emerging challanges of ageing

8/2/2019 emerging challanges of ageing

1/17

1

Thelma Kay

Director

Emerging Social Issues Division

UNESCAP

Em er g in g Ch a l leng esand Oppo r t un i t i e s o f

Age ing

Decreasing fertility in the ESCAP region

Fertility trends by major regions of the world 1950-2005

Source: World Population Prospects: The 2006 Revision, United Nations Population Division, New York.

0

1

2

3

4

5

6

7

1950-

1955

1955-

1960

1960-

1965

1965-

1970

1970-

1975

1975-

1980

1980-

1985

1985-

1990

1990-

1995

1995-

2000

2000-

2005

Totalfertility

ra

te

Europe

Northern America

Australia/New Zealand

Asia

Eastern Asia

South-Central Asia

South-Eastern Asia

Western Asia


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2

Lowest-low fertility (TFR 1.5)

0.0 2.0 4.0 6.0 8.0 10.0

Georgia

Armenia

Russian Federation

Japan

Singapore

Republic of Korea

Hong Kong, China

Macao, China

TFR

2005-2010

1990-1995

1970-1975

Source: World Population Prospects: the 2006 Revision, United Nations Population Division, New York.

Increasing Life Expectancy in ESCAP region

35

40

45

50

55

60

65

70

75

80

85

1950

-195

5

1955

-196

0

1960

-196

5

1965

-197

0

1970

-197

5

1975

-198

0

1980

-198

5

1985

-199

0

1990

-199

5

1995

-200

0

2000

-200

5

Years

Europe

Northern America

Australia/New ZealandAsia

Eastern Asia

South-Central Asia

South-Eastern A sia

Western Asia


Life expectancy at birth by major region of the world1950-2010


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3

0 10 20 30 40 50

Japan

Republic of KoreaSingapore

China

Thailand

Indonesia

Myanmar

Viet Nam

Malaysia

Philippines

Cambodia

Lao People's Democratic Republic

Brunei Darussalam

Percentage

2005 2025 2050

Percentage of population over age 60


Population ageing rapidly in ESCAP region

Speed of population ageing in selected countries

Number of years required or expected for per cent of populationaged 65 or over to rise from 7% to 14%

More developed countries

26

45

45

65

69

73

85

115

Japan 1970-1996

Spain 1947-1995

United Kingdom 1930-1975

Canada 1944-2009

United States 1944-2013

Australia 1938-2011

Sweden 1890-1975

France 1865-1980

Less developed countries

19

19

22

23

26

Republic of Korea 1999-2018

Singapore 2000-2019

Thailand 2003-2025

Sri Lanka 2004-2027

China 2000-2026

Source: Kinsella and Philippes (2005). Global Ageing: The Challenge of Success, Population Bulletin, vol. 60, No. 1.


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Potential support ratio (15-64/65+)

0.0 2.0 4.0 6.0 8.0 10.0 12.0

China

Thailand

Singapore

Republic of Korea

Japan

Asia

Australia/ New Zealand

No rthern America

Europe

2050 2025 2005


2005, 2025 and 2050

Feminization of the elderly populationSex ratio of population aged 60+ in 2005

96

79

88

76

78

90

86

77

69

0 10 20 30 40 50 60 70 80 90 100

China

Thailand

Singapore

Republic of Korea

Japan

Asia


Northern America

Europe

Females Males



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Feminization of the elderly population

Sex ratio of population aged 80+ in 2005


0 20 40 60 80 100

ChinaThailand

Singapore

Republic of Korea

Japan

Asia


Northern America

Europe

Females Males

More women not currently married (single)

Percentage of currently married population aged 60 years or over

78

83

83

87

86

76

77

81

75

80

56

49

49

37

53

50

50

50

48

47

China

Thailand

Singapore

Republic of Korea

Japan

Australia

New Zealand

Asia

Northern America

Europe

Men Women

Source: Population Ageing 2006, United Nations Population Division, New York.


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6

8.1

2.9

1.6

7.7

12.7

17.1

5

15

13

8.1

5.5

2.7

7.7

12.7

36.1

9

34

35

China

Thailand

Singapore

Republic of Korea

Japan

New Zealand

Asia

Northern America

Europe

Males Females

In Asia lower proportion of older persons living alone


Percentage of population aged 60 years or over living alone

Feminization of ageing

Gender-related demographics:(a) Longer female life expectancy e.g. female

advantage in China 3.1 yr, Japan 5.3 yrs;

(b) Advantage bigger in older old

Educational attainment: Low literacy rates forolder women; cohort differences

Labour force participation: lower paid, parttime/temporary


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Living arrangement: mainly co-residence withchildren; reciprocity (more likely provide ratherthan receive support)

Universality of family formation but increasingnumbers of single, divorced

Health: more prone to chronic diseases,mobility affected, dementia

Finance: more financially dependent vulnerable,fewer assets, fewer benefits from formal socialsecurity schemes

Feminization of ageing (Contd)

Changing demographics

Decreasing fertility

Increasing life expectancy

Speed of ageing

Potential support ratio Feminization of ageing

Increasing older old

Increasing number single

Living alone


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UN and ESCAP Agenda on Ageing

1982: First World Assembly on Ageing Vienna1992: Proclamation on Ageing General Assembly1995: World Summit for Social Development

Copenhagen (Society for All)1999: International Year of Older Persons (Society

for all Ages)1999: Macao Plan of Action on Ageing2002: Madrid - Madrid International Plan of Action on

Ageing MIPAA)

2002: Shanghai Regional Implementation Strategy forthe Madrid International Plan of Action on Ageing

2007: Macao Outcome Document of Highlevel review ofMIPAA implementation

Madrid International Plan of Action on Ageing(MIPAA)

