Programme Launch 20-21 February 2008 - Aviemore, Scotland 1 The burden of dependency The burden of dependency perspective perspective To the extent that the ... economic contexts To the extent that the ... economic contexts will be clarified and generally understood, will be clarified and generally understood, this displeasure with the all too many old this displeasure with the all too many old people will seek for justification in a people will seek for justification in a reproach which will not be able to reject: reproach which will not be able to reject: this heavily weighing generation of this heavily weighing generation of geriatrics has been a burdening generation geriatrics has been a burdening generation already in its vital days. already in its vital days. (Myrdal & Myrdal 1935, 127 (Myrdal & Myrdal 1935, 127-127; 127;The The Population Crisis, free translation Population Crisis, free translation) Demographic bomb? (SE) Demographic bomb? (SE) YEAR 1900 YEAR 2050 15-64 years 65+ years Tornstam
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Programme Launch
20-21 February 2008 - Aviemore, Scotland
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The burden of dependency The burden of dependency perspectiveperspective
To the extent that the ... economic contexts To the extent that the ... economic contexts will be clarified and generally understood, will be clarified and generally understood, this displeasure with the all too many old this displeasure with the all too many old people will seek for justification in a people will seek for justification in a reproach which will not be able to reject: reproach which will not be able to reject: this heavily weighing generation of this heavily weighing generation of geriatrics has been a burdening generation geriatrics has been a burdening generation already in its vital days.already in its vital days.(Myrdal & Myrdal 1935, 127(Myrdal & Myrdal 1935, 127--127;127;The The Population Crisis, free translationPopulation Crisis, free translation))
The Swedish population 1750The Swedish population 1750--20502050Age Groups 0Age Groups 0--1414 , , 1515--6464, , 65+65+
Year
Sum 100 percent
1750 1800 1850 1900 1950 2000 20500
20
40
60
80
100
Source: Swedish Official Statistics 2007. Data prognosis for 2007-2050
The Swedish Age Composition
15-64 years
65+ years
0-14 years
60%
60%
Graphics Lars Tornstam
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Demographic dependency ratioDemographic dependency ratioTotal population / Population Total population / Population 2020−64−64 (SCB 2003)(SCB 2003)
Dependency ratio for the work forceDependency ratio for the work forceTotal population / Population in the work force (SCB 2003)Total population / Population in the work force (SCB 2003)
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“Will there be a helping hand?”“Will there be a helping hand?”Swedish LongSwedish Long--term study 1999/2000term study 1999/2000
POLICYRECOMMENDATIONSPOLICYRECOMMENDATIONS�� Increased childbirthIncreased childbirth�� Increased participation in the work force Increased participation in the work force
among immigrantsamong immigrants�� Introduction of ”Elderly care contracts”Introduction of ”Elderly care contracts”�� Influx of foreign Influx of foreign labourlabour�� Decrease of early exit from the Decrease of early exit from the labourlabour
marketmarket
Ideal types of social structuresIdeal types of social structures(Riley & Riley 1994)(Riley & Riley 1994)
Imagined and experienced problems Imagined and experienced problems among elderly (%)among elderly (%) (Finns 60+, Old Age Barometer 1998)(Finns 60+, Old Age Barometer 1998)1) Illness and functional incapacity 1) Illness and functional incapacity 2) Social difficulties2) Social difficulties3) Economical difficulties 3) Economical difficulties 4) Violence and criminality4) Violence and criminality5) Shortage of social services 5) Shortage of social services 6) Shortage of health services6) Shortage of health services7) Too much youth idealization7) Too much youth idealization 8) Shortage of activities8) Shortage of activities9) Something else9) Something else
0
10
20
30
40
50
60
70
80
90
1 2 3 4 5 6 7 8 9
Old peoplegenerallyOne self
Conflicts or solidarity between Conflicts or solidarity between generations?generations?
