As the World Ages: Rethinking a Demographic Crisis by Kavita Sivaramakrishnan (review)

This ambitious book offers an enlightening intellectual history of the making of gerontology and emergence of aging as a global concern. The author, a public health historian, traces the politics of aging from the colonial era, through decolonization, to the early twenty-first century, bringing together intellectual, medical, social, and political-economic history to illuminate key international debates. Although academic work on gerontology has privileged Western perspectives, this groundbreaking book explores how gerontological experts, social activists, and policy makers in Asia and Africa recast aging in light of the social, economic, and moral imperatives of their own societies. In this way, As the World Ages explores both how universalizing global agendas of aging emerged in the West and how these agendas “were then received and remade—or ‘provincialized’ as the historian Dipesh Chakrabarty has termed it—in ‘developing countries’ as experts in these countries made this knowledge their own” (p. 7). In so doing, the book dispels notions of aging as a uniform, universal problem, while making important contributions to analyses of decolonization, development, and globalization.

The book’s chapters proceed more or less through a chronological history of aging as a sociopolitical concern, beginning in the colonial era of the 1930s to 1950s and moving to the birth of international biomedical research networks, the emergence of gerontology as a distinct field of expert knowledge in the 1950s through 1970s, the development of aging experts in Asia and Africa, debates among United Nations and regional professionals concerned with population aging as a global challenge, and finally international NGOs focused on aging as a worldwide social-moral responsibility and problem of human rights.

A key agenda of As the World Ages is to unpack the assumptions and meanings ascribed to age and aging in all of these projects—including in colonial attempts to define and measure age, teleological models of modernization and development, narratives of abandonment and neglect, and debates over the best site of elder care: whether in the family, the modern welfare state, the self-reliant individual, or the innovative entrepreneurial market. In the colonial era, experts and administrators interpreted and measured aging as an administrative principle of social organization. Censuses were rarely reflexive in exploring alternative constructions of the life cycle, and colonial demographers were frustrated that local “primitive and illiterate” populations did not know their chronological ages according to the “highly organized systems followed in the civilized states” (p. 31).

As voices from the former colonies became more prominent, policy makers from Africa, India, and China challenged normative assumptions about aging developed in Europe and North America. Regional experts frequently held up intergenerational family support as both the rightful site of elder care and a valued traditional cultural norm, while arguing that developing countries lack the resources for elaborate state welfare schemes in any event. Regional experts also “voiced a moral parable of development and its discontents,” arguing that aging populations were victims of the disease, poverty, urbanization, labor migration, and rapid social changes growing out of “failed and unequal development initiatives” (p. 169) and a “capitalist money economy” (p. 125).

One trend that Sivaramakrishnan does not address, more than in a few words in passing, is the healthy, active, and successful aging paradigm that has dominated aging agendas in Europe and North America over the past few decades. However, this may be because until quite recently successful aging discourse has been less prominent in the Global South.

As a whole, As the World Ages is an extremely well-researched and eye-opening volume. In her ambitious investigations, Sivaramakrishnan consulted archives around the world and conducted interviews with retired and serving UN experts, gerontologists, social workers, and NGO functionaries in Asia, Africa, and the United Kingdom. The text would be even more vivid and revealing if it included more quotes from the plethora of primary-source materials cited in the notes. As it is, the book focuses on rather abstract although highly informative...