America, it’s time to pay the demographic piper

With low fertility, higher mortality, population aging and rising illegal immigration, it’s time for America to pay the demographic piper. 

The U.S. fertility rate is now well below the replacement level of about two births per woman. The country’s fertility rate in 2021 was 1.66 births per woman or less than half the peak rate of 3.7 births per woman in the late 1950s. 

America’s fertility rate has been generally below the replacement level since 1971 and consistently less than the replacement level for more than a decade. Population projections do not envisage the country returning to the replacement level any time soon. 

In addition, after years of gains, life expectancy in the U.S. dropped for the second year in a row in 2021. 

Life expectancy at birth declined from 77.0 to 76.1 years from 2020-2021, its lowest level since 1996. Also, 2020 saw a drop of 1.8 years in the country’s life expectancy. Together, those make the biggest two-year decline in U.S. life expectancy since 1921-1923.

The declines were largely the result of the COVID-19 pandemic, which rather than remaining a U.S. public health issue, was politicized and morphed into a contentious topic across the country. COVID-19 deaths accounted for approximately 75 percent of the decline in U.S. life expectancy from 2019-2020 and 50 percent of the decline from 2020-2021.

In addition to lower fertility and life expectancy, America’s aging population threatens to overwhelm its budget for older citizens and cause slower economic growth. 

The number of Americans aged 65 years and older has increased to approximately 56 million, or 17 percent of the population — nearly double the 1960 level of 9 percent. 

With the growing numbers of older Americans, the large-scale exit of Baby Boomers from the labor force and rising health care expenditures per person, the U.S. government faces rapidly rising costs and worrisome expected insolvencies in the near future of programs such as Social Security and Medicare.

Also, in 2024, the Historical Reversal of America’s age structure is expected to occur, i.e., when persons aged 65 and older outnumber children under the age of 15. That demographic milestone represents a significant and far-reaching transformation of the U.S. population. It will usher in a new demographic era unlike much of the country’s youthful past when approximately one out of three Americans were children under 15.

Moreover, the demand for caregivers in homes, assisted-living communities, memory-care centers, hospice facilities and nursing homes is outstripping the supply. That situation is expected to worsen with growing numbers of America’s older women and men needing care services with most unprepared to cover those costs.

The rising federal costs and older beneficiaries are coupled with relatively fewer workers contributing financially to support them. The number of persons working ages 15 to 64 for each person aged 65 years and older has declined from nearly eight in 1950 to about four today and is projected to decline even further to slightly more than two by 2070.

In addition to the federal government’s financial challenges, states with shrinking and aging populations are likely to encounter similar fiscal risks, including threats to their economies, tax bases and revenue. 

Increasing illegal immigration is also challenging the country nationally and locally. Congress has not been able or willing to pass legislation to address the record-high numbers of unauthorized border crossings, the large numbers of visa overstayers and the millions residing unlawfully within the country’s borders.

More than 11 million estimated illegal immigrants are currently in America — approximately one-quarter of the U.S. foreign-born population. Surges of people attempt unauthorized entry across the U.S.-Mexico border every day and hundreds of thousands of foreign visitors overstay their temporary visas annually.

States and cities are reeling from the costs of illegal immigration. The mayor of New York City says it needs $3 billion from the federal government to handle the influx of illegal immigrants. The mayor of El Paso said the spike in illegal migrant arrivals has overwhelmed local resources and shelters and forced the mayor to declare a state of emergency.

Despite all of this, America requires a level of legal immigration to maintain population stability.

Rather than paying the demographic piper, many in America are trying to avoid the issue. Much of the business community and GOP members in Congress are opposed to increasing taxes in order to pay for the rising costs. Republicans in the House of Representatives have proposed cuts to Social Security and Medicare and in order to achieve those cuts, they are threatening to not increase the nation’s debt ceiling.

Businesses may lobby, Republicans may attempt to cut entitlement programs and threaten debt limit default and the public may have fears about America’s rapidly changing demographic landscape.

However, demography doesn’t care about such things; it simply deals with population realities. Hence, America must pay the demographic piper or be obliged to face the increasingly evident consequences. 

Joseph Chamie is a consulting demographer, a former director of the United Nations Population Division and author of numerous publications on population issues, including his recent book “Population Levels, Trends, and Differentials”