��”Young people get it harder ”Young people get it harder ––older people better and better” older people better and better” ((Metro 2005Metro 2005))
��Integration at the micro level will Integration at the micro level will prevent conflicts at the macro prevent conflicts at the macro levellevel
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Uppsala Newspaper Uppsala Newspaper (UNT May 19th, 2005)(UNT May 19th, 2005)
“Brisk elderly make the “Brisk elderly make the housing shortage housing shortage worse”worse”
((Pigga äldre förvärrar Pigga äldre förvärrar bostadsbristenbostadsbristen))
Ageing of the populationAgeing of the population�� Reflecting long term decrease in both Reflecting long term decrease in both
fertility and mortalityfertility and mortality�� More people live into old ageMore people live into old age�� How ageing of the population changes How ageing of the population changes
social relationssocial relations�� Changes during the 20th century of both the Changes during the 20th century of both the
experience of ageing and the meaning of experience of ageing and the meaning of ageingageing
�� Changes in the life course and the relations Changes in the life course and the relations between generationsbetween generations
�� Cultural and lifeCultural and life--style changes of old agestyle changes of old age
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Ageing and family lifeAgeing and family life
�� Increase of households with one and two Increase of households with one and two personspersons
�� The ”verticalisation” of the familyThe ”verticalisation” of the family�� More grandparents More grandparents –– less grandchildrenless grandchildren
�� Relations based on increased equality Relations based on increased equality (emotional bonds, free choices instead of (emotional bonds, free choices instead of tradition and obligations)tradition and obligations)
�� Decreased feminization of old ageDecreased feminization of old age
Ageing and family lifeAgeing and family life�� Postponing of timing and ”ageing” of family Postponing of timing and ”ageing” of family
transitionstransitions�� Increased time in marriageIncreased time in marriage
�� Increase of men in elderly care institutionsIncrease of men in elderly care institutions�� Increase of divorced older peopleIncrease of divorced older people
�� Affects potentials for informal careAffects potentials for informal care�� Divorced men have smaller social networks Divorced men have smaller social networks
than widowed men and higher mortalitythan widowed men and higher mortality
�� Increase of new forms of intimacy Increase of new forms of intimacy �� LAT and cohabitationLAT and cohabitation�� Homosexual relations more visibleHomosexual relations more visible
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Percentage divorced people 60+in Sweden 1970–2004 (SCB, Öberg)
AGEAGE 19701970 19901990 20042004
6060––69 years69 years 4,44,4(39.034)(39.034)
11,211,2(97.136)(97.136)
19,219,2(181.643)(181.643)
7070––79 years79 years 3,33,3(17.190)(17.190)
7,37,3(52.254)(52.254)
13,113,1(86.922)(86.922)
80+80+ 2,72,7(5.099)(5.099)
4,64,6(16.901)(16.901)
7,77,7(37.052)(37.052)
Changes in Marital Status over Time for Men Changes in Marital Status over Time for Men 65+ in England and Wales, 200165+ in England and Wales, 2001−−2021 (%)2021 (%)
(Davidson 2006)(Davidson 2006)
MEN 65+MEN 65+ 20012001 20212021 Change Change 20012001−2021−2021
MarriedMarried 7171 6666 − 5 %− 5 %
WidowedWidowed 1717 1313 − 4 %− 4 %
DivorcedDivorced 55 1313 + 8 %+ 8 %
NeverNeverMarriedMarried 77 88 + 1 %+ 1 %
100%100% 100%100%
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Changes in Marital Status over Time for Changes in Marital Status over Time for Women 65+ in England and Wales, Women 65+ in England and Wales,
20012001−−20212021 (Davidson 2006)(Davidson 2006)
WOMEN 65+WOMEN 65+ 20012001 20212021 Change Change 20012001−2021−2021
MarriedMarried 4040 4545 + 5 %+ 5 %
WidowedWidowed 4848 3535 − 13 %− 13 %
DivorcedDivorced 66 1414 + 8 %+ 8 %
NeverNeverMarriedMarried 66 55 −− 1 %1 %
100%100% 100%100%
Theory of the Third AgeTheory of the Third Age(Peter Laslett)(Peter Laslett)
1)1) FIRST AGEFIRST AGE�� Dependency, socialisation, immaturity, Dependency, socialisation, immaturity,
educationeducation2) 2) SECOND AGESECOND AGE�� Independency, maturity and responsibility, Independency, maturity and responsibility,
earnings and savingsearnings and savings3)3) THIRD AGETHIRD AGE�� Personal selfPersonal self--fulfilment, “crown of life”fulfilment, “crown of life”4)4) FOURTH AGEFOURTH AGE�� Dependency, decrepitude and deathDependency, decrepitude and death
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WILL OLD AGE BE HEALTHIER?WILL OLD AGE BE HEALTHIER?�� 1) Compression of morbidity1) Compression of morbidity
�� ““ Healthy life expectancy” increase more than life Healthy life expectancy” increase more than life expectancyexpectancy
�� 2) Extension of morbidity2) Extension of morbidity�� “Healthy life expectancy” constant “Healthy life expectancy” constant –– increase of increase of
ill years of lifeill years of life�� Medical paradox: the more people saved to life Medical paradox: the more people saved to life ––
the more health care problems (“Survival of the the more health care problems (“Survival of the ununfittest”)fittest”)
WILL OLD AGE BE HEALTHIER?WILL OLD AGE BE HEALTHIER?�� 3) Postponement of morbidity3) Postponement of morbidity
�� Increase in life expectancy corresponding to increase in Increase in life expectancy corresponding to increase in “healthy life expectancy”“healthy life expectancy”
