Active and Dignified Ageing in Asia

Iris Chi, DSWGolden Age Association/Frances Wu Chair for Chinese Elderly

School of Social Work, University of Southern California

2012 Joint World Conference on Social Work and Social Development

Stockholm, Sweden

July 9th, 2012

Country/district composition of Asia regions

Countries (excluding North East, Near East and Oceania)• Afghanistan, Armenia, Azerbaijan,

Bangladesh, Bhutan, Brunel, Burma, Cambodia, China, Georgia, Hong Kong SAR, India, Indonesia, Iran, Japan, Kazakhstan, Kyrgyzstan, Laos, Macau SAR, Malaysia, Maldives, Myanmar, Mongolia, Nepal, N. Korea, Pakistan, Philippines, Singapore, S. Korea, Sri Lanka, Taiwan, Tajikistan, Thailand, Timor-Leste, Turkmenistan, Uzbekistan, Vietnam

Sub-regions• North Asia (NA)• East Asia (EA)• Asia Pacific (AP)• South East Asia (SEA)• South Asia (SA)

Size, complexity and diversity

• The world's largest and most populous Region– 36 countries/districts– Area: 44 million km2 (44,579,000 km2)– Population: ~4 billion (3.879 billion in 2010)

• Diversity– More than 1,500 languages – Oldest and youngest; largest and smallest– Among the richest and poorest in the world– Still more developing than developed countries

Outline of the presentation

• Demographic trends in Asia• Define active and dignified

ageing and trace its theoretical development

• Policy options to support active and dignified ageing in Asia– Financial security (poverty)– Health & long term care

support (disability)

Population ageing in Asia, 1950-2050

05

101520253035

1950 1975 2000 2025 2050

% a

ge

of

po

p 6

0+

EA

SEA

SA

1950 2000 2050

Number of older adults (65 and above)

55 million 207 million 865 million

What is “Active and Dignified Ageing”?• Process of optimizing

opportunities for health, participation and security in order to enhance quality of life as people age

• Aims to extend healthy life expectancy and quality of life for all people as they age

WHO, 2002

Theoretical development of Active Ageing

Activity Theory 1963

Productive Ageing 1982

Successful Ageing 1989

Active Ageing 2002

Healthy Ageing 1995

Active Ageing: A Public Policy Framework

Not only physically active, but also socially, intellectually, culturally, and (for many seniors) spiritually active

• Every country is looking for ways to meet the needs of its senior citizens

• How were they doing collectively as a region?

• Active in considering and reviewing ageing policies

• Macau Plan of Action on Ageing for Asia and Pacific

• Second World Assembly on Ageing in 2002

• Given the diversity of country features, one should expect a wide-ranging ageing policy in Asia

Policy options to support for Asia’s growing elderly population

(1) Labor and retirement policies; (2) Policies affecting traditional family support systems; (3) Government and employer-sponsored pension

schemes; and(4) Policies that encourage saving and investment

East-West Center, 2000

Trend towards early retirement in Asia

• Median age of retirement for men dropped from 67 in 1960 to 63 in 2000

• In 1950, 38 percent of Asian men and women age 65 and above were still in the labor force. In 2010, only 22 percent in this age group were still working

Labor and retirement Policies

• Increase mandatory retirement ages • Introduce a system of sliding pension benefits • Allow flexible and part-time employment options• Provide occupational training

Family support and living arrangement

• Families are still the primary source of support for older people in most Asian countries

• Most older people in Asia reside with family

• Intergenerational co-residence is on the decline

Total fertility rate for selected Asian countries: 2012 Est.

Developed countriesSingapore 0.8

Macau 0.9

Hong Kong 1.1

Taiwan 1.2

South Korea 1.2

Japan 1.4

Replacement rate:

2.1 live births per woman

Developing countriesChina 1.6

Thailand 1.7

Iran 1.9

Vietnam 1.9

Indonesia 2.2

India 2.6

Malaysia 2.6

Source: CIA The World Factbook

Decline in Fertility

Declining support base

Potential support ratio Women labor force participation

0

5

10

15

20

1950 1975 2000 2025 2050

EA

SEA

SA

Pop. 15-64 per person aged 65 and more

Family support policies

• Maintenance of Parents Act: Singapore and China• Tax incentives: Malaysian and Hong Kong• Subsidize care and support services• Public housing policies

North Amer-ica

Western Eu-rope

CIS Central and Eastern Eu-

rope

Latin Amer-ica and the Caribbean

Middle East North Africa Asia and the Pacific

Sub-Saha-ran Africa

Total0

10

20

30

40

50

60

70

80

90

10075

77

67

62

64

40

34

32

26

42

73

70

65

59 58

38

34

28

14

37

0 1 0

2

5

2

4

2

72

65

40

50

37

22

10

18

5

26

Legal coverage - percentage of the working-age population covered: All old-age programmes

Legal coverage - percentage of the working-age population covered : old-age contributory programmes excluding voluntary

Legal coverage: old-age voluntary coverage for self-employed

Effective old-age coverage in percentage of the working-age: contributory programme

Per

cen

tag

e

Sources: ILO Social Security Department based on SSA/ISSA, 2008, 2009; ILO, LABORSTA (ILO, 2009e); national legislative texts; na-tional statistical data for estimates of legal coverage; and compilation of national social security schemes data for effective cover-age. See also ILO, GESS (ILO, 2009d).Country data are available in the Statistical Annex.

Demand of long term care

• About 15 to 20% of older people are estimated to have mild degree of disability in their ADLs

• Less than 5% need high level of care • Even maintain a stable proportion, the absolute

number will increase

Elderly residents’ perspectives on filial piety and institutionalization in Shanghai (Chen, 2011)

Hiring a domestic helper to care for an older parent was interpreted as a form of subcontracting filial care

Number of domestic helpers in Hong Kong: 21,500 (in 1982) 292,473 (in 2011)

Key Challenges in Caring for Elderly Persons in Asia

• Lack of an overall strategy in ensuring a continuum of care for older persons;

• Inadequately addressing older persons’ needs in the health and long term care systems;

• Lack of elderly-friendly health & social services; and• Human resources gaps in elder care

Regional Forum on Elderly Care Services in Asia and the Pacific, 2011

Recommendations

• Should develop or strengthen a strategy in providing comprehensive continuum of care;

• Health and social care systems need to be adapted to address the rising demands for elder care services;

• Laws and regulations should be put in place to strengthen legal protection; and

• Should include strengthening caregiving service industry in their national development plans

Regional Forum on Elderly Care Services in Asia and the Pacific, 2011

• Many Asian countries have barely begun to implement programmes for the support of the elderly

• Some of these countries will have to develop better legal structures, financial markets, professional training and services, and administrative mechanisms

• Given the pace of population aging in Asia, policy-makers will need to act quickly

After all, the Asia region is taking care of the majority of elders in the world!!

Conclusion

Thank you