As reported by UNCTAD, there were 54 children or older people for every 100 individuals of working age in 2022. All of the top 30 countries that recorded the highest age dependency ratios were situated in Africa, with a high child dependency being the primary driver. On the other extreme, economies on the Arabian Peninsula and in the Caribbean had low age dependency ratios.
Generally, age dependency ratios initially tend to decrease before increasing as a larger population approaches an age above 64. This initial decline in the age dependency ratios has occurred in most regions of the world. Age dependency ratios are already increasing in developed economies and have been forecasted to reach 73% by 2050. However, the decrease in age dependency will continue in Africa even after 2050.
The age structure also varies between the developed and developing nations. Developed economies have relatively smaller young age cohorts. The largest age groups in such economies are those aged between 35 and 54 years. On the contrary, developing countries have older age classes smaller than their younger classes.
High Dependencies in Africa: An Analysis
As compared to the rest of the world, Africa’s population is younger. As reported by the US Census Bureau, only 5.6% of Africa’s population was above 60 years of age in 2020, as compared to 23.4% in North America. Although the share of adults in the total population across Africa is less, these adults still account for a high number. In 2020, 18 African countries had more than 1 million people aged above 60. Furthermore, the population over 60 in Sub-Saharan Africa is expected to rise from 50 million in 2020 to 600 million by 2100. This implies that the old-age dependency ratio, the proportion of elderly individuals relative to the working-age population, is set to increase in the region.
Fertility tends to influence the age structure across countries. Many sub-Saharan African countries have high fertility levels which impacts their age structure for instance Uganda has one of the lowest median ages in the world. Tunisia in Northern Africa has witnessed a decline in fertility and hence, the median age in the country is comparatively higher. Low median ages also indicate a higher dependency ratio where the working-age population is relatively younger and the older and younger populations depend on them.
Africa remains subjected to poor health conditions among its adults as compared to high-income and even other low- or middle-income countries since the region allocates a limited share of GDP to health. As reported by the National Bureau of Economic Research, the elderly in Africa tend to be disproportionately impacted by non-communicable conditions since 80% of health budgets go to infectious diseases. Older people in African countries such as Nigeria, Kenya, and Uganda are deprived of accessing healthcare facilities. 30% of the region’s elderly population is a victim of an illness or injury that has halted regular activities including work for them.
Companies Addressing the Elderly's Disease Burden
Life expectancy as well as the health conditions for the elderly around the world have significantly improved as a result of healthcare companies such as AstraZeneca plc (NASDAQ:AZN), Novo Nordisk A/S (NYSE:NVO), and Pfizer Inc. (NYSE:PFE) making advancements. Let’s take a look at what these companies have been up to.
AstraZeneca (NASDAQ:AZN) is a renowned biopharmaceutical company that operates in more than 100 countries across the world. The company recently made a development in regards to HR-positive breast cancer, the most common breast cancer subtype globally. On March 27, AstraZeneca (NASDAQ:AZN) reported that the Japanese Ministry of Health, Labour, and Welfare (MHLW) has approved its Truqap in combination with Faslodex for adult patients with advanced HR-positive breast cancer. The approval was granted based on a trial that showed that Truqap plus Faslodex decreased the risk of disease progression or death by 50% as compared to Faslodex alone.
Novo Nordisk A/S (NYSE:NVO) is another known global healthcare company that caters to serious chronic diseases. The firm continues to target widespread adult diseases including diabetes through innovation. On March 21, Novo Nordisk A/S (NYSE:NVO) reported that Awiqli has been recommended for approval by the European Medicines Agency’s Committee for Medicinal Products for Human Use (CHMP). Awiqli is a once-weekly basal insulin icodec that has been made to treat diabetes in adults by covering the basal insulin requirements for a week with a single subcutaneous injection.
Pfizer Inc. (NYSE:PFE) manufactures medicines and vaccines that cater to oncology, cardiology, immunology, and neurology. On February 19, the company reported that VELSIPITY has been given marketing authorization by the European Commission (EC) for the treatment of patients aged 16 years and above in the EU with moderately to severely active ulcerative colitis. Previously, VELSIPITY from Pfizer Inc. (NYSE:PFE) was approved by the U.S. Food and Drug Administration (FDA) for adults with moderately to severely active ulcerative colitis, which is an inflammatory bowel disease.
