Grey Clouds or Silver Lining?

We are in the middle of a demographic revolution. Thanks to steep and continuing declines in fertility and mortality, the world is rapidly growing older. While population ageing offers opportunities, it also presents considerable challenges for policymakers.

Longevity is one of humanity's greatest achievements. This process is unprecedented, pervasive, profound and enduring.^[1] It is a trend that affects economic growth, savings, investment, consumption, labour markets, pensions, taxation and intergenerational transfers. It influences family composition and living arrangements, housing demand, migration trends, epidemiology, energy use and the need for health-care services. And it may shape voting patterns and political representation.^[2]

Population ageing has different features and effects in different countries. In the more developed regions, population growth is stagnant (or falling), and the proportion of older people has been increasing for decades, giving rise to concerns about a ‘birth dearth’.

Least developed countries are coping with rapid population growth, large youth populations and a slower increase in the proportion of older people. In between are many countries where ageing is proceeding much more rapidly than it did in the West, but at a much lower level of economic development.

Societies and public health systems need to respond to this demographic revolution with an equally dramatic revolution in policymaking and planning if they are to find the silver lining in greying societies.

The Madrid International Plan of Action on Ageing, adopted by the international community in 2002, provides recommendations to guide policy formulation and implementation towards the goal of successful adjustment to an ageing world.

Content

• Get the Facts
• Diverse patterns of ageing
• Women outnumber men in old age
• What Needs to be Done?
• Links between the ICPD and the Millennium Development Goals
• Real Stories
  
  • “Older People a Resource, Not a Burden, in AIDS Fight”
• References

Get the Facts

• Globally, the number of persons aged 60 or over has reached 739 million in 2009 and is expected to increase to 2 billion by 2050.
   
• The number of older persons is expected to triple in the first half of the 21st century, due in large part to longer life expectancy.^[3] By 2050, the world will have more older people than children for the first time in history, if fertility continues to decline.
   
• The majority of the world’s older persons are found in the developing world, a trend that is accelerating rapidly. In the more developed regions, the population aged 60 or over is expected to increase from 264 million in 2009 to 416 million in 2050. In the developing world, the numbers are expected to increase from 475 million in 2009 to 1.6 billion in 2050.
   
• Globally, the elderly population is growing by 2 per cent each year, much faster than the population as a whole.
   
• Households run by older persons often survive on less than other households, as old age coincides with diminished earnings.
   
• Many older persons, however, continue to contribute to their families, communities and societies in many different ways. In fact, transfers from older persons to the younger generations are much higher than previously thought and, in many cases, the flows of services from older persons to their adult children exceeds that of flows in the opposite direction.
   
• If policies support their well-being and contributions, older people can be a tremendous resource. They often serve as caretakers for the children of working parents, orphans and other vulnerable people in their families and communities. Their wisdom and experience can be invaluable in many other areas as well.
   
• Old age is also associated with increased medical spending. But the expected increase in health-care costs can be decreased with prevention and promotion of healthy habits to delay onset of disability.
   
• Population ageing poses challenges to the financial sustainability of pension systems based on the redistribution of earnings from younger to older generations and of health-care systems. In developing countries, an estimated 342 million older persons currently lack adequate incomes, and their number may rise to 1.2 billion in 2050 if the coverage of pension schemes does not expand.^[4]
   
• Conflict, natural disasters and other emergencies disproportionately affect the most vulnerable, including older people. People over 60 accounted for the highest percentage of fatalities caused by the 2004 Indian Ocean tsunami in Indonesia, and the majority of the 14,000 victims of the 2003 heat wave in Europe were older persons.^[5]Yet emergency response seldom addresses the special needs and vulnerabilities of the elderly.^[6]
   
• Older persons are vulnerable to abuse and exploitation. This can be physical, sexual, psychological or financial, and may be committed by family members, institutions or others who are known to the victim.

Diverse Patterns of Ageing

Today the median age for the world is 29 years; that is, half the world’s population is below that age and the other half is above it. Over the next four decades, the world’s median age will likely reach 38 years in 2050. But this shift is proceeding differently in different regions.^[7]

• In more developed countries, 22 per cent of the population is elderly, compared to 9 per cent in developing countries. In some developed countries, there will be twice as many older persons as children by 2050.^[8] Japan, the world's oldest country, has a median age of 43 years.
   
• Although countries in Asia and Latin America are still seeing increases in the proportion of the working age population (15 - 49), their populations are expected to age more rapidly than those of developed nations. This is taking place at the same time that the traditional, intergenerational social contract is breaking down.
   
• Most countries in Africa still have relatively young populations, in part because fertility and mortality remain relatively high.^[9] The country with the youngest population is Uganda, with a median age of 15 years.
   
• The effective age at retirement also varies considerably. In countries with high per capita incomes, older persons retire earlier. Just 13 per cent of men aged 65 years or over are economically active in the more developed regions, compared to 39 per cent in less developed regions. This has important implications for social security systems in developed countries. In many developing countries, older persons continue to work until they are no longer able to do so.
   
• Despite changing family dynamics, evidence suggests the elderly are not abandoned. Technological advances and family adaptation strategies have enabled family members to stay connected and ensured the flow of communication and transfer of goods and services.^[10] In many cases the flow of services from older persons to the younger generations exceeds that of flows in the opposite direction.^[11]

Women outnumber men in old age^[12]

• Women typically outlive men, and their proportion of the elderly becomes even higher among the very old.
   