Core concepts:

Development approach - integrate evolving processof ageing into development process; more focus ondeveloping countries

Life-course intergenerational approach -inclusiveness of all age groups

Three priority directions:

Older persons and development

Advancing health and well-being into old age

Ensuring enabling and supportive environments


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Diversity of ESCAP region

Some countries with ageing population but with

cushion of affluence e.g. Australia, NZ, Japan,Republic of Korea, Singapore

Some developing countries with rapidly ageing

populations can reap demographic dividend butalso need to address unemployment,underemployment and youth unemployment

Income security for older persons

Labour force in many ESCAP countries ininformal sector where social security schemescannot or do not apply

Formal social security coverage ranges from 9-

20 percent; only Japan, ROK, Singapore havelargely universal pension systems

Limited development of multi-tiered systemse,g. 5-tier World Bank taxonomy


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Social security for older persons

Non-contributory social pensions in somecountries e.g Nepal

Challenge of coverage, targetting vsuniversality, affordability, sustainability

New and innovative instruments e.g.reversemortgage

Scope for higher social expenditure with fiscal

space from economic growth and reallocativedistribution

Health security

Subregions within the ESCAP region have lowest proportion of total

health expenditure of GDP compared to other regions

They also have lowest proportion of public health expenditure of GDP

ESCAP region has highest level of out-of-pocket expenditure in the

world

Expenditure levels on health by region

4.56.5Europe and Central Asia

3.36.8Latin America and Carribean

2.75.6Middle East and North Africa

2.46.1Sub-Saharan Africa

1.95.0East Asia and the Pacific

1.14.4South Asia

Public healthexpenditure as % GDP

Total health expenditureas % GDPRegion


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Health security

Deaths due to non-communicable, chronic diseases

set to increase

Developing countries face double burden of disease

Most countries have health policies that imply

principle of universal coverage but struggle to

implement it

Can be achieved by multi-pillar approaches (tax-

funded, social health insurance, private insurance)

Economic growth has expanded fiscal space for

higher social expenditures

Addressing health security

Comprehensive strengthening of healthsystems (not stove-pipe approach)

Universal health-care coverage for basic

package of services Healthy life expectancy, compressed morbidity

Address promotion and prevention not just

curative and rehabilitative

Address long-term care


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Ensuring an enabling and supportive environments

Develop age-friendly physical environments topromote ageing in place to ensure readily

accessible community level facilities and healthservices;

Promote barrier-free physical environment,

transportation, public facilities, services, andinformation and communications to meet the

accessibility needs of older persons;

Macao Outcome Document

Promote the use of technological advances , suchas ICT applications to enhance connectivity,communications and advocacy

Increase access by older persons to information

about their rights at home and in the community,including about their publicly supportedentitlements

Foster the provision of community-based servicesto older persons by making use of existingnetworks and support to caregivers to ensure thesustainability of the services provided

Ensuring an enabling and supportiveenvironment


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Enabling and supportive environment

Ageing in place

Independent living

Accessible and affordableconnectivity/transportation

Lifetime neighbourhood/community

Ageing in place

Help older people stay at family home or home-like environment

Adapt /modify homes

Programmes that support family health givers

Financial support policies subsidies, salaries ,tax credits

Social services e.g daycare ; training forcaregivers


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Independent living

Assistive devices

Universal design ageproof homes (e.g wider

doors/internal corridors , wheelchair accessiblebathroom, lever taps/handles;

Legislation for all homes ( especially built with

public funds) /regulatory requirement for

universal design/lifetime home standards

Accessible/affordable connectivity

Telephone (landline/mobile),internet

penetration

Availability/application of ICT

Access to transportation Access to information/advice (rights,

entitlements)


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Lifetime community/neighbourhood

Mixed housing

Accessible common facilities

Community alarm , telecare schemes (esp. to

assist older persons in emergencies)

Network of barrier-free linkages to majoractivity modes and amenities

Increase the level of integration and mainstreaming ofageing concerns in national policies and povertyreduction strategies;

Establish and strengthen multi-pillared and multi-

layered social security systems ( income security,health security, long term care);

Recognize contribution of older persons in labourmarket, in reciprocity living arrangement,intergenerational support, political participation

Promote silver market for financial services, healthprovision, travel and leisure;

Future Priorities for Action


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Conduct multidisciplinary research for evidence-basedplanning and decision-making;

Mobilize international donor community to providenecessary technical and financial support to addresspopulation ageing issues at all levels;

Strengthen collectivization/solidarity/voice e.g olderpersons associations at community, local, national,global levels

Build capacities to identify challenges, formulateappropriate measures and programmes on ageing,and monitor the progress of implementation;

Future priorities for action

Sources of dataSuggested indicatorsPriorityDirections/Objective

1.Government information2.Survey3.NGO information

4.Private sector information

1.National census2.Survey3.MDG reports if

disaggregated

Instrumental : Availability,scope and coverage of

programmes promoting age-

integrated housing

Outcome: Percentage of older persons

reporting on their housing andliving conditions as age-adequate

Percentage of households witholder persons having a toilet,bathing facilities,sewage disposal,solid waste disposal , electriclighting,improved sanitation andsafe water

Housing and the livingenvironment

Objective 1: Promotionof ageing in place inthe community with dueregard to individualpreferences andaffordable housing

options for persons

Instrumental and Outcome Indicators

Ensuring enabling and supportive environments


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Moving forward

Ageing poses many challenges but can be

addressed and overcome by:

Well-focused policies

Timely preparations

Partnership of governments, private sector, civil

society esp. associations of older persons Regional and global partnerships

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emerging challanges of ageing

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