Perlunya Atensi Menyiapkan dan
Membangun Dasar “Active Ageing”: Lessons Learned based on Global Review of
National and International Actions
Evi Nurvidya ArifinCentre for Ageing Studies
Universitas Indonesia
Disampaikan sebagai Kuliah Tamu Mata Kuliah “Gizi Remaja, Dewasa dan Lansia”, Departemen Gizi Masyarakat, IPB,
11 September 2015
Economy Social
Sustainable Development
Environment
People
Planet
Sustainable Development Goals:
The Future Indonesia Wants
Source: Salim et al (2015)
Post 2015 Development Agenda
Sumber: Salim et al (2015)
3 MEGA-DEMOGRAPHIC
TRENDS
AGEING
POULATION
CHANGING
PATTERN OF
MOBILITY
AN EVER
LARGER GIANT
POPULATION
Source: Arifin and Ananta (2013)
Demographic Transition
• High Fertility and Mortality Rates
• Too many births
• Too many younger persons
• Young Age Structure of the population
• High dependency because of too many young population
• Low Fertility and Mortality Rates
• Too few births
• Too many older persons
• Old Age Structure of the population
• High dependency because of too many older persons and too few younger persons
Fertility Revolution: 1950-2000
0
1,00
2,00
3,00
4,00
5,00
6,00
7,00
8,00
19
50
-55
19
55
-60
19
60
-65
19
65
-70
19
70
-75
19
75
-80
19
80
-85
19
85
-90
19
90
-95
19
95
-00
20
00
-05
20
05
-10
20
10
-15
Brunei Cambodia
Indonesia Lao
Malaysia Myanmar
Philippines Singapore
Thailand Vietnam
E. N. Arifin
Total Fertility Rate : ASEAN countries
Replacement level
Singapore Thailand Vietnam
Source: World Population Prospects: The 2010 Revision, http://esa.un.org/unpd/wpp/index.htm
Young population vs Old population
• Too many young people
• Burden
• Consumers but not yet producers
• Reduce the number of birth through family planning
• Improve mortality, gain longevity
• Too many old people
• Burden
• Consumers, no longer producers
• Policy to promote Active Ageing to empower to shift older persons as liability into asset
From Family Planning to Active Ageing
Smaller Number of Children will continue in the next several decades
0
1,00
2,00
3,00
4,00
5,00
6,00
7,00
8,00
19
50
-55
19
55
-60
19
60
-65
19
65
-70
19
70
-75
19
75
-80
19
80
-85
19
85
-90
19
90
-95
19
95
-00
20
00
-05
20
05
-10
20
10
-15
20
15
-20
20
20
-25
20
25
-30
20
30
-35
20
35
-40
20
40
-45
20
45
-50
20
50
-55
20
55
-60
20
60
-65
20
65
-70
20
70
-75
20
75
-80
20
80
-85
20
85
-90
20
90
-95
20
95
-00
Brunei Cambodia
Indonesia Lao
Malaysia Myanmar
Philippines Singapore
Thailand Vietnam
E. N. Arifin
Total Fertility Rate : ASEAN countries
Source: World Population Prospects: The 2010 Revision, http://esa.un.org/unpd/wpp/index.htm
Living Longer: Healthy Life?
20,00
30,00
40,00
50,00
60,00
70,00
80,00
90,00
100,00
19
50
-55
19
55
-60
19
60
-65
19
65
-70
19
70
-75
19
75
-80
19
80
-85
19
85
-90
19
90
-95
19
95
-00
20
00
-05
20
05
-10
20
10
-15
20
15
-20
20
20
-25
20
25
-30
20
30
-35
20
35
-40
20
40
-45
20
45
-50
20
50
-55
20
55
-60
20
60
-65
20
65
-70
20
70
-75
20
75
-80
20
80
-85
20
85
-90
20
90
-95
20
95
-00
Brunei Cambodia
Indonesia Lao
Malaysia Myanmar
Philippines Singapore
Thailand Viet Nam
Cambodia
E. N. Arifin
Expectancy of Life at Birth: ASEAN
Singapore
Source: World Population Prospects: The 2010 Revision, http://esa.un.org/unpd/wpp/index.htm
Migration
• In- or out-migration can be another important factor in determining the pace and speed of ageing population, particularly in small countries or sub-national regions.
• Out-migration of young population can accelerate ageing population, while in-migration can the opposite impact. Yet, influx of older persons can accelerate it.
E. N. Arifin
CHANGING
AGE-SEX POPULATION
STRUCTURE
Indonesia
E. N. Arifin
Changing Age-structure: Indonesia 1971 - 2010
From Borobudur to Prambanan
1971 2010
Contrast between Indonesia and Singapore
Indonesia’s Population, 2010 Singapore Resident Population, 2010
E. N. Arifin
200.000 150.000 100.000 50.000 0 50.000 100.000 150.000 200.000
0-4
5 - 9
10 - 14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75+
Female
Male
Indonesia 2030
• Candi Mendut
How Old is Old?
• 50, 60, 65, 70 or 80??