• The burden of care typically falls disproportionately on the women (wives and daughters) in the family who often simultaneously supply child care and support to older members of the family.
   
• Widowed women are less likely to remarry than men, so there are far more elderly women living alone than elderly men. In many developing countries, widows may be left with little support in old age due to lack of access to pensions and the right to own property or inherit, and in many cases, a lifetime spent in unpaid caretaking work.
   
• Women suffer from high rates of disability at older ages, reflecting burdens that accumulate over the life cycle due to factors ranging from multiple pregnancies in quick succession to discrimination and abuse.
   
• Older women are more likely to be poor than older men.

What Needs to be Done?

Because they have a shorter time to adapt to the changes associated with the ageing of their populations, it is urgent that the governments of developing countries begin taking steps to face the challenges and make the best of the opportunities that population ageing brings. In general, and as outlined by the Madrid International Plan of Action, older persons must be empowered to contribute to development and also share in its benefits. In all countries, the situation of women, including those who take care of older persons, must be a priority for policy action.

To accomplish this, governments, international organizations and civil society need to enact 'active ageing' policies and programmes that:

• Focus on the older poor in development and poverty reduction strategies.
   
• Develop a social security system with coverage that protects older persons from falling into poverty.
   
• Promote training to enhance capacity and build up human resources for the provision of services to older persons.
   
• Enable people to continue to work according to their capacity and preferences as they get older.
   
• Ensure equal access to basic social and health services.
   
• Set up formal and informal support systems to help families take care of elderly persons within the family.
   
• Give increased attention to promoting health and preventing disease at the community level.
   
• Promote and implement 'active ageing' policies and programmes, including life-long education and training.
   
• Support the full participation of older persons in community life.
   
• Build intergenerational solidarity.
   
• Recognize and support the care-giving services provided by grandparents, especially women, to grandchildren orphaned by AIDS and other causes.
   
• Eliminate all forms of discrimination based on age.
   
• Prevent and minimize elder abuse by training law enforcement officials, health and social service providers and others to recognize, report and respond to elder abuse.
•  
• Counter the vulnerabilities of older women by enabling their full participation in political life and decision-making. Protect widows from theft, allow them to inherit, and provide social security to women who have no pensions or have only meager retirement savings because they spent the bulk of their lives in unpaid caretaking work.

Countries facing population decline along with population ageing should consider developing more family-friendly policies to mitigate fertility declines, as well as more open migration policies and integration of recent migrants and their descendants. They also need to reassess their policies on appropriate ages for retirement and how to fund health care for older people.

Links between the ICPD and the Millennium Development Goals

The 1994 International Conference on Population and Development recognized that the economic and social impact of population ageing is both an opportunity and a challenge to all societies.Its five-year review reiterated the need for all societies to address the significant consequences of population ageing in the coming decades.

The increasing proportion of the world’s elderly to more than 20 per cent over the next two generations has serious implications for several of the Millennium Development Goals. For example, MDG 1 (eradicate poverty) is unattainable if national and international development frameworks fail to address the unique vulnerabilities of the elderly poor. Supporting the role of the elderly in providing care for orphans can contribute to the achievement of MDGs 2 (achieve universal education), 4 (reduce child mortality), 5 (improve maternal health) and 6 (combat HIV/AIDS, malaria and other diseases). Older people are often repositories of ecological knowledge, which can contribute to the achievement of MDG 7 (ensure environmental sustainability).

Real Stories

“Older People a Resource, Not a Burden, in AIDS Fight”

“In modern societies where people tend to place products above human relations, older people are often considered a burden. But in this poor community affected by AIDS, they are valuable assets. After a lifetime of chores and farm work, Mother Peng, a 73-year old widow, took on a new job as caregiver when her daughter, Buakhao, became ill. Although her own health was poor, she told herself she had to be strong”.

Read More: The United Nations Population Fund, October 23, 2009. http://www.unfpa.org/public/News/pid/200

References

1. United Nations Population Division, World Population Ageing 2007 (Executive Summary)
2. United Nations Population Division, World Population Ageing 2007 (Executive Summary)
3. Help Age International, accessed 14 February 2009
4. World Demographic Trends, Report of the Secretary-General, ECOSOC Commission on Population and Development, 2009
5. "The French Heatwave of 2003: Solidarity, the Elderly and the Republic"Paper presented at the annual meeting of the ISA's 49th Annual Convention, Bridging Multiple Divides, Hilton San Francisco, San Francisco, CA, USA, Mar 26, 2008.
6. World Health Organization, accessed 14 February 2009.
7. UN Population Division, World Population Prospects, The 2009 Revision
8. Madrid International Plan of Action (2002) 
9. UN Population Division, World Population Prospects, The 2009 Revision
10. John Knodel, "Is Intergenerational Solidarity Really on the Decline? Cautionary Evidence from Thailand". Paper delivered at the seminar on Family Support Networks and Population Ageing (Doha, Qatar, 3-4 June 2009).
11. Luis Rosero Bixby, "Intergenerational Economic Transfers and Population Ageing in Latin America". Paper delivered at the seminar on Family Support Networks and Population Ageing (Doha, Qatar, 3-4 June 2009).
12. State of World Population 2002: People, Poverty and Possibilities.