ndings from the fly had vation of the pathway means that we Partridge broader implications. The worm and can use powerful analytical methods on aging the fly are very different kinds of organ- with fewer ethical implications on the isms; they are only distantly related to invertebrates, with all their advantages each other and have diverged over mil- of relatively short life spans (about three lions of years of evolutionary time. If the weeks in the worm and three months genes of the insulin-like pathway could in the fly, as opposed to three years in affect life span in both, then it was dis- the mouse), simplicity, and low main- tinctly possible that the pathway could tenance costs to understand how this control life span in mammals as well. pathway might control mammalian life Some straws in the wind were already span. This has long been the Holy Grail suggesting that insulin-like growth fac- of aging research. But it opens up a ma- tor signaling could play a role in the jor paradox. control of mammalian life span. It was How can a mutation in a single gene known, for instance, that several muta- produce such a large increase in life tions that cause lesions in the develop- span if many genes influence the multi- ment of the pituitary gland and in the ple, parallel processes that control the signaling by the growth hormone pro- rate of aging? duce long-lived dwarf adult mice. Then, in 2003, two key papers implicated both A clue may come from the effects of the insulin-like growth factor signaling diet. Dietary restriction is an environ- pathway and the insulin signaling path- mental intervention that, along with way in the control of life span in the mutations in single genes, has long been mouse. In one, scientists manipulated known to extend life span in laboratory the gene that encodes a receptor on the rodents. Its effects have been conserved surface of cells that responds to signals over evolution; ½rst discovered to ex- from the insulin-like growth factor. tend life span in laboratory rats in 1935, They reduced the number of copies dietary restriction has since been shown of this gene from two copies to one to have a similar effect in organisms as throughout the mouse. The resulting diverse as yeast, worms, flies, and mice female, but not male, mice lived lon- as well as other less intensively studied ger. In the other, scientists removed the species. During dietary restriction the receptor on cell surfaces that reacts to amount of food an animal consumes is insulin from the mice’s fat cells, their reduced dramatically. In rats and mice white adipose tissue. The engineered a reduction to about 50 percent of vol- mice were leaner and longer-lived. untary levels can produce a substantial These results had huge implications. increase in life span. Dietary restriction The insulin or insulin-like growth fac- does not merely reverse the effects of a tor signaling pathway, which is present sedentary existence and overeating. In in all multicellular animals, appears to worms, flies, and mice dietary restric- have conserved one of its functions, the tion also reduces fecundity; female mice control of life span, over the very large subjected to strong dietary restriction evolutionary distances between the in- become completely infertile. vertebrate worm, the fly, and the mouse. This correlation between the longer The pathway is therefore a strong candi- life span that results from dietary restric- date for the control of human life span. tion and lowered fertility has led some Furthermore, the evolutionary conser- to suggest that reduced fertility is an
44 Dædalus Winter 2006 evolved, adaptive mechanism for sitting and other diseases. In the fly, too, sev- Of worms, out hard times. Reproduction is expen- eral lines of evidence, including the mice & men: altering sive in nutrients and can compromise ability to reproduce for longer, suggest rates of the survival of the parents. If food is that dietary restriction helps animals aging scarce, parents cannot produce many remain youthful. For these reasons, it offspring anyway and their offspring’s seems that dietary restriction really likelihood of survival is low. Under these might slow down the aging process circumstances, it may pay for a parent to itself. We might, then, have two inter- lower its reproductive rate and thereby ventions–conserved by evolution– increase its own chance of survival until that can increase life span by slowing the food supply improves. down the aging process. But if aging Numerous species show greater lon- occurs through multiple, parallel path- gevity and reduced fecundity in response ways of accumulation of damage, how to lowered food intake. However, we could dietary restriction slow down all do not know precisely what it is about of them? As for the effects of the insu- lower intake that influences longevity, lin or insulin-like growth factor path- for instance, whether the overall intake way, the evolutionary and mechanistic of energy or particular dietary compo- ½ndings seem to be at variance with each nents are critical. Nor do we fully under- other. stand how the animal senses the change in nutrition and how it uses this infor- We are making steady progress to- mation to change its internal state and ward understanding how lesions in extend its life span. For these reasons, the insulin or insulin-like growth factor it is not yet certain if different animals signaling pathway and dietary restric- achieve these responses to dietary re- tion extend life span. We have already striction in the same way, as we would made some important ½ndings. One expect if the processes at work have is that these interventions do not slow been conserved over large evolutionary down the rate of living; the metabolic distances. Thus, we cannot exclude the rate of these long-lived animals is nor- alternative possibility–that these re- mal. Nor does the reduction in repro- sponses have evolved independently in ductive rate we often see in conjunction different lineages. Still, there is intense with the increase in life span appear to interest in the mechanisms by which di- play any simple direct role. We have also etary restriction lengthens life span in sequenced all the genomes of the worm, laboratory organisms. fly, and mouse, opening up powerful av- Dietary restriction also keeps labora- enues to understanding how genes con- tory rats and mice healthy for longer, trol vital processes. While we have a delaying the impact of aging-related dis- long way to go to this goal, it is becom- ability and disease. Dietary restriction ing clear that when life span is extended, enables animals to remain active and the genes that control processes such as able to reproduce for longer, maintains detoxi½cation and turnover of damaged better immune function, slows down the molecules, resistance to stresses, immu- changes in the musculoskeletal system nity and inflammation, and the meta- that alter body shape as the animal ages, bolic pathways by which nutrients are preserves the structure and function stored and used can all show changes in of the nervous and endocrine systems, expression. Some of these may be irrele- and reduces the frequency of cancers vant to the extension of life span; only
Dædalus Winter 2006 45 Linda experimental work will eventually reveal living in high temperatures are perma- Partridge which are the critical changes, where in nently elevated above those of flies with on aging the organism they occur, and how exact- a history of life in a cooler environment; ly they lead to increased survival. and the longer that they have stayed in The discovery of interventions–be the warmer conditions the higher their they diet or single gene mutations–that death rates. These ½ndings demonstrate have the potential to improve health that, in flies, warmer temperatures in- during aging is a massive step forward. duce more irreversible damage that The current intense interest in their leads to death; in other words, they ele- mode of action will undoubtedly con- vate the rate of aging. tinue amidst high hopes that the results This kind of experimental approach, will translate into medical practice. But where animals are switched between do these interventions really slow aging, regimes partway through adult life, has or could they be prolonging life in some revealed some surprising ½ndings about other way? dietary restriction in flies. When flies that have been on a normal diet are sub- Since aging is the accumulation of un- jected to dietary restriction, they adopt repaired, irreversible damage, we would within forty-eight hours the lower death expect an organism that has aged more rates of flies that have been on restricted slowly to have less cumulative damage. diets. Similarly, when flies that have Flies that have lived at different temper- been on restricted diets are fully fed for atures demonstrate this phenomenon. the ½rst time, they show within forty- Flies–reared to adulthood at a single eight hours the elevated death rates intermediate temperature and then kept characteristic of flies that have been on at different temperatures as adults– normal diets throughout adulthood. It live longer the lower the temperature does not seem to matter how late in life at which they are kept. Flies are much they switch; after a short lag their life too small to regulate their own body spans show no memory of nutritional temperature and immediately adopt history, and the death rates of flies that the temperature of the environment have switched diets converge with those in which they live. Lower temperatures of the flies that have been kept perma- slow down the rates of all chemical pro- nently in that nutritional regime. At cesses, including, presumably, those least in flies, then, dietary restriction leading to death. does not slow down aging. Rather, die- Low temperatures extend the life span tary restriction somehow acts acutely to of flies by slowing down the rate of ag- make the flies less likely to die from the ing. If flies that have been in the cold damage that they have accumulated. for varying lengths of time are moved We do not know if dietary restriction to higher temperatures, their death rates has similarly acute effects on death rate are lower than those of flies that have in mammals because we have not carried been previously kept at the higher tem- out the appropriate experiments yet. If peratures. Also, the degree of protection the effects were acute, then we would that they enjoy is greater the longer that expect the switch in death rates after a they are left in the cold before being change in nutritional regimes to take transferred to the warmer environ- longer in mammals than in flies, per- ment. Similarly, the death rates of flies haps on the order of some weeks. At switched to a cooler environment after ½rst sight, the idea that dietary restric-
46 Dædalus Winter 2006 tion acts acutely to reduce death rates affected. Perhaps the pervasive effects of Of worms, seems incompatible with the ½nding altered temperature for ectothermic ani- mice & men: altering that it also delays the impact of aging- mals and the slow, cumulative effects of rates of related disability and disease. However, evolution really are the only means by aging these two ½ndings can be reconciled. which the rate of aging can be altered. Dietary restriction could act acutely to The fact that we may not yet be able lower the likelihood that aging-related to alter its rate in humans is disappoint- damage will lead to the appearance of a ing. But the discovery that there are in- lethal, aging-related pathology. The lag terventions that can act acutely to delay period during which death rates switch the impact of multiple forms of aging over to those characteristic of the new and pathology is in some ways even bet- nutritional regime would then represent ter. For those with unhealthy habits, it the period during which individuals that may mean it is never too late to adopt a have acquired a lethal pathology are lost lower-risk lifestyle. from the high-risk population, with a switch to dietary restriction, or gained by it, in a switch to full feeding. We have not yet determined, even in flies, if the reduced activity of the insu- lin or insulin-like growth factor signal- ing pathway extends life span by slow- ing the rate of aging or through an acute effect. Answering that question will re- quire an experiment switching the ac- tivity of the pathway partway through adulthood, which is now coming within the realms of technical feasibility. These are important questions for the future. The acute effects of dietary restriction in the fly have unexpectedly revealed the existence of a type of intrinsic risk factor whose mechanistic basis requires elucidation. If similar acutely acting in- terventions exist for humans, we could eliminate the adverse long-term conse- quences of some risky habits.
So far, we have not proven that die- tary restriction or single gene mutations extend life span by reducing the rate of accumulation of aging-related damage in any organism. The information that we have about their effects is compatible with the alternative possibility that they increase life span by making animals less likely to die of damage already accumu- lated, leaving the rate of aging itself un-
Dædalus Winter 2006 47 Hillard Kaplan
The life course of a skill-intensive foraging species
The study of model organisms, such leave historical, archaeological, and pa- as flies and worms, is becoming an in- leontological records; and we can report creasingly important tool in aging re- on the phenomena that are relevant to search. They are ideal for experiments the aging process. We certainly know that manipulate rates of aging because much more about aging in humans than they are small, do not live long, repro- we do about aging in any other mammal, duce rapidly, and have relatively uncom- with the possible exception of laborato- plicated genomes. To the extent that ry rats and mice. many of the basic processes governing In fact, the study of human aging and aging are similar across a wide range of its evolution is especially promising to- organisms, we can learn much about hu- day. It is revealing clues not only to our man aging through the study of simpler evolutionary history, but also to the creatures. forces shaping life span evolution among But in other ways, human beings living creatures in general. themselves are also model organisms. More speci½cally, research with the We live and have lived in a diverse array few remaining people that still practice of environments; we can know our ages a traditional hunting and gathering life- without observing our own births; we style is providing critical information about the life histories of our ancestors Hillard Kaplan is professor of anthropology at and the selection pressures that acted the University of New Mexico. Best known for on them. Humans lived as hunter-gath- his applications of evolutionary biology to demo- erers for the vast majority of their evolu- graphic processes, Kaplan is currently directing tionary history (the genus Homo has ex- ½eld research in lowland Bolivia with Tsimane isted for about 2 million years). Modern Native South Americans. He has coauthored ar- hunter-gatherers, who are affected by ticles that have appeared in publications such as global socioeconomic forces, are not liv- the “Proceedings of the National Academy of ing replicas of our stone age past. Yet, Sciences,” “Population and Development Re- in spite of their variable historical, eco- view,” the “American Economic Review,” and logical, and political conditions, forag- the “American Journal of Human Biology.” ing peoples exhibit remarkable similari- ties, especially in the realms of develop- © 2006 by the American Academy of Arts ment and aging, suggesting that in our & Sciences species natural selection has produced a
48 Dædalus Winter 2006 characteristic life history. This life histo- hood, compared to 35 percent of chim- The life ry is quite distinct from that of our clos- panzees. Chimpanzees also have a much course of a skill- est living primate relatives. shorter adult life span than humans. At intensive the age when they ½rst reproduce, chim- foraging When we compare humans to oth- panzees live, on average, an additional species er living beings, our brains and our at- ½fteen years, compared to thirty-eight tendant mental abilities stand out. The more years among human foragers. Im- human brain, which weighs about three portantly, women spend more than a pounds, is about three times as large as third of their adult life in a postrepro- that of a chimpanzee, our closest living ductive phase, whereas very few female relative and arguably one of the most chimpanzees even reach a postreproduc- intelligent nonhuman species. Any at- tive phase. Overall, fewer than 10 per- tempt to account for our unique evolu- cent of chimpanzees last to age 40, but tionary path will also have to explain more than 15 percent of hunter-gatherers why human brains became so large and make it to age 70. In this sense, a human why we became such good learners. year is equal to about two ‘chimpanzee In addition to our large brain size, years.’ humans are also distinctive because Chimpanzees also age faster, display- of our very long lives. As children, we ing signs of aging in their thirties that learn that a human year is equal to sev- humans show in their sixties. In con- en ‘doggy’ years, a recognition that our trast, elderly people in foraging societies pets live shorter lives and age faster than are surprisingly vigorous, as I learned we do. After their ½rst decade of life, our during my ½rst few days living with Ache dogs show signs of aging–hearing and hunter-gatherers in Paraguay. As a young vision loss, arthritis, incontinence, and single male, I shared a ½re with ‘Grand- increased likelihood of cancerous tu- father Jaguar,’ who was about 70 at the mors. time. While he had outlived his prime Comparing the life span of people liv- hunting days, he still chased small game ing in remote societies without Western and dug six-foot holes with a stick to medicine and that of wild chimpanzees capture armadillos, who were them- and gorillas is particularly revealing. selves digging as fast as possible to es- Among chimpanzees, the risk of dying cape him. He was also a font of wisdom, is high during infancy, decreasing rapid- advising younger hunters and introduc- ly after infancy to its lowest point (about ing me to culinary delicacies like large 3 percent per year) at about age 13, the rodent feces cooked with fat and hearts age of ½rst reproduction for females– of palm. and increasing sharply thereafter. In Delayed aging and long adult life spans contrast, mortality among people still appear to be evolved characteristics of living as hunter-gatherers drops to a our species. Adult mortality risks are re- much lower point (about 0.5 percent markably uniform across human soci- per year) and remains low without any eties, even in those without access to increase between about 15 and 40 years Western medicine. Although the ances- of age. Mortality rates then rise slowly, tors of the aboriginal peoples of South with a very rapid jump in the sixties and America, Africa, and New Guinea went seventies. their separate ways more than ten thou- As a result, about 60 percent of hun- sand years ago, the risk of dying at each ter-gatherer children survive to adult- age is very similar from society to socie-
Dædalus Winter 2006 49 Hillard ty, and not that different from historical Brains evolving by natural selection Kaplan Europe’s prior to modern medicine. must provide bene½ts that pay for their on aging costs. If the average cost of the brain How do we explain our large brains outweighed the bene½ts it provided, and long lives? For more than a half- individuals with smaller brains would century, we have known that larger leave more descendants than the larger brains are associated with longer life brained members of their population, spans among mammals in general. and the average brain size of the popu- But for humans in particular, we must lation would shrink. examine our primate ancestors to un- Since learning transforms present derstand the evolution of our larger experiences into better future perform- brains and longer lives. As the primate ance, we can see brain development– order evolved and different species ra- especially of the cerebral cortex, which diated across the world’s warmer areas, expanded disproportionately during pri- there was a series of four grade shifts mate evolution–as an investment in the that increased ‘encephalization’–brain future. During primate evolution, brain size relative to body size–and slowed size appeared to increase as the learning life histories. required by the feeding niche grew more The ½rst grade shift began about 60 intense. The monkey radiation, for ex- million years ago with the evolution of ample, involved a shift from the prosim- prosimians, who probably lived longer ians’ smell- and hearing-based insect because living in trees afforded them eating to a reorganized sensory system more safety. The second grade shift with binocular, color vision able to ½nd came about 35 million years ago with many different plant foods, all captured the evolution of the monkey lineage. It by dexterous hands and manipulated involved a huge increase in both brain through hand-eye coordination. Because size and life span. The development of monitoring and exploiting the fruits and the ape lineage–represented today by leaves of different trees demanded more chimpanzees, gorillas, and orangutans learning, brain size, accordingly, had to –was the third major grade shift in pri- evolve. mate brain size and longevity. Apes can During the third shift, apes adopted a live almost twice as long as most mon- diet that emphasized ripe fruits, which keys and have much bigger brains, even requires even more environmental mon- after adjusting for their larger body size. itoring and more complex, extractive The fourth grade shift occurred with the foraging techniques. These higher pre- divergence of the hominid line, partic- requisites for learning explain why ularly the evolution of genus Homo and apes take longer than monkeys to be- its extreme manifestation in modern hu- come competent foragers. For example, mans. even though chimpanzees can provide This coevolution of brains and life most of their own caloric needs by age spans makes sense when one considers 5, those under age 7 are unable to utilize that natural selection depends on both and make tools for termite ½shing, and costs and bene½ts. Brains are very cost- therefore still rely on their mothers for ly: in the extreme case, humans expend protein, even after weaning. Orangutans about 65 percent of all resting energy in also depend on their mothers for about supporting the maintenance and growth seven years. Today, as conservation- of the brain during the ½rst year of life. minded scientists attempt to reintroduce
50 Dædalus Winter 2006 captive-born orangutans into the forest, Comparative data on digestive anato- The life they are discovering how much learning my con½rm that these contemporary dif- course of a skill- must take place before these creatures ferences reflect long-term adaptations. intensive are able to survive on their own. Gorillas and chimpanzees have a very foraging long large intestine and caecum, which species During their evolutionary history, promote the bacterial fermentation nec- humans took the learning-intensive essary for the conversion of plant cellu- diet to an extreme. Mounting evidence lose in leaves and other structural plant from various sources, including diges- parts into a source of dietary protein. tive anatomy, digestive biochemistry, Humans, on the other hand, have very bone isotope ratios, archaeology, and short large intestines, incapable of pro- observations of hunter-gatherers, cessing cellulose in large quantities, and shows that humans are specialized in very long small intestines, geared toward the consumption of calorie-dense, low- digesting fat. Although the data are still ½ber foods that are rich in protein and relatively scarce, this dietary shift appar- fat. Although there is considerable var- ently began with the origin of the genus iation across societies depending on Homo about 2 million years ago, about their ecology, modern foragers all differ the time the hominid brain expanded considerably in diet from chimpanzees. beyond that of apes. The majority of forager diets is meat, Because of the learning-intensive na- accounting for about 60 percent of their ture of their feeding niche, humans take calories. In contrast, chimpanzees ob- even longer than apes to become compe- tain only about 2 percent of their food tent foragers. Whereas chimpanzees can energy from hunted foods. meet most of their caloric needs by age Resources such as insects, roots, nuts, 5, humans produce fewer calories than seeds, and dif½cult-to-extract plant parts they consume for close to twenty years! such as palm ½ber or growing shoots In fact, the total calories that human comprise the next most important food parents must provide for their offspring category for foragers. These resources increases from birth to about age 14, as tend to be embedded in a protective children grow but remain unproductive. context, such as underground or in hard A Machiguenga man in Amazonian Pe- shells. Such ‘extracted’ foods make up ru once complained that his two older about 30 percent of the forager diet as boys, 12 and 14, ate faster than he could opposed to 3 percent of the chimpanzee bring food in, requiring him to hunt diet. more than ever before. In contrast to hunted and extracted Yet however burdensome childrear- resources, which are dif½cult to acquire, ing may sometimes seem to parents, collected foods such as fruits, leaves, this long period of dependence pays off flowers, and other easily accessible plant in the long run. Human adults are much parts form, on average, 95 percent of the more productive than chimpanzees. Net chimpanzee diet but only 8 percent of production (the surplus after one’s own the human forager diet. The data suggest food consumption is taken into account) that humans specialize in rarer but more climaxes at about 1,750 calories per day nutrient-dense resource packages–such for human adults, compared to 250 for as meat, roots, or nuts–whereas chim- adult female chimpanzees. However, hu- panzees specialize in easily attainable mans generally do not reach that level but less nutritionally dense plant parts. of productivity until about age 45. Fe-
Dædalus Winter 2006 51 Hillard male Hiwi foragers from Venezuela, for strategies. The skill and cleverness with Kaplan example, do not reach their peak rate which hunter-gatherers capture and pre- on aging of root acquisition until their late thir- pare food may help explain why brains ties; meanwhile, 10-year-old girls only and longevity evolve together. Feeding attain 15 percent of the adult maximum. niches that demand high levels of learn- Changes in hunting yields with age ing and information processing should demonstrate the skill- and learning- not only select for bigger brains, but also intensive nature of human hunting as for increased longevity because the brain well. For instance, the amount of meat costs a lot early in life, providing bene½ts Ache men obtain per hour spent hunt- only later in life. To illustrate the impor- ing does not peak until the mid-thirties. tance of longevity to a learning-intensive Ten-year-old boys only obtain about 1 feeding niche, consider what would hap- percent as much as the adult maximum, pen if a human forager group suffered and even full-grown 20-year-olds only the same mortality rates that chimpan- acquire 25 percent of the adult maxi- zees do. Less than 10 percent of chim- mum. panzees live to the age at which human Between 20 and 40, human hunters productivity peaks. Humans depend on go through the equivalent of graduate their parents for a long time, creating a school and a period of on-the-job train- large calorie de½cit that they only grad- ing. This is because humans, unlike oth- ually pay back during their highly pro- er predators, rely more on knowledge ductive middle adulthood years. With a than on physical prowess. For example, chimpanzee life span, a human forager Ache men know that the paca, the large group would go into calorie de½cit and rodent whose feces Grandfather Jaguar become extinct. so adeptly prepared, lives in burrows with a main entrance and up to seven Several other distinctive features of hidden escape hatches. When jaguars human history also make sense in light attempt to dig a paca out, it can run of this dietary niche. Physical growth away unscathed through one of its al- in humans differs from growth in chim- ternative exits. But rarely does it fool panzees and gorillas. At ½rst, it is faster: an Ache hunter, who calls the other human newborns weigh about seven hunters to the hole while quietly and pounds, whereas newborn gorillas and systematically searching for each escape chimpanzees weigh about four to ½ve route. When the other hunters arrive, pounds. Moreover, human newborns a younger, less-skilled hunter is given are much fatter, having almost four the task of ramming a large log into the times the fat that mammals of compa- main entrance. Simultaneously, each of rable weight have. The difference in the remaining hunters dives on top of the rates of brain growth may well be his respective escape hatch while his responsible for this difference in neona- hands form a noose–allowing the flee- tal body size. At birth, a human’s brain ing paca’s head through his open hands is about the same size as an adult chim- only to grab its throat and suffocate it. panzee’s–huge considering that an Typically, human hunters do not even adult chimpanzee weighs ½fteen times specialize in a single species but regular- more than a human newborn. Humans ly exploit more than a dozen different are probably born with relatively bigger kinds of prey, each with its own feeding bodies than other primates and more habits, grouping patterns, and escape stored energy in the form of fat in order
52 Dædalus Winter 2006 to support the brain’s rapid postnatal while they hunt, human hunter-gather- The life growth. ers carry their babies with them from course of a skill- Following infancy and early child- place to place–as do all primate moth- intensive hood, humans grow more slowly than ers. This makes hunting a very risky foraging chimpanzees. In fact, growth is almost activity for women with babies–and species arrested for human children during mid- without contraception, women spend dle and late childhood. By age 10, chim- most of their adult lives prior to meno- panzees have caught up to and surpassed pause either pregnant or lactating. Also, human children in body size. Perhaps since traditional human hunting is so human growth in middle childhood is learning intensive, it only pays to hunt slow because children do very little work if one spends many years doing so. If and therefore do not need large bodies. women were to hunt only when they Instead, they learn through observation were not pregnant or nursing, they and play. It is only in adolescence, when would get less food from hunting than their brains are almost ready for large from gathering because of their lack of bodies, that humans undergo growth experience. spurts and achieve their adult body sizes. Males probably became providers when hunted foods became an impor- The flows of food and other services– tant part of human diets. The protein both within and among families–that and fat from meat along with the car- support this long period of dependen- bohydrates obtained from plant foods cy is also particular to humans. Unlike created a balanced diet. Although the our ape relatives who give females the proportion of food provided by men entire burden of feeding and caring for and women varies across hunter-gather- infants, humans engage in a sexual divi- er societies, men acquire, on average, sion of labor, a practice that appears to about twice as many calories and seven have ancient roots. Although the details times as much protein as women. After vary from society to society, all existing taking into account their own consump- hunter-gatherers and peoples who de- tion, women supply only 3 percent of the pend on a mix of foraging and farming calories to offspring while men provide worldwide cooperate in raising children. the remaining 97 percent. Typically, men focus on hunting but do This assistance from men enables wo- some gathering as well, while women men to focus their energy on providing participate in a mix of activities such as high quality childcare, resulting in al- gathering, food preparation, and child- most double the survival rate for human care. children than for chimpanzees. In addi- Why is a division of labor so funda- tion to behavior, women’s physiology is mental to the human way of life? Af- consistent with an evolutionary history ter all, women are physically capable of extensive male parental investment. of being adept hunters and sometimes Unlike other primates, human females do so when it is necessary. In one fami- lower their metabolic rates during preg- ly of forager-farmers in Amazonian Pe- nancy and store fat, the result of receiv- ru, for example, the eldest daughters ing provisions. Human female foragers hunted with their father in order to feed also tend to work less during lactation the family because the only son was the unlike female primates who heighten youngest child. But unlike other preda- mortality risk by working more during tors, who often hide their young in a den lactation.