Now that we have analyzed the age structures around the world and the factors contributing to them, let’s move to the 20 countries with the highest age dependency in the world.
20 Countries with the Highest Age Dependency Ratio in the World
20 Largest Economies in Africa Ranked by PPP
Our Methodology:
In order to compile a list of the 20 countries with the highest age dependency in the world, we sourced data from the World Bank. The age dependency ratio as a percentage of the working population has been selected as our metric. This metric represents the ratio of dependents aged below 15 or above 64 to the working-age population aged between 15 and 64. This represents the proportion of dependents per 100 working-age individuals. The most recent data is available from 2022. Hence, the countries have been ranked in ascending order of their proportion of dependents per 100 working-age population, or their age dependency ratios.
20 Countries with the Highest Age Dependency Ratio in the World
20. Cameroon
Age Dependency Ratio (2022): 81.4%
The age dependency ratio for Cameroon was recorded at 81.4% in 2022. The country had a median age of only 17.55 years during the same period which is one of the lowest among other countries in the world.
19. Malawi
Age Dependency Ratio (2022): 82.5%
Malawi is another country with a high proportion of dependents per 100 working-age individuals. According to the World Bank, the country’s age dependency ratio was 82.5% in 2022.
18. Gambia
Age Dependency Ratio (2022): 83.4%
Gambia is one of the 20 countries with the highest age dependency ratio in the world. In 2022, 43% of the country’s population was below 14 years of age which indicates high younger dependents compared to the working-age population.
17. Benin
Age Dependency Ratio (2022): 83.5%
Benin is a country situated in West Africa where a lot of non-working individuals tend to depend on the working population. The country had an age dependency ratio of 83.5% in 2022.
16. Afghanistan
Age Dependency Ratio (2022): 83.6%
In 2022, the proportion of dependents per 100 working-age population in Afghanistan was as high as 83.6%. Furthermore, the country had a low median age of 16.87 years.
15. Nigeria
Age Dependency Ratio (2022): 85.3%
Nigeria is one of the most densely populated countries in Africa and has one of the youngest populations across the globe. The fertility rate in the country is high and the consequent dependency rate is also high.
14. Mozambique
Age Dependency Ratio (2022): 85.5%
Mozambique’s age dependency ratio declined from 86.1% in 2021 to 85.5% in 2022. However, the country still has a high age dependency ratio.
13. Burkina Faso
Age Dependency Ratio (2022): 86.1%
Burkina Faso is a West African nation plagued with numerous issues including food and nutritional insecurity, poverty, and lack of education. The country has a high age dependency ratio which implies a huge burden coming from its economically dependent people.
12. Tanzania
Age Dependency Ratio (2022): 86.8%
Although the age dependency ratio in Tanzania declined from 2021 to 2022, it is still one of the highest in the world. In 2022, the country recorded an age dependency ratio of 86.8%.
11. Uganda
Age Dependency Ratio (2022): 86.8%
Uganda has one of the highest age dependency ratios in the world. The country’s age dependency ratio decreased from 88.2% in 2021 to 86.8% in 2022. The median age in Uganda is one of the lowest globally.
10. South Sudan
Age Dependency Ratio (2022): 87.8%
The proportion of dependents in South Sudan per 100 working-age individuals was recorded at 87.8% in 2022. Other than the average life expectancy, the median age is also low in South Sudan.
9. Angola
Age Dependency Ratio (2022): 90.9%
The 20 countries with the highest age dependency ratio in the world include Angola as well. As evident from its age dependency ratio of 90.9% in 2022, the working-age population takes a high burden of the young and the elderly in the country.
8. Burundi
Age Dependency Ratio (2022): 93.2%
Burundi is an African country with an age dependency ratio as high as 93.2% as recorded in 2022. The country has a high fertility rate and is densely populated.
7. Monaco
Age Dependency Ratio (2022): 95.9%
Monaco is situated in Western Europe and ranks among countries with high age dependency ratios. In 2022, Monaco’s age dependency ratio was 95.9%, the 7th highest among other countries in the world.
6. Democratic Republic of the Congo
Age Dependency Ratio (2022): 97.9%
The age dependency ratio for the Democratic Republic of the Congo was recorded at 97.9% in 2022. The median age in the country is significantly less than the global average. Therefore, the Democratic Republic of the Congo ranks among countries where the age dependency ratio is high.
