Review of As the World Ages: Rethinking a Demographic Crisis. Kavita Sivaramakrishnan, Cambridge, MA: Harvard University Press, 2018, 320 pp.

Reviewed Book

As the World Ages: Rethinking a Demographic Crisis. Kavita Sivaramakrishnan, Cambridge, MA: Harvard University Press, 2018, 320 pp.

In this ambitious and impressive book, Kavita Sivaramakrishnan presents a compelling and nuanced analysis of how aging has become a global problem and a domain of expertise. Motivated by critical historical questions that decenter the often-universalizing assumptions of Western gerontology, this “intellectual history of the politics of aging” (p. 19) shows how processes of decolonization, industrialization, and globalization have shaped knowledge about and policies directed toward aging populations. By presenting perspectives from activists and scholars in Asia and Africa alongside those from Europe and North America, spanning the late colonial period to early 21st century, Sivaramakrishnan offers new, dynamic understandings of how aging has been linked to issues of health, family, labor, and social policy.

Throughout the book, Sivaramakrishnan shows how aging is produced as a form of difference. Knowledge on aging was caught up in global transformations of the 20th century, including World War II, the Cold War, decolonization, and international development projects. Amid these social changes, Western experts relied on explicit or implicit biological, racialized, social, or political–economic logics to construct older people and population aging in the Global South as other. This point emerges most clearly in discussions of the late colonial period, in which anxieties in the colonial metropolis about modernization and migration in the colonies loomed large in discussions of population aging. For instance, British demographers created census surveys in colonial Africa that focused on “welfare- and productivity-centered concerns,” rather than “recording ethnological data for enumerative and ‘civilizational’ ends,” as was the focus several decades earlier, in the late 19th and early 20th centuries (p. 31). These shifts in demographic attention reflected and co-produced shifting colonial concerns, from civilizational to productive aspirations; the aging population was constructed as part of a “primitive” culture in need of civilization, and then as part of a “backwards” political economy in need of modernization. At the same time, when building comparative understandings of aging, experts in the late colonial era “compar[ed] the marginalized [African] colonial subject with the more civilized and modern African American body that had been measured and pathologized in a more scientific manner” (p. 34). This logic of aging-as-difference had a recursive quality, as when American social scientists were interested in “primitive societies” to help them understand the migration of aging African Americans to the urban North from the rural South (p. 24). In this way, racialized logics of difference shaped understandings of biological and social aspects of aging.

Another recurring theme across these global transformations is expert concern for how population aging occurs in different parts of the world. A dominant assumption in Western social science has been that demographic change everywhere would mirror European and North American patterns. However, locally based models developed by experts in the Global South argued against this universalizing perspective to show how population aging, like development, had markedly different features than those in the West. Researchers and activists in the global South documented lived experiences of rapid social change, such that they saw aging as part of “wider social and economic inequities of the international economic order and the unchecked economic instability and dependency these had generated” (p. 151). Via networks of experts, these perspectives flow from South to North, as well as North to South, meaning that knowledge about aging did not develop in a single linear model. Rather, knowledge on aging was “provincialized” (p. 7), following Dipesh Chakrabarty’s terminology, thus disrupting normative Western universalist perspectives of both development and aging.

Sivaramakrishnan shows that different solutions to the problem of aging depend on the logic by which the problem is constructed, and as such, the solutions take on different social forms and temporal scales. For instance, British relief and refugee-assistance organizations in the 1980s and 1990s presented global aging as a humanitarian crisis, for which nation-states should take a “social and moral responsibility” (p. 170). Rather than longer term structural projects that would address poverty and social justice, these were short-term projects that “offer[ed] ready solutions to a complex humanitarian problem” (p. 177). These Western-based constructions of problems and solutions differed from those created by experts living in the Global South, as when a social worker in Zimbabwe noted the complexities of older Mozambican refugees’ experiences that could not be reduced to that of “an individual with an autonomous occupation who shunned economic and social dependency” (p. 184). This “interdependence of old and young across the life-course” (p. 184) characterized the sociality of refugees, and is an example of the multiple instances in which African and Asian views on aging are part of a social world that goes beyond “productivity and activity” (p. 183). By foregrounding these contextualized embedded perspectives, Sivaramakrishnan provides important empirical evidence for challenging normative Western models of aging that are based on narrow, neoliberal understandings of human sociality and vitality.

Sivaramakrishnan weaves together data from a wide array of primary sources, including reports from regional and international gerontology and aging-focused policy conferences and professional associations, correspondence among aging experts worldwide, interviews with the same, and reports from local NGO staff, missionaries, social workers, activists, and social scientists (including anthropologists) in India, China, southern and western Africa, and Central and South America, as well as Europe and North America. The book is largely chronologically organized, which, in addition to the geographic and disciplinary complexity of the networks being traced, can sometimes lead to an overwhelming level of descriptive detail. However, this complexity reflects the nature of the empirical material itself, which makes the recurring themes all the more striking. Across multiple eras, the Janus-faced narrative of population aging as both a reflection of the success and impending crisis of modernity recurs, even as multiple alternative narratives offer understandings of aging that incorporate more expansive analytic framings. 

This book is essential reading for any anthropologist or social scientist who studies aging, and is a key contribution to aging studies, to the history of public health and public policy, and to postcolonial studies. It would fit well on the syllabus of advanced undergraduate or graduate courses in the anthropology of aging and the lifecourse, critical development studies, and the history of expertise. In this rich and nuanced book, Sivaramakrishnan makes a compelling case for understanding aging as part of social transformations at multiple scales, including interpersonal, institutional, regional, and (trans)national, and across domains, including kinship, labor, health, and political economy. This insistence on complexity is necessary for developing understandings of aging that go beyond a logic of difference by reflecting its mutual imbrications with the multiple and shifting forms of interdependence that characterize demographic transformations.