Dædalus Winter 2006 53 Hillard This extensive cooperation between some whales, are rare in ceasing to re- Kaplan human men and women would only produce with many years of life remain- on aging make evolutionary sense if the repro- ing. ductive performance of spouses were Some have suggested that menopause linked. Even though divorce is common evolved because women would leave in many hunter-gatherer societies, mar- more genetic descendants by helping as riages stabilize once children are born. a grandmother than by continuing to re- The long period of dependence on par- produce. As women age, the reasoning ents means that at any one time, most goes, their pregnancies are less likely to parents are raising several dependent succeed and they are more likely to die offspring of different ages. This puts in childbirth. Indeed, among foragers, pressure on couples to stay together. there are no ‘golden’ retirement years; In each of the ½ve small-scale societies both grandmothers and grandfathers where I have lived and worked, men spend signi½cant time helping to raise and women reported that stepparents children. Although older people switch are often less motivated to take care of to less physically demanding and more stepchildren. And those who divorce knowledge-intensive activities as they and remarry while raising children fre- age, they still work very hard until death. quently argue with new spouses over the Still, an elderly person in a foraging division of resources among their joint society generally has a very short inter- children. Avoiding those conflicts is an val between the time that he or she is additional incentive for a couple to stay ½rst unable to contribute and death. together and have all or most of their Stories like the one two brothers in children together. Peru told me are not uncommon: When asked how their mother died, they said Although men are physiologically ca- she had been very old and beginning to pable of reproducing throughout their falter. One day while collecting bark in lives, most men appear to undergo ‘be- the forest, she collapsed at the foot of havioral menopause.’ Among Ache hun- the tree. When she did not return, the ter-gatherers, for example, if a couple brothers searched for her and found her had at least two children together, the almost unconscious. They ended her woman’s last birth was the same as her misery with one quick blow. Although husband’s last child in 90 percent of they hated putting her to death, they cases. Grandfather Jaguar had his last expressed no remorse and agreed she child more than two decades before he would not have wanted to live any lon- died. ger. Likewise, in lowland Bolivia only From a biological perspective, meno- several months ago, an elderly man pause, whether physiological or behav- bled to death after falling logs crushed ioral, seems like an odd phenomenon. his leg. His nephew, in recounting the Most organs–such as the heart, lungs, story, mentioned in passing that it was liver, and brain–tend to age at roughly probably better that he died, since he the same rate. This makes sense, since would not have been able to work with only whole organisms reproduce and all a damaged leg. organs are necessary for survival. Chim- While grandparents undoubtedly play panzees and other primates can experi- an important role in traditional soci- ence menopause, but in the wild almost eties, this doesn’t seem to account for all die before this age. Humans, and menopause. Jocelyn Peccei points out
54 Dædalus Winter 2006 parenting duties alone could explain adulthood, and old age. Fetal develop- The life the two decades women survive after ment and infancy–the ½rst stage–is course of a skill- their last birth, since it will take their distinctive in its commitment to brain intensive last child that long to become fully eco- growth, supported by large fat reserves foraging nomically independent. In addition, in both baby and mother. By age 5, in- species attempts to measure the bene½cial ef- fants have completed most of their fects of aging people on the survival and brain growth and language learning, reproduction of children and grandchil- giving them the tools necessary for a dren have shown that they are not great lifetime of learning. The second stage, enough to offset the costs of not having childhood, is characterized by very slow more children. physical growth, a large allocation of Overall, the aging of the human repro- energy to building the immune system, ductive system remains a mystery. For several important phases of cognitive example, why do females lose more eggs development facilitated by play and oth- before rather than after puberty? In a er forms of practice, very low productivi- process called atresia, eggs in the ovary ty, and very low mortality. Complete re- ‘die’ at a relatively constant rate (with a liance on family, which reduces exposure brief acceleration in death rates just be- to mortality hazards and allows time for fore menopause) until menopause when learning, is another unique feature of none are left. Perhaps atresia helps select human childhood. The slow physical among eggs so that only the most viable growth of children eases the burden for are fertilized; a slower rate of cell death families; faster growth would only raise might lead to poorer embryo quality the cost of rearing children until they and wasted investment in less viable off- are ready to provide food for themselves. spring. Given the intense and prolonged The third stage, adolescence, follows. investment that humans make in chil- During this period, the brain and the dren, selection may have favored more rest of the body become ready for adult quality control in our species. productivity: the body grows rapidly to Even though many mysteries are not adult size, the reproductive system ma- yet solved, it is clear the human life tures, and the ½nal phases of cognitive course is an integrated adaptation to development occur. a specialized niche. Human digestive ‘On the job training’ distinguishes the physiology and anatomy, nutritional bio- fourth stage, from early adulthood to chemistry, brain growth and cognitive prime adulthood in the mid- to late thir- development, the timetable of physical ties. Productivity increases signi½cantly growth, productivity throughout the life during this period, while mortality rates cycle, parental and grandparental invest- remain low and virtually constant. Men ment, reproduction, and ultimately, the and women cooperate in a division of life span are coadapted to a learning- labor to raise children. Middle age, the intensive feeding niche. It is this adap- ½fth stage, is a period of simultaneous tive complex that has allowed people to parenthood and grandparenthood. De- colonize all the world’s environments. pendency loads on parents peak around age 40 and gradually diminish over the The human life course is highly struc- next twenty years, as does productivity. tured, consisting of at least six stages: The sixth stage, ‘old age,’ commences the fetal and infant period, childhood, around 60. During this seventh decade adolescence, early adulthood, middle of life, physical deterioration proceeds
Dædalus Winter 2006 55 Hillard rapidly and brain aging becomes evi- Such risks may be important determi- Kaplan dent, followed by a dramatic increase nants of the aging process, but the hu- on aging in mortality rates. Parenting is ½nished, man story also directs us to think about and both work effort and productivity the value of living to older ages and why decrease. Nevertheless, older adults that should vary from one organism to attempt to be as productive as possible, another. In the human case, it appears allocating more time to skill-intensive that the value of slowed aging is related but less energy-intensive activities. to the investment in learning and the If this set of stages characterizes the shift in productivity as one ages. average life course of human beings for The value of living to older ages may the last one hundred thousand to two help explain the ½ve-thousand-fold var- hundred thousand years, it is likely se- iation in the life spans of insects, from lection shaped the processes of mainte- mere days to more than a decade. All nance and repair from the intracellular the longest-lived insects are queens in level to the whole-organism level to social colonies, in species as diverse as achieve a life span that would include ants, bees, and termites. These social all six stages. It may be that the sixth insects make a large investment in their stage–old age–is actually an artifact physical plant–building tunnels, stor- of selection to maintain the body and age rooms, reproductive chambers, mind in good condition through the and defensive structures. It takes time ½rst ½ve stages of life. The sixth stage to build such a plant and to grow a large could thus result from the impossibility workforce, but once it is completed, a of nature designing a body that collapses large colony can be extremely produc- the moment the aged person is no longer tive. This may be why insect queens highly functional. Another possibility is can sometimes live over a decade. Oth- that the sixth stage has been positively er factors may also affect the value of selected for because of the ½tness ben- long life. e½ts produced during old age. Besides helping us to understand the This detailed understanding of our life present, we can also use our evolution- course sheds light on how evolution has ary past to look to our future. When shaped the life spans of other organisms. compared to other species, human life The majority of long-lived organisms do histories have a characteristic pattern, not have large brains and a learning in- yet they also vary systematically with tensive feeding niche. For the most part, the environment. Perhaps the most dra- evolutionary biologists have focused on matic example is the pattern of changes ‘extrinsic’ mortality risks to explain lon- accompanying modernization–a pat- gevity: some types of organisms face tern often referred to as the secular trend. higher risks of dying from predation, Improved nutrition and decreased dis- disease, and accidents. When the risk ease loads have systematic effects on of dying from these extrinsic causes is human developmental physiology: high, it does not pay to repair the body physical growth is more rapid and matu- and slow down aging. Steven Austad, for ration begins earlier, resulting in greater example, has proposed that primates live stature and body weight and earlier pu- longer than comparably sized mammals berty in girls. This change probably re- because living in trees make them less flects adaptive flexibility in growth and vulnerable to predation. maturation that evolved in response to
56 Dædalus Winter 2006 variation in food supply and disease as- tions of genes and gene products, re- The life sault rates during human evolutionary sulting in large-scale life span increases. course of dna a skill- history. Greater understanding of cell and intensive Slower aging may also be a response repair mechanisms that have evolved foraging to better nutrition and a lower burden by natural selection may also play an species of infectious disease. On the other hand, important role in lengthening life. If heart disease, diabetes, and cancer be- the difference in rates of aging between cause of excess fat and lack of exercise humans and our ape relatives is any are more prevalent than ever–and pos- guide, another leap in life span could sibly also the result of evolved responses. well be possible in our near future. Past activity regimes and the variability in food supply may have selected for hu- man appetites and nutritional biochem- istry designed to store fat and increase blood lipid levels when food is abun- dant. Those very adaptations, however, reduce the life span in the context of modern activity regimes and virtually unlimited food access. Behavior also responds to moderni- zation. With more education comes increases in longevity, though more schooling lowers earnings early in adult- hood. Just as in the learning-intensive foraging niche, though, earnings then rise later in adulthood. It is not known why higher levels of education, on aver- age, correlate to longer life, but the ef- fect is rather strong. The large educa- tional gradient in longevity throughout evolutionary history may be partly re- sponsible for this effect. Or, it may be due partially to a lifestyle change that is consciously or unconsciously concerned with living longer. Whether we are now reaching the up- per limit of our flexibility in the life span is the subject of an ongoing and lively scienti½c debate. With respect to stature, and perhaps age of menarche, the data suggest we may be nearing the limit. But there appears to be more scope for varia- tion in the life span, given investments in medical technology designed to re- duce disease and the effects of aging. And better knowledge of the human genome is likely to lead to manipula-
Dædalus Winter 2006 57 Dennis J. Selkoe
The aging mind: deciphering Alzheimer’s disease & its antecedents
Last scene of all, that ends this strange memory, reasoning, judgment, abstrac- eventful history, tion, and language. In the popular mind, Is second childishness, and mere and even among scientists and philoso- oblivion . . . phers, the idea that great age inevitably brought about an inability to think clear- –Shakespeare, As You Like It ly was widely accepted. But intensive re- search into the pathology and biochem- istry of the aging brain during the last efore the last century, only a small B few decades has revealed that speci½c portion of the human population sur- diseases cause major impairment of cog- vived into the eighth decade of life. nition late in life and that the process Those few individuals who successful- of aging per se results only in relatively ly avoided the myriad causes of adult subtle changes in certain mental func- mortality–principally, infectious dis- tions. eases, trauma, and cardiovascular fail- This reinterpretation of the nature of ure–were expected to face a steady at- the aging mind has profound implica- trition of their most human qualities: tions on both the personal and societal levels. In contrast to the assumption in- Dennis J. Selkoe is Vincent and Stella Coates Pro- herent in Jacques’ soliloquy, the passing fessor of Neurologic Diseases at Harvard Medi- of time does not by itself destroy our cal School and the Brigham and Women’s Hos- ability to think cogently. Rather, certain pital. He cofounded and serves as cochair of the diseases that devastate those areas of the Harvard Center for Neurodegeneration and Re- brain serving memory and cognition be- pair. Selkoe was the principal founding scientist come increasingly prevalent after age 70 of Athena Neurosciences, now Elan Pharmaceu- or so. For example, the two major causes ticals. Widely published in the ½eld of Alzheimer’s of late-life dementia in most developed disease research, Selkoe has received numerous nations, Alzheimer’s disease and multi- honors, including the Dr. A. H. Heineken Prize ple small strokes (multi-infarct demen- for Medicine from the Royal Netherlands Acade- tia), afflict just a few individuals in their my of Arts and Sciences and the Potamkin Prize forties or ½fties, but the numbers rise from the American Academy of Neurology. very substantially in the mid-sixties and beyond. © 2006 by the American Academy of Arts In this sense, aging, the passage of & Sciences time, does contribute to the develop-
58 Dædalus Winter 2006 ment of dementing diseases in at least yond eighty years and the accompany- Deciphering two broad ways. First, over time, the ing social and economic stresses demand Alzheimer’s disease & its brain accrues molecular and cellular that the scienti½c community focus far antecedents defects in neurons and glia, which re- more attention on the determinants of duce its physiological reserve, just as successful aging and the prevention of occurs in muscle cells with age. This age-linked disease–particularly in the process makes the brain more suscep- brain, which helps regulate non-neural tible to loss of function if and when a organ function. neurological disease is imposed. Second, Based on personal observation, many some of the speci½c diseases that cause people have come to realize that the ag- dementia require great time to produce ing process does not usually wreak hav- enough brain abnormalities, or lesions, oc on the mind. But as recently as thirty to compromise function. For instance, years ago, gerontologists and neurosci- in Alzheimer’s disease and certain oth- entists were not at all sure of this conclu- er dementias, a lot of time is needed to sion and continued to catalog a complex reach a critical tissue concentration of array of relatively minor de½cits in the particular proteins that allows for their numbers and biochemical properties polymerization into potentially toxic of brain cells in aged mammals, includ- forms. In short, the process of brain ag- ing humans. Understandably, scientists ing can contribute to the development focused mostly upon the health of neu- of a clinically noticeable dementing ill- rons, the excitable cells in the brain that ness, but aging by itself appears to be in- convey signals through electrochemical suf½cient to cause the illness. impulses–for example, a response to light impinging upon the photoreceptor Life expectancy at birth in the United cells of the retina or to sound waves vi- States and in many other developed na- brating the hair cells of the inner ear. tions has risen from roughly ½fty years Because the long cytoplasmic exten- in 1900 to more than seventy-½ve years sions of neurons, the axons and den- in 2000, an unprecedented 50 percent drites, pass information from one place increase in just one century. This sud- to another in the brain, age-related de- den jump in average longevity is the fects in the innumerable molecules that result of major improvements in public allow them to do so could lead to cogni- health, intensive biomedical research, tive failure. Indeed, scientists have docu- and subsequent pharmacological, surg- mented a host of quantitative and quali- ical, and lifestyle interventions. It is by tative changes in neuronal receptors, en- no means assured that life expectancy zymes (specialized proteins that catalyze will continue to rise in the coming cen- chemical reactions), structural proteins, tury, with the threat of highly resistant and lipids in the brains of aged rodents, infectious diseases and an emerging ep- lower primates, and humans. idemic of obesity and associated meta- But when one counts the actual num- bolic disease.1 Nevertheless, the sheer bers of surviving neurons in aged versus number of humans now surviving be- middle-aged or young brains, most brain regions show very little or no signi½cant neuronal attrition. This recent realiza- 1 S. J. Olshansky et al., “A Potential Decline in Life Expectancy in the United States in the 21st tion flies in the face of the long-held as- Century,” New England Journal of Medicine 352 sumption that neurons steadily die out (2005): 1138–1145. during the life span, a conclusion based
Dædalus Winter 2006 59 Dennis J. on what we now recognize as technically substantially, the brains of older mam- Selkoe flawed cell-counting methods. For ex- mals reveal a remarkable array of cellu- on aging ample, the number of pyramidal neu- lar and molecular alterations. There are rons in certain areas of the hippocam- defects in nuclear and mitochondrial pus, a seahorse-shaped brain region crit- dna; in many different proteins, partic- ical for memory, does not decline appre- ularly enzymes; and in the lipids of the ciably in older humans. membranes enveloping cells and inter- On the other hand, the number of nal organelles. What bearing do these neurons in the substantia nigra–a small diverse molecular changes have on the cluster of neurons in the brain stem that mind? secrete the neurotransmitter dopamine For most of us, the answer is very lit- –does decline steadily with age, perhaps tle. In aged people without Alzheimer’s because these cells produce the pigment disease and other mind-threatening ill- neuromelanin as a by-product of their nesses, the clinical effects of biochemi- dopamine metabolism, a process that cal and anatomical alterations seem to results in the excessive oxidation of pro- be modest. In many studies reporting teins and lipids. The age-related dys- age-related neurochemical de½cits– function and loss of substantia nigra neu- such as a reduction in a particular en- rons likely contributes to the decreased zyme or in certain proteins or rna mol- speed and fluidity of movement and ecules–the levels or functional activities somewhat stooped, shuffling gait that in elderly adults have ranged from 5 to very old people often display. This ½nd- 30 percent below those in young adults. ing provides an example of the relation- And though a 30 percent loss might ship of the aging process in the brain to seem quite high, such gradual declines diseases of the elderly. Age-associated over several decades often have little nigral cell loss, which may normally measurable effect on thinking. Indeed, amount to 30 to 50 percent or so of these positron emission tomographic (pet) neurons, is not suf½cient to induce the scans and functional magnetic reso- clinical syndrome of Parkinson’s dis- nance imaging (fmri) scans show that ease. However, this level of attrition may the brains of healthy people in their reduce the physiological reserve enough eighties are almost as active metaboli- so that a superimposed insult, e.g., the cally as those of people in their forties. presence of an inherited mutation in a In some brain regions such as parts of speci½c gene or prolonged exposure to the frontal cortex, healthy aged humans an environmental toxin, may elevate the may even exhibit more metabolic activ- degree of nigral cell loss to some 70 to ity, though it is unclear whether this 80 percent, enough to produce clinically seemingly paradoxical rise in activity apparent symptoms of Parkinson’s dis- represents the brain’s attempt at com- ease. But it must be added that the loss pensation for some neuronal loss or just of neurons during normal aging in the a nonspeci½c and potentially adverse re- substantia nigra is more severe and pre- cruitment of remaining local neurons.2 dictable than one observes in many oth- Overall, the aged brain tolerates relative- er regions of the brain such as the cere- bral cortex. 2 R. L. Buckner, “Memory and Executive Function in Aging and ad: Multiple Factors Even when the absolute number of that Cause Decline and Reserve Factors that neuronal cell bodies does not decline Compensate,” Neuron 44 (2004): 195–208.
60 Dædalus Winter 2006 ly small de½cits in neuronal structure At different times over the course of Deciphering and function rather well, although cer- the last century, various disorders have Alzheimer’s disease & its tain mental functions required for high- assumed greater or lesser relative impor- antecedents ly specialized activities–such as the rap- tance in contributing to late-life demen- id visual-motor tasks required to pilot tia. In the early 1900s, for example, neu- a 747 or perform complex surgery–may rosyphilis was considered a common become compromised in older humans. cause of dementia; Alzheimer’s disease Epidemiological and neuropsycholog- had not yet been recognized as a speci- ical studies generally paint a similar pic- ½c brain disorder. More recently, the ture to that emerging from neurobiologi- proportion of dementia cases attributa- cal research. Estimates of the prevalence ble to one or more strokes has declined of senile dementia–the progressive loss because of the successful control of hy- of cognitive function after roughly age pertension and hyperlipidemia and the 65–vary widely, but most data suggest gradual reduction in some types of car- that a large majority of individuals in diovascular disease. When Alzheimer’s their seventies and eighties are free of disease comes under reasonable medi- signi½cant cognitive loss that interferes cal control, other disorders will assume with daily function. And analyses of greater relative importance in the differ- healthy elderly adults reveal only sub- ential diagnosis of late-life dementia. tle declines in performance on tests But in developed countries today, Alz- of memory, perception, and language. heimer’s disease is still by far the most One decrement on which numerous common basis for senile dementia, studies agree, however, is a reduction in accounting for some one-half to two- the speed of some aspects of cognitive thirds of all cases. For several decades processing. Hence, septuagenarians are after Alois Alzheimer reported his index often unable to quickly retrieve certain case, a 53-year-old woman from Frank- details of a particular past event–say, furt, the disorder was classi½ed as a rare the precise date or place–although they ‘presenile’ dementia, that is, a dementia are often able to recall the information having its onset prior to roughly age 65. minutes or hours later. Given enough But in the mid-1960s, three British scien- time and an environment that keeps tists–Garry Blessed, Bernard Tomlin- anxiety at bay, many healthy elders score son, and Martin Roth–conducted land- almost as well as young or middle-aged mark clinical-pathological correlative adults on tests of mental performance. studies that made clear what some ear- A measure of guarded optimism emerges lier investigators had suspected: com- from investigations of ‘normal brain ag- mon senile dementia is usually associat- ing’: one may not learn or remember as ed with the classical ½ndings in the brain rapidly later in life, but one may learn that Alzheimer had described. The term and remember nearly as well. ‘senile dementia of the Alzheimer type’ was subsequently coined, but nowadays, The range of brain diseases that express ‘Alzheimer’s disease’ designates this themselves as a progressive loss of intel- syndrome, regardless of the age of onset. lectual function is remarkably broad. For research purposes, one still refers to Vascular, metabolic, infectious, neoplas- ‘early-onset ad’ and ‘late-onset ad,’ di- tic, traumatic, and degenerative disor- vided arbitrarily at age 65, but little evi- ders can all present with symptoms of dence exists that these are fundamental- dementia. ly distinct biological processes or that
Dædalus Winter 2006 61 Dennis J. we could not ultimately treat them as nance imaging of mci-amnestic brains Selkoe one entity. on suggests that the neuronal dysfunction aging In the United States, multi-infarct de- is restricted to the hippocampus and mentia has long been considered the a small number of other brain struc- second most common basis for late-life tures connected to it. Studies of the fate dementia, even though Parkinson’s dis- of mci-amnestic subjects over time sug- ease-associated dementia plus a related gest that roughly 12 to 15 percent of them disorder, Lewy body dementia (named ‘convert’ to clinically diagnosable, mild after the characteristic neuronal lesion ad each year, meaning that these indi- that de½nes Parkinson’s disease), are viduals begin to exhibit signs of a more now equally if not more prevalent. Care- general disturbance of recent memory ful microscopic analyses of autopsied as well as disorientation to time and Parkinson’s disease brains often reveal place, decreased attention span, confu- the features of ad or else ad plus Lewy sion in executing complex tasks, and body dementia, confounding precise sometimes, dif½culty in ½nding words. diagnostic classi½cation. Nevertheless, This slow progression of cognitive ‘pure’ Alzheimer’s disease is still the symptoms occurs in an individual who most common neuropathological ba- appears fully alert and demonstrates no sis for late-life dementia in the United abnormalities of the motor system, e.g., States and most developed countries. decreased mobility, stiffness, and slowed A number of less common causes of de- gait, until later in the disease. mentia, including frontotemporal de- mentia and Creutzfeld-Jakob disease, What causes this initially subtle but share certain pathological or biochemi- ultimately devastating loss of higher cal features with ad, but they are etio- cortical function? The answer has be- logically distinct. gun to emerge from three decades of Virtually everyone beyond late middle intensive neuropathological, biochem- age has worried that an occasional mem- ical, and genetic research. While there ory lapse–a name forgotten or an object is still earnest debate about the detailed misplaced–could represent the earliest sequence of events, the majority of sci- sign of ad. But such momentary losses, entists researching ad now believe that with recovery of the detail within min- the misfolding, aggregation, and accu- utes and a complete awareness of the mulation of a small protein of forty-two lapse, are usually not progressive. In amino acids, the amyloid ß-protein (aß), contrast, the repeated inability to re- initiates a complex cascade of molecular member recent, minor episodes of dai- and cellular changes that compromise ly life–a call from a friend, a trip to the neuronal function in brain regions serv- department store, the paying of a bill, ing memory and cognition. a brief news story–can represent the According to this scenario, widely earliest harbinger of ad. In a condition referred to as the ‘amyloid (or aß) cas- now referred to as ‘mild cognitive im- cade hypothesis,’ a chronic imbalance pairment (mci)-amnestic type,’ the between the production and the clear- individual shows a subtle, intermittent ance of this otherwise normal protein decline in episodic memory but is oth- arises in the brain long before the ½rst erwise intact cognitively and performs symptoms of dementia. This accumu- very well in everyday life. Evidence from lation leads to the self-association of structural and functional magnetic reso- aß into ‘oligomers’ (doublets, triplets,
62 Dædalus Winter 2006 quadruplets, etc.), which in turn can sequently formulate biochemical hy- Deciphering assemble into ½lamentous polymers potheses about what actually kills cells. Alzheimer’s disease & its (‘amyloid ½brils’) that clump together But in the case of Alzheimer’s disease, antecedents to form the cores, or spherical centers, the opposite sequence occurred: prog- of tiny plaques. These amyloid deposits ress in the 1980s in understanding the are gradually surrounded by degenerat- biochemistry of the disease identi½ed ing axons and dendrites (collectively the proteins that comprise the plaques called neurites) and activated brain in- and tangles, providing geneticists with flammatory cells (microglia and astro- key clues to the location of the dna mu- cytes), completing the formation of so- tations that might cause Alzheimer’s dis- called neuritic plaques. ease. During this slowly evolving process, In 1991, researchers discovered the ½rst some of the neurites within and adja- mutation responsible for ad on chromo- cent to the emerging plaque develop rig- some 21, speci½cally in the gene that en- id intracellular ½laments, or ‘paired he- codes the amyloid precursor protein lical ½laments,’ that are composed of (app), the parent protein of aß. In addi- a neuronal protein called tau. Tau ½la- tion to the fact that app molecules give ments also accumulate in large bundles rise to the aß fragments that form the that comprise the neuro½brillary tangles neuritic plaques, a crucial clue that the found inside many neuronal cell bodies app gene might be the site of an ad- in the hippocampus and cerebral cortex, causing defect came from a disorder as well as in certain subcortical neurons at the opposite end of the life span: that send their axons to these areas. In Down syndrome. Humans with Down short, the accumulation and self-assem- syndrome, or trisomy 21, the most com- bly of the aß protein is believed to initi- mon form of chromosomal duplication ate a series of ½rst functional (biochem- compatible with life, invariably develop ical) and then structural (anatomical) the plaques and tangles of ad in their changes in selected neurons, to the ul- thirties and forties. This is because they timate detriment of the thinking pro- harbor three copies of the app gene in cess. all of their cells, rather than the usual Perhaps the most compelling evi- two copies. The extra copy of the app dence for this aß hypothesis has come gene results in a roughly 50 percent in- from identifying and characterizing crease in the cellular levels of the app genetic mutations that cause rare inher- protein throughout life and the conse- ited forms of ad. It is a truism of mod- quent start of aß deposition in the Down ern biomedicine that searching patients’ syndrome brain as early as age 10. genomes for faulty genes opens up the Another powerful clue pointing to study of diseases of previously unknown the app gene had come from studying cause and mechanism. For example, un- a family in the Netherlands with a his- til the cloning of the Huntington gene tory of multiple brain hemorrhages in 1993, no one had any real clue as to caused by the severe build-up of the what might be killing off certain brain aß protein in cerebral blood vessels. In neurons in patients with Huntington’s 1990, scientists discovered that a muta- disease. In this and many other heritable tion in the app gene that changes a sin- diseases, the unbiased search of the hu- gle amino acid within the aß region of man genome for the genes responsible app was responsible for this rare disor- for the disease allowed scientists to sub- der, demonstrating for the ½rst time that
Dædalus Winter 2006 63 Dennis J. mutations in app could cause aß accu- drug-like molecules and pinpoint com- Selkoe pounds that lower aß production with- on mulation. aging With all of this knowledge in hand, out damaging the cells. And through the geneticists scrutinized the app region wonders of genetic engineering, scien- of chromosome 21 in a few families with tists could also create ‘transgenic’ mice a hereditary form of ad that led to the that express a human app gene bearing onset of dementia in the ½fties. In one an ad-causing mutation. After consider- such family, they discovered a ‘missense’ able trial and error, the latter approach mutation in app that changed one ami- generated several highly useful mouse no acid near the end of the sequence lines that mimic several, but not all, fea- encoding the aß region to another. The tures of ad in their brains, including study of other families with early onset the abnormalities of neurites and glia of ad revealed additional app missense around the amyloid plaques. As they mutations, most of which occurred in age, these mice develop de½cits in cog- amino acids either at the beginning or nition such as dif½culty remembering at the end of the forty-two-residue aß how to negotiate mazes ef½ciently. Tak- region. Tellingly, geneticists did not ½nd en together, these and many other ex- any ad-causing mutations away from periments have produced a wealth of the aß region of this large (770–amino evidence that ad can arise at least in acid long) precursor protein, indicating part from an imbalance in the econo- that the mutant amino acids might lead my of the aß protein in brain regions to increased cutting of app at the begin- important for memory and cognition. ning or end, resulting in the heightened The practical outcome has been to en- production of the aß fragment. courage scientists to ½nd ways to lower As these genetic ½ndings were emerg- aß levels in humans. ing, a major biochemical discovery was Still, there are many unanswered made: all cells normally produce the aß questions about the aß hypothesis. peptide throughout life. Thus, aß is the What causes the imbalance in aß levels product of healthy app metabolism in in the brains of the large majority of ad all of us, implying that unknown factors patients who do not have known genet- –genetic, environmental, or both–can ic mutations? For example, can environ- increase its production or decrease its mental factors influence the brain’s aß degradation in those individuals who levels? Does the aß peptide begin to ag- develop ad, all of whom have too much gregate inside the neuron before the aß aß in their brains. oligomers are exported into the extracel- Putting together these two key obser- lular space and then bind back to the vations–that healthy cells continually cell? Which type of brain cell–neurons, make aß and that rare mutations within microglia, or astrocytes–is the ½rst to its precursor, app, can cause ad–led to respond adversely to the excess of aß in groundbreaking experiments. Inserting the local microenvironment? Precisely a gene that bore an ad-causing app mu- why do neuronal extensions, i.e., axons tation into cultured cells resulted in sig- and dendrites, respond with an aggrega- ni½cantly greater aß production. Scien- tion of their tau protein? Are the result- tists could now study many details of ant tau aggregates the prime culprits in the production and metabolic fate of aß compromising neuronal function and in simple cell models. They could also ultimately killing the neurons? And per- use such cells to screen large libraries of haps most perplexing, how does the en-
64 Dædalus Winter 2006 tire process select for neurons serving production. Several groups have iden- Deciphering memory and cognitive function? ti½ed inhibitors of ß-secretase, the en- Alzheimer’s app disease & its zyme that cuts ½rst. But these in- antecedents Answering all of these questions in hibitors require modi½cation to make detail should not be necessary in order them more potent yet still able to pene- to treat or even prevent Alzheimer’s trate the blood brain barrier and achieve disease. Because human genetic data effective levels in brain tissue. At this and the modeling of the effects of the writing, there are no such ß-secretase faulty genes in engineered mice have inhibitors ready for human testing. Sci- continued to support the aß hypothe- entists have also discovered many small sis, scientists in both academia and the molecules able to inhibit γ-secretase, the biopharmaceutical industry have spent enzyme that makes the second and ½nal the last decade devising strategies to in- cut of app. Unfortunately, most of these terrupt the aß cascade at an early point molecules also interfere with the cutting in its development.3 Without know- by γ-secretase of a protein called ‘Notch’ ing precisely how aß compromises the that is crucial for the normal function- functions of selected neurons, they have ing of most cells. However, the serendip- searched for compounds that can de- itous discovery that certain anti-inflam- crease brain aß levels, initially in mouse matory drugs like ibuprofen can gently models. ‘tweak’ γ-secretase to lower the produc- Three broad approaches have been tion of aß42, a particularly noxious form conceptualized. First, one could partial- of aß, without decreasing Notch cleav- ly inhibit one of the two specialized en- age has helped researchers continue to zymes, ß-secretase and γ-secretase, that pursue this approach. And since the anti- cut app to release the aß region. Second, inflammatory properties of such drugs one could allow these reactions, which are not responsible for this selectivity, occur normally in all of us, to proceed scientists have identi½ed and are now unimpeded but instead prevent a single testing in humans derivatives that solely aß protein, a monomer, from binding tweak γ-secretase. Early trial results sug- with another to form oligomers, the gest that these specialized ‘γ-secretase small aggregates that appear to initiate modulators’ may indeed slow cognitive the amyloid build-up and the associated decline, at least in some ad patients. short circuiting of neurons. Third, one The second approach, preventing the could attempt to ‘clear’ the brain of var- self-assembly of aß into oligomers and ious forms of aß, including monomers, ½brils, makes good theoretical sense but oligomers, and larger amyloid deposits. has received less attention. While some The ½rst approach–inhibiting the compounds have performed well in test- protein-cutting enzymes that generate tube experiments, very small assemblies aß–is somewhat analogous to the use of aß (dimers and trimers) can already of statin drugs to decrease cholesterol interfere with synaptic function and behavior, raising concern that a partial 3 D. J. Selkoe and D. Schenk, “Alzheimer’s inhibition of aß aggregation might sta- Disease: Molecular Understanding Predicts bilize such small species and actually Amyloid-based Therapeutics,” in Annual Review worsen the disorder. of Pharmacology and Toxicology, vol. 43, ed. A. K. aß Cho, T. F. Blaschke, P. A. Insel, and H. H. Loh The third approach–clearing from (Palo Alto, Calif.: Annual Reviews, 2003), the brain–has progressed the furthest to 545–584. date, advancing into human trials. Here,
Dædalus Winter 2006 65 Dennis J. the novel idea of immunizing patients and the societal levels. A vaccination Selkoe with the very peptide that builds up in strategy for a noninfectious disease in on aging their brains has led to evidence in mice late life is unprecedented. Were a safe that one can ef½ciently clear aß plaques vaccine or another aß-lowering thera- with aß antibodies. This has been ac- peutic such as a γ-secretase modulator complished in two ways: either active- approved, healthy people might avoid ly vaccinating the mice with synthetic the onset of Alzheimer-type cognitive aß so that they gradually generate their loss by undergoing the therapy in late own aß antibodies, or passively admin- middle age or perhaps even earlier. Such istering laboratory-made aß antibodies an approach would have to include a for- to them. When the active vaccination mal, semiquantitative assessment of an approach was initially tried in ad pa- individual’s likelihood of developing tients, some 6 percent developed in- ad. Components of such a risk assess- flammatory cell in½ltrates in the brain, ment may encompass a neurological ex- or meningoencephalitis, and the trial amination that includes cognitive test- stopped. The apparent reason for the ing, a detailed family history, a blood inflammation: some patients had gen- screen for genetic mutations known to erated specialized T-lymphocytes di- predispose to ad or other dementias, rected against the tail end of the aß pep- a blood test for plasma aß levels, and a tide. Modi½ed active vaccines compris- special brain imaging procedure like the ing the front end only have now been emerging ‘amyloid scans’ that employ designed but not yet tested in humans. an injected chemical agent to visualize In the meantime, a phase 2 trial of pas- one’s cerebral aß burden. Such a multi- sive antibody administration is under- component assessment could assign way in ad patients, with initial results individuals a rough probability of devel- hoped for by late 2006. oping ad and perhaps other dementias, In addition to the above approaches and those in moderate- or high-risk cate- to the aß part of the ad equation, there gories could then be offered one of the are strategies that attempt to target oth- preventative agents envisioned above. er key steps in the disease cascade. These While such a combined diagnostic/ include oxidative injury to neurons, the therapeutic paradigm seems achievable build-up of tau as tangles, local inflam- with time, it raises dif½cult new ques- matory changes, or a potential imbal- tions. How can we administer such a ance of certain metals such as copper relatively complex protocol to very and zinc in the ad brain. The use of cell large numbers of aging individuals? culture and mouse models has assisted How will we pay for it? Will only rela- in the development of each of these po- tively well-off individuals in developed tential therapies, followed in some cases nations have access to it, at least for the by the initiation of clinical trials. At this foreseeable future? And how will we writing, unequivocal evidence of suc- handle the ethical challenges posed by cessful slowing of the disease has not widespread testing for the genetic risk emerged, but hope runs high. of a major, brain-destroying disease? And there are other social implica- The advent of therapeutic agents that tions to ponder should a successful slow and perhaps even prevent ad could therapy for Alzheimer’s disease emerge have profound effects on the aged hu- from current research. The prospect of man population, both on the individual many more people retaining most of
66 Dædalus Winter 2006 their cognitive functions into late life Deciphering should accelerate the current trend to- Alzheimer’s disease & its ward longer careers, potentially displac- antecedents ing younger workers. And because im- provements in the physical health of octogenarians will likely accompany the prevention of Alzheimer’s disease, and later other dementias, we will need to expand the availability of activities such as driving, entertainment, tourism, and ½nancial services. Healthy elders them- selves will presumably provide much of the labor required to deliver these serv- ices, but younger members of the work force should also bene½t from these new opportunities. Medical questions also abound. Could widespread access to effective therapy for late-life cognitive failure actually in- crease longevity? Certainly, the average life expectancy at birth would rise mod- estly, at least in developed societies, but will resolving dementia have a direct and measurable impact on the maximal age that humans achieve? Will many more people live to 90 or 100 with their mentation largely intact and then suc- cumb fairly rapidly to other causes of mortality? And will other, currently infrequent forms of cerebral deteriora- tion take the place of Alzheimer’s dis- ease as the primary cause of dementia, just as Alzheimer’s emerged strongly after the eradication of neurosyphilis and the more recent decline in strokes? The looming prospect of solving Alz- heimer’s disease should be incorporated into the thinking of politicians, econo- mists, and all those concerned about planning the future of our societies. While we will no doubt experience nu- merous ½ts and starts along the way, it appears increasingly likely that a world with less Alzheimer’s disease lies ahead.