�� Decrease in mortality corresponding to decrease in Decrease in mortality corresponding to decrease in morbiditymorbidity
�� Support from studies in Norway, Sweden and FinlandSupport from studies in Norway, Sweden and Finland�� Both ADL and IADL has improved for all age groups 65+ Both ADL and IADL has improved for all age groups 65+
in Sweden 1988/89in Sweden 1988/89--2002/032002/03�� “Heroic medicine” not only saves lives “Heroic medicine” not only saves lives –– but also reduces but also reduces
the effects of the chronic disease on illness and the effects of the chronic disease on illness and functional capacity functional capacity
�� The important issue for health care costs is not how The important issue for health care costs is not how old one is old one is –– but how many years of life one has but how many years of life one has aheadahead
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Prognosis for the number of 80+ Prognosis for the number of 80+ people in Sweden 2010people in Sweden 2010((National Statistics of SwedenNational Statistics of Sweden))
Year ofYear ofPrognosisPrognosis
Number of Number of people 80+people 80+
2010201019781978 340.000340.000
19861986 430.000430.000
19971997 500.000500.000
Percentage of 75Percentage of 75--84 year old men and 84 year old men and women with ”bad” or ”very bad” health women with ”bad” or ”very bad” health
experience (1980experience (1980−−2003)2003)
WomenMen
%
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Percentage with IADLPercentage with IADL--impairment among impairment among Swedish Women 65+ (1988/89Swedish Women 65+ (1988/89--2002/03)2002/03)
Percentage with higher education (>3 years) among 60-74 year oldSwedes 1985–2004 (SCB, Öberg)
AGEAGE 19851985 19951995 20042004
6060––64 years64 years MenMenWomenWomen
5533
8877
13131414
6565––69 years69 years MenMenWomenWomen
5522
7755
10101010
7070––74 years74 years MenMenWomenWomen
4422
6633
9988
Percentage of Finnish households having a Percentage of Finnish households having a carcar according to the age of the reference according to the age of the reference
person person 19851985--2001/20022001/2002(Reference person: the highest income in the household)(Reference person: the highest income in the household)
0102030405060708090
%
-35 35-54 55-64 65-74 75+
Age
19852001-2
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Toothless 70 year old peopleToothless 70 year old people(H70; Sweden)(H70; Sweden)
YearYear PercentagePercentage
19711971 52 %52 %
19761976 38 %38 %
19921992 17 %17 %
20012001 8 %8 %
Smoking among 70 year old Smoking among 70 year old Swedish men and women (%)Swedish men and women (%)
“It is important for me to be sexually “It is important for me to be sexually active”active” (Percentage in different ages who agree) (Percentage in different ages who agree) (Öberg & Tornstam 2003)(Öberg & Tornstam 2003)
0102030405060708090
%
20-24
25-34
35-44
45-54
55-64
65-74
75-85
Age
MenWomen
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Image of Elderly i Nordic CountriesImage of Elderly i Nordic Countries(Eurobarometer)(Eurobarometer)
��Have a good economyHave a good economy��Are active and participate in Are active and participate in
societysociety��Typical “Old age home” is the Typical “Old age home” is the
own apartment or houseown apartment or house��Are treated with respectAre treated with respect��Are not particularly religiousAre not particularly religious
Norwegian study on life course, Norwegian study on life course, ageing and generationsageing and generations
1)1) Will tomorrow’s elderly have other Will tomorrow’s elderly have other preferences, opinions or values than preferences, opinions or values than elderly today?elderly today?
2)2) Will changes in family structure affect Will changes in family structure affect the potential for informal care and the potential for informal care and support?support?
�� 5.600 individuals in 30 municipalities5.600 individuals in 30 municipalities�� 4040--79 years old79 years old
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Tomorrow’s elderlyTomorrow’s elderly (NO)(NO)
�� Elderly care users will be less modest, Elderly care users will be less modest, more demanding, and expect more more demanding, and expect more autonomyautonomy
�� Have more individualistic values Have more individualistic values �� personal achievement, pleasure, new experiencespersonal achievement, pleasure, new experiences�� More consuming instead of saving for childrenMore consuming instead of saving for children
�� Less likely to hold traditional valuesLess likely to hold traditional values�� conformity and modestyconformity and modesty
�� Fourth age decrease possibilities for Fourth age decrease possibilities for individualistic valuesindividualistic values
Tomorrow’s elderlyTomorrow’s elderly (NO)(NO)
�� More divorced elderly parents may receive More divorced elderly parents may receive less care from their childrenless care from their children�� Less children, more childless couples, more Less children, more childless couples, more
living alone, more coliving alone, more co--habitationhabitation�� New gender rolesNew gender roles
�� “Modern” elderly men partake more in “Modern” elderly men partake more in household and care work (may lessen the household and care work (may lessen the demand on social service)demand on social service)
�� Differences in health behaviour between Differences in health behaviour between men and women decliningmen and women declining