• In developed countries, some used the age of 65 as the cutoff
• However, some used 60 years old as an older person
• World Population Ageing (UN) : 60+
Who are Older Persons in Indonesia?
• Law no 4/1965 on Provision of assistance for frail elderly, the 1st law made by GoI since its independence
• Enacted in time when ageing pop was not an important issue
• Explanatory notes of the Article 1, an older person was defined as those reached 55+
• Universal for all frail elderly
• Law no 11/1969 pension benefits for civil servant. Article 9(1a) the right to retire was granted to those aged at least 50
45 551965 Retired after surpass e0
e0 OP
Who are Older Persons in Indonesia?
• Law no 13/1998 on Older Persons’ Welfare, Article 1:
an OP = chronological age of 60
e0 = nearly 70 years in the early 2000s
Retirement age = 55
55 60 701998
retired OP e0
45 551965 Retired after surpass e0
Early retirement ?
e0 OP
The21st Century: The Age of Ageing in SEA
0
5
10
15
20
25
30
35
40
45
19
50
19
60
19
70
19
80
19
90
20
00
20
10
20
20
20
30
20
40
20
50
20
60
20
70
20
80
20
90
21
00
Brunei
Cambodia
Indonesia
Lao
Malaysia
Myanmar
Philippines
Singapore
Thailand
Vietnam
E. N. Arifin
Percentage of Population Aged 60+
Source: World Population Prospects: The 2010 Revision, http://esa.un.org/unpd/wpp/index.htm
The Size of Population Aged 60+
0
10000
20000
30000
40000
50000
60000
70000
80000
90000
100000
19
50
19
60
19
70
19
80
19
90
20
00
20
10
20
20
20
30
20
40
20
50
20
60
20
70
20
80
20
90
21
00
Brunei
Cambodia
Indonesia
Lao
Malaysia
Myanmar
Philippines
Singapore
Thailand
Vietnam
E. N. ArifinSource: World Population Prospects: The 2010 Revision, http://esa.un.org/unpd/wpp/index.htm
Indonesia is the giant, Brunei is the tiniest
4 Stages of Ageing Population (Arifin and Ananta (2009)
– Very young: %age 60+ < 6%
– Youthful : 6 – 8%
– Transitional : 8 – 12%
– Old : > 12%
Stages of Ageing Population: 2005
Old > 12%
Transitional 8-12%
Young 6 - 8%
Very Young < 6%
Yogyakarta,
old pop Source: Arifin, Braun and
Hogervorst (2012)
Source: Salim et al (2015)
Ageing and Economy
0
2
4
6
8
10
12
14
16
0,0 5.000,0 10.000,0 15.000,0 20.000,0 25.000,0 30.000,0 35.000,0 40.000,0
GDP against Ageing PopulationAgeing in 2010
Rich before Old
E. N. Arifin
Thailand Singapore
Old and RichOld before
Rich
Brunei
Old before Rich
Indonesia
GDP/cap in 2009
Active Ageing
• WHO (2002) Framework for Ageing Research:
“… the process of optimizing opportunities for
health, participation, and security in order to
enhance quality of life as people age.”
3 Pilar Kerangka KebijakanMenua dengan Aktif
Determinan Active Ageing
Sumber : WHO, 2002
Determinan Active Ageing
Sumber : Arifin, Braun and Hogervorst, 2012
Pendekatan Siklus Hidup(Life Course Approach)
Balita
Remaja
DewasaLanjutUsiaAktif
Functional Capacity over the Life Course
as cited at WHO (2002)
Life Course Functional Trajectories
Source: Kuh et al (2014)
Life Course Approach: Causal Link between Nutrition and Chronic Diseases
Sumber: Darnton-Hill, Nishida and James (2004)
Source: Salim et al (2015)
Age-Specific Prevalence of Physical Difficulty by Type and Degree of Difficulty: Indonesia, 2010
Source: Salim et al (2015)
7 Dimensions of Wellness
AAI (Active Ageing Index)
• 27 European Countries
Source: Zaidi et al (2013)
Kota Ramah Lansia(Age-friendly City)
Kota Ramah Lansia
1. Gedung dan Ruang
Terbuka
2. Transportasi
3. Perumahan
4. PartisipasiSosial5.
Penghormatan dan Inklusi / Keterlibatan
Sosial
6. Partisipasi Sipil dan Pekerjaan
7. Komunikasi dan Informasi
8. Dukungan Masyarakat dan
Pelayanan Kesehatan
EXAMPLES
At Community Level: C3A (Council for Third Age)
• AA according to 6 dimensions of wellness: social, physical, intellectual, vocational, emotional and spiritual.
• KNAP (Knowledge networking on Ageing Program) to facilitate knowledge sharing on AA and gerontology : C3A – OIA (UK)
• GO Fund (Golden Opportunity Fund) disbursed by MCDYS
Some Activities
Lifelong Learning
Basic Computer Skills
Silver IT Fest 2015
Optimism on Senior Employability
Writing of Wills
Trainings for officials in SEA
Concluding Remarks
• Life course approach to study ageing population
• From Family Planning to active ageing
• From the need to right based approach
E.N. Arifin