Dædalus Winter 2006 67 Caleb E. Finch
Aging, inflammation & the body electric
In a famous photograph of Walt Whit- the age of 55, he suffered a stroke that man taken in the 1860s (see inside back paralyzed his left side. Other strokes cover), the great American bard looks followed, though without noticeably wizened–his hair white, his face weath- impairing his memory. Whitman even- ered. He looks, in short, like an old man. tually lived to the age of 72, exceeding In fact, he was only in his forties. his generation’s life expectancy by about During the Civil War, Whitman spent thirty years. Yet shortly before his death, hours each day in hospital wards attend- one of his doctors noted, “His apparent ing to desperately sick soldiers, which age was greater than his real years.” exposed him to dysenteries and horrib- A postmortem by experts in gross ly infected wounds. As a result, a bad morbid anatomy showed that Whitman infection in one hand climbed up into had long suffered from both meningitis his shoulder, and he became beset by and tuberculosis. Tuberculous meningi- chronic headaches and fevers. tis may have contributed to his strokes One hundred and ½fty years after and would have been consistent with his Whitman sang “the body electric,” we other reported ailments. Both infections can ½nd in Whitman’s fate some clues inflame arteries at the base of the brain, to the nature of aging. For much of his which, in turn, increases the risk of in- adult life, he complained of chronic farcts and strokes that selectively dam- headaches, fevers, and weakness. At age deep brain centers in a ‘tb zone,’ but usually spare higher cognitive func- tions. Although tuberculous meningi- Caleb E. Finch is arco/William F. Kieschnick tis is a rare disease, the ‘Whitman case’ Professor in the Neurobiology of Aging at the points us to more general principles in Leonard Davis School of Gerontology, Professor aging. of Biological Sciences, and University Professor Inflammation is increasingly recog- at the University of Southern California. His nized as fundamental to aging. As mod- books include “Longevity, Senescence, and the ern medicine has brought infectious dis- Genome” (1990) and “Chance, Development, eases like tuberculosis and meningitis and Aging” (with Thomas Kirkwood, 2000). under control, successive generations have had to carry less of the inflamma- © 2006 by the American Academy of Arts tory burden of such diseases–which & Sciences may help account for recent improve-
68 Dædalus Winter 2006 ments in human longevity. Changes ing birth cohorts over their life spans, Aging, of the inflammatory burden may also Eileen Crimmins and I discovered that inflamma- tion & anticipate limits ahead. Aging, of course, the survivors in birth cohorts with high the body is an immensely complex process gov- early-age mortality rates showed much electric erned by multiple gene-environment higher mortality rates at all later ages interactions. No single factor governs than survivors in birth cohorts with low- aging–biogerontology is a graveyard of er early-age mortality rates.1 Evidence single-cause hypotheses. from Sweden, which has kept remark- ably complete records of mortality since In the past century and a half, human 1750, makes a very strong case for this. life spans have increased remarkably, We hypothesized that this outcome with one year added to the life span was the result of chronic infections and for every three to four years of calendar inflammations accelerating aging pro- time. Before the Industrial Revolution, cesses. For example, rheumatic fever, the average life span was about thirty- the result of streptococcus infections, ½ve to forty years. Even if one survived killed many children in the ‘bad old the hazards of childhood to reach ma- days’ before antibiotics. But the disease turity, the remaining life span was still continued to affect even its survivors, shorter than today’s. Currently, life ex- who rarely lived beyond middle age, pectancy in most developed countries because the bacterial colonization of has doubled to about eighty years and the valves had weakened their hearts. continues to climb. The result is a ma- tb was another common scourge often jor shift in population age structure, acquired in childhood that shortened from broad-based pyramids with youn- adult life spans. Thus, it appears that ear- ger groups in the majority, to skyscrap- ly infections have a strong connection to er-shaped structures, which are aris- adult longevity. ing everywhere because of the steadily This ‘cohort morbidity’ has gradually growing rates of survival at younger decreased during the past two centuries. ages and survival to increasingly older Its decline began long before people un- ages. In fact, centenarians are the fastest derstood the germ theory of infectious expanding age group. Sitting on the transmission and very long before mod- topmast is Jean Calment (1875–1997) ern medicine discovered vaccination who tested cognitively normal at 119. and antibiotics. By Whitman’s time, Her 122-year longevity may yet be sup- and even a century before in Sweden, erseded. societies were improving public health The decline in childhood mortality and personal hygiene. The stink of hu- rates is yet another remarkable change man waste and rotting garbage was be- that has occurred in recent generations. coming less acceptable. Governments Not so long ago, infant and childhood were increasingly expected to provide mortality rates were very high almost clean public water, covered sewers, and everywhere; rates of 30 percent were sanitation squads to clean up after hors- very common in Europe and North es. Improving transport was also giving America until the Industrial Revolution, broader access to better food year round. when early-age mortality began to de- 1 Caleb E. Finch and Eileen M. Crimmins, “In- crease. This is signi½cant because child- flammatory Exposure and Historical Changes hood mortality trends are the strongest in Human Life Spans,” Science 305 (5691) (Sep- predictors of later mortality. In follow- tember 17, 2004): 1736–1739.
Dædalus Winter 2006 69 Caleb E. Still, it is fair to say that we do not fully immune cells, are rapidly activated dur- Finch understand the precise relation of the ing the ‘acute phase response.’ Enzymes on aging improvements in education, hygiene, in these macrophages convert oxygen to and nutrition to the advance in health the radical superoxide and fuse with car- during the Industrial Revolution. bon, chlorine, hydrogen, and nitrogen We do know, though, that the legacy to form other radicals. As the free radi- of bad conditions can persist for several cals from activated macrophages diffuse generations. Low–birth w eight babies from their cell source to attack an infec- not only grow up with a higher risk of tion, however, they also inflict local ‘by- heart disease and hypertension, but also stander’ oxidative damage on other cells tend to produce relatively small proge- and molecules. ny of their own. Impaired fetal growth During systemic infections, the liver affects the pelvic blood vessels, which also shifts gears to secrete inflammato- may never develop optimally even with ry proteins, e.g., C-reactive protein good nutrition after birth. Maternal in- (crp), cytokines such as interleukin-6 fections may be at least as important as (il-6), and complement system proteins. nutrition in impairing fetal growth: for crp is an ancient protein that binds to example, women with hiv or tb, even certain classes of bacteria and enhances with good diets, tend to have smaller their uptake and digestion by macro- babies. Smoking can also have trans- phages. il-6 and other cytokines cause generational effects. If your grandmoth- fever and also mediate the next phase er smoked during pregnancy, your risk of host defense, instructive immunity, of asthma is two times greater because which emerges days later with speci½- the egg from which you came was fully cally targeted antibodies or cell defenses formed (and, as a result, exposed to car- through B-cells and T-cells. cinogens) while your mother was still a While free radicals play a vital role fetus. We may ½nd still other infections in the body’s defense as well as in the and environmental inflammogens with normal and essential signaling between persistent effects; such factors will likely cells, they can also cause slow yet cu- slow or limit future average increases in mulative damage to irreplaceable mol- life span. ecules and cells. Such multiple effects, or ‘pleiotropies,’ underlie a basic prin- When Walt Whitman sang of the ciple in aging called ‘antagonistic pleio- “body electric,” he coined a metaphor tropy’: some mechanisms that evolved that turns out to be more literally true to mete immediate bene½ts to the young than he may have imagined. Our aer- have delayed consequences that slowly obic metabolism is continuously pro- emerge during aging. Another example ducing free radicals, ‘chemical sparks’ is glucose. While an essential fuel, glu- that attack invading microbes with cose also spontaneously reacts with the their highly reactive, unpaired elec- amino groups of proteins and nucleic trons.2 When microbes enter our bodies, acids. The resulting oxidative modi½- macrophages, one of the most ancient cations, or advanced glycation end-prod- ucts (age), can cross-link proteins and 2 In chemical terms, ‘free’ refers to the avail- cause dna mutations. We know that ability of the unpaired electron to form a stable chemical bond; the taking of electrons from chronic hyperglycemia, as in diabetes, another atom by free radicals is called oxida- accelerates age formation. Moreover, tion. in diabetic neuropathology, ages also
70 Dædalus Winter 2006 cause cell death by synergizing with free often had advanced fatty plaques in their Aging, radicals. arteries. Even fetuses often have minute inflamma- tion & Because many chronic diseases of versions of atheromas. While these ‘pro- the body aging develop through inflammatory dromal’ atheromas do not block arter- electric mechanisms, inflammation and aging ies they may seed further growth. Ul- are now merging ½elds of research. The trasound imaging has also shown that case is strongest for vascular disease as obesity and diabetes can accelerate the an inflammatory process. Because ath- growth of atheromas even in childhood. eromas, the raised fatty plaques in the Over the course of a lifetime, the aorta arteries that can contribute to vascular and most other arteries progressively disease, are actually hotter than sur- accumulate fatty deposits. Some spon- rounding vessels, the idea that the taneously regress, while others balloon sparks within are driving aging is not into full-blown intrusive plaques. In just a metaphor. Atheromas are loaded general, atheromas with many macro- with inflammatory cells and proteins– phages and large lipid cores are the most cytokines, complement factors, etc. In unstable and likely to form the throm- fact, the foam cell of atheromas, which boses (clots) that block blood flow. Be- accumulates lipids, is an activated mac- sides these focal lesions, many vessels rophage. also develop thicker and more rigid walls Moreover, in brains with Alzheimer’s during aging through the accumulation disease, senile plaques harbor many of of ages. Thickening in the carotid arter- the same inflammatory processes found ies that feed the brain is a predictor of in vascular atheroma. Senile plaques are stroke. surrounded by the brain’s special mac- There is growing evidence that various rophage, the microglial cell. Besides the common infections increase the risk of cytokines and complement factors also heart attacks and strokes. The number found in atheromas, Alzheimer plaques of antibodies to different infections cor- contain the beta-amyloid protein, which relates with blood crp and risk of heart is induced by hemorrhage and inflam- attack. Hepatitis C virus (hcv) alone, mation. for example, may heighten the risk of Inflammation seems also to play a key coronary disease up to ½ve times. When role in the etiology of heart attacks. Ele- present in a donor for cardiac transplant, vated blood crp and il-6, when com- hcv tripled the mortality risk from ac- bined with elevated ldl, result in a ½ve- celerated coronary disease in the grafted fold or higher risk of a future heart at- heart. Other common infections have tack. In the Honolulu Asia Aging Study, modest, but potentially important, ef- elevated blood crp also predicted a fects over the long haul. Helicobacter threefold higher risk of later develop- pylori, which leads to ulcers and a high ing Alzheimer’s disease and vascular risk of gut cancer, also increases the risk dementia. Tellingly, most of the known of heart attack by about 20 percent. Be- risk factors for heart attacks are also risk sides the blood vessels, the heart valves indicators for Alzheimer’s disease and are vulnerable to microbial attack, as in vascular dementia. rheumatic fever. Even oral infections play a role in vas- Vascular disease typically begins de- cular disease. Our gums and teeth har- cades before symptoms arise. At autop- bor an amazing diversity of bacteria as sy, soldiers killed in Korea and Vietnam dense bio½lms, which resist scrubbing
Dædalus Winter 2006 71 Caleb E. and flossing. Tooth loss due to periodon- improvements of both childhood mor- Finch tal disease was once common: before tality and adult longevity rates. Animal on aging 1900, few adults reached age 60 with any models have supported these associa- teeth. The great improvements in oral tions by showing that inflammation or hygiene that now help us keep our bites chronic infection accelerates vascular into old age are also thought to have re- disease, cancer, and Alzheimer’s-like duced vascular disease by lightening the changes. These modern developments load of systemic pathogens. However, it also support the importance of inflam- is hard to prove a particular bacteria or mation in the historical improvements virus carried elsewhere in the body, par- in mortality across the life span. ticularly in low-grade infections, is a speci½c cause of vascular disease. The Besides common infections, obesity classic requirement of Koch’s postulates is also a risk factor in vascular disease, that the condition be transmissible with cancer, and possibly Alzheimer’s dis- the same result may not apply to heart ease. Again, obesity and diabetes are disease and other multifactorial condi- characterized by increased inflamma- tions. tion, including higher blood crp. Con- Anti-inflammatory drugs, which re- versely, animal studies consistently duce the risk of heart attacks, give fur- show health and longevity bene½ts in ther evidence of the importance of in- proportion to the level of caloric restric- flammation in vascular disease. Aspirin tion. In laboratory rodents, reducing is best known for helping prevent heart caloric intake by 10 to 40 percent delays attacks. Statins also demonstrate pow- many chronic diseases, lowers free radi- erful anti-inflammatory capabilities, cal production and oxidative damage, for example, lowering blood crp. Fur- and reduces blood crp. Moreover, in ther, since oxidative damage is a shared mice engineered with genes that cause mechanism in the progression of vascu- cancer, vascular disease, or Alzheimer’s lar disease, cancer, and Alzheimer’s dis- disease, caloric restriction slowed all ease, most drugs that retard vascular dis- these conditions. In these same models, ease by acting on shared inflammatory obesity and diabetes accelerated many processes also help prevent other chron- aging changes slowed by caloric restric- ic diseases. For example, aspirin reduces tion. Scientists have discovered that the the risk of gi-tract cancer, though how mechanisms at work in caloric restric- it does so is still unclear. It is also uncer- tion include lower blood glucose and tain how much of the oxidative damage age formation. is the ‘prime mover’ or a secondary ef- The bene½ts of caloric restriction to fect. lab animals, however, may be something Nonetheless, anti-inflammatory of an artifact of their con½nement. Be- drugs, in reducing the activity of mac- nign lab environments do not demand rophages and other inflammatory pro- the activity required in the real world cesses, appear to lower the risk of vari- for the relentless search for food and ous chronic diseases. This correlation avoidance of predators. Primates in cap- points strongly to a connection between tivity tend to obesity and diabetes, mak- infections and vascular disease, one that ing them good models of our modern provides modern evidence for the criti- couch-potato lifestyle. In humans, obe- cal role that reducing infections and in- sity and diabetes may be successfully flammation has played in the historical treated by diet and exercise.
72 Dædalus Winter 2006 Would caloric restriction bene½t cur- aging that we can apply to earlier times. Aging, rent human aging? One widely used Graying hair certainly is not a good in- inflamma- bmi tion & measure is body mass index ( ), dicator of one’s state of health or future the body which adjusts body weight for height. longevity: Whitman’s hair had begun to electric A bmi below twenty represents extreme turn gray by 30, when he was in robust leanness; a bmi above thirty, obesity. health. Even today, there is no consensus A bmi below twenty may be unhealthy on which biomarkers of aging can pre- because of anorexia, smoking, or wast- dict the remaining life span of an indi- ing diseases. On the other hand, a bmi vidual. above thirty increases the risk of dia- Genetic vulnerabilities undoubtedly betes, hypertension, and vascular dis- account for some of the individual dif- ease. Most studies agree that a bmi ferences in mortality risk–but they are somewhere between these extremes not the whole story. The longevity of has little influence on mortality risk. highly inbred laboratory rodents with- So would caloric restriction bene½t the in the same colony, for example, differs majority in the mid-bmi range? John O. widely. Individual rats of the same sex Holloszy’s study of eighteen volunteers living in the same cage also vary widely showed that a 20 percent caloric restric- in learning ability, reproduction, tumor tion for three or more years improved incidence, and molecular damage to mi- risk indicators of vascular disease. Sev- tochondrial genes as they age. Within eral groups are accumulating personal the same colony, life spans may range data on caloric restriction, and efforts 50 percent about the mean, from twenty are underway to ½nd drugs that mimic to forty months. Flies and worms also caloric restriction. But one cannot for- show wide individual variations in cell get that Jean Calment was also known damage during their month-long life for her hearty appetite for food and spans. Humans show a similar range, wine. when calculated in proportion to life span. The recent increase in human longevi- From observing human twins and lab- ty contradicts old beliefs that life spans oratory animals, geneticists have con- are ½xed. The scourge of heart attacks cluded that the heritable component of has diminished remarkably in the past longevity is relatively modest, between thirty years, in part because of the grad- 10 and 35 percent. Studies of human ual decrease in smoking. There is grow- twins make clear the limits of genetics ing recognition that lifestyle choices in aging. Menopause in identical twin strongly influence health at later ages. pairs is typically separated by two years Aging is very plastic, whichever genes but can be up to twelve years apart. an individual has inherited. This plastic- Chance variations in the numbers of egg ity implies that in past centuries earlier cells formed in the ovary before birth signs of aging accompanied the shorter may be responsible for these differences life spans. To Walt Whitman, even 50 in menopause. However, after 80, the was old. In a February 12, 1867, letter, he percentage of the remaining life span in wrote, “[I] am now in good spirits . . . I twin pairs that is attributable to heredi- don’t feel a bit ‘pegged out’–only get- ty is almost zero. At this point, the more ting old–most 50, you know . . . . ” It is sociable twin is likely to live longer. On frustrating that we do not have reliable average, human sociobehavioral factors general markers for rates of individual also have a stronger influence than ge-
Dædalus Winter 2006 73 Caleb E. netics on an individual’s ability to sur- ther back to consider how humans be- Finch vive, for example, a hip fracture. came the longest-lived primate. In na- on aging Nonetheless, the genetics and geno- ture, life expectancy for monkeys at mics of aging is a thriving, exciting ½eld. birth is about ½fteen years; for great Some centenarians carry rare genes that apes, it is about twenty. When protected appear to favor longevity, including ones in a zoo, primates live longer, but still that mediate cholesterol metabolism. not as long as humans live. The evolu- Major advances are also being made in tion of longevity in primates may have the genetics of longevity for many dif- occurred in two stages; the ½rst consist- ferent species. Mutations in metabolic ed of having fewer children per pregnan- pathways relevant to insulin have in- cy. Among animals, great apes are dis- creased longevity in yeast cells, flies, tinctive for giving birth to one child at worms, and mice. Some of these mu- a time and providing the child parental tations, however, are less viable under care almost to puberty. Chimpanzees, more natural conditions. Dwarf mice, for example, may continue to nurse for in particular, can live longer in certain six years; orangutans, ten years. This conditions; until those conditions were extended care requires great apes to live discovered, they were thought to show longer than monkeys, whose maternal accelerated signs of aging. What regu- care ends after three years. For chim- lates the rate of oxidative damage is panzees and monkeys in captivity, the also mysterious–for example, why do duration of parental care is proportion- humans live thirtyfold longer than lab ate to life span: chimpanzees live to mice, despite identical levels of blood about forty-½ve years, monkeys to about glucose and body temperature? thirty years. Humans, who have further extended How did aging evolve? In nature, the care and training of their young to overall mortality is vastly higher than twenty years or more, also live propor- in our current human societies. Most tionately longer. Our unusually slow animal populations are dominated by maturation depends on a multigenera- young adults who do most of the repro- tional support system not found in oth- duction needed for the perpetuation er primates. These social support sys- of the species. Thus natural selection tems were instrumental in evolving our is strongest against genes that impair tool-based cultures and effectiveness as development of young adults. Accord- hunters. Perhaps multigenerational sup- ing to the evolutionary theory of aging, port also favored survival to later ages genes that cause dysfunctions later in and enhanced the evolutionary bene½t life are permitted to accumulate in pop- of elders to their offspring. An edentu- ulations because any adverse effects are lous fossil jaw found in the Dmanisi site delayed to minimize impact on repro- in the Transcaucasus implied such social duction. In effect, it is the ‘schedule of support, even of the physically in½rm, reproduction’ that determines potential existed as long as 1.7 million years ago. longevity. If a gene mutation arose that However, Whitman’s paralytic stoke caused heart attacks or strokes soon af- would have soon doomed him to be left ter puberty, this gene would be strongly behind by some migratory foragers. selected against. Diet is another key difference between Having considered the recent im- the great apes and humans. Anthropo- provements in longevity, let’s look far- logists ½nd that hunter-gatherers around
74 Dædalus Winter 2006 the world, like most of us, love to eat lots flammatory responses; thus, in head Aging, of meat. In this regard, humans differ trauma, for example, apoE3 carriers inflamma- tion & hugely from the great apes, who are pre- show less damage. Conversely, because the body dominantly vegetarians with little regu- of premature Alzheimer’s changes, the electric lar intake of cholesterol–a substance punch-drunk boxer’s condition (demen- not produced by plants. While some tia pugilistica) is more common among male chimpanzees avidly hunt and eat apoE4 carriers. Although we do not small animals, females do not eat meat think of head trauma as very common, during pregnancy or nursing. Because soccer players who ‘head’ the ball fre- high-cholesterol diets accelerate vascu- quently have higher risks of cognitive lar disease, cancer, and Alzheimer’s dis- losses in middle age. This should put ease in laboratory animals, Craig Stan- ‘soccer parents’ on alert for the future ford and I have hypothesized that the brain health of their kids who often evolution of greater longevity despite emulate the pros in ‘heading’ the ball. this new diet required our human ances- Given the consistent evidence that tors to evolve ‘meat-adaptive genes.’3 apoE4 increases the risk for delayed One potential meat-adaptive gene is brain dysfunctions, it is not far-fetched the cholesterol carrier, apolipoprotein E, to think that athletes in contact sports which has two common genetic variants may soon care to consider apoE4 and apoE3 and apoE4. The ‘good’ apoE3 gene other genetic risk factors. lowers the risk of elevated cholesterol ApoE gene variants may also influence and Alzheimer’s disease, and increases brain development. When engineered life span by several years. Carriers of the into mice, the human apoE4 decreases ‘bad’ apoE4, on the other hand, show the complexity of neurons, relative to lower frontal lobe metabolism, which human apoE3. Thus, the evolution of the could be an early stage of neurodegen- apoE3 variant several hundred thousand eration. ApoE4 is the ancestral gene and years ago may have supported greater may once have been advantageous be- brain development as well as longevity cause its proinflammatory activities may in our species before we left Africa. have been protective in an earlier envi- ronment. For example, people who have Further increases in human longevi- hcv infections but carry apoE4 have less ty seem likely through improving ‘gero- liver damage. This double-edged impact technology.’ New drugs are being devel- of apoE4 can be described as an ‘antago- oped to reduce obesity, possibly as mi- nistic pleiotropy,’ bringing advantages metics of caloric restriction. If we ½nd earlier in life, but contributing to disad- drugs that give normal humans longe- vantages (e.g., Alzheimer’s disease) that vity bene½ts equal to caloric restriction emerge later. These genes were not ac- in rodents, then life expectancy could tively selected against because so few grow to 110 and possibly beyond 150 people survived to advanced ages until (which should give those political or recently. religious organizations that elect their ApoE genes also influence response heads for life pause). Other drugs may to injury. ApoE3 minimizes many in- broadly protect against Alzheimer’s dis- ease or arrest it at early stages. We may 3 Caleb E. Finch and Craig B. Stanford, “Meat Adaptive Genes and the Evolution of Slower also achieve cancer prevention someday, Aging in Humans,” Quarterly Review of Biology despite increasing exposure to carcino- 79 (1) (March 2004): 3–50. gens.
Dædalus Winter 2006 75 Caleb E. Many also look to regenerative med- However, new risks are appearing. Finch icine. One day, we may engineer stem Obesity and diabetes are more preva- on aging cells to replace cells lost in diseased or- lent, even among children. Maternal gans. Current debates about embryo diabetes, moreover, heightens the risk stem cells will sooner or later fade as of obesity in children. This fatty trend, research discovers ways to reprogram if it continues to grow, could reverse his- an individual’s own skin or marrow torical gains. Air pollution is also on the cells for new functions. Still there is a rise. Small particles from internal com- long way to go before neuronal stem bustion engines and various industrial cells can restore neurological damage sources inflict cardiovascular inflam- from traumatic injury or Alzheimer’s matory damage; animal studies have disease. We may also ½nd new ways shown that airborne pollutants activate of repairing vascular damage, through lung macrophages and increase oxida- engineered cells or circulating micro- tive stress. robots (vaso-rooters?) that are sent on Also important to consider is the gap patrol to repair unstable atheromas. Of between rich and poor. Not far from course, such future regenerative medi- the healthiest and most affluent elite cine will be very expensive because of in any large city are many who experi- the huge cost of development, limiting ence the onset of diabetes, hypertension, access to those who can afford it. If the and other chronic diseases earlier. Epi- current U.S. political climate is any demiologists associate the poor health guide, these costly wonders will not of those of lower socioeconomic status soon be available to those with low with higher exposure to infections and incomes. pollution, poor diet, and limited health Beyond these anticipated biomedi- care. In migrant workers, tb is at least cal advances, we need a broader view of ½ve times more prevalent than in oth- the ecology of human aging. A starting er groups. Moreover, the spread of hiv point for modeling future population increases the risk of tb and other infec- age structures is a more comprehensive tions that shorten life. Thus, poverty account of aging that includes the load both dooms the disadvantaged to higher of infections and environmental inflam- morbidity and shorter life spans, and mogens. We must also consider social increases the reservoirs of infectious dynamics such as the change in multi- agents that can spread to the advan- generational support for the elderly that taged. Sooner or later, voters must see is sweeping across developed countries. that the potential for longer, healthier The ecology of human aging must also lives depends on much higher standards consider the genetic changes evolved of health for the whole population. from our great-ape ancestors who were largely vegetarian and had limited mul- tigenerational interactions. We should also expect greater demographic diver- sity, both of life spans and health dur- ing the later years. The fortunate who grew up with little childhood illness and maintain optimum body weight through diet and exercise could live even longer than present cohorts.
76 Dædalus Winter 2006 Kenneth Clark
The artist grows old
“What is it to grow old?” asked Mat- Festers the dull remembrance of a thew Arnold, and gave a depressing an- change, swer: But no emotion–none! . . . ’Tis not to have our life Arnold was about forty when he wrote Mellowed and softened as with sunset- these melancholy lines, and his experi- glow ence of old age was presumably drawn . . . ’Tis not to see the world from his father’s friends or his fellow As from a height, with rapt prophetic civil servants. He wrote in a reaction eyes, against the conventional picture of a And heart profoundly stirred. golden old age which had been current . . . It is to spend long days in antiquity from Sophocles to Cicero’s And not once feel that we were ever de Senectute. Everyone remembers Ceph- young; alus, Plato’s dear old man at the begin- . . . Deep in our hidden heart ning of the Republic: ‘Old age has a great sense of peace and freedom. When the passions have lost their hold, you have Kenneth Clark, a Foreign Honorary Member of escaped, as Sophocles says, not only the American Academy from 1964 until his death from one mad master, but from many!’ in 1983, was a preeminent art historian of his Arnold was justi½ed in refuting this clas- generation. He was a director of the National sical myth of a golden sunset. But all the Gallery, a Surveyor of the King’s Pictures, Slade same, his diagnosis is not entirely cor- Professor of Fine Art at Oxford, and the author rect. ‘No emotion–none!’ On the con- of many books, including “Leonardo da Vinci” trary, elderly people feel emotion, and (1939), “Landscape Painting” (1950), “The tend to weep more than young ones. But Nude” (1956), and “Civilization” (1969), a best- bbc is it the kind of emotion that can be ex- selling companion to his renowned television pressed in memorable words? A few series of the same name. “The artist grows old” minutes’ reflection shows that it is not. was originally delivered in 1970, when Clark was The number of poets who have written Sir Robert Rede’s Lecturer at Cambridge Univer- memorable verse over the age of seven- sity. ty is very small indeed, and to write tol- © 1972 by Cambridge University Press. Re- erably over the age of sixty-½ve is excep- printed with the permission of Cambridge tional. This decline in the poetic faculty University Press. in old age must be distinguished from
Dædalus Winter 2006 77 Kenneth the loss of inspiration that may afflict a some unforeseeable Open Sesame, can Clark poet at any age. But the two are obvious- bring them out of bondage. In 1835 on aging ly connected. However desirable it may Wordsworth heard of the death of James be, in the conduct of life, to be free from Hogg, the Ettrick Shepherd. He went in- passion, the mad masters have been re- to the next room. He thought of Chatter- sponsible for at least three-quarters of ton, that marvellous boy; he thought of the great poetry in the world. And old his lost friends; and in less than an hour age, although it does not put an end to he returned with an extempore effusion: our emotions, dulls the intensity of all Nor has the rolling year twice measured our responses. The romantic poets rec- From sign to sign its stedfast course, ognised that this was the cause of declin- Since every mortal power of Coleridge ing inspiration; and, as we know from Had frozen at its marvellous source. Coleridge, it could happen quite early. The rapt one, of the Godlike forehead, He was only thirty-two when he wrote The heaven eyed creature sleeps in earth. that long and moving letter in verse to And Lamb, the frolic and the gentle, Sarah Hutchinson from which he later Has vanished from his lonely hearth. extracted his ‘Ode to Dejection’: A parallel instance can be quoted from I see them all, so excellently fair, Tennyson; he had long been deprived I see, not feel, how beautiful they are. of poetic inspiration, and had just ½n- And he went on to de½ne more precisely ished writing ‘Romney’s Remorse’, the feeling that he had lost: which even the most fervent Tenny- sonians do not defend, when, crossing Joy is the strong voice, joy the luminous to the Isle of Wight in October 1889, cloud. he was struck by an exceptionally high We in ourselves rejoice. tide, which seemed for some reason to This is a much more accurate descrip- symbolise his recent recovery from a tion of the loss that befalls us in old age serious illness. Open Sesame. When he than Arnold’s ‘no emotion–none!’ El- returned to Faringford he went straight derly people do not, and perhaps should to his room and in twenty minutes not, rejoice in themselves. Coleridge emerged with a poem: read this letter to the Wordsworths on But such a tide as moving seems asleep, 21 April 1802. At that time William had Too full for sound and foam, not lost the faculty of joy: in fact he When that which drew from out the was at work on the ‘Immortality’ ode. boundless deep He was so shocked by Coleridge’s pes- Turns again home. simism that he added one (or perhaps two) stanzas to the ‘Ode’ in order to re- He knew what had happened, and fute it. Alas, a few years later he suffered knew that it wouldn’t happen again. the same fate. He continued to write po- He gave instructions that ‘Crossing the etry; he wrote on high themes, with con- Bar’ should always be placed last in any scientious skill. ‘But emotion–none!’ collection of his works. Of course, the As most of you will know, there was an trouble about these flashes from the exception, and I will quote it to prove, depths of an elderly poet’s buried life is if proof were needed, that our feelings that they cannot be sustained. To do so do not die, but are buried so deeply in requires the kind of concentration that our memories that only some shock, is a physical attribute. ‘I can no longer
78 Dædalus Winter 2006 expect to be revisited by the continu- on a vigorous use of memory, with its The artist ous excitement under which I wrote my resulting confluence of ideas, is usually grows old other book’, said A. E. Housman in his in decline. The most ironic instance is preface to Last Poems, ‘nor indeed could that of Bernard Shaw, who believed that I well sustain it if it came.’ man would become wise if he could live If, for obvious reasons, elderly writers to be over 100 and to prove it wrote a dif- cannot sing with the same fervour as fuse and unreadable play that lacks all young ones, are there not other branches the intellectual vigour of his maturity. of literature in which they can excel? Such are the facts that must be faced One poet, who himself wrote movingly if we are to consider the old age of writ- in old age, tried to put a case for his fel- ers and artists. But they do not by any low ancients: means exhaust the subject. I believe that old, even very old, artists, have added And yet, though ours be failing frames, something of immense value to the sum Gentlemen, of human experience. There is undoubt- So were some others’ history names edly what I may call, translating from the Who trod their track light-limbed and fast German, an old-age style, a special char- As these youth, and not alien acter common to nearly all their work; From enterprise, to their long last, and during the rest of the lecture I shall Gentlemen. try to discover what it is. For some reason which is rather hard Sophocles, Plato, Socrates, to analyse, painters and sculptors do Gentlemen, not suffer from the same loss of creative Pythagoras, Thucydides, power that afflicts writers. Indeed the Herodotus and Homer–yea, very greatest artists–Michelangelo, Clement, Augustin, Origen, Titian, Rembrandt, Donatello, Turner Burnt brightlier towards their setting day, and Cézanne–seem to us to have pro- Gentlemen. duced their most impressive work in It is a valiant effort, but I do not ½nd the last ten or ½fteen years of fairly long Hardy’s roll-call wholly convincing. lives. I say seem to us because this was Sophocles is the classic instance, and not formerly the accepted opinion. In we must allow it. But we have no means the nineteenth century Turner’s later of knowing whether the late works of paintings were considered the work of Homer and Pythagoras were superior a madman, and Rembrandt’s Conspiracy to their early ones. I am ashamed to say of Claudius Civilis was called a grotesque that I have not compared the late and masquerade. The lack of polish in Tit- early works of Clement and Origen; but ian’s later canvases was excused on the I have compared St Augustine’s Confes- grounds that the painter was over nine- sions with the City of God, and have no ty, and John Addington Symonds said hesitation in saying that the Confessions, of Michelangelo’s Capella Paolina, ‘the written twenty years earlier, is the more frigidity of old age had fallen on his brightly burning of the two. I fear that imagination and faculties–one cannot after the age of seventy, or at most sev- help regretting that seven years . . . should enty-½ve, not only is the spring of lyric have been devoted to a work so obvious- poetry sealed up in the depths which ly indicative of decaying faculties.’ cannot be tapped, but the ordering, or That we should now admire these late architectonic faculty, which depends works so highly, often ½nding in them
Dædalus Winter 2006 79 Kenneth some anticipation of the tastes and feel- The Ark stood ½rm on Ararat; th’ return- Clark ings of the present day, tells us two ing Sun on aging things about them–that they are pes- Exhaled earth’s humid bubbles, and emu- simistic and that they are not concerned lous of light, with the imitation of natural appear- Reflected her lost forms, each in prismatic ances. Contrary to the Sophoclean or guise Ciceronian myth, it is evident that those Hope’s harbinger, ephemeral as the sum- who have retained their creative pow- mer fly ers into old age take a very poor view Which rises, flits, expands and dies. of human life, and develop as their on- Turner could express his sense of trag- ly defence a kind of transcendental pes- edy only through red clouds and a men- simism. We need only think of the eyes acing vortex of sea and sky. His ½gures, that look out on us from the late self- although not insigni½cant, are ridicu- portraits of Rembrandt to realise how lous. But in the great period of ½gure deeply this great lover of life became painting the aged artists chose tragic disenchanted by life. Michelangelo’s themes, and treated them in such a way head becomes, in Daniele da Volterra’s as to bring out their most disturbing portrait bust, an emblem of spiritual possibilities. As far as I know the ½rst suffering as poignant as his own Jere- artist to develop what I have called the miah; and when he portrayed himself old-age style was Donatello. Already in it was as the flayed skin of St Barthol- the St Anthony reliefs in Padua he had omew in the Last Judgement. Mantegna, moved a long way from the Hadrianic a name that can be added to the list of beauty of the David or the Dionysiac aged painters, looks in his bronze bust rapture of the dancing putti. The scenes more indignantly pessimistic than Mi- are vehemently dramatic, but the char- chelangelo, but he left in the corner of acter of St Anthony prohibits tragedy. one of his last pictures, the S. Sebastian By the time he came to the pulpits of in the Ca’ d’Oro, the emblem of his be- S. Lorenzo–he worked on them till his liefs, a smoking candle, with a scroll on death at the age of eighty–he was no which are written the words Nihil nisi div- longer persuaded by the comforting inum stabile est, coetera fumus. beliefs of humanism, so beautifully ex- This at least suggests a belief in God, pressed by the arcaded aisles beneath which has been denied to pessimists which the pulpits are placed. The rough, since the Enlightenment. ‘He was with- passionate, hirsute ½gures who surround out hope’, said Ruskin of Turner, one Christ in the Harrowing of Hell and seem can imagine how reluctantly. By the time to menace him with their angular ges- that the author of Modern Painters had tures, have no interest in reason and de- met his hero, Turner had grown almost corum. They are like a new race of Lan- completely monosyllabic in conversa- gobardi; and Christ himself, as he rises tion, but he continued to pour his feel- from the tomb in the next panel, is like a ings about human life into the formless, shipwrecked sailor, only just able to drag ungrammatical verses of The Fallacies himself ashore. The means by which this of Hope, and celebrated the salvation of ½erce new world of the aged imagination mankind after the Flood with these lines is made visible are equally remote from (which, incidentally, are the best he ever the humanist tradition of decorum. The wrote):
80 Dædalus Winter 2006 scenes are crowded, a reckless perspec- come for them a torture. Michelangelo The artist tive is used intermittently in order to is, perhaps, not a good example, because grows old heighten emotional effect, and the actu- he grumbled about every job he under- al modelling (or rather the carving, for took; but when he wrote beneath a late almost the whole surface has been cut in drawing of the Pietà ‘Dio sa che sangue the bronze) is as free and expressive as costa’, he was surely thinking of himself the stroke of a pen in an impassioned as well as of his Redeemer. drawing. At the opposite end of the spectrum As with many works of the old-age of art, Claude Monet, whose skill in style (Titian will provide another exam- rendering a visual experience has never ple) the S. Lorenzo reliefs are so far out- been surpassed, created his own marvel- side the humanist norm that an earlier lous and unforeseeable late manner, out generation of critics questioned their of in½nite pain. He wrote of his water- authenticity. And when they were done garden canvases, ‘in the night I am con- –in the light-footed youth of Lorenzo stantly haunted by what I am trying to de’ Medici–Donatello must have felt realise. I rise broken with fatigue each completely isolated from his contem- morning. The coming of dawn gives me poraries. Old artists are solitary; like all courage, but my anxiety returns as soon old people they are bored and irritated as I set foot in my studio . . . Painting is by the company of their fellow bipeds so dif½cult and torturing. Last autumn I and yet ½nd their isolation depressing. burned six canvases along with the dead They are also suspicious of interference. leaves in my garden.’ Gone the same way Vasari describes how, late one night, he as Christ’s torso in the Rondanini Pietà. was sent by Pope Paul III to Michelange- The aged Degas wrote in almost identi- lo in order to obtain from him a certain cal terms. drawing. Michelangelo, recognising his So the aged artist’s pessimism ex- knock, came to the door carrying a lamp, tends from human life to his own cre- and Vasari just had time to see that he ative powers. He can no longer enter was working on a marble pietà; but sympathetically into what he sees, when Michelangelo noticed that his visi- and he no longer has any con½dence tor was looking at it, he dropped his lan- in human reason. This, as I have said, tern, and they remained in the dark, till is something that we can understand Michelangelo’s servant, Urbino, a feeble more easily than could our grandfathers. candle in his hand, returned with the They loved the art of the renaissance be- drawing. Then, as if to excuse himself, cause it was based on naturalism, a love Michelangelo said, ‘I am so old that of- of physical beauty and rational order. ten death tugs at my sleeve, and soon I Berenson, no less than John Addington shall fall like this lantern and my light Symonds, speaks with real hatred of Mi- will go out.’ The reason, says Vasari, why chelangelo’s Last Judgement and (as far as Michelangelo dilettassi della solitudine was I know) never even mentions the fres- his great love of his art. But it would be coes in the Capella Paolina. Yet for those a mistake to suppose that great artists who have the good fortune to see them, escape the pains of old age through the these two extraordinary works provide joys of creative labour. On the contra- an experience as moving as anything in ry, all old artists who have left us a writ- art, as moving as the storm scenes of ten record of their experiences, have de- King Lear, and as rich in layer upon layer scribed how the act of creation has be- of meaning.
Dædalus Winter 2006 81 Kenneth As usual Michelangelo had undertaken this drama some of his greatest formal Clark them reluctantly. ‘I cannot refuse any- inventions, many of which would have on aging thing to Pope Paul; but I am ill-pleased had a special meaning for his contem- to do them and they will please nobody.’ poraries. For example, the pose of Saul ‘The art of fresco’, he complained, ‘was extended on the ground is clearly rem- not work for old men.’ But, as he said iniscent of Raphael’s Heliodorus, the in the same year, ‘one paints with the would-be despoiler of the Temple. Paul brain and not with the hands’, and hav- III would have instantly recognised his ing once started on the work, his whole allusion. He would have thought of the mind and spirit were engaged. The sub- contrast between the avengers of Helio- jects selected for him were the Conver- dorus and the divine apparition that re- sion of Saul and the Cruci½xion of St directs Saul; and would also have no- Peter, episodes which had a particular ticed that Michelangelo’s age-old enmity theological and doctrinal importance with Raphael had at last been reconciled. to Paul III. The Conversion of Saul was Another example: Saul’s horse, whose the supreme example of grace, and in panic leap away from us is, so to say, the Rome of the 1540s the doctrine of justi- most massive fragment of the exploded ½cation by grace was a topic of heart- world, is one of the antique horses of the searching and earnest discussion. The Quirinal, seen from below, as Michelan- most learned and devout of the Cardi- gelo must have seen it almost every day nals, Contarini, Morone and Pole, who when he made his way to Vittoria Colon- had been the associates of Paul III before na’s apartment. Almost every ½gure has his elevation, were deeply impressed by a resonance of this kind. the arguments of Luther, and at the cen- But marvellous as it is, the Conversion tre of their discussions was Michelange- of Saul is a less moving work than the lo’s dearest friend, Vittoria Colonna. Cruci½xion of St Peter, and I may add a Thus the Conversion of Saul became for less complete example of the old-age Michelangelo almost a personal experi- style. The Conversion is still full of en- ence, and he has made Saul’s head an ergy and the intervention of the heav- idealised self-portrait. There are many enly powers gives us reason for hope. representations in art of ecstasy, of suf- The Cruci½xion of St Peter portrays the fering, and of enlightenment; but none human lot as hopelessly and monoto- that equal this portrayal of the painful nously tragic. Instead of an explosion, transition through blindness to spiritual with its possibility of a new life, the sight. Saul lies on the ground protected Cruci½xion of St Peter is a wheel of life, a by the encircling arms of one of his com- rond des prisonniers, revolving round the panions, an ordinary man. The rest of central ½gure, in and out of the frame. his troop breaks up in confusion. Their On the left-hand side Roman legionar- world seems to have exploded, as Chris- ies, inspired by Trajan’s column, move tendom had just exploded, touched off upwards; on the right, conquered and by the doctrine of faith. The cause of this disinherited people move downwards. explosion, the ½gure of Christ, swoops Their leader, a barbarian giant with head down from the sky. With one hand he bowed and arms folded in resignation, con½rms Saul in his new belief; with is one of Michelangelo’s noblest inven- the other he points to the world beyond tions, a piece of visionary art that was Damascus, in which St Paul will preach to inspire Blake’s ½rst dated engraving. His Gospel. Michelangelo has put into Two groups are not part of the wheel.
82 Dædalus Winter 2006 One represents the forces of law and technique or facture. The aged artist The artist order, who have condemned St Peter usually employs a less circumscribed grows old to death, and have been ordered to see and rougher style. In fact parts of the that the sentence is being carried out. frescoes are painted with considerable They are led by a captain, who is the freedom; but as a whole Michelangelo pitiless embodiment of action, and has maintained the ½rm outlines of ev- closely resembles one of those ideal ery form, either because the medium heads which Michelangelo had drawn seemed to demand it, or because he felt twenty-½ve years earlier for presenta- that great truths must, in Blake’s words, tion to those handsome young men be bounded by the wiry line of rectitude. who so troubled his peace of mind. Bal- This clarity of enunciation (even when ancing these active participants is a the statements are themselves obscure) group of four women, two of them look- the old-age style tends to reject. To illus- ing at the Martyrdom, one gazing wild- trate this characteristic we must turn to ly into space, one looking directly at us. the only artist of equal greatness whose They are like a Sophoclean chorus. Inci- lifespan probably equalled Michelange- dentally, technicians tell us that this was lo’s eighty-nine years–Titian. the last day’s work on the wet plaster of Nobody knows when Titian was born. the fresco, and so the last piece of paint- Renaissance artists were in the habit of ing ever executed by Michelangelo. lying about their birthdays for ½nancial Within the circle of life is an inner reasons, and the tradition that Titian circle formed by St Peter’s arms, and was born in 1477 is hardly credible. But the men who are raising his cross, and when he painted the pictures in which it, too, has an appendage–the young he develops his old-age style, he was cer- man who, with mindless concentration, tainly over eighty. Three of them, the digs the hole in which the cross will be Martyrdom of St Lawrence in the Escorial, placed. He is innocent, the air-force pi- the Crowning with Thorns in Munich and lot who releases the bomb. The saint the Flaying of Marsyas in Kromeresz, are himself is one of Michelangelo’s most reworkings of pictures that Titian had formidable embodiments of faith and painted earlier, and it is remarkable that will. Unlike Saul, who receives his pain- he chose to repeat three of the most vio- ful enlightenment with a kind of grati- lent and tragic subjects in the whole of tude, St Peter is not at all resigned to his œuvre. In the later versions of all his fate, and glares at us angrily. He will three the sense of tragedy and its univer- break through the circle of human bon- sal application to human life is enhanced dage if he can. It is no accident that Mi- by purely pictorial means. The earlier chelangelo has given his body the same Crowning with Thorns is a superb academ- form that we ½nd in his magni½cent ic exercise, but visitors to the Louvre do drawings of Prometheus. not look at it for long. We have all grown Michelangelo’s frescoes in the Pauline too suspicious of rhetoric, and Christ’s Chapel exhibit almost every characteris- anguished movement has a chilling ef- tic of the old-age style: its pessimism, fect. Translated into the old-age style it its saeva indignatio, its feeling of hermetic is subordinated to a single passionate cry isolation; and on the formal side its anti- made through the medium of colour and realism, and its accumulation of symbol- design. The central theme is no longer ic motives. In one respect, however, they the expression of Christ’s head, but the do not entirely conform: in the actual cruel geometry of the soldiers’ sticks. A
Dædalus Winter 2006 83 Kenneth powerful diagonal leads up to a basket vour on Olympus because the goddess Clark full of flames, and we suddenly realise Athena, having invented it, found that on aging how great a part ½re and flame play in it distorted her features and threw it Titian’s later work. It became an obses- away. It was picked up by Marsyas, who sion similar to the ageing Leonardo’s learned to play the instrument so skilful- obsession with destruction by water; ly that he was emboldened to challenge and we ½nd it again in the Escorial St Apollo to a musical contest. The judge Lawrence, where the ½re that lights up the was King Midas, who, as King of Phry- evil faces of his executioners is, for the gia, decided in favour of Marsyas; but saint, a source of ecstasy. I am reminded the Muses reversed his decision, and or- of some lines by one of the rare poets dered that as a punishment for his inso- who continued to write great poetry in lence, Marsyas should be flayed. It is one advanced age, W. B. Yeats: of those offsprings of the Greek imagi- nation in which the forces of divine or- Saeva indignatio and the labourer’s hire der assert themselves by an act of cruel- The strength that gives our blood and ty and we are left horri½ed by the price state magnanimity of its own desire that it seemed worth paying for Olym- Everything that is not God consumed pian harmony and reason. The antique with intellectual ½re. world does not seem to have questioned Throughout his life, Titian had been it, and two groups of statuary, one of the supreme master of fruitfulness. He them by Myron, were amongst the most had used his skill in the cuisine of paint- frequently copied sculptures of the an- ing to render the smooth, full pressure cient world. The hanging Marsyas from of flesh on skin, or pulp on rind. In the one of these groups was, in fact, known work of his old age these sensual and to Michelangelo and provided a model vegetable images are replaced by ½re, for those late drawings of a Cruci½xion flame and smoke. Titian, like Turner, which are amongst his most moving ex- did not put his thoughts into words, amples of the old-age style. Titian saw but even his earlier paintings leave us the myth in less simple terms. To begin in no doubt that he had a powerful and with his Marsyas is hung up by the feet, well-stored mind; and in his last pic- like a dead animal in a butcher’s shop– tures he becomes a profound philoso- or like St Peter who would not be cruci- pher. The most complete expression of ½ed in the same position as his Saviour. his philosophy is to be found, after con- All the other protagonists crowd round siderable search, in the Moravian town him in a circle, giving the design that of Kromeresz. It represents one of the uninterrupted fullness which is a mark cruellest myths of antiquity, the Flaying of the old-age style. Titian understands of Marsyas. As with the St Lawrence, we that this sacri½ce is questionable. Mi- know that he had painted a version of das sits beside the central ½gure, sunk the subject in his maturity, but the pic- in reverie, and behind him a satyr who ture at Kromeresz is one of those left in has come to help his tortured sovereign, his studio on his death, and sold by his starts back with pity and astonishment. great-nephew, Tizianello, to the Earl of The flaying goes on as a ritual act, ac- Arundel. In case the story of Marsyas is companied by the music of Apollo’s not fresh in your minds, let me remind cithara. He plays as if in ecstasy, and vi- you that he was a satyr who excelled in brations of sound seem to ½ll the whole playing the flute. The flute was out of fa- canvas. We are ravished, and yet we feel
84 Dædalus Winter 2006 that beauty achieved at the expense of the subject alone would not achieve. Tit- The artist life is outrageous. This is a kind of cruci- ian’s subject is horrifying, Rembrandt’s grows old ½xion, a sacri½ce of pure instinct to rea- grotesque, yet both arouse in me a sim- son, and if all that reason can achieve is ilar emotion. For a second I feel that I the hideous shedding of blood, why not have had a glimpse of some irrational leave the Dionysiac impulses to follow and absolute truth, that could be re- their own course? An answer is given by vealed only by a great artist in his old another masterpiece of the old-age style, age. the Bacchae of Euripides. The triumph of Clouds of affection from our younger eyes the irrational produces its own kind of Conceal the emptiness which age descries. catastrophe, as cruel as the triumph of The soul’s dark cottage, battered and reason. decayed, This bare description of Titian’s imag- Lets in new light through chinks that time ery suggests a wealth of visual metaphor hath made. almost as great as is to be found in Mi- chelangelo’s Pauline frescoes. But what The Rembrantesque image of Edmund I cannot convey in words is the extraor- Waller is irresistible. But it is only part- dinary freedom with which it is painted. ly accurate, because the light that en- Every stroke of the brush is itself a meta- trances us in these old-age pictures is morphosis, in its ½rst dictionary sense, not the result of exhaustion or decay, ‘the action of changing in form or sub- but is communicated to us by the inde- stance, especially by magic.’ Paint is no structible vitality of the painter’s hand. longer a solid sticky substance, but pre- Nearly all the painters who have grown cious, volatile and alive. greater in old age have retained an as- The transformation of paint into an tonishing vitality of touch. As their han- endless series of direct messages from dling has grown freer, so have strokes the painter’s imagination appears in of the brush developed an independent another great masterpiece of the old- life. Cézanne, who in middle life painted age style, Rembrandt’s Conspiracy of with the delicacy of a water-colourist, Claudius Civilis. As with Titian, this is and was almost afraid, as he said, to sul- the reworking of an earlier invention, ly the whiteness of a canvas, ended by only in this instance Rembrandt has attacking it with heavy and passionate painted over a fragment of the original strokes. The increased vitality of an aged canvas which, for some unexplained hand is hard to explain. Does it mean reason, had been rejected by his patrons, that a long assimilation of life has so the City Fathers of Amsterdam. He has ½lled the painter with a sense of natural felt free to please himself and in the Cy- energy that it communicates itself invol- clopean hero and his grotesque atten- untarily through his touch? Such would dants has produced a world so bizarre seem to be the implication of the famous that one cannot but admire the courage words of Hokusai in the preface to his of the seventeenth-century connoisseurs Hundred Views of Fuji: who saved the picture from destruction. All I have produced before the age of sev- But these strange ½gures have the inev- enty is not worth taking into account. itability of Macbeth’s porter or Ham- At seventy-three I learned a little about let’s gravedigger. And the freedom with the real structure of nature, of animals, which every form is translated in the plants, trees, birds, ½shes and insects. colour holds us spellbound in a way that
Dædalus Winter 2006 85 Kenneth In consequence when I am eighty, I shall Christ’s head is twisted in agony, like Clark have made still more progress. At ninety Laocoon; in the later version he sits on aging I shall penetrate the mystery of things; at motionless with downcast eyes. His last a hundred I shall certainly have reached great Pietà in the Venice Academy unites a marvellous stage; and when I am a hun- both the elements of the ‘old-age style’; dred and ten, everything I do, be it a dot Mary Magdalene steps forward from the or a line, will be alive. I beg those who live platform, passionate, enraged, like an ac- as long as I to see if I do not keep my word. tress who can no longer endure her role, Written at the age of seventy-½ve by me, but must break out of the scene and ap- once Hokusai, to-day Gwakio Rojin, the peal to the audience; but the Virgin and old man mad about drawing. St Jerome are resigned. Incidentally, we may suppose that ‘Everything I do, be it but a dot or a line, this sublime work was originally in the will be alive.’ Rembrandt could have said same style as the Marsyas, and perhaps the same, and so, before his loss of man- for that reason was refused by the monks ual skill, could Leonardo. There is noth- of the Frari. Palma Giovane, who ½n- ing more mysterious than the power of ished it with skill and understanding, an aged artist to give life to a blot or a added an inscription, saying that it had scribble; it is as inexplicable as the pow- been inchoatum. We cannot blame him, er of a young poet to give life to a word. but if it had come down to us as Titian Another reason for the reckless free- left it, I think it would have been one of dom of facture in the old-age style is the greatest pictures in the world. the feeling of imminent departure. ‘I Writers on Titian have long accepted haven’t long to wait. I shall say what I that St Jerome who kneels before the like, how I like, and as forcefully as pos- Virgin is an idealised self-portrait, and, sible.’ Maer Grafe put it more vividly as I have said, the Midas in the Flaying in his description of Van Gogh’s style: of Marsyas is almost identical. Twenty ‘He paints as one whose house is beset years earlier Michelangelo had included by burglars, and pushes his furniture his idealised self-portrait, as Nicodemus, and everything he can lay his hands on in the marble pietà now in the cathedral against the door.’ Van Gogh was in his of Florence. It may have been the piece thirties. Cézanne and Monet did not ar- which Michelangelo was carving when rive at this state of desperation till their Vasari paid his nocturnal call, and short- last years. Then they began their furious ly afterwards Michelangelo broke it up; battle with time, not staining, but scar- just as Rembrandt cut up his canvases, ring the white canvas of eternity. But in and Monet burned his. Later Michelan- contrast to this grandiose impatience is gelo was persuaded to sell the pieces to an ultimate feeling of resignation and a friend named Bandini, and it was re- total understanding. In Rembrandt’s stored by the sculptor Calcagni. It was Prodigal Son in the Hermitage we feel really inchoatum and Calcagni was more that the whole of humanity has been en- ambitious and less sensitive than Palma folded in an act of forgiveness, beyond Giovane. But fortunately he died before good and evil. completing his work. The ½gure of Nico- Titian, the sensualist, courtier and lib- demus remains unrestored, and as one ertine, reveals himself in his latest pic- looks at his noble head from different tures, the master of resignation. In the angles and in different lights one ½nds ½rst version of his Crowning with Thorns, a whole range of human emotion be-
86 Dædalus Winter 2006 ginning with unutterable grief, passing Turning back to writers of equal stature, The artist through practical solicitude (specially one cannot but be struck by the differ- grows old praised by Vasari), and ending with ence between the two arts. calm and an almost beati½c resignation. One of the ½nest critical essays in I do not think that Titian was inspired by English begins with the words, ‘It is a this precedent, and indeed it is most un- mistake of much popular criticism to likely that he had seen the group. Nor do regard poetry, music and painting–all I think that the desire of an aged artist the various products of art–as but trans- to include himself in his last great work lations into different languages of one was a piece of egotism. Rather, I would and the same ½xed quantity of imagina- suppose that he has come to think of the tive thought, supplemented by certain great tragic myths of the human imagi- technical qualities.’ Pater’s warning is nation as almost his private property. always in my mind. Nevertheless the el- He sees them with a mixture of heartfelt derly great do seem to have a good deal participation and detachment that re- in common, and it is worth speculating quires his actual presence in the drama. on the reasons why they can express Now let me try to summarise the char- themselves so much more movingly in acteristics of the old-age style as they ap- painting and sculpture than in poetry. pear, with remarkable consistency, in the Perhaps a clue is given by Coleridge’s work of the greatest painters and sculp- words, ‘we in ourselves rejoice’ togeth- tors. A sense of isolation, a feeling of er with the word vitality. The painter holy rage, developing into what I have is dealing with something outside him- called transcendental pessimism; a mis- self, and is positively drawing strength trust of reason, a belief in instinct. And from what he sees. The act of painting is in a few rare instances the old-age myth a physical act, and retains some element of classical antiquity–the feeling that of physical satisfaction. No writer enjoys the crimes and follies of mankind must the movement of his pen, still less the be accepted with resignation. All this click of his typewriter. But in the actual is revealed by the imagery of old men’s laying on of a touch of colour, or in the pictures, and to some extent by the treat- stroke of a mallet on a chisel, there is a ment. If we consider old-age art from moment of self-forgetfulness. Harassed a more narrowly stylistic point of view, public servants–presidents, statesmen we ½nd a retreat from realism, an impa- and generals–take up painting; they do tience with established technique and not (with the exception of Lord Wavell) a craving for complete unity of treat- write poetry. It may seem ridiculous to ment, as if the picture were an organism compare the therapeutic activities of in which every member shared in the life these amateurs to the struggles of Titian of the whole. or Rembrandt; but I think that they do I have mentioned a few of the artists indicate a fundamental difference be- in whose late work these characteristics tween the two arts. A visual experience can be found. I could have extended it to is vitalising. Although it may almost im- almost every great painter who has lived mediately become a spiritual experience beyond the age of 65 or 70. Indeed I can (with all the pain which that involves), it think of only one exception, Piero della provides a kind of nourishment. Where- Francesca; and there a physical cause, as to write great poetry, to draw continu- cataract or partial blindness, prevented ously on one’s inner life, is not merely him in his old age from painting at all. exhausting, it is to keep alight a consum-
Dædalus Winter 2006 87 Kenneth ing ½re. What in old age feeds this ½re? was half enchanted by visions of beauty Clark Memories of past emotions; only very and half bored to death’, although it has on aging occasionally fresh experiences which, if been rejected with horror by most schol- they are strong enough to generate poet- ars of Shakespeare, seems to me sub- ry, cannot as Housman said, be endured stantially true. No man has ever burnt for any length of time. himself up more gloriously. But The Tem- Before trying to discover instances of pest does seem to show some character- the old-age style in literature and music, istics that only an artist who has lived I ought perhaps to consider the question his life could give. Far more than the ear- of what, in a creative artist, is meant by lier plays it creates a private world of the ‘old.’ Painters and sculptors tend to live imagination. Shakespeare, who had in much longer than writers or musicians, the past written so immediately for his and their work shows no sign of old age actors and his audiences, now seems to till their last years. Mr Henry Moore is be writing only for himself. And Pros- seventy-three, but neither in himself pero’s last speech could surely not have nor in his carving is there the slightest been written by a young man, even the sign of old age. Matisse became bedrid- young Shakespeare. den, but his art remained as fresh as a I have hesitated to quote the example daisy. Conversely, Beethoven was under of Shakespeare in The Artist Grows Old; ½fty when he entered what critics agree and I would de½nitely exclude Racine, to call his last period, and the quartets, for, in spite of the enormous change that written when he was ½fty-½ve, are clas- took place in his life during the twelve sic examples of the old-age style in their years’ silence between Phèdre and Esther, freedom from established forms and and the considerable difference of style their mixture of remoteness and urgent of his last two plays, they do not seem personal appeal. Like the last works of to reflect the liberation of old age. But Michelangelo and Titian, they seem to I have no such hesitation in including go beyond our reach, and yet there is an a third–I might say the third–great Eu- ultimate reconciliation. One should, I ropean dramatist: Ibsen. His last plays, suppose, add that Beethoven’s isolation from The Master Builder to When We Dead may have been increased by his deafness. Awaken, are perhaps the most complete But there are other examples of an old- illustration in literature of the character- age style in a great artist under ½fty for istics of the old-age style as we have seen which there is no such simple explana- them more consistently revealed in the tion. How do we explain Shakespeare’s visual arts. last four plays? Critics tend to write of First, isolation. In the 1890s Ibsen was them as if they were the work of an old the most famous writer in Europe, but man, although Shakespeare was in his after his return to Norway he lived in a middle forties when he wrote them. Peri- solitude of his own making. He was as cles, Cymbeline and The Winter’s Tale do lonely as Michelangelo, and if anything indeed show some of the negative char- rather grumpier. Then the flight from acteristics of the old-age style–the im- realism. Viewed as a realistic drama The patience, the recklessness and the bitter- Master Builder is unconvincing, and in ness. But these seem to me symptoms of When We Dead Awaken all pretence of exhaustion rather than of a new direc- naturalism is abandoned. Both plays are tion. Lytton Strachey’s notorious judge- still based on marvellous and embarrass- ment that ‘Shakespeare in his last years ing psychological insights; but in form
88 Dædalus Winter 2006 they are allegories of guilt and redemp- Goethe in his list. Perhaps he could The artist tion. They are full, perhaps too full, of not bring himself to say (and we sym- grows old symbols; and as usual with the old-age pathise with him) that the second part style, these symbols can be interpreted of Faust burned brightlier than the ½rst. differently and leave us with an uneasy The numerous lyrics that Goethe wrote feeling that we can decipher only half in his last years at the drop of a hat may the message. They are intensely person- be better than Longfellow. I cannot tell. al; in fact it can be argued that the hero- What is certain is that they might have villain of each play is Ibsen himself, the been written by any middle-aged poet man who sacri½ced life to art and came conscious of his powers, and of his re- to believe that life is the more impor- sponsibilities to a rather conventional tant. Michelangelo, when asked to de- notion of poetry. sign the reverse side of his portrait med- In the present century, as opposed al by Leone Leoni, chose as his emblem to the last, poets have tended to gain an old blind pilgrim, led by a mongrel in power as they grew older, and a num- dog, trotting along con½dently with tail ber of them have written movingly in erect. Ibsen would have agreed. But soli- the old-age style–Yeats, Rilke, Thomas tude and physical inaction do not imply Hardy himself. Yeats and Rilke used the a lack of vitality, and during the years freedom of address and the almost im- in which his last play was being written, penetrable symbolism of aged painters. Ibsen was constantly falling in love with Thomas Hardy in such a poem as After- young girls. Hilde Wangel and Irene math spoke more simply, but with a feel- were real experiences and few things ing of isolation and imminent depar- gave him more satisfaction than to read ture. But with no disrespect to these about the aged Goethe’s love affair with ½ne poets, I think one must allow that Mariana von Wilmer. Only instead of they are in a different category to Mi- his young ladies inspiring him to write chelangelo, Titian and Rembrandt. Can poems to the rising moon, as Goethe we name an aged poet of this stature? did, whether effectively or not it is hard Although he arouses no enthusiasm to say, Ibsen saw them as a new kind of among modern critics, I hope I may be Eumenides, playing on his sense of guilt allowed to pronounce the name of Mil- and driving him on to self-destruction. ton. Samson Agonistes is, so to say, a dou- On the name of Goethe, I must con- ble distilled example of old-age writing, fess that the greatest and most proli½c because it is undisguisedly modelled on of septuagenarian poets does not illus- the Oedipus at Colonus which Sophocles trate the characteristics of an old-age is supposed to have written after the age style, which seems to me so evident in of 87. Like the other examples I have the work of painters and sculptors. It is quoted, it is deeply personal. Milton true that the second part of Faust ends was himself blind; his hopes had been with symbolic utterances as mysterious shattered, his cause betrayed, and al- as the last speeches in When We Dead though his relations with the opposite Awaken. But Goethe’s respect for con- sex were certainly not as simple as those formity (what is usually referred to as of Samson and Delilah, he felt that his his wisdom) led to a tone of vague op- love of women was in some way con- timism, which his fellow ancients have nected with his failure. Samson Agonistes not usually shared. It is remarkable is almost as autobiographical as the last that Thomas Hardy does not include plays by Ibsen. But it differs from them
Dædalus Winter 2006 89 Kenneth in that Samson discovers a humility that ½ery pessimism of Michelangelo and Clark Ibsen’s guilt-ridden characters cannot Titian, and is perhaps the least painful on aging achieve, and so unlike the questionable expression of growing old. victories of Solness and Rubeck, he ends The fact is that Arnold was not far his career with an apotheosis which is wrong. The outstanding poet of our also the highest victory of old age. own day, Mr T. S. Eliot, has ampli½ed Samson Agonistes, like Paradise Regained, his statement with more subtlety and also ends on a note of resignation; and even greater bitterness: in its actual diction it introduces one Let me disclose the gifts reserved for age more aspect of the old-age style–a stoic To set a crown upon your lifetime’s effort. austerity which denies any appeal to the First, the cold friction of expiring sense emotions made through the sensuous Without enchantment, offering no prom- quality of the medium. Michelangelo, ise Titian, Rembrandt, Donatello, Cézanne, But bitter tastelessness of shadow fruit all continued to use their media with an As body and soul begin to fall asunder. added sense of its material possibilities. Second, the conscious impotence of rage But at least two great artists of the seven- At human folly, and the laceration teenth century voluntarily rejected that Of laughter at what ceases to amuse. charm of colour, light and joy in the use And last, the rending pain of re-enactment of paint which captivates us in their ear- Of all that you have done, and been; the ly work. These are Poussin and Claude. shame Poussin had equalled the great Venetians Of motives late revealed, and the aware- in his richness of colour and had sought ness for subjects that might allow him such Of things ill done and done to others’ sensuous delights. But by the time he harm had come to paint his second series of Which once you took for exercise of the Seven Sacraments, he had come to feel, virtue. as did Milton in Paradise Regained, that to display any pleasure in sensation would Any elderly person can vouch for the be to deprive the subject of its high seri- accuracy of those lines. They record ousness. Poussin by the intellectual pow- the common lot of homo sapiens. And er of his invention seems to me to have the miraculous fact, which I have tried justi½ed his puritanical renunciation. to describe in this lecture, is that many But a poem, which has to hold our atten- artists and some writers have, with in- tion and keep our faculties warm for a ½nite pain, created great works of art longer time than a picture, may suffer out of these miserable conditions. Their more severely from the exclusion of or- rage at human folly has not been impo- nament and graphic invention. The old- tent, their re-enactment of things done age style of Claude was less calculated. has been a means of re-creating them In his latest landscapes he did not delib- as part of a life-preserving myth, and erately exclude the enchantments of they have arrested the moment when light and distance; but he retreated in- the body and soul fall asunder, caught to a remote world of his own creation, enough of the body to make the moment where colour is subdued to a near mono- comprehensible, and seen how its disin- chrome and events take place in a sort of tegration reveals the soul. trance. This gentle, dreamlike departure from reality is very different from the
90 Dædalus Winter 2006 Jagadeesh Gokhale & Kent Smetters
Measuring Social Security’s ½nancial outlook within an aging society
The U.S. Social Security program value of the program’s ½nancial short- provides an important ‘½rst pillar’ of falls over the next seventy-½ve years.2 retirement income.1 Policymakers and These measures have two problems. the media, therefore, pay considerable First, they create a misleading impres- attention to the ½nancial viability of sion of the program’s ½nancial outlook. the program. Each year, the Social Se- Second, they are biased against poten- curity trustees release a report that sum- tial reforms that could improve the pro- marizes the ½nancial position of the gram’s ½nances. Social Security program. Among other Fortunately, the trustees have recently measures, the report draws attention to adopted new accounting measures that the program’s ‘crossover date’ (the year deal with both problems. These meas- the program’s bene½t outlays will begin ures reveal an $11.1 trillion present-value exceeding its tax receipts), the date of shortfall, which equals about 3.5 percent ‘trust fund exhaustion,’ and the present of the present value of all future taxable payrolls. Unfortunately, because these new measures are buried in the trustees’ Jagadeesh Gokhale is a Senior Fellow at the Cato report, they have received only scant Institute. An expert on entitlement reform, labor consideration from policymakers and productivity and compensation, and U.S. ½scal policy, Gokhale has authored papers in the “Re- view of Economics and Statistics,” the “American 1 Kent Smetters’s research was supported by Economic Review,” and the “Journal of Public the U.S. Social Security Administration (ssa) Economics,” among others. through a grant in 2003 to the Michigan Retire- ment Research Consortium as part of the ssa Retirement Research Consortium. The opinions Kent Smetters is associate professor of insurance and conclusions expressed are solely those of and risk management at the Wharton School of the authors and do not represent the opinions the University of Pennsylvania. He has published or policy of the ssa, any agency of the federal articles in the “American Economic Review,” the government, or the Cato Institute. The authors thank Howell Jackson, James Lockhart, William “Journal of Public Economics,” and the “Journal Niskanen, Peter Orszag, and Peter Van Doren of Political Economy.” for useful comments.
© 2006 by Jagadeesh Gokhale & Kent 2 ‘Present value’ is a number that summarizes Smetters a sequence of ½nancial shortfalls by applying
Dædalus Winter 2006 91 Jagadeesh the media. The newer measures should of their previous earnings. Social Secu- Gokhale receive greater attention. Indeed, were rity is often credited with reducing pov- & Kent Smetters these new measures taken more serious- erty among the elderly in the United on ly, reforming Social Security and Medi- States.3 aging care could reemerge as the top policy Participation in Social Security is man- priority that it deserves to be. datory for most occupations.4 Social Se- curity is ½nanced by a 12.4 percent pay- Social Security covers almost the en- roll tax on covered earnings up to a lim- tire U.S. population, providing partic- it. This limit is currently $94,200, but it ipants and their spouses with retire- increases each year with the economy- ment, disability, and other bene½ts dur- wide average wage. Employer and em- ing different stages of life. Social Secu- ployee split this tax evenly. Participants rity is currently the largest single out- become ‘fully insured’ after they have lay in the U.S. federal budget; many worked in a covered job for forty calen- consider it one of the most successful dar quarters and earned more than a pre- programs in U.S. history. Although So- determined wage. Fully insured partici- cial Security, on average, replaces only pants, however, do not acquire a con- about 40 percent of a worker’s annual tractual right to speci½c amounts of ben- earnings before retirement, it provides e½ts.5 Instead, they earn a noncontractu- an important ‘½rst pillar’ of retirement al right to bene½ts that are governed by income. Indeed, for poorer retirees, So- the laws in effect when they become eli- cial Security replaces 90 percent or more gible to receive bene½ts. These laws as well as the bene½t formula are subject to change by Congress. a discount factor to future shortfalls and tak- ing their sum. The further in the future that Social Security’s bene½t formula is a shortfall occurs, the larger the discount fac- similar to a private-sector de½ned-ben- tor applied. This is done to place dollars ac- e½t plan’s, where a speci½c formula ap- cruing at different points in time on an equal plied to a retiree’s wage history deter- valuation scale. Discount factors are usually of mines his or her bene½ts.6 In contrast, the form [1/(1+r)]t. Here, r is an annual interest rate that signi½es the ‘time value of money.’ If voluntary, tax-favored de½ned-contribu- investing $1 earns interest of 5 cents per year, tion retirement plans–401(k), 403(b), the value of $1 available today is the same as Keogh, and others–generate retirement $1.05 available next year. Similarly, the value income based directly on a person’s pre- of $1 available next year equals $[1/(1.05)] today, which is less than $1: in other words, 3 Gary Engelhardt and Jonathan Gruber, “So- this amount plus accrued interest will amount cial Security and the Evolution of Elderly Pov- to $1 next year. The discount factor applied erty,” National Bureau of Economic Research, to dollars accruing after t years is, therefore, Working Paper 10466, May 2004. [1/(1.05)]t (where r=0.05). The ‘present value’ of all future ½nancial shortfalls is the sum of 4 A notable exception includes state workers those shortfalls taken after each is discounted who are covered by state pension programs. according to the number of years in the future that it occurs. When calculating the present 5 See the U.S. Supreme Court case, Nestor v. value of projected shortfalls for government Flemming, 363 U.S. 603 (1960). programs, the appropriate interest rate to use is the ‘government’s interest rate’–the market 6 One major difference is that Social Security rate that it must pay lenders to obtain funds. bases a retiree’s bene½t on many more years For Social Security, the annual inflation-adjust- of earnings throughout his or her lifetime than ed interest rate used in recent years by the pro- the number of years most private-sector de- gram’s trustees equals 3.1 percent. ½ned-bene½t plans use to determine bene½ts.
92 Dædalus Winter 2006 vious contributions and subsequent During the early 1980s, the independ- Measuring market investment returns. Social ent Of½ce of the Actuary at the Social Security’s Whereas previous contributions ‘ful- Security Administration projected that ½nancial ly fund’ withdrawals from voluntary tax- revenues would fall short of bene½t out- outlook favored retirement plans, Social Securi- lays during the early part of the twenty- ty operated mostly on a ‘pay-as-you-go’ ½rst century, largely because of the baby basis between the 1940s and the early boom generation’s retirement. Although 1980s: payroll tax revenue collected each this generation enlarged the labor force year was paid out almost immediately as considerably (in part through the great- bene½ts rather than saved, thereby pro- er participation of women in the work- ducing rates of return on previous con- force) and made signi½cant contribu- tributions in excess of the risk-adjusted tions over the past several decades, its rates of return that those contributions members will soon retire, substantially could have earned in ½nancial markets.7 reducing the number of workers avail- For those who retired shortly after So- able to ½nance their Social Security and cial Security began, this ½nancing struc- Medicare bene½ts through payroll and ture meant that they received more ben- other taxes. As Figure 1 shows, today e½ts from Social Security in present val- there are almost ½ve people of working ue than they had paid in payroll taxes. age–between ages 20 and 64–for each These windfalls occurred each time that retiree age 65 and older. By 2030, the Congress expanded Social Security’s number of people of working age per coverage and bene½ts, after 1950 until retiree will decline to less than three; well into the 1970s.8 by 2080, the ratio will fall to about two. Unfortunately, the windfalls awarded Recognizing these future demograph- to prior generations of retirees do not ic changes, Congress amended the So- come for free: future generations must cial Security Act in 1983 in an attempt to pay for them by receiving lower rates of increase the system’s cash flow over the return on their payroll taxes compared next seventy-½ve years. Those amend- to the rates they could have earned if ments approved payroll tax hikes, sub- they had invested their contributions in jected the Social Security bene½ts of government bonds instead. In fact, all those with other income sources to in- future generations are worse off.9 come taxation, and scheduled a gradual increase in the full retirement age from 7 Dean R. Liemer, “Cohort-Speci½c Measures 65 to 67 beginning in 2003. Since 1983, of Lifetime Net Social Security Transfers,” these changes have generated surpluses Social Security Administration, Of½ce of Re- search and Statistics, Working Paper No. 59, in the Social Security trust fund, which February 1994. currently holds $1.7 trillion in Treasury ious. 8 John Geanakoplos, Olivia S. Mitchell, and Despite these reforms, Social Securi- Stephen P. Zeldes, “Would a Privatized Social ty remains mostly pay-as-you-go in its Security System Really Pay a Higher Rate of Return?” in Framing the Social Security Debate: Values, Politics and Economics, ed. R. Douglas Systems,” Journal of Institutional and Theoreti- Arnold, Michael J. Graetz, and Alicia H. Mun- cal Economics 145 (1989): 643–658. Assuming nell (Washington, D.C.: National Academy of that the growth rate of the economy is less Social Insurance, 1998), 137–157. than the interest rate, the so-called dynamic ef½ciency condition, the present value of the 9 F. Breyer, “On the Intergenerational Pareto gains and losses across all past, current, and Ef½ciency of Pay-As-You-Go Financed Pension future generations is exactly zero.
Dædalus Winter 2006 93 Jagadeesh Figure 1 Gokhale Workers (Ages 20–64) Per Retiree (Age 65 and older) & Kent Smetters 8 on aging 7 ...... Projected 6
5
4
3 Workers per Retiree 2
1
0 19901980197019601950 20402030202020102000 20602050 2070 2080 Year
Source: Social Security Administration. ½nancing structure. And though $1.7 tril- increasing because of interest income lion sounds like a lot, it is insuf½cient to accruals through 2027, after which it is pay current retirees their scheduled ben- projected to decline gradually and be e½ts for more than three years. Had the exhausted by 2041. The Social Security 1983 amendments ‘fully funded’ the So- trustees estimate that the present value of cial Security system instead, the trust bene½ts, scheduled under current law, fund would hold about $13.7 trillion to- over the next seventy-½ve years will ex- day. Contributions by past and current ceed by $4 trillion the present value of its generations would have been enough to payroll tax revenues plus the current val- cover their own bene½ts, and future gen- ue of the trust fund’s Treasury securities. erations would not have to shoulder any In other words, only if the government of the burden. immediately deposited an additional $4 trillion into the trust fund, by increasing At the time, many thought that the taxes or reducing spending, would it be 1983 amendments had resolved Social able to pay current-law bene½ts over the Security’s ½nancial shortfalls for the next seventy-½ve years. An infusion of subsequent seventy-½ve years. But soon money into the trust fund would also thereafter projected seventy-½ve-year increase public and national saving if it imbalances began appearing again. were not reborrowed and spent on other As shown in Figure 2, payroll tax sur- government programs–a topic of recent pluses will probably continue until 2017 debate.10 Were the new monies spent –the so-called crossover date–after which projected bene½ts will exceed 10 Peter Diamond, “Social Security, the Gov- revenues. The trust fund will continue ernment Budget and National Savings,” un-
94 Dædalus Winter 2006 Figure 2 Measuring Social Security’s Revenues and Outlays Social Security’s 4000 ½nancial outlook
3000
2000
1000 Billions of Constant 2004 Dollars 0 2004 2008 2012 2016 2020 2024 2028 2032 2036 2040 Year
Income Excluding Interest Outlays Trust Fund
Source: Social Security Administration. entirely on other programs, the govern- In other words, because the measures ment’s overall capacity to pay future So- of the system’s solvency used in 1983 cial Security bene½ts would not improve were based on a limited time horizon, even though the value of Treasury secu- policymakers back then failed to include rities in the trust fund would increase. the additional adjustments to taxes and The ‘moving window’ phenomenon bene½ts necessary to achieve a sustain- partially explains why the seventy-½ve- able Social Security system. Unfortu- year imbalances reappeared after 1983. nately, their failure means that we must In 1983, the projected seventy-½ve-year make even larger adjustments in the fu- window ended in 2057; today it ends in ture. 2079. Simply moving the seventy-½ve- The same limited perspective on the year window to cover the years 2058 system’s ½nancial condition is again through 2079–when cash-flow short- hampering reform efforts today. Indeed, falls are projected to accrue–created the problem of a ‘moving window’ im- most of the recent $4 trillion imbalance. plies that reforms that make the system solvent over the next seventy-½ve years mit will just falter again as the window published mimeo, , March 24, 2003; Sita moves forward into the future. As Nataraj and John Shoven, “Has the Uni½ed Budget Undermined the Federal Government shown in the ½rst panel in Table 1, the Trust Funds?” mimeo, Stanford University, 2005 Social Security Trustees Report proj- 2004; and Kent Smetters, “Is the Social Secu- ects an additional $7.1 trillion imbalance rity Trust Fund a Store of Value?” American in present value (as of 2004) after the Economic Review Papers and Proceedings 94 (2) year 2079. (May 2004): 176–181.
Dædalus Winter 2006 95 Jagadeesh Table 1 Gokhale Unfunded oasdia Obligations [present values as of January 1, 2005; dollar amounts in & Kent trillions] Smetters on aging Unfunded obligations through 2079b $4.0 Unfunded obligations after 2079c 7.1 Equals total unfunded obligations (open-group obligations) 11.1
Unfunded obligations attributable to past and current participants (closed-group obligations)d 12.0 Unfunded obligations attributable to future participantse -0.9 Equals total unfunded obligations (open-group obligations) 11.1
a ‘Old age, survivors, and disability insurance’ is the of½cial name of Social Security. b Present value of future costs less future taxes through 2079, reduced by the amount of trust fund assets at the beginning of 2005. c Present value of future costs less future taxes after 2079. d This concept is also referred to as the closed-group unfunded obligation. It is equal to the present value of bene½ts paid to current and past generations less the taxes and the value of the trust fund. e People age 14 and below in 2005.
Source: 2005 Social Security Trustees Report, Table iv.b6 and iv.b7.
Adding the $7.1 trillion imbalance af- only tells part of the story. Still, even rel- ter the year 2079 to the $4 trillion imbal- ative to the present value of all future ance projected through 2079 produces a payrolls, Social Security’s problems will present-value imbalance of $11.1 trillion, grow worse over time. And when added which is equal to about 3.5 percent of the to Medicare’s shortfalls–about seven present value of all future taxable payroll times larger than Social Security’s13– revenue.11 Barring any reform this year, the imbalance grows by almost 2 percent this $11.1 trillion imbalance will only of the present value of all future covered grow with interest, just like any regular payroll for every ½ve years that we delay ‘debt rollover.’ Indeed, according to the fundamental reforms. In other words, trustees, this imbalance will increase by for every ½ve years that we do not enact about $600 billion over just a single year policy reform, we would have to perma- if we do not take legislative action.12 To nently increase taxes by an additional be sure, the economy will also expand 2 percent of taxable payrolls, or reduce over time and so this $600 billion ½gure outlays by the same amount. The cost of delaying Social Security reforms is, 11 Social Security’s projected shortfalls could therefore, enormous. also be represented as a share of the present value of future projected gdp. But we think that representation is quite misleading since Whereas solvency typically refers to the the government taxes only between 50 and 60 government’s ability to pay bene½ts over percent of gdp (the payroll tax applies to an the next seventy-½ve years, sustainability even smaller portion) and will likely continue refers to its ability to pay bene½ts into to do so in the future. An even more mislead- ing statistic is to state only the seventy-½ve- 13 Jagadeesh Gokhale and Kent Smetters, year shortfall in present value relative to gdp. “Fiscal and Generational Imbalances: An Up- date,” in James M. Poterba, ed., Tax Policy and 12 Social Security Trustees, 2005 Social Security the Economy, vol. 20 (Cambridge, Mass.: mit Trustees Report, Section iv.b.5.a. Press, forthcoming 2006).
96 Dædalus Winter 2006 the inde½nite future. A Social Security appears sustainable under this ad-hoc Measuring reform that achieves solvency over a approach. However, under this plan, we Social Security’s limited horizon, but not sustainability, must continue to raise payroll tax rates ½nancial will soon fail to achieve even solvency as after the seventy-½fth year in order to outlook the window moves forward to include pay present-law projected bene½ts and future years. However, a sustainable re- prevent the trust fund from disappear- form will also be solvent. Under Social ing. Without raising taxes, we would Security’s current projections, achieving eventually exhaust the trust fund.16 sustainability is harder than achieving Conversely, a reform might not ap- solvency: an additional $7.1 trillion in pear sustainable under the ad-hoc meas- tax and bene½t adjustments is necessary ure even though it fully eliminates the to address the shortfalls accruing after current $11.1 trillion present-value im- 2079. balance. For example, Model 2 of the The government routinely uses an ad- President’s Commission to Strengthen hoc measure of sustainability that asks Social Security17 is not projected to whether the system satis½es two condi- achieve solvency over the ½rst seventy- tions.14 First, is the Social Security sys- ½ve years–the ½rst condition for sus- tem solvent? That is, can Social Security tainability under the ad-hoc measure– afford to pay current-law bene½ts over without general revenue transfers from the next seventy-½ve years with current- the U.S. Treasury. However, if we main- law tax revenues over the next seventy- tained its reform measures beyond the ½ve years plus the current trust fund val- seventy-½fth year, Model 2 would more ue? Second, is the trust fund projected than eliminate the existing $11.1 trillion to be increasing in size toward the end imbalance even without general revenue of the seventy-½ve-year window? Social transfers. That is, Model 2’s cost savings Security is deemed ‘sustainable’ if both after the seventy-½fth year would more conditions are met. than offset, in present value, the short- This ad-hoc measure of sustainability falls projected during the ½rst seventy- assumes that the trust fund will continue ½ve years. to increase in size after the seventy-½fth year. This assumption is often invalid. The traditional ad-hoc measure of sus- For example, the recent reform plan tainability, therefore, has serious short- by Peter Diamond and Peter Orszag15 comings.18 But the most important weakness of this and other traditional 14 See, for example, President’s Commission to Strengthen Social Security, Strengthening measures of Social Security’s ½nances is Social Security and Creating Personal Wealth for All Americans (Washington, D.C.: President’s Commission to Strengthen Social Security, 16 Ibid. Diamond and Orszag, however, ad- 2001), 68–71; Council of Economic Advisors, vocate continuing to increase payroll tax rates 2004 Economic Report of the President (Wash- after the seventy-½fth year. ington, D.C.: Council of Economic Advisors, 2004), 139; Social Security Trustees, 2004 17 President’s Commission to Strengthen Social Security Trustees Report (Washington, Social Security, Strengthening Social Security, D.C.: Social Security Trustees, 2004), Section 68–71. iv.b.5.a. 18 Additional criticisms can be found in How- 15 Peter Diamond and Peter Orszag, Saving ell Jackson, “Accounting for Social Security and Social Security: A Balanced Approach (Washing- Its Reform,” Harvard Journal on Legislation 41 (1) ton, D.C.: Brookings Institution Press, 2004). (Winter 2004): 59–225.
Dædalus Winter 2006 97 Jagadeesh that they introduce a bias in policymak- Still, under this reform, all three meas- Gokhale & Kent ing. In particular, reforms that could re- ures traditionally used to judge Social Smetters duce Social Security’s $11.1 trillion im- Security’s viability–the trust fund ex- on balance–and improve Social Security’s haustion date, the crossover date when aging sustainability–often worsen each of the costs exceed income, and the seventy- more traditional measures, including the ½ve-year imbalance–would worsen. trust fund exhaustion date, the crossover We would exhaust the trust fund earlier date, and the seventy-½ve-year imbal- because of the short-run decline in pay- ance. roll contributions; similarly, the cross- Consider the ‘actuarially fair carve over date would occur sooner. The sev- out.’ This reform is very similar to the enty-½ve-year imbalance would also ap- plan President Bush is now advocating, pear larger because much of the lost tax which allows participants to ‘carve out’ revenue would show up inside the seven- some of their payroll taxes and deposit ty-½ve-year window while a larger por- them into a personal account that would tion of the future reduction in bene½ts later augment their traditional bene½t, would fall beyond the seventy-½ve-year much like 401(k)s and iras.19 Since window. these participants would be contribut- Now let’s modify the example to con- ing less to the traditional system, their sider a ‘carve out with a haircut.’ Under traditional bene½t would also be reduced this approach, we would reduce a partic- by an ‘actuarially fair’ amount equal to ipant’s traditional Social Security bene- one dollar in present value for each dol- ½t by more than a dollar, say $1.10, for lar carved out. every dollar carved out and deposited This reform would have no impact into a personal account. A worker might on the $11.1 trillion imbalance. Each be willing to take this ‘haircut’ on future dollar that the government loses in pay- bene½ts in order to obtain greater own- roll contributions would be fully offset ership and control over his or her retire- by a dollar that the government saves ment resources. in present value of future bene½t pay- In this case, we would reduce the $11.1 ments. Furthermore, unless capital mar- trillion imbalance since the government kets responded in an uninformed man- saves more on bene½t payments in pres- ner (discussed in more detail later), this ent value than it loses in contributions. reform would not affect wages, interest Still, if policymakers focused only on the rates, or gross domestic product (gdp) traditional measures of Social Security’s in any year. Neither would this reform ½nances to judge this reform plan,20 change the net lifetime resources avail- they might reject it even though it would able to any household born at any time. improve Social Security’s ½nancial out- In economic terms, this reform would look. The improvement in Social Securi- be fully neutral. ty’s ½nancial outlook–as reflected by its reduced present value of unfunded obli- 19 Technically, President Bush’s plan is not quite actuarially fair because his bene½t-offset rate does not adjust for preretirement mortal- 20 Technically, whether the seventy-½ve-year ity; it is also tied to expected Treasury yields imbalance would get better or worse would de- instead of actual yields. The ½rst issue is of sec- pend on the timing of the haircut. In any case, ond-order importance as preretirement mortal- the seventy-½ve-year imbalance measure would ity will be low in the future. The second issue is fail to capture many of the bene½t reductions easily correctable. after the seventy-½fth year.
98 Dædalus Winter 2006 gations–should exert salutary effects recently endorsed these new meas- Measuring ures.22 Social on the economy immediately. In particu- Indeed, these measures corre- Security’s lar, private agents’ economic decisions spond to the way that economists have ½nancial would no longer be distorted by the ex- thought about Social Security’s ½nances outlook pectation of higher future costs of re- for many years.23 solving Social Security’s ½nancial prob- The ½rst measure is sometimes called lems. the ‘open-group unfunded obligation.’ Thus, the traditional measures are It is the sum of bene½ts that all past, not very revealing of the program’s true present, and future generations, or ‘groups,’ ½nancial status, and worse, they are bi- have received (and are projected to re- ased against reforms that could reduce ceive) in present value less the amount Social Security’s $11.1 trillion imbalance. of taxes they have paid (and are project- Unfortunately, these measures often in- ed to pay). We can also calculate it as the fluence the design of reform plans. For present value of all projected Social Se- example, in Model 2 of the President’s curity bene½ts minus the present value 2001 Commission to Strengthen Social of all projected payroll taxes and the cur- Security, participants are allowed to rent value of the trust fund. carve out 4 percent of payroll, up to a The open-group unfunded obligation maximum of $1,000 per year (wage in- reveals the extent to which the current dexed over time).21 The Commission Social Security program is unsustain- imposed the $1,000 ceiling to prevent able. That is, it shows Social Security’s the Social Security system from ‘losing’ ½nancial imbalance arising from all gen- too much money over the projected sev- erations. Table 1 shows that based on enty-½ve-year horizon. Restricted to that horizon, the Commission did not take into account the large cost savings that 22 See “The 2003 Technical Panel on Assump- would begin accruing after the seventy- tions and Methods Report”
Dædalus Winter 2006 99 Jagadeesh calculations provided by the independ- neutralities of the ‘actuarially fair carve Gokhale ent Of½ce of the Actuary at the Social out’ discussed earlier. In the case of a & Kent Smetters Security Administration, the trustees ‘carve out with a haircut,’ the open- on estimate the open-group obligations at group and closed-group measures both aging $11.1 trillion in present value. In other improve (they are both smaller), corre- words, in order to make Social Security sponding to a move toward sustainabil- sustainable, we must reduce scheduled ity and smaller burdens on future gen- bene½ts and/or increase taxes so that the erations. In contrast, the traditional sum of cost savings and new revenues measures such as the trust fund exhaus- total $11.1 trillion in present value. tion date and crossover date incorrectly The second measure is sometimes show a deterioration of Social Security’s called the ‘closed-group unfunded ob- ½nances in both instances. ligation.’ It shows the amount of Social Security’s $11.1 trillion imbalance arising Although the usefulness of the closed- from providing bene½ts to past and pres- group measure in determining sustain- ent generations (those age 15 and older ability is not as widely understood as the up to those who are deceased as of 2005) open-group measure’s, the closed-group in excess of their payroll taxes in present measure is vital to comprehending So- value. Unlike the open-group obligation, cial Security’s impact on the economy. this calculation is ‘closed’ to, or does not Some believe that the closed-group include, future generations. measure is mostly meaningful in the Based on calculations provided again context of a ‘fully funded’ system.24 by the Of½ce of the Actuary, the trust- Under such a system, each generation ees estimate that past and current gen- would pay for its own bene½ts, and so erations will receive about $12 trillion the closed-group obligation would be more in bene½ts in present value than zero. they will pay in taxes (see Table 1). In But the closed-group measure is a very contrast, future generations (those age important statistic even in a pay-as-you- 14 and younger in 2005 as well as the un- go system for two key reasons. First, it born) are projected to receive $0.9 tril- indicates the extent to which any reform lion less in bene½ts than they will pay in will reshuffle ½scal burdens across gen- taxes (see Table 1). The ‘overpayment’ erations. For example, suppose Social by future generations, though, is still not Security bene½ts were increased and this enough to pay for the ‘overhang’ of $12 increase were ½nanced on a strict pay- trillion they are projected to inherit from as-you-go basis by raising payroll taxes. past and current generations under cur- This policy change would not have any rent law. Either future generations will impact on the open-group measure or have to pay an additional $11.1 trillion in present value or generations alive to- 24 Stephen Goss, “Measuring Solvency in the day will have to make this sacri½ce, or a Social Security System,” in Olivia S. Mitchell combination of both. et al., eds., Prospects for Social Security Reform The open-group and closed-group (Philadelphia: University of Pennsylvania measures are robust to the criticisms Press, 1999), 16–36. An equally plausible sto- that apply to traditional measures of ry is that policymakers allowed Social Securi- ty to become mostly pay-as-you-go over time Social Security’s ½nances. For example, because the burdens being placed on future both measures correctly identify the generations were not easily observable under economic as well as intergenerational traditional measures.
100 Dædalus Winter 2006 the traditional measures. But the closed- The Congressional Budget Of½ce esti- Measuring group measure would grow larger be- mates that every dollar transferred from Social Security’s cause this reform would transfer wealth future to current generations reduces ½nancial from future generations to current gen- private savings by zero to ½fty cents.27 outlook erations. Current generations would Although the wide range of this estimate gain from this policy change since they suggests considerable uncertainty, it fol- would receive more in bene½ts in pres- lows that Social Security may have re- ent value than they paid in taxes; indeed, duced the U.S. capital stock by as much current retirees would receive additional as $6 trillion and reduced gdp by as bene½ts for free. But future generations much as $1.1 trillion.28 Nonetheless, the would pay for this windfall by receiving traditional measures as well as the open- a bene½t less valuable than the addition- group measure do not indicate these al taxes they paid in present value. The large macroeconomic effects. Presum- closed-group measure, which shows the ably, any discussion of Social Security net gain to past and current generations, reform would want to take into account would become larger, thereby clearly in- the impact of a reform on the economy. dicating the extent of this intergenera- Although Social Security has had many tional transfer. successes, its potentially large deleteri- Second, the closed-group measure re- ous effect on capital stock and national veals how much pay-as-you-go ½nanc- output deserves more attention in the ing may ‘crowd out’ private saving and, debate over Social Security reform. hence, increase interest rates, lower wages, and reduce the nation’s gdp.25 Because the open-group measure ex- Consider again a pay-as-you-go ½nanced tends the traditional seventy-½ve-year increase in bene½ts. Because this reform imbalance measure beyond the seventy- transfers resources from future to cur- ½fth year, one might at ½rst be tempted rent generations, it reduces the amount to argue that the open-group measure of money today’s generations must save for their own retirement. This reform, therefore, could permanently reduce the American Economic Review 82 (5) (1992): 1177– 26 1198. Consistently, Gokhale et al. trace a large economy’s level of capital. share of the secular decline in U.S. national saving during the last several decades to the 25 Martin Feldstein, “Social Security, Induced ½scal transfers from workers to retirees. Jaga- Retirement, and Aggregate Capital Accumula- deesh Gokhale, Laurence J. Kotlikoff, and John tion,” Journal of Political Economy 82 (5) (Sep- Sabelhaus, Understanding the Postwar Decline in tember/October 1974): 905–926. Feldstein is U.S. Saving: A Cohort Analysis, Brooking Papers the ½rst to analyze the empirical issue of Social on Economic Activity, Winter 1996. Security ½nancing’s impact on private saving. 27 Congressional Budget Of½ce, “Social Secu- 26 The Ricardian equivalence hypothesis, how- rity and Private Saving: A Review of the Liter- ever, argues that parents might leave a larger ature,” Congressional Budget Of½ce Paper, July bequest in response to a transfer from their 1998. children, thereby leaving national saving un- changed. Robert J. Barro, “Are Government 28 The calculated reduction in gdp assumes Bonds Net Wealth?” Journal of Political Eco- Cobb-Douglas production with inelastic labor nomy 82 (6): 1095–1117. Altonji et al.’s empir- supply, a net-of-depreciation capital share of ical tests, however, reject this hypothesis. Jo- 0.25, and a current capital-output ratio of 3. seph G. Altonji, Fumio Hayashi, and Laurence The calculation also assumes that the private- J. Kotlikoff, “Is the Extended Family Altruisti- saving offset is constant at ½fty cents for each cally Linked? Direct Tests Using Micro Data,” dollar of closed-group obligation.
Dædalus Winter 2006 101 Jagadeesh places too much emphasis on Social remove the biases, embedded in the tra- Gokhale Security’s long-run ½nances. In other ditional measures, against reforms that & Kent Smetters words, one could imagine a hypotheti- could improve Social Security’s long-run on cal ‘reform’ that does nothing to ½x So- ½nancial outlook. These newer measures aging cial Security’s ½nances during the ½rst focus attention on the true magnitude of seventy-½ve years but enacts large re- the reforms needed to place Social Secu- forms after the seventy-½fth year in or- rity on a sustainable path and, hence, re- der to eliminate Social Security’s $11.1 veal the urgent need for action. Social trillion imbalance. Security’s $11.1 trillion open-group un- This potential criticism, however, is funded obligation is almost three times as misplaced since it forgets that the $11.1 large as the amount the seventy-½ve-year trillion open-group obligation is in imbalance measure indicates, despite the terms of present value. Besides adjusting fact that the present-value calculation for inflation, the present-value calcula- considerably reduces the weight placed tion adjusts for the real interest costs on shortfalls that accrue after the seven- that we save from paying obligations ty-½fth year. sooner rather than later. For example, Robert Myers, who was chief actuary increasing payroll taxes by one dollar of the Social Security Administration today would reduce the open-group ob- from 1947 to 1979, points out that before ligation by, of course, one dollar. But if 1965 Social Security actuaries routinely we postponed this one-dollar tax in- relied on measures looking beyond sev- crease (still measured in 2004 inflation- enty-½ve years. In 1965, however, Social adjusted dollars) in one hundred years Security’s actuaries and policymakers we would reduce the $11.1 trillion open- began focusing on seventy-½ve-year group obligation by only 4.7 cents in to- shortfalls because then, unlike today, ex- day’s dollars.29 Delaying the one-dollar tending the ½nancial projections beyond tax increase 150 years would reduce the seventy-½ve years made very little differ- unfunded obligations by only one cent. ence to the program’s ½nancial outlook. Attempting to postpone reforms would However, Mr. Myers always thought just mean enacting unrealistically large that truncating measures at seventy-½ve reforms later on. years was never right in theory because The closed-group obligation measure of the moving-window problem: “I’m reflects the amount of projected over- still an ‘in½nity’ guy, because even if you spending on past and current genera- have a seventy-½ve-year period, every tions. Thus, a policy that lets current year you do a new valuation you have generations ‘off the hook’ produces a some slippage.”30 This slippage is espe- larger closed-group obligation than a cially acute today, with over two-thirds reform that requires current generations of the $11.1 trillion shortfall lying outside to bear more of the costs. of the seventy-½ve-year window. Rather than drawing ‘too much’ at- tention to the long run, the open-group Critics also charge that present-value and closed-group obligation measures estimates beyond seventy-½ve years are sensitive to underlying demographic and
29 This calculation uses an inflation-adjusted interest rate of 3.1 percent, the rate the trustees 30 Robert Myers, “Oral History Overview,” use to calculate the $11.1 trillion unfunded obli- 1995,
102 Dædalus Winter 2006 economic assumptions.31 Of course, un- value for each dollar placed into a per- Measuring Social certainty should only enhance the de- sonal account. Security’s sire to seek remedies rather than to ig- From an economic perspective, one ½nancial nore the expected problem.32 dollar of government debt is not very outlook Furthermore, different interest rate different than one dollar of federal un- and productivity assumptions and dif- funded obligations. Both represent a ferent demographic projections do dollar the government owes. Hence, real not greatly affect the size of the policy interest rates should not rise in response changes–either tax increases or bene- to the President’s plan because investors ½t cuts–needed to reduce Social Secu- should be indifferent between the two rity’s imbalance.33 Although changes under reasonable circumstances.34 in these underlying assumptions will Legally, however, debt held by the pub- alter the present value of the imbalance, lic is a legal liability that the government the present value of Social Security’s must honor unless it declares bankrupt- tax base and future bene½ts also move cy.35 Social Security and Medicare ben- almost proportionally and in the same e½ts, on the other hand, are only obliga- direction. As a result, the increases in tions of the government, which an act tax rates or cuts in bene½t rates required of Congress can alter. In practice, there- to eliminate Social Security’s current ½s- fore, capital market participants may be cal imbalance exhibit much smaller sen- discounting future Social Security ben- sitivity to parametric changes in eco- e½ts at a higher rate than the yield on nomic and demographic assumptions. Treasury securities because the capital market participants think that the gov- President Bush’s plan for personal ac- ernment might pay only a portion of its counts would create additional govern- present-law Social Security obligations ment debt while simultaneously reduc- in the future. Replacing a dollar in pres- ing Social Security’s unfunded future ent value of future Social Security ben- outlays. Government debt would in- e½ts with a dollar of explicit debt, there- crease as households could divert some fore, could negatively affect how inves- of their payroll taxes to their personal tors perceive the outlook of the federal accounts, thereby reducing government government’s ½nances. revenue. Future Social Security outlays However, the government is not nec- would also decline however, under the essarily more likely to pay explicit debt President’s actuarially fair carve out be- liabilities in real terms than Social Se- cause the government could reduce ben- curity obligations. Indeed, the opposite e½t payments by one dollar in present is also conceivable: most explicit debt
34 Technically speaking, the new government debt must have the same stochastic properties 31 See, for example, Congressional Budget as Social Security bene½ts, including sensitivity Of½ce, “Measures of the U.S. Government’s to inflation and changes in the average wage in Fiscal Position Under Current Law,” Congres- the economy. sional Budget Of½ce Paper, August 2004. 35 Of course, in practice, the government can 32 This fact holds under any standard prefer- use inflation to reduce the real value of nomi- ence toward risk that shows a prudence motive. nally denominated debt. The government would have to declare bankruptcy, however, 33 Gokhale and Smetters, Fiscal and Generation- to avoid paying off inflation-protected instru- al Imbalances. ments.
Dædalus Winter 2006 103 Jagadeesh is not protected against inflation. So Gokhale faster inflation compounded over time & Kent Smetters could easily erode the value of the gov- on ernment’s payments to bondholders. aging In contrast, the Social Security bene½ts of retirees and others, once determined, are fully protected against inflation, and will likely remain so well into the future. Moreover, even if policymakers believed that market participants discount future Social Security bene½ts by, say, 10 per- cent above the government’s discount rate then policymakers could offer a ‘carve out with a 10 percent haircut’ to avoid disrupting capital markets.
The Social Security program provides an important source of income for most of the nation’s retirees, but the pro- gram’s long-term viability is in serious doubt unless a fundamental reform is undertaken–either by increasing taxes or by reducing the growth rate of ben- e½ts. Unfortunately, the traditional ac- counting measures used by policymakers and the media convey very little about the true magnitude of the ½nancial prob- lem facing Social Security. Those meas- ures are also biased against reforms that could reduce Social Security’s imbal- ance. Fortunately, the Social Security trust- ees have begun to include new measures of Social Security’s ½nancial outlook, be- ginning with their 2003 report and con- tinuing with the 2004 and 2005 reports– measures that fully convey the dimen- sions of Social Security’s ½nancial hole. The independent panel of experts ap- pointed by the Social Security Advisory Board has endorsed these measures but, unfortunately, policymakers and the media are not paying suf½cient attention to these new measures. We argue that these measures deserve much more care- ful consideration.
104 Dædalus Winter 2006 Lisa F. Berkman & M. Maria Glymour
How society shapes aging: the centrality of variability
We have all known people who grow that a great deal of what super½cially old suddenly or seem much older than may seem like random variability in their chronological age. Conversely, we health outcomes is in fact patterned by see people who appear vibrant and seem the kinds of social and economic experi- resilient to the challenges they face late ences that people confront throughout in life. What role does society play in their lives. Such variability is key to un- shaping these distinct outcomes of ag- derstanding aging. ing? The kinds of dif½culties each of Social conditions help determine sev- us are liable to face as we grow older eral health outcomes as we age. Varia- are determined by our opportunities tions in life expectancy and disability, for social interaction and intimacy, by for example, reflect differences in past our economic and educational experi- social investments in the health and ences, and by our exposure to severe well-being of different groups within social and physical stresses. We believe society. Perhaps more surprising, ag- ing at the biological level–as indicated Lisa F. Berkman is Thomas D. Cabot Professor by measures of metabolic function, glu- of Public Policy at the Harvard School of Pub- cose metabolism, blood pressure regu- lic Health, where she also serves as chair of the lation, and pulmonary function–is also Department of Society, Human Development, correlated with social conditions. and Health and Epidemiology. Published in nu- merous journals, Berkman has worked extensively One of the most common indicators on understanding social influences on health out- of health and aging used in epidemiolo- comes. gy and demography is life expectancy, a summary estimate of how long we M. Maria Glymour, a social epidemiologist, is can expect people to live in the future. an instructor at the Harvard School of Public Life-expectancy measures are derived Health. Currently, her research focuses on the from current death rates for men and effects of social and economic conditions, espe- women in speci½c age groups. The as- cially education, on physical and cognitive health sumption is that age-speci½c death rates in old age. today will be applicable in the future. Because death rates historically have © 2006 by the American Academy of Arts changed rather quickly, though, projec- & Sciences tions are not always very accurate.
Dædalus Winter 2006 105 Lisa F. Measures of life expectancy, however, However, over the last several decades Berkman & are valuable when comparing countries we have also achieved substantial gains M. Maria Glymour or populations over time–especially in life expectancy for older people. Be- on when used to look at historical or cur- tween 1980 and 2000, life expectancy for aging rent, not future, patterns. In the United 65-year-olds rose 1.6 years. In these de- States in 2002, life expectancy was 77.3 cades, increases were greatest for men, years at birth and 18.2 years at age 65. who gained almost two years. These The latter number means that if a per- added years narrowed the gender gap son survived to age 65, he or she could slightly, but women can still expect to expect to live, on average, another 18.2 live three years longer than men. years. These summary statistics, how- Living longer may be problematic, ever, hide large differences in life expec- though, if the elderly spend many of tancy across gender, racial, and ethnic those extra years disabled or suffering groups. For example, life expectancies from chronic conditions. Ideally, we for white women were 80.3 years at birth want to increase ‘active’ or ‘disability- and 19.5 years at age 65, but for African free’ life expectancy. Scienti½c opinion American women those same numbers on whether increased life expectancy were 75.6 and 18.0. Life expectancies for would translate into increased old-age black men were 68.8 years at birth and disability has evolved over time. 14.6 years at age 65. For white men, they In the early 1980s, investigators such were 75.1 years at birth and 16.1 years at as James Fries anticipated “compression age 65. Thus, even a preliminary unpack- of morbidity” to accompany increases in ing of average life expectancies of white life expectancy.2 Early evidence contra- women and African American men re- dicted this notion: Health surveys indi- veals a difference of 11.5 years at birth cated that people were living longer, but and about 5 years at age 65. with substantial levels of disability for Equally startling are advances in life many of those years. Better treatments expectancy that have occurred over the for many diseases were saving lives, but last century and those predicted based also leaving survivors with serious dis- on data from the last decade or two. abilities. However, more positive signs Life expectancy in the United States in- have emerged over the past few decades: creased over twenty years between 1900 Eileen Crimmins reported that disabili- and 1950, from 47.3 to 68.2, and nearly ty-free life expectancy improved more another ten years by 2000, to 76.7. If during the 1980s than the 1970s,3 while one looks at the long-term increases in some evidence suggest rates of cognitive life expectancy, the majority of ‘added’ impairment have been decreasing over years in the ½rst half of the century the last decade or so.4 occurred because of improvements in infant and childhood mortality, mater- 2 J. Fries, “Aging, Natural Death and the Com- nal mortality, and control of infectious pression of Morbidity,” New England Journal of Medicine 303 (1980): 130–135. diseases–the results of major public- health efforts at the turn of the century.1 3 E. M. Crimmins, Y. Saito, and D. Ingegneri, “Trends in Disability-Free Life Expectancy in the United States, 1970–1990,” Population and 1 D. Cutler and G. Miller, “The Role of Public Development Review 23 (3) (1997): 555–572. Health Improvements in Health Advances: The Twentieth-Century United States,” Demography 4 V. Freedman et al., “Resolving Inconsisten- 42 (1) (2005): 1–22. cies in Trends in Old-Age Disability: Report
106 Dædalus Winter 2006 Unfortunately, researchers have found disparities had existed in 1980. Thus, How society marked social inequalities in disability- class disparities were preserved. In 1991, shapes aging free life expectancy. Although data are manual laborers in France still lived 5.4 limited, recent studies show that Afri- years less than managers and spent 1.4 can Americans, especially those living more years with a disability.6 in urban poverty areas, have a striking- ly shorter active life expectancy than Three important ½ndings emerge from whites or African Americans living in these studies that are generally applica- nonpoverty areas. In a study of life ex- ble to the United States and to other in- pectancy from age 16, Arline Geronimus dustrialized countries. First, in recent discovered that white women living in decades, both mortality and disability the United States have an active life ex- rates have dropped for older men and pectancy of ½fty-two years while African women. Second, these gains have af- American women–even in nonpoverty fected men and women across virtually urban areas such as Queens, New York, all social classes and racial and ethnic and the better parts of Detroit and Chi- groups, though the socioeconomically cago–have one of forty-three. Black advantaged have experienced slightly women in Harlem, central Detroit, or larger absolute gains. Third, while pop- the south side of Chicago, on the other ulation health as a whole has improved, hand, have the lowest active life expec- inequality has persisted across the socio- tancy, only thirty-nine years. Even white economic strata. The gap between rich women living in poverty areas generally and poor has not narrowed and, depend- have active life expectancies better than ing upon which indicators are used, may those of African American women, rang- actually have increased in both absolute ing from forty-two years in Appalachian and relative terms. Kentucky to forty-nine years in west The good news is that greater long- North Carolina and south central Loui- evity does not mean that we also have siana. Thus, both poverty and race are to endure many more years of severe factors in the variations in active life disability. Even though the incidence expectancy.5 of many diseases has not declined dra- Similar variations in life expectancy matically in the last decades, the conse- have been observed between occupa- quences–mortality and disability–have tional grades in other countries. Both decreased.7 Despite this positive result, disability-free and total life expectancy differences in outcomes among people increased in France between 1980 and based on their social and economic posi- 1991, with larger improvements in dis- tions are large and persistent. In the next ability-free life expectancy. Though the section, we explore the extent to which gains were relatively uniform across social and economic investments made socioeconomic groups, substantial class 6 E. Cambois, J. Robine, and M. Hayward, “So- cial Inequalities in Disability-Free Life Expec- from a Technical Working Group,” Demography tancy in the French Male Population, 1980– 41 (3) (2004): 417–411. 1991,” Demography 38 (4) (2001): 513–524.
5 A. T. Geronimus et al., “Inequality in Life 7 J. M. Robine, P. Mormiche, and C. Sermet, Expectancy, Functional Status, and Active Life “Examination of the Causes and Mechanisms Expectancy Across Selected Black and White of the Increase in Disability-Free Life Expectan- Populations in the United States,” Demography cy,” Journal of Aging and Health 10 (2) (1998): 38 (2) (2001): 227–251. 171–191.
Dædalus Winter 2006 107 Lisa F. at the national level have had a major dren during the Dust Bowl years, when Berkman & impact on the health of the current gen- bad weather and economic downturns M. Maria Glymour eration of older men and women. We deprived millions of their farms, their on speculate that as much as explicit, turn- primary livelihood. aging of-the-century investments in public This cohort entered adulthood as the health helped to control infectious dis- nation entered World War II. After the eases and curb infant and maternal mor- war, many members of this generation tality, other social and economic invest- experienced prosperity, but many also ments initiated in the ½rst half of the faced continued poverty and racial dis- twentieth century may have also broad- crimination. The government responded ly influenced the successful aging of cur- to many of these social conditions with rent senior citizens. investments in public education, work- place regulation, federal housing initia- The trajectory of health or ill health tives, and employment and income in- that the elderly undergo does not be- surance programs. Further economic gin at age 65: experiences accumulated progress and extensions of civil rights throughout life set the stage for well- reflected both secular developments and being in old age. To understand the government intervention. health of today’s elderly, it is impor- Improving health and longer lives may tant to examine the experiences of have been among the most dramatic and these cohorts before entering old age. unexpected consequences of these social The majority of the elderly in America policies. Medicare and Medicaid were today were born between the two world obvious investments in medical care, wars; those who celebrate their eighti- but investments in other social goods eth birthday in 2005 were born during conferred inadvertent health bene½ts the presidency of ‘Silent Cal.’ During that may have played an even more im- this time, women gained greater formal portant role in how older men and wo- political power and rights, while in the men age today. South, lynchings of blacks, though de- So which social changes were most clining, still constituted an important relevant to the health of the aging in the form of social control.8 Southern blacks twentieth century? Educational attain- responded to changing economic and ment, working conditions, minimum social conditions by migrating north in income and income stability, and hous- record numbers.9 Some older people ing conditions all changed profoundly today may have been immigrants in the between 1910 and 1980. Civil rights laws large waves of migration that came from in the second half of the century also Europe, crowding into urban tenements. changed, extending rights and oppor- Others may have been midwestern chil- tunities to many who had been denied them earlier. However, because so lit- 8 E. M. Beck and S. E. Tolnay, “The Killing tle research has directly addressed the Fields of the Deep South–The Market for Cot- health consequences of social policies, ton and the Lynching of Blacks, 1882–1930,” we are not in a position to give com- American Sociological Review 55 (4) (1990): 526– pelling evidence about which social or 539. economic policies had the greatest ef- 9 S. E. Tolnay, “The African American ‘Great fect on health. Migration’ and Beyond,” Annual Review of Soci- Still, what we can surmise is sugges- ology 29 (2003): 209–232. tive. For example, we expect work-relat-
108 Dædalus Winter 2006 ed policies to have profound health ef- To illustrate how we might explore How society fects. During the twentieth century, such associations, we will focus here shapes aging both public and private efforts to im- on one set of policies, relating to educa- prove occupational health and safety tional attainment. Our goal is to show directly reduced fatalities: between 1933 how signi½cant changes in these poli- and 1997, deaths from unintentional cies, enacted decades ago, may continue work-related injuries declined by 90 to reverberate in the health patterns of percent.10 Improvements in working today’s elderly. conditions probably also affected long- Educational attainment, in general, standing chronic conditions and risk is a potent predictor of good health. of disability. But a number of labor pro- Epidemiological studies suggest more tection policies introduced or universal- education correlates with better cog- ized in the twentieth century–such as nitive and physical function, as well as workmen’s compensation, unemploy- decreased risks of death, dementia, and ment, and minimum wage standards– a number of diseases–including car- also likely influenced health outcomes diovascular disease, the major cause of in workers. Although implemented death in the United States. The reasons primarily to buffer workers from pov- for this are undoubtedly complex and erty, these policies may have increased have often been thought to reflect the chances of survival and freedom from intrinsic values, health, and intelligence disability in old age. of individuals who continue their educa- Similarly, we might examine the tion, not the bene½ts of education per health impacts of housing policies that se. However, there is good reason to be- regulated physical hazards in homes lieve that there may be a more causal or promoted homeownership by in- link between education and health. On creasing mortgage availability. Some average, education translates into higher policies may have even been harmful, incomes and therefore higher standards e.g., home loan programs that served of living. People with higher levels of to stabilize racial segregation in neigh- education also tend to have health-pro- borhood housing. moting behaviors like consuming less We believe that the variations in life tobacco and alcohol and getting more expectancy and health in old age ob- physical activity. served in current cohorts of the elderly Educational policies changed dras- may reflect the consequences of differ- tically in the twentieth century in the ential social investments. Thus, research United States and many other countries. on social and economic policies imple- Lawrence Katz and Claudia Goldin have mented decades ago is important. Poli- described the ½rst half of the twentieth cies impact living conditions, which century as the “second transformation in turn may have profound effects on of U.S. education,”11 when high school health and the aging process. completion, previously a rare achieve- ment, became the norm. Changes in average educational attainment partially 10 “Improvements in Workplace Safety–Unit- ed States, 1900–1999,” Morbidity and Mortali- ty Weekly Report 48 (22) (1999): 461–469. This 11 C. Goldin and L. F. Katz, “Human Capital decline was presumably also attributable, at and Social Capital: The Rise of Secondary least partially, to changes in the predominant Schooling in America, 1910–1940,” Journal of types of jobs held by workers. Interdisciplinary History 29 (1999): 683–723.
Dædalus Winter 2006 109 Lisa F. reflected greater demand for schooling. On top of local action to build high Berkman & However, extensive and explicit govern- schools and enroll students, and state M. Maria Glymour ment intervention also increased both changes in compulsory schooling laws, on the demand for and supply of schooling. the G.I. Bill (formally the 1944 Service- aging In the United States, state and local man’s Readjustment Act) represented governments have historically deter- a tremendous federal investment in ex- mined educational policy, and the ½rst panding educational opportunities. The half of the twentieth century was a time G.I. Bill provided unemployment ben- of exceptionally rapid changes in school- e½ts, job search assistance, and loan ing policies and standards. For example, guarantees for small businesses or home in 1918, six states required students to purchases; however, it is best known for complete six or fewer years of schooling promoting education via subsidies for before leaving school, and seven more tuition and living expenses–at a cost of required only seven years of schooling. over $14 billion to the government. Ulti- By 1939, the lowest state schooling re- mately, because nearly 8 million World quirement was seven years, and all but War II veterans received bene½ts under four states required eight or more years. the aegis of the G.I. Bill, participation Still, compulsory schooling laws var- in World War II probably raised college ied widely across states and over time. completion rates by 5 to 6 percentage For instance, in 1918, North Carolina points, a substantial increase over pre- mandated enrollment at age 8 and per- war college completion rates.12 Millions mitted exit at age 14. By 1939, the enroll- more Korean War veterans also bene½t- ment age dropped to age 7, effectively ed from subsequent G.I. Bills. adding one year to the length of com- Social investments such as schooling pulsory schooling. Florida during this laws and the G.I. Bill did not affect ev- time switched from requiring schooling eryone in the country equally. In states from ages 8 to 14 (six years) to requiring where school segregation was legal, in- schooling from ages 7 to 16 (nine years). vestments in measures such as longer Similar increases occurred all across the school-term lengths were unequal. Sim- United States during this period. ilarly, compulsory schooling laws did By virtue of extensive social invest- not dramatically help young African ments, signi½cant improvements in the Americans because many states rarely quality of schooling–including exten- enforced them for blacks. Even ‘race- sions of the school year, construction neutral’ policies such as the G.I. Bill, of new buildings, grade separation, in- bene½ted southern blacks very little.13 creasing teacher quali½cations, and In the postwar period African Ameri- standardization of curriculum–were also achieved during the ½rst half of the twentieth century. The expansion 12 J. Bound and S. Turner, “Going to War and Going to College: Did World War II and the of high school education was probably G.I. Bill Increase Educational Attainment for quite costly to the communities that ac- Returning Veterans?” Journal of Labor Econom- complished it: direct costs of offering ics 20 (4) (2002): 784–815. high school were roughly twice that of elementary school, and indirect costs, 13 S. Turner and J. Bound, “Closing the Gap or Widening the Divide: The Effects of the G.I. in terms of transportation and lost ado- Bill and World War II on the Educational Out- lescent labor, were also likely substan- comes of Black Americans,” Journal of Economic tial. History 63 (1) (2003): 145–177.
110 Dædalus Winter 2006 can G.I.s were much less likely than very effectively to explore the effects of How society white veterans to have completed high numerous social ‘exposures,’ which are shapes aging school and to be eligible for college tu- normally dif½cult to randomize in a tra- ition bene½ts. Southern colleges serving ditional experiment. Because states have blacks also had few seats, turning away often enacted or extended compulsory many veterans because of inadequate schooling laws differently or at different resources.14 The G.I. Bill, one of the times, we can view this situation as a most important federal educational pol- ‘natural’ experiment. Except here, the icies in the history of the United States, ‘treatments’ are assigned to individuals probably reduced educational inequali- by states rather than by a scientist. ties among white men. For blacks, how- In the case of compulsory schooling ever, it may have stabilized or exacerbat- regulations, individuals receive varying ed inequalities. levels of exposure depending on their states’ compulsory schooling require- Research explicitly evaluating the ef- ments. While other factors at the state fects of twentieth-century social poli- level may occur simultaneously with cies on health is relatively limited, in changes in compulsory school laws, part because of the enormous challenge nothing innately individual determines of ½nding compelling study designs to exposure. Therefore, we can sometimes investigate these questions. Recently, make stronger causal inferences from however, economists have exploited natural experiments than we can from the temporal variations in changes to many observational studies. state schooling requirements–in what There are two important limitations amounts to a ‘natural’ experiment– to such a research design. First, when to examine the effects of education on state-level factors determine exposure, adult earnings.15 This work is now being it is dif½cult to disentangle correlated extended to explore the consequences state characteristics and identify which of compulsory schooling on health.16 characteristic is at work. Second, for sta- We often think of natural experiments tistical reasons, the results of these stud- as arising out of natural disasters such ies tend to have wide bounds of uncer- as earthquakes or hurricanes, but social tainty. Nonetheless, natural experiments scientists have employed this concept represent one of the most promising approaches to understanding how social policies and socioeconomic conditions 14 D. H. Onkst, “‘First a Negro . . . Incidentally a Veteran’: Black World War II Veterans and influence health, and to strengthening the G.I. Bill of Rights in the Deep South, 1944 our con½dence in the results of observa- –1948,” Journal of Social History (Spring 1998): tional studies. 517–543. Initial ½ndings are striking. Early work suggests that changes in compul- 15 D. Acemoglu and J. D. Angrist, “How Large Are the Social Returns to Education? Evidence sory schooling laws impacted both mor- from Compulsory Schooling Laws,” National tality and cognitive function. Adriana Bureau of Economic Research, Working Paper Lleras-Muney compared changes in 7444 (1999). state schooling laws between 1915 and 1939 with census information on the ed- 16 J. Angrist and A. Krueger, “Does Compul- sory School Attendance Affect Schooling and ucation and mortality rates of people Earnings?” The Quarterly Journal of Economics who were age 14–roughly the prime age 106 (4) (1991): 979–1014. to drop out–during these years. Lleras-
Dædalus Winter 2006 111 Lisa F. Muney found that one additional year general importance of social-environ- Berkman & of compulsory schooling (or schooling mental conditions during childhood in M. Maria Glymour required for a work permit) translated determining risk of later cognitive im- on into a 5 percent increase in the average pairment. Despite the common percep- aging completed years of education for people tion that cognitive impairment late in born in that state.17 Each additional year life is a function of one’s genetic endow- of schooling induced by the laws was ment, these results suggest that state also associated with a 3 to 6 percentage policies, perhaps related to schooling, point reduction in the risk of death over can help protect the elderly regardless ten years.18 of their individual genetic backgrounds. Recently completed analyses of the We can and do change policies such as effects of compulsory schooling laws schooling requirements or resources in on men and women who were born response to evolving social demands. between 1900 and 1947 con½rmed that If we can show that compulsory school- individuals born in states with high lev- ing plays a salutary role in growing old els of mandatory schooling completed gracefully, then we can change public more schooling. They also performed policy in order to promote healthier ag- better on cognitive tests taken many ing for future cohorts. decades after ½nishing school, even af- ter adjusting for demographic charac- Individual characteristics undoubted- teristics such as race and parental edu- ly influence how we do in old age. Our cation.19 We are now extending this genes shape how we age–but so do gov- work to examine whether other state- ernment policies. Indeed, the example level characteristics that changed con- of educational attainment indicates that temporaneously with schooling poli- critical childhood experiences can shape cies, such as economic development outcomes in late life. Mark Hayward or the spread of kindergarten enroll- has referred to this phenomenon as ment, might account for this relation, “the long arm of childhood.”20 Impor- and whether schooling appears to have tant questions remain. First, what are the same effect on other health out- the crucial biological, psychological, or comes. social mediators between early life expe- While we are actively working to iden- riences and adult health? Second, we tify the most influential policies, these know, for example, that education pro- results, in the meantime, highlight the tects individuals from a range of phys- ical and psychological stressors. But are 17 A. Lleras-Muney, “Were Compulsory At- there windows of time in the human life tendance and Child Labor Laws Effective? An course during which social exposures Analysis from 1915 to 1939,” Journal of Law & are most powerful and after which they Economics 45 (2) (2002): 401–435. are ineffective? To answer these ques- 18 A. Lleras-Muney, “The Relationship Be- tions, gaining further insight into the tween Education and Adult Mortality in the biological pathways linking social ex- us,” Review of Economic Studies 72 (1) (2005): periences to aging processes is crucial. 189–221.
19 M. M. Glymour, “Identifying Social Deter- 20 M. Hayward and B. Gorman, “The Long minants of Old Age Cognitive Function” (dis- Arm of Childhood: The Influence of Early-Life sertation, Harvard School of Public Health, Social Conditions on Men’s Mortality,” Demog- 2004). raphy 41 (1) (2004): 87–107.
112 Dædalus Winter 2006 Here, we explore the ways in which both for intimate partners and close family, How society stressful and ful½lling social experiences had been known to increase risk of mor- shapes aging actually shape the biology of aging. tality and a host of mental and physical Scientists used to believe that each problems.23 But the biological basis for individual was born with an intrinsic the heightened risk was unclear. This ‘biological clock’ that determined his study discovered that mothers who had or her rate of aging. Extensive research been taking care of a chronically ill child focused on identifying indicators of an for a long time had shortened telomeres, individual’s ‘biological’ age. Telomere decreased telomerase activity, and high- length emerged as a powerful marker er levels of oxidative stress than mothers of aging. Telomeres are dna-protein who had not been in that caregiving role complexes that cap chromosomal ends, for long. Furthermore, perceived stress promoting chromosomal stability; telo- correlated with telomere shortening in merase is a cellular enzyme that protects all the mothers. In terms of telomere telomeres. With age, telomeres shorten length, women with the highest levels in humans, and in vitro cells become of perceived stress were comparable to senescent when telomeres shorten suf- women a decade older. Thus, we can see ½ciently. Indeed, investigations have how social stressors influence aging at a linked telomere shortening to higher cellular level. mortality rates in the elderly and to car- Several theories are compatible with diovascular disease.21 New evidence in- this ½nding. Researchers have long dicates that both internal and external speculated that social and psycholog- environmental conditions influence ical stressors, much like physical activi- telomere length, potentially producing ty, have generalized consequences for some of the health variability we ob- health. These stressors influence a wide serve among older people. array of diseases through a set of physio- A recent study by psychologist Elissa logical pathways that are so strongly re- Epel and biochemist Elizabeth Black- lated to chronological age they are con- burn examined the effect of social stres- sidered markers of the aging process. We sors on telomeres, providing us with in- have hypothesized that stresses present- credible insight into how social stressors ed by social disadvantage and social iso- might accelerate aging. The researchers lation, as well as major life events such assessed perceptions of stress in a group as bereavement and loss, affect health by of almost sixty healthy mothers between accelerating the rate of aging.24 By erod- the ages of 20 and 50 who had either ing individual capacity for resilience, a seriously chronically ill child or a healthy child.22 Caregiving, especially ly Greater Among Women with Central Fat,” 21 R. M. Cawthon et al., “Association Between Psychosomatic Medicine 62 (2000): 623–632. Telomere Length in Blood and Mortality in People Aged 60 Years or Older,” Lancet 361 23 S. Lee et al., “Caregiving and Risk of Coro- (9355) (2003): 393–395, and S. Brouilette et al., nary Heart Disease in U.S. Women: A Prospec- “White Cell Telomere Length and Risk of Pre- tive Study,” American Journal of Preventive Medi- mature Myocardial Infarction,” Arteriosclerosis cine 24 (2) (2003): 113–119. Thrombosis and Vascular Biology 23 (5) (2003): 842–846. 24 L. Berkman, “The Changing and Heteroge- neous Nature of Aging and Longevity: A Social 22 E. Epel et al., “Stress and Body Shape: and Biomedical Perspective,” American Review Stress-Induced Cortisol Secretion is Consistent- of Gerontology & Geriatrics (8) (1988): 37–68.
Dædalus Winter 2006 113 Lisa F. these stressors presumably leave people exposure to quite different social experi- Berkman & more vulnerable to a host of other ge- ences may provide us with critical clues M. Maria Glymour netic or environmental risks. Encoun- as to how we can improve the health on ters with these other risks determine the and well-being of older men and wom- aging speci½c disease developed. That is, the en. We believe that the investments so- social stress ‘leans’ on the aging body, ciety makes for its citizens all along the accelerating the onset of disease, but life cycle from early childhood to old does not necessarily determine which age accumulate to affect the health of speci½c disease occurs. the older population, for good or ill. Two related theories support this The degree to which those social invest- framework. ‘Weathering,’ a concept ments are unequally distributed will cre- elaborated by Geronimus, explains ate health inequalities dif½cult to erase African Americans’ more rapid deteri- as people age. oration in health and different experi- ences of reproductive health in terms of their prolonged exposure to discrim- ination and stress.25 Other work has fo- cused on ‘allostatic load,’ or the cost of adapting to the heightened physiologi- cal responses that result from repeated or chronic environmental challenges– the wear and tear on the body.26 In stud- ies of humans, Teresa Seeman and Bruce McEwen initially identi½ed a number of biological indicators of allostatic load. These biomarkers include those related to the sympathetic-adrenomedullary system, the hypothalamic-pituitary-ad- renal axis, and the cardiovascular met- abolic and immune systems. Longitudi- nal studies have shown that socioeco- nomic disadvantage and social isolation predict allostatic load, which itself pre- dicts mortality. Accumulating evidence indicates that social as well as biological factors deter- mine how people age. Paying attention to the variability in aging produced by
25 E. Breeze et al., “Do Socioeconomic Disad- vantages Persist Into Old Age? Self-Reported Morbidity in a 29-Year Follow-Up of the White- hall Study,” American Journal of Public Health 91 (2) (2001): 277–283.
26 B. S. McEwen, “Sex, Stress and the Hip- pocampus: Allostasis, Allostatic Load and the Aging Process,” Neurobiology of Aging 23 (5) (2002): 921–939.
114 Dædalus Winter 2006 Poem by Charles Wright
Last Supper
I seem to have come to the end of something, but don’t know what, Full moon blood orange just over the top of the redbud tree. Maundy Thursday tomorrow, then Good Friday, then Easter in full drag, Dogwood blossoms like little crosses All down the street, lilies and jonquils bowing their mitred heads.
Perhaps it’s a sentimentality about such fey things, But I don’t think so. One knows There is no end to the other world, no matter where it is. In the event, a reliquary evening for sure, The bones in their tiny boxes, rosettes under glass.
Or maybe it’s just the way the snow fell a couple of days ago, So white on the white snowdrops. As our fathers were bold to tell us, it’s either eat or be eaten. Spring in its starched bib, Winter’s cutlery in its hands. Cold grace. Slice and fork.
Charles Wright, a Fellow of the American Academy since 2002, is Souder Family Professor of English at the University of Virginia in Charlottesville and the author of many books of poetry, including “Country Music: Selected Early Poems” (1982), which won the National Book Award, and “Black Zodiac” (1997), which received the Pulitzer Prize. He has also published two works of criticism, “Halflife” (1983) and “Quarter Notes” (1995). In 1999 he was elected a Chancellor of the Academy of American Poets. This poem will appear in “Scar Tissue” in the spring of 2006.
© 2006 by Charles Wright
Dædalus Winter 2006 115 Fiction by Ree Davis
I kneel before you
Light streaming into the room wakes I move across the hall to the toilet, not me. I curl around Jaichin’s body and looking at the door to her room. I do not close my eyes. Jaichin pushes me away. want to think about her yet, so I go into “Get up,” he says, his face buried in the toilet and rinse my face in the sink. the pillow. “Get up, Xiao-li. It’s your My eyes are swollen with sleep. Every- time.” one was up late. I cannot wait until they The morning is my responsibility. decide it is time for her to go. The others always sleep late. I sit up I shuffle into the kitchen, pausing to on the mattress. This room is small, listen at her door. There is no sound. I but the apartment is large with seven get a bowl ofrice and sit to eat. I drink rooms. Our one window faces east, so the tea that remains in my cup from yes- we always get morning sun. It does not terday. I sit longer than I should, delay- bother Jaichin, but the morning light ing the start ofthe day. I wash my dishes reminds me ofhome. I miss my moth- and look out the window into the nar- er most in the morning, but now I push row space behind our building. It is lined her from my mind. with windows to other kitchens just like I stand up and pull on my pants and ours. Everything is ½lthy and worn; no t-shirt. Jaichin’s long, lean body lies one cares about this place. After putting motionless on the bed. He wears only the dishes away, I leave the kitchen, stop- underpants. I would love to wake him ping in the toilet to get a bucket and and make love, but he needs the sleep. cloth. I cross the hall to her room. He will be hung over from last night. I I open the door and peer in before leave, without disturbing him. entering. Around her, the room is emp- ty except for some old construction “I kneel before you” won ½rst runner-up in the materials stacked by the door. She is in “South China Morning Post”/Radio Television the center ofthe room, just as they left Hong Kong’s 2003 short ½ction competition. her. Her head hangs down on her chest; After spending three years in China, Davis lives she is still asleep. Her wrists are tied to- in North Carolina, where she is an architect and gether behind the chair. Her ankles are a writer. She is ½nishing her ½rst novel, “A Ter- bound and tied to the chair’s legs. Her rible Energy.” head is covered with her blouse; I tied it there myselflast week. I cannot see her © 2006 by Ree Davis face.
116 Dædalus Winter 2006 I do as I have been instructed, clean- head, trying to face me. She is crying. I kneel ing the blood and urine that has collect- This makes me angry. before you ed on the floor at her feet during the “It is your own fault. You stole from night. She stirs; I step back. I know she Mr. Wong.” I am annoyed. “Your fault. cannot hurt me; she is bound too tight- Not mine. Your tears mean nothing.” ly. Her cloaked head faces mine. Can She tries to move the chair with her she see through the fabric? I look away. body, but she is too weak. She has been I hear her mutter through the tape cov- here for four weeks. Wong, Jaichin, and ering her mouth. I ignore her muffled Xin, Jaichin’s younger brother, brought words and ½nish cleaning. As I stand to her here one night. I came to the door take the bucket from the room, she mut- ofthe room, but it was locked. I asked ters again and a new pool ofurine forms Jaichin what was happening. He said to on the floor. I put down the bucket, soak go to our room, where I waited for him. the cloth in the puddle at her feet, and Through the walls, I could hear her cry- squeeze it over her. She struggles be- ing to be left alone, to go home, to go neath the stream. back to her baby. They were beating her, I clean the floor again and leave the calling her a whore and an addict. I was room to dump the contents down the scared, but did nothing. toilet and rinse the rag. When I am Before that night, everything was through, I return and sit on the floor ½ne between Jaichin and me. I would behind her. As with every morning, do anything for him, but now, he spends my mind wanders and I think ofmy most ofhis time with her. Jaichin said mother. I came to this house six months she used to buy drugs from them, but ago, soon after I started seeing Jaichin. stopped when she had a baby. She stole Though I am much younger than he, from them, so they had to make an ex- we fell passionately in love. My father ample ofher. After seeing her, I won- claimed Jaichin was a gangster and our dered ifthey also brought her here be- affair brought shame to the family. He cause she was beautiful. banished me from my home. That was My thoughts are interrupted when the last time I saw my mother. She knelt she starts banging the chair legs against on the floor behind him, sobbing not the floor. I am afraid she will wake ev- to lose her only daughter. Now, I can eryone, so I get up. I face her cloaked only take comfort in my memories of head, “Stop. Now.” her. When I was not in school, I spent I can see tears have soaked the blouse. every moment with her. In the evening, This makes me angrier. She is naked after she put me to bed, she bathed my from the waist up. Her skin is bruised father’s mother in our kitchen. I was and marked from these weeks with us, quite young, but I remember watching but her breasts are still beautiful. My them from the nook where I slept. My face flushes. Her beauty, which shines mother would help my grandmother through her beaten flesh, angers me undress. Then, my mother would wash more. Jaichin has been touching this her from a bucket of warm soapy water. skin instead ofmine. Jaichin comes to In silence, my mother lifted each with- our bed smelling ofher. Jaichin does ered limb and stroked it clean. The ritual not want to touch me anymore. continued until my grandmother died. Suddenly, the door bangs open and My thoughts are interrupted when the Jaichin enters. “Stupid, useless girl. woman shifts in her chair. She rolls her Can’t you keep her quiet?”
Dædalus Winter 2006 117 Fiction by I shrink at his rage. He picks up a pipe sons. During the mornings ofthat week, Ree Davis leaning near the door and crosses the I spat on her. Now, I see how fragile she room. In one graceful swing, he smashes is. Her arms and legs are pale and thin. the pipe against her head. Her torso Again, I have to push the scissors into slumps forward. He hands the pipe to the flesh of her ankles to cut the bind- me and leaves the room, slamming the ings. Again, dried blood binds her limbs door. together. I will have to clean her to be I am stunned and stand motionless able to remove the other bindings, so I with the cold pipe in my hands. Deep get the bucket and rag. As I move across red begins to seep through the fabric the hall, I notice the other rooms are covering her face. Her head hangs loose quiet: no one else is awake. from her neck. I think she is dead. Hot I return, closing the door and locking tears race down my cheeks. I pace back it. I soak the rag in warm water and clean and forth, clutching the pipe, scared by the blood from her torso. I gently soak the thin stream ofblood seeping down the cords that encircled her before I un- her bare breasts and by what Jaichin may wrap them. When she is ½nally free, I have done. pull her from the chair and lay her body It seems hours pass before I have the on the floor. I cut her tattered and soiled nerve to put the pipe down and untie the skirt, pulling it off from under her body. blouse. I remove the fabric, revealing her She is naked, but covered with blood face. It is now slack with death. Her jaw and ½lth. I change the water in the buck- falls loose from the blow. The tape hangs et several times, flushing the red liquid useless from her mouth. I kneel before down the toilet and re½lling it with fresh her. I must compose myself; this is no water. I rinse her blouse clean too. Each time for self-pity. time after I return to her, I close and lock I get up, go to the kitchen, and get the door. scissors. When I return, I kneel to cut When she is completely clean, I put the bindings from her wrists. Her thin away the bucket, return to the room, ½ngers are bruised and broken. The nails and lock the door. I sit beside her. Her are ringed in blood and dirt. The bind- body is a map ofthe last four weeks. ings are tight. I must push the scissors The yellowish purple areas ofher face, into the flesh of her wrists to cut them. arms, and hands mark week one, when They have been there for so long, I must every day she pleaded to be returned peel them off. Once discarded, the bind- to her child, but instead was beaten un- ings form a broken ring on the floor. Her conscious. Dark purple areas on her hands are stuck together with blood; I wrists, ankles, and thighs mark week pull them apart and bring them around two, when they gagged her and repeat- to place in her lap. Her waist is bound edly raped her. Burns on her face, to the chair, so she does not fall. I kneel breasts, legs, and feet were formed in again to undo the bindings at her ankles week three. Red welts extend from and see bruises up the length ofher legs.these areas, indicating infection had These are from the second week, when set in. Some marks are chemical burns the men stopped beating her and began from caustic cleaning fluid. These were raping her. I listened from the other my contribution to her torment. I felt room as she struggled beneath them; excluded, so I gave them ideas for tor- my face grew hot with jealousy. I wanted ture and was proud to be allowed to Jaichin to stop, but for the wrong rea- participate. It felt good to hurt her then;
118 Dædalus Winter 2006 she was the woman who stole Jaichin I kneel from me. This last week, week four, they before you had grown tired ofher, so she was beat- en just to keep her unconscious. Despite the shroud ofviolence she wears, I know she was still beautiful until Jaichin’s last blow. My hands tremble as I tie her shat- tered jaw closed with the blouse that has served as her mask. I close her eyelids. As I sit beside her, I see the marks of childbirth on the skin ofher stomach and the edges ofher breasts. I see the holes in her earlobes that once held ear- rings, and the white bands on her ½n- gers where there once were rings. There is a scar on one knee, perhaps from a childhood fall. I hold her hand in mine, as my mother held my grandmother’s hand after preparing her body the day she died. I want to cry for this woman, but know I do not have the right, so we sit together in silence, she and I, for hours. The room is peaceful until I hear the men waking in the rooms beyond. It is not long before they begin pounding on the door.
Dædalus Winter 2006 119 Dialogue between Daniel Bell & Wolf Lepenies
On society & sociology past & present Translated by Howard Eiland
“That’s no way to start a newspaper ar- Daniel Bell say that? For several years ticle!”* How many times have I heard he and I worked together with a Japanese colleague–the literary critic and author Daniel Bell, a Fellow of the American Academy of No plays, Masakazu Yamazaki–to ed- since 1964, is Henry Ford ii Professor of Social it Correspondence, a magazine funded by Sciences Emeritus at Harvard University. Bell’s the Japanese Suntory Foundation and publications include “The End of Ideology” ½rst published by the American Acade- (1960), “The Reforming of General Education” my, and then by the Council on Foreign (1965), which won the gold medal of The Amer- Relations in New York. Although there ican Council of Education, and “The Cultural were no of½cial positions on the staff, Contradictions of Capitalism” (1976). He has Masakazu and I gladly followed Daniel written or edited eighteen books, a number of Bell’s lead on a host of matters, ranging these in Japanese. He was for twenty years a coun- from choice of themes for particular cillor of the Suntory Foundation in Japan and for issues, to the makeup of pages, and the ten years Scholar-in-Residence at the American selection of vignettes to illustrate arti- Academy. cles. There was no question who was in fact the primary editor. Wolf Lepenies, a Foreign Honorary Member of I was not the only one who thought the American Academy since 1992, was Rector of that Daniel Bell was a great journalist. the Wissenschaftskolleg zu Berlin (1986–2001) Bell’s retirement in 1958, after ten years and is now a Permanent Fellow there and pro- with the magazine Fortune (with the fessor of sociology at Freie Universität Berlin. exception of a year and a half in Paris), Among other prizes, he received the Alexander astounded the newspaper magnate von Humboldt Prize for French-German Scien- Henry Luce. ti½c Cooperation, the Karl Vossler Prize, and the “But why?” he wanted to know. Joseph Breitbach Prize. His publications include “You’re body and soul a journalist! What “Die drei Kulturen” (1985), “Benimm und Erken- reason could you possibly have to return ntnis” (1997), and “Sainte-Beuve: au seuil de la to academic life?” modernité” (2002). His latest book, “The Seduc- tion of Culture in German History,” will be pub- * Wolf Lepenies met with Daniel Bell on De- lished by Princeton University Press in the spring cember 4, 2004, in Cambridge, Massachusetts. of 2006. The German version of the interview was pub- lished in the newspaper Die Welt on January 12, © 2006 by Wolf Lepenies 2005.
120 Dædalus Winter 2006 “Three reasons,” answered Bell. “June, the destruction of the temple? The sa- Society July, and August.” cred writings.” & sociology past & Of course, the lure of summer vaca- Our conversation took place in Cam- present tions was not the only thing that led bridge, where Bell lives with his wife Bell, who during his time at Fortune was Pearl (younger sister of literary critic already teaching at Columbia Universi- Alfred Kazin) near Harvard Yard. I ty, to return to an academic career. Born hadn’t seen him in over a year. His in 1919 in New York, Daniel Bell early on house now has a small addition, so that developed a sociological eye for things, Pearl, who had a serious accident a few an intuitive grasp of the fundamental years ago, could move back in and re- changes taking place in the structure ceive round-the-clock treatment from of society. Today the titles of his books two nurses. –The End of Ideology, The Cultural Con- The house is not only, as one would ex- tradictions of Capitalism, and The Coming pect, full of books. Bell is also an art con- of Post-Industrial Society–have become noisseur and has collected Japanese and bywords in discussions of modernity. German Expressionist prints. He once Bell taught at Columbia as a professor described himself as a liberal in politics, of sociology until 1969. He then switched a socialist in economics, and a conserva- to Harvard, where he remained until his tive in culture. Does this self-characteri- retirement in 1990. He’d come a long zation still hold? “Yes, certainly. I had way from ‘the poor man’s Harvard’– recourse to this tripartite division be- that is, City College in New York, where cause I don’t regard society as a holistic he studied from 1935 to 1938. As the son system. You can be a radical in one area of poor Eastern European Jewish immi- and conservative in another. I’m a liber- grants, he was able to enroll at City Col- al in politics because I believe in individ- lege tuition-free. Soon he was actively ual achievement and reward, in the idea involved with the ‘New York Jewish in- of a just meritocracy. In economics, I’m tellectuals,’ not all of whom were reli- a socialist, because community partici- gious, but who all shared a certain ethos. pation is important to me; everyone is They saw themselves as deracinated cos- entitled to a decent share of the avail- mopolitans, but at the same time as part able resources. And in art and culture of a widely dispersed intellectual family. I’m conservative, because I uphold val- Bell describes himself as “decidedly ues and traditions.” religious.” “My upbringing was very Bell’s description of himself as a so- Jewish,” he recalls, “and my native cialist makes him smile. He remembers tongue was Yiddish. I attended a Jew- a time when there were socialists every- ish school (kheder), where neither teach- where at City College; many Stalinists ers nor students spoke English. We were so argumentative that New York translated from Hebrew into Yiddish.” at the time was known as the most in- Still, religion for Bell is “not so much teresting city in the Soviet Union. The about God, as about the sacred. It’s socialists at City College were abundant- not a matter of ritual or orthodoxy. Re- ly self-conscious, returning manuscripts ligion for me is the holy and the tradi- with the comment: “Tolstoy did it bet- tion, something that sets limits and that ter.” And in the midst of a political de- you can’t go beyond. I was particularly bate, one might hear someone say, en- impressed by the fact that rabbis are not tirely in earnest: “I know what Trotsky priests but teachers. What remains after should do, and so do you. But does Trot-
Dædalus Winter 2006 121 Dialogue sky know?” Daniel Bell was a socialist the de½nition once devised in a City Col- between like the others, but, unlike most, he was lege cafeteria, a New York intellectual Daniel Bell & Wolf never doctrinaire. How does he explain is someone who, after two minutes’ Lepenies that? preparation, can talk uninterruptedly “I was lucky. I became a socialist in on any subject whatsoever for at least a reaction to the Depression. I saw people quarter hour. Bell needs no two-minute living in hovels and starving. Capitalism preparation, and one can listen to him seemed to be on its last legs–so you for hours. He personi½es a kind of Amer- became a socialist. Then I met Rudolf ican intellectual who, unlike his Euro- Rocker, who though born a Christian pean colleagues, has never had any illu- had learned Yiddish in order to edit the sions about belonging to a ‘socially free- Free Workers’ Voice (Fraye Arbeter Shtime), floating intelligentsia.’ Nor has he ever a Yiddish-language newspaper printed taken refuge in a concept of ‘the inner in Hebrew letters. Rocker gave me anar- life.’ “With Roosevelt and the New Deal, chist writings, and I read about the sail- there came into being a type known as ors in Kronstadt who, in 1921, went to the ‘policy intellectual.’ That was what Trotsky and demanded food supplies I wanted to be: someone who under- and the free elections they’d been prom- stands something of the details of pol- ised. And Trotsky, the organizer of the itics, and is interested in its everyday Red Army, cried ‘Insurrection!’ and working. Friends of mine would say: the had the sailors shot. ‘Kronstadt’ then be- intellectual has to be critical. That was came a code word for withdrawal from not enough for me. For me, the most the Communist Party. Some people had important function of the intellectual their ‘Kronstadt’ during the mass purges was to take responsibility.” in the 1930s, others during the Hungari- It was because of this ‘ethic of respon- an uprising, and still others during the sibility’ that Bell became a member of Prague spring. My Kronstadt was Kron- four government commissions and, in stadt.” 1965, cofounded the journal The Public Like many of his college friends, Dan- Interest, with his old friend Irving Kristol. iel Bell grew up on the Lower East Side Bell resigned in 1972, and was replaced of New York–in a milieu marked by per- by Nathan Glazer. Kristol became the sistent poverty if not by overwhelming intellectual forerunner of the neoconser- misery. His generation did not come to vatism that brought Richard Nixon and socialism through dramatic conversion Ronald Reagan to the White House. experiences but rather grew into it, as Bell likes to quote Irving Kristol’s youngsters grow into the clothes of older de½nition of the neoconservative as siblings. Schoolchildren were already “a liberal mugged by reality.” But he trade unionists and agitated from soap- does not by any means number himself boxes for a more just society. In this spir- among the neoconservatives. “In 1972, it, the young Bell, speaking on soapbox- the New York Times invited Kristol and es, memorized passages from Upton Sin- me to contribute guest columns. They clair’s novel The Jungle. His reward–the wanted us to explain why he supported astonished exclamations of passersby on Nixon and I supported McGovern. We the New York sidewalk, “How eloquent wrote our commentaries, but at the last he is!” minute the Times could not print them. At eighty-six, Daniel Bell has lost none We still have the articles. Unlike Kristol, of his youthful eloquence. According to I didn’t trust Nixon for a minute. But my
122 Dædalus Winter 2006 friendship with Irving Kristol was never ness of most citizens to make sacri½ces Society compromised by our differing political for the community. He also predicted & sociology past & views. Friendship has always been more thirty years ago a resurgence of religious present important to me than ideology.” conviction in the world; he believes Eu- Bell’s political differences with the ropean society is only super½cially secu- neoconservatives–those who provide larized. And he has cited the observation the ideological lining to U.S. policy at of his friend Irving Kristol, that societies present–became clear in the course of in the West are unprepared for major ca- our conversation: “I don’t trust a poli- tastrophes. 9/11 was proof of that. tics geared to securing American hege- Asked if he was worried about any- mony. Cheney, Rumsfeld, and the rest thing in particular these days, Bell had –I don’t trust them. They’re obsessed this to say: “Optimism is a philosophy, with geopolitics.” Still, Bell refuses to pessimism a character trait. My charac- describe American hegemony as ‘im- ter trait is pessimism. Jews continually perialism.’ “There’s a big difference be- have had cause for anxiety; that’s part tween hegemonic and imperial. Hege- of our history. I’m a pessimist–there’s mony, and, above all, military hegemo- always something that’s got me worried. ny, the role of superpower–this role At the moment, it’s the Israeli-Palestin- has fallen to the Americans. I once cited ian conflict, to which the American gov- André Malraux, who had it right: An ernment is paying insuf½cient atten- imperial style is something denied to tion.” Americans. Nixon aimed for it–with- With this, our conversation came out success. And Bush, too, with his to an end–though not our evening to- ‘Mission accomplished!’–his advisors gether. We went to dinner at the Kebab came up with that. Our society is much Factory, a popular Indian restaurant in too bourgeois to be able to cultivate an Cambridge. The table was small but the imperial style.” noise level high. Bell requested that the In speaking of members of the Bush music be turned down a little. He want- administration, Bell frequently uses one ed to sing me a song he’d written in his adjective: “smart.” Unlike most intellec- youth at City College. The song was tuals, he has not believed that those who called “The Old Bolshevik.” He started hold the reins in Washington today are up: “When I was a lad in Nineteen Six, / blockheads. As a sociologist, he is care- I joined a group of Bolsheviks.” There ful not to underestimate the reelected were at least six choruses, and before president. “What drives George W. Bush long nearly everyone in the Kebab Fac- is his faith. He’s a born-again Christian tory had stopped eating. I thought of the and must be taken seriously as such. passersby in New York who had once Compared to, say, Ronald Reagan, who listened in amazement to the little soap- in these things was very clever, Bush is box orator; like them, one wanted to ex- no operator. I sometimes wish he were claim: “How eloquent he is!” –then there might be some chance of changing him. But, no, he really believes in what he says. It’s on this score that so many people misjudge him.” For over forty years, Daniel Bell has bemoaned the lack of civitas in the life of the modern democracies, the unwilling-
Dædalus Winter 2006 123 have always shied away from discussing it with me because it was too upsetting. It was also too remote. Why concern themselves with gross abuses happen- ing in far-flung parts of the world, about Jeri Laber which there was little an ordinary Amer- ican citizen could do? And anyway, on torture don’t those people–the torturers–have a distinct ‘mentality’ that enables them to torture? Nothing like that would ever happen here! No wonder Americans were shocked and trans½xed by the spectacle of Amer- ican soldiers, ordinary men and women from towns across the United States, subjecting Iraqi detainees to painful and humiliating treatment–and recording the abuses on their camcorders with It has been well over a year since we ½rst boastful glee. Who are these people? learned about the torture by American Who are their superiors? And who in soldiers in Iraq’s Abu Ghraib prison. our great democracy gave them permis- Yet only low-level offenders have been sion to act as they did–with a sense of tried and punished. Americans have impunity, without any shame? been forced to confront dif½cult ques- “Are you surprised?” friends asked tions: Why were these abuses commit- me. My answer was yes . . . and no. On ted? Who is ultimately responsible? the one hand, I was surprised because As a human rights activist for the past such behavior goes against the basic thirty years, I have learned a lot about principles of American democracy, torture. My colleagues and I at Human against our belief in the rights of the Rights Watch have documented the use individual and the sanctity of his or of torture in many parts of the world and her person. I believe in those princi- have pressured offending governments ples. They have made me proud to be to change their practices. an American. Torture is a gruesome subject. My Yet I am not surprised. Since Septem- friends and acquaintances, on the whole, ber 11, our government has systemati- cally chipped away at the guarantees that have kept our democracy sound– Jeri Laber, a Fellow of the American Academy by refusing to apply the Geneva Con- since 2003, is a writer, human rights activist, ventions to detainees in Guantánamo, and one of the founders of Human Rights Watch. by using the U.S. Patriot Act to under- Some of the material in this article is adapted mine our civil liberties at home, by say- from her memoir, “The Courage of Strangers: ing that torture may be justi½ed under Coming of Age With the Human Rights Move- certain circumstances because of our ment” (2002). war against terrorism. In direct violation of international law and the Convention © 2006 by the American Academy of Arts Against Torture, senior of½cials in the & Sciences U.S. government stated that the presi-
124 Dædalus Winter 2006 dent has the authority to set aside such In doing so, I learned to close off part of Torture laws in wartime. The administration has my feelings and not allow myself to fully engaged in a deliberate policy of permit- imagine the experiences they described. ting illegal, coercive interrogation tech- Only then could I stay measured and dis- niques. It has then tried to cover up or ciplined in dealing with their terrible ignore reports of torture and other abuse tales. by U.S. soldiers, in Afghanistan, in On my desk each day were dozens Guantánamo, and in Iraq. of grotesque torture descriptions. I had There is no such thing as ‘lite’ torture. to pick those that I thought would be Once the rules are bent, or lifted, despi- most effective for an article or a report, cable acts like those at Abu Ghraib be- discarding others that were either not come possible. graphic enough or too ghastly for the It was a 1975 article about torture that average reader. It was a strange experi- started me on my human rights career. ence indeed to matter-of-factly edit a Though it may seem surprising today, report, inserting the appropriate com- the use of torture in more than 150 coun- mas between sequential words like “be- tries around the world was not widely headed, mutilated, and raped,” while reported back then, and the facts were trying to ignore the import of the words not known to even the most thoughtful themselves. and concerned people. Shocked by what Most torture victims never fully recov- I read and convinced that I had to do er from the experience. The most devas- something about it, I became part of the tated are usually those who broke under nascent human rights movement in the torture and incriminated others. They United States. In 1978, I became a found- live with intense pain–physical, emo- er and then the long-term executive di- tional, and spiritual. rector of Helsinki Watch, which grew Other torture victims have amazed to be Human Rights Watch, the largest me with their strength to resist and re- human rights organization based in the bound. There is a remarkable similarity United States. in what they have to say: I will never forget my ½rst interview “I could stand the pain because there with a torture victim. In 1977, I met with was a part of me they couldn’t touch.” an Iranian poet and professor who had “They tortured my body, but not my been imprisoned and tortured in 1973 soul.” by the Shah’s secret police, the dreaded I have given a lot of thought to the psy- savak. He described beatings that tore chology of the torturers, trying to under- apart the soles of his feet, threats to rape stand how ‘ordinary’ people could com- his wife and daughter, and a mock exe- mit such atrocities. Torture victims of- cution in which he thought he was about ten describe their torturers as “family to die. He depicted torture chambers men” who left home each morning to do with iron beds to which prisoners were a job like everyone else. Occasionally, I tied and “roasted.” He spoke of whips also read reports by a few repentant tor- and electric prods that shocked the chest turers who had the courage to confess and genitals. He described how torturers what they did and deplore their own ac- hung their victims upside down and tions. raped them. Not every torturer is born a monster. In the years that followed, I went on to Many are ambitious young people, re- interview hundreds of torture victims. cruited as soldiers into elite forces and
Dædalus Winter 2006 125 Note by specially trained for the dirty work in against torture. The U.S. government Jeri Laber which they then feel trapped. Others, should change its policy and conduct a like those Americans in Iraq, are un- serious, independent investigation of trained and inexperienced, led to believe the deplorable events that have so tar- that they are serving a good purpose by nished our country’s reputation and ‘softening up’ prisoners for interroga- self-respect. tion. They believe that their work is nec- essary in order to get information that will protect their country. But in the process of torturing other human be- ings, they destroy their own humanity and become overwhelmed with feelings of power that enable them to commit monstrous deeds. Particularly instructive are the ½nd- ings of Stanley Milgram, a Yale psychol- ogist who, in 1974, attempted to prove that ordinary New Haven residents would follow orders to the point of ad- ministering life-threatening shocks to an innocent victim in the course of a supposed scienti½c experiment. While Milgram’s research on obedience to authority may have been flawed, the results demonstrate the complexity of human behavior: people are not neces- sarily bad or good; the circumstances of the moment may influence their actions. Torturers, or potential torturers, may exist in every society: it is society’s re- sponsibility to pass laws to protect its citizens–sometimes from themselves. Torture is destructive to all involved– to the victims, to the torturers, to those who ignore or deny what is happening. Lectures about what is right and what is wrong are not enough to stop it. Soci- ety needs principles, of course, but it al- so needs laws to protect its citizens. It needs strong institutions to enforce those laws and to punish all transgres- sors, including senior of½cials responsi- ble for a high-level policy of abuse. It is inexcusable for any government –and especially the government of the United States with its high moral pre- cepts–to make exceptions to the laws
126 Dædalus Winter 2006 did ful½ll their vaunted function as labo- ratories of democracy, as was true with welfare reform, ensuing reforms enacted at the national level soon eclipsed the states’ contribution. Robert F. Nagel Most people have not mourned this loss of state authority. In fact, only a few on the decline years ago, sophisticated observers be- offederalism came alarmed at what they perceived as the Supreme Court’s attempts to en- gage in a radical, even revolutionary, effort to revive the role of states in the federal system. Over the past three years, however, the clamor has begun to sub- side as the Court has issued several rul- ings that once again expand the scope of Congress’s power and limit state im- munity from that power. These recent In the last century, federalism dramat- decisions, together with a long-running ically declined in signi½cance to the series of cases that constrict state regu- American public. One reason for this latory authority through the aggressive deterioration was the development of creation of individual rights, make it new individual rights, particularly as clear that federalism is not nearly as high a result of the civil rights movement, a priority for the justices as their occa- when state sovereignty was closely as- sional states’ rights rhetoric might sug- sociated with opposition to racial inte- gest. gration and, more distantly, with slav- Yet a lack of public or scholarly in- ery itself. The expansion of government terest in states is not the same as a lack at the national level also reduced the im- of interest in decentralization. In fact, portance of states. If states sometimes since at least the 1950s, considerable aca- demic and journalistic concern has been expressed about the loss of political life Robert F. Nagel, a Fellow of the American Acade- at the local level. On both the right and my since 2003, is Ira C. Rothgerber, Jr. Professor left, many have called for the reinvigora- of Constitutional Law at the University of Col- tion of neighborhood councils, school orado School of Law. His most recent publica- boards, and the various private clubs and tion, “The Implosion of American Federalism” associations that grow up around local (2001), examines the cultural and constitutional governmental institutions. What makes implications of political centralization. He has this kind of decentralization appealing, also authored “Judicial Power and American of course, is that it provides the opportu- Character: Censoring Ourselves in an Anxious nity for direct, personal dealings among Age” (1994) and “Constitutional Cultures: The citizens and for decision making that is Mentality and Consequences of Judicial Review” highly sensitive to local conditions. (1989). These communitarian values have al- so attracted the justices of the Supreme © 2006 by the American Academy of Arts Court. For instance, they have approved & Sciences local ½nancing of public education, de-
Dædalus Winter 2006 127 Note by spite the unequal funding patterns that cial, ingrown, and oppressive. Localism Robert F. result, because local taxation means in America is so attractive precisely be- Nagel local control. They have also urged dis- cause we have had very few truly isolat- trict judges in school desegregation law- ed communities; the norm, largely taken suits to return authority over education- for granted, has been a federated politi- al policy to elected school boards as soon cal system that ensures various ties to and as fully as possible. Many other deci- wider communities and thus helps local sions–for example, favoring the autono- institutions and associations to function my of the Boy Scouts, the prerogatives of in healthy ways. parents in shaping family life, or the par- This possibility ½nds some support ticipation of religious schools in voucher in the fact that local associational life programs–acknowledge the importance began its precipitous decline in the of decentralized community life. 1960s along with the waning of federal- Political and cultural life at the nation- ism. Skocpol observes that as the range al level, then, is naturally appreciated of national undertakings widened dur- because it is visible, important, and dra- ing the civil rights revolution, organiza- matic, while political and cultural life at tions centralized, abandoning the mem- the local level is naturally appreciated bership-based structure previously so because it is intimate and responsive. common and altering their lobbying Associational life at the state level, poor tactics. Consequently, a national leader- gray thing, cannot regain the appeal it ship class, cut off from any roots in lo- lost during the long history of racial con- cal communities, emerged, replacing the flict because it seems to be neither espe- rich associational life of federated organ- cially signi½cant nor highly personal. izations with direct mailings and single- But what if the intermediate organi- issue advocacy. zations constituting (and also surround- But the damage to state-level organi- ing) state governments enable local in- zations must have been more complex stitutions and associations to remain than a mere quantitative increase of healthy? In that case, the very structures power in Washington. The expansion that almost everyone neglects would be of the power of the national government vital to the kind of social and political began, after all, long before the 1960s. life that almost everyone values. What changed during the civil rights era There are some commonsense rea- was qualitative. It was during this period sons to think that federalism promotes that the federal government began to de- local community life. As Theda Skocpol termine not just industrial or commer- shows in her recent book, Diminished cial policies but moral issues of immedi- Democracy, local groups can affect na- ate signi½cance in people’s lives. tional policies through state-level organ- During the 1960s federal courts and izations. Moreover, leadership that cir- bureaucracies began to control sensitive culates up and down through a federated aspects of public education, including system can become relatively sophisti- such issues as attendance policies and cated while staying connected to local the place of religious subject matter and communities. In fact, small associations observances. They also began to have and governments, while easy to romanti- signi½cant influence over mental health cize, have many disadvantages if isolat- policies, police practices, contraception, ed. Without intermediate connections, defamation rules, standards for public they tend to be homogeneous, provin- decency, and so on. This extraordinary
128 Dædalus Winter 2006 set of initiatives was followed within a life–nationwide! Even if states had not The decline decade by the nationalization of policies been stripped of important regulatory of federal- ism on abortion, gender relationships, and authority and delegitimized, they would family life. The extension of national still have had the defect of limited juris- power to such vital, and often intimate, diction. No longer would the antiquated issues came in the form, of course, of system of federalism frustrate the utopi- expanded individual rights. an desire for uniform progress. The civil rights revolution, therefore, It is, then, only a small step from did far more than nationalize a new Skocpol’s data to the hypothesis that range of public policy issues. In some what happened beginning in the 1960s of the most crucial areas of human life, was the eclipse of the moral status of it severed individuals from their state state and local governments. When and local governments. These govern- participation at intermediate levels of ments, after all, were the institutions organizational life became less impor- that rights were held against. In part, tant and less morally attractive, local the states were disabled from regulat- associational life suffered as a conse- ing, and in part, they were actually de- quence. legitimized–seen as potential threats to If the decline of state governments the individual’s happiness and freedom. is in fact linked to the deterioration of State institutions became less important local associational life, reinvigorating and, at the same time, vaguely sinister. the moral status of state governments As a result, political discourse at the may help to remedy the depletion at the state and local level became more bland local level. But is that solution practical? and insigni½cant, and less self-assured. Maybe not, but we should approach the Moreover, the repeated validation by issue with the recognition that many of national institutions of individuals’ the alternative reforms suggested are claims to autonomy and self-realization not especially likely to be effective ei- helped to unleash what the postwar ther. Modern communitarians tend to prosperity had made possible: limitless exhort people to join and participate; demands for happiness and freedom their concrete proposals often involve from responsibility. This utopianism peripheral matters like national holidays fueled dissatisfaction with constraints of and shaming rituals. all kinds, most especially those imposed Nevertheless, we must acknowledge as part of the traditional regulatory func- that the system of federalism in the tions of state and local governments. United States is in many ways past the At the same time that the moral sta- point of no return; indeed, the dynamics tus of states was receding, reformist im- of centralization are now self-reinforc- pulses found their outlet in Washington, ing. Strong identi½cation with or attach- D.C. Political control over some of the ment to a particular state, much less pol- most interesting and signi½cant issues itical loyalty, is now largely a thing of the had moved from local and regional are- past. It is also true that potent political, nas to the national stage. Of course, am- intellectual, and cultural trends underlie bitious professionals could not be con- the moral eclipse of state governments. tent to devote their energies as a part of We should consider a number of coun- federated organizations. Suddenly, there tervailing factors, however. First, the was the possibility of imposing reform– federated structure of American govern- relating to the most signi½cant areas of ment has, needless to say, deep historical
Dædalus Winter 2006 129 Note by roots. Second, state governments, while regain some of the moral status and Robert F. often neglected and sometimes scorned, sense of connection that they lost, es- Nagel are still ongoing operations. They per- pecially if a signi½cant public reaction form fundamental functions like taxa- against the excesses of the rights revolu- tion and moral regulation, and they pro- tion were to develop. vide important services such as educa- Another realistic change would be for tion, transportation, and police protec- scholars who value local associational tion. These functions, moreover, are life to give more attention to the rela- carried out as a consequence of famil- tionships between that life and inter- iar political processes and institutions, mediate organizations at the state level. and they are carried out by of½cials who Without an accurate understanding of utilize all of the signs and rituals that at- the preconditions for vigorous local as- tend governmental status. Third, given sociations, no reform will be effective. the constitutional functions that states One of those preconditions may be state play in the operation of the national gov- governments that are not discredited in ernment, the quasi-sovereign, constitu- the eyes of their citizens and not discon- tive nature of state power is visible to all nected from organizational life at the lo- and dif½cult to eliminate. cal level. And, as for the Supreme Court, In short, even if powerful and cumu- it does not need to lead a federalism rev- lating forces are working against any olution, but it might at least take into ac- broad revival of state power, state gov- count more fully its own role in isolating ernments remain signi½cant institu- and, therefore, diminishing local com- tions. The pivotal issue, therefore, is munity life. how much invigoration of status and power at the state level is necessary to help revive local associational life. If such a revival would require radical changes, such as a signi½cant rollback of New Deal regulatory power or the dismantling of the technology that un- derlies the nationalization of political discourse, the widespread tendency to ignore federalism is understandable. But some degree of reinvigoration of community life may be realistic without wholesale changes in state power and prestige and even in the face of a contin- ued decline in state power as a quantita- tive matter. Some moderate qualitative shifts in the public attitude toward state govern- ments are within the realm of possibili- ty. After all, what changed with the civil rights campaigns of the 1960s was the way Americans perceived state govern- ments. It is not entirely unthinkable that state governments might gradually
130 Dædalus Winter 2006 Letters to the Editor of Dædalus
On compromised work for all.” And, while not always perfect in execution, Hill & Barlow had the reputa- November 22, 2005 tion of coming closer to balancing per- sonal and professional needs than any To the Editor: ½rm in town at that time. In this respect, other ½rms followed Hill & Barlow’s I write in response to the article “Com- lead. promised work” by Howard Gardner In my view, the collapse of Hill & Bar- in the Summer 2005 issue of Dædalus. low was the direct result of its culture, I read some months ago the much lon- a culture so strong that it made it impos- ger research paper that Gardner summa- sible for the ½rm to take drastic actions rizes by Paula Marshall, his colleague on solely for business purposes that were in The GoodWork Project. contradiction to their values. Even when My reaction to his comments about information was put before them that Hill & Barlow is the same as it was to should have raised alarms, most partners Marshall’s long report. I felt she did paid little or no attention. They couldn’t an excellent job of putting the history believe that it would not turn around of Hill & Barlow’s last few years in the ‘next year.’ broad context of the trends in law ½rms For example, they shied away from that have been going on now for several separating unproductive partners on a decades. Boston was the last major city large scale. Hill & Barlow just ‘didn’t do to succumb to the drift towards ever that’ to its partners. And even though larger and less personal organizations they tinkered around the edges from that look more like businesses than they time to time, the ½rm could never bring do professions. Gardner/Marshall were itself to seriously alter its policy and also right in saying that the leadership procedures for approving associates for of Hill & Barlow failed to see the changes partnership. At Hill & Barlow, associates coming when they should have and did could be con½dent of being made part- too little in response once they did. But ner as long as they were bright and did they don’t get at the underlying reason basically good legal work without regard why all this happened. to their overall ½t into the department’s In the past, the great strength of law pro½le or their capacity to attract new ½rms (and, indeed, of most professions) clients. In one year in the 1990s, the ½rm was their ‘culture.’ We understood this elected to partnership all seven associ- to mean the values a ½rm held and the ates who were eligible, an extraordinari- degree to which they lived by them. Hill ly high number. & Barlow was renowned for its culture. Gardner/Marshall lay special blame The ½rm lived, for example, by the old on Real Estate for the ½rm’s collapse fashioned creed of “all for one, and one without providing support for that prop-
Dædalus Winter 2006 131 Letters to osition. They couldn’t put forward any own standards in today’s changed con- the Editor evidence because there isn’t any. By the ditions. I like to think of it that way. 1990s, Real Estate was by a substantial measure the strongest department in Simone Reagor the ½rm. Sometime in 2000, the Real Estate partners became fully aware of Simone Reagor was executive director of Hill & how weak the ½nances of the ½rm were, Barlow from 1990 to 2000. She received her doc- and they had no con½dence that there torate in history from Oxford University. She is was a plan in place that could be imple- currently a management consultant, principally mented quickly enough to salvage the for Education Development Center, Inc., in New- ½rm. Some members began considering ton, Massachusetts. options to move to other ½rms. If the se- nior partner in the department had not begun working to ensure that this ex- November 28, 2005 tremely well-knit group could stay to- gether, even if it meant outside Hill & Howard Gardner and Paula Marshall Barlow, many of the department’s youn- respond: ger partners would have walked imme- diately. In the end, the result would have We appreciate Simone Reagor’s com- been the same for the ½rm and, perhaps, ments on the sad demise of Hill and Bar- a much worse ½nancial result for all the low (H&B). However, our detailed study remaining partners individually. of this institution, carried out principal- As executive director of the ½rm ly by Paula (see www.goodworkproject. from 1990 until my retirement in 2000, org) and reported in Howard’s synthe- I watched all the early trends unfold sizing piece, yielded a different story and was not surprised when the ½rm and pointed to a different moral. collapsed. (I was not interviewed for First, our sources of information. For either of these articles.) This is not the study, we contacted ½fteen key, long- an instance in which blame should be term partners, each of whom had been placed anywhere. This was an instance nominated by a knowledgeable partner in which an institution was condemned or observer, and secured in-depth inter- to die because of the very culture that views from twelve partners. We also had had once made it great. Perhaps the comments from informed observers of end could have been managed less dras- the legal scene in Boston. Revealingly, tically, but apparently there were press- the only group that resisted participa- ing ½nancial reasons that led the part- tion in this retrospective inquiry were ners to vote unanimously to close the individuals from the Real Estate (re) doors when they did. So, the ½rm van- group. When a draft of the paper was ished with a bang instead of a whimper. completed, we sent it to all interviewees, Hill & Barlow died because it refused, and secured comments from several of perhaps blindly, to sacri½ce its classical them; these comments were incorporat- values. It wasn’t because of “compro- ed in the paper that was posted in Sep- mised work.” Some might call it the tember 2004. Far from being an idiosyn- result of stupidity and unwillingness cratic interpretation by outsiders, our to face facts. But, perhaps, it was some- study represented an emerging consen- thing of an heroic end for a grand insti- sus among the chief participants, except tution that could no longer exist by its for members of the re group.
132 Dædalus Winter 2006 Second, what actually happened. We for dozens of long-term employees and On agree that the culture of H&B had been retirees. compromised work special–indeed exemplary–for decades, Finally, the issue of “compromised and its demise cannot simply be attrib- work.” This is a term coined by How- uted to the greed of the re group. We ard to delineate work that is not, strictly disagree, however, on what happened speaking, illegal but that undermines the over the last thirty years and what could core values of a profession. It is a ques- have been done about it. Cultures can- tion of judgment whether to apply the not be taken for granted; they need to be same term to the sins of commission by recognized as such, nurtured as much as Jayson Blair at the New York Times and possible, and–when survival is at stake by the accountants of Arthur Andersen –adjusted and revitalized so that the with those of the legal community at core values can be maintained. Some H&B. In view of the avowed high stan- law ½rms have been able to do just this. dards of the legal profession in general, Indeed, the Boston ½rm most often and the fabled reputation of H&B, we compared with H&B–Ropes and Gray conclude that an indeterminate number –appears to have weathered the legal of the partner/managers did not live up storms. One of their methods has been to pivotal responsibilities: in particular, a long-term, self-renewing management placing service to the profession above team, which, among other things, deter- personal gain; ensuring that core profes- mines salaries for the partners. sional and institutional cultural values As detailed in Paula’s paper, H&B is are preserved and passed on to young better described as a confluence of mis- associates; assuming responsibility for steps, miscalculations, and missed op- the welfare of paraprofessionals; par- portunities, followed by a series of poor ticipating in the management process management practices and decisions. (as faculty do in university governance), For sure, some members of the ½rm did making adjustments in management try valiantly to save it and to preserve its when necessary; and, ½nally (if colloqui- core values. But they were not the major- ally), not abandoning the ship. Instead, ity, and the practices that had been in the in Reagor’s telling phrase “most partners dna of partners for decades had begun paid little or no attention.” to unravel by the 1980s. By any criterion Simone Reagor may continue to be- except that of a completely marketized lieve in the romantic picture of H&B. We ‘bottom-line’ profession, the re group sought to document a principal conclu- did not have to leave the ½rm. They were sion of the GoodWork project: a healthy making a very good living! Our inter- dosage of realism is essential if key pro- views documented grave disappoint- fessions and institutions are to survive in ment at the re group and the secretive the current American climate. and preemptive way in which it operat- ed–the diametric opposite of the pic- ture intimated by Reagor. Moreover, in Poetry for nonpoets retrospect, many of the partners whom we interviewed came to believe that the August 29, 2005 ½rm could and should have been recon- To the Editor: stituted and saved. They regretted the disappearance forever of a precious in- May I explain my submission? The po- stitution and the loss of jobs and bene½ts em that appears in each issue of Dædalus
Dædalus Winter 2006 133 Letters to is often written by a recognized compos- the Editor er, sometimes with several books of po- ems to his or her name. There is a class of members of the Aca- demy who never read published poems anymore. I would like to capture their attention. At the head of the page where my sub- mission appears perhaps you could sub- stitute “Jingle” as an indicator that the contribution is not a serious poem. This might get the attention of the class of members at which I am aiming. Jingle Alarming The one-l lama, He’s a priest. The two-l llama, He’s a beast. And I will bet A silk pajama There isn’t any Three-l lllama. –Ogden Nash
Ogden Nash once said to me My poem is lovely as a tree. I said to him, It’s rather trendy But outdone by my daughter Wendy. Yes, she can count a little higher A three-ell lama is a ½re. Though as a rule she’s not a sinner She eight-ell lama for her dinner; And once when I was in Peru I eight-ell lama in a stew! –Ronald N. Bracewell, ao
Ronald N. Bracewell, ao, a Fellow of the Amer- ican Academy since 2002, is L. M. Terman Pro- fessor of Electrical Engineering Emeritus at Stan- ford University. In 1998 he was named Of½cer of the Order of Australia (ao).
134 Dædalus Winter 2006 President Patricia Meyer Spacks Chief Executive Of½cer Leslie C. Berlowitz Vice President Louis W. Cabot Treasurer John S. Reed Secretary Jerrold Meinwald Editor Steven Marcus Librarian Robert C. Post Vice President, Midwest Geoffrey R. Stone Vice President, West Jesse H. Choper
Dædalus Board of Editors Committee Steven Marcus, Chair, Joyce Appleby, Russell Banks, Stanley Hoffmann, Donald Kennedy, Martha C. Nussbaum, Neil J. Smelser, Rosanna Warren, Steven Weinberg; ex of½cio: Patricia Meyer Spacks, Leslie C. Berlowitz
Committee on Publications Jerome Kagan, Chair, Emilio Bizzi, Jesse H. Choper, Denis Donoghue, Jerrold Meinwald; ex of½cio: Patricia Meyer Spacks, Steven Marcus, Leslie C. Berlowitz
Inside back cover: Old before his time, the poet in middle age–Walt Whitman, c. 1860. See Caleb E. Finch on Aging, inflammation & the body electric, pages 68–76: “One hundred and ½fty years after Whitman sang ‘the body electric,’ we can ½nd in Whitman’s fate some clues to the nature of aging.” Photograph © Corbis.
Dædalus coming up in Dædalus: Dædalus on the humanities Patricia Meyer Spacks, Steven Marcus, Andrew Delbanco, Pauline Yu, Gerald Early, Anthony Grafton, Thomas Crow, Jack Journal of the American Academy of Arts & Sciences Balkin & Sanford Levinson, and Dag½nn Follesdal & Michael L. Friedman Winter 2006
on body in mind Antonio & Hanna Damasio, Jerry Fodor, Carol Gilligan, Gerald Winter 2006: on aging Edelman, Jorie Graham, Raymond Dolan, Arne Öhman, Mark on Chris Wilson The century ahead 5 aging Johnson, Jacques d’Amboise, and William E. Connolly Henry J. Aaron Longer life spans: boon or burden? 9 Sarah Harper Mature societies 20 on identity Akeel Bilgrami, Wendy Doniger, Amartya Sen, Stephen Greenblatt, Paul B. Baltes Human dignity & the limits of life 32 Kwame Anthony Appiah, Sydney Shoemaker, Joseph Koerner, Susan Green½eld, David A. Hollinger, Claudio Lomnitz, Carol Linda Partridge Of worms, mice & men 40 Rovane, Todd E. Feinberg, Ian Hacking, and Courtney Jung Hillard Kaplan The life course of a foraging species 48 Dennis J. Selkoe Deciphering Alzheimer’s disease 58 on nonviolence William H. McNeill, Adam Michnik, Jonathan Schell, James Carroll, Caleb E. Finch Aging, inflammation & the body electric 68 & violence Breyten Breytenbach, Mark Juergensmeyer, Steven LeBlanc, James Kenneth Clark The artist grows old 77 Blight, Cindy Ness, Neil L. Whitehead, and Mia Bloom Jagadeesh Gokhale & Kent Smetters Social Security & the aging of America 91 on sex Joan Roughgarden, Terry Castle, Steven Marcus, Claudia Goldin, Lisa F. Berkman Brian Charlesworth, Elizabeth Benedict, Wendy Doniger, Lawrence & M. Maria Glymour How society shapes life spans 105 Cohen, Anne Fausto-Sterling, Catharine MacKinnon, Tim Birkhead, and Margo Jefferson poetry Charles Wright Last Supper 115
on capitalism Joyce Appleby, John C. Bogle, Lucian Bebchuk, Robert W. Fogel, ½ction Ree Davis I kneel before you 116 & democracy Jerry Z. Muller, Peter Bernstein, Richard Epstein, Benjamin M. Friedman, John Dunn, and Robin Blackburn dialogue Daniel Bell & Wolf Lepenies on society & sociology past & present 120 on life Anthony Kenny, Thomas Laqueur, Shai Lavi, Lorraine Daston, Paul Rabinow, Michael S. Gazzaniga, Robert George, Robert J. Richards, notes Jeri Laber on torture 124 and others Robert F. Nagel on the decline of federalism 127
plus poetry by Peg Boyers, Kevin Carrizo di Camillo, John Kinsella, letters on compromised work, poetry for nonpoets &c. 131 Charles Simic, Lawrence Dugan &c.; ½ction by Adam Braver, Dorian Gossy &c.; and notes by Michael Cook, Norbert Schwarz, Joel F. Handler, William B. Quandt, William Galston, Richard Morris, Robert J. Sharer &c. U.S. $13; www.amacad.org FOUNDED 1780