ANN E. BIDDLECOM AND LITA J. DOMINGO

AGING T R E N D S - THE PHILIPPINES

INTRODUCTION

The elderly population in the Philippines (adults aged 65 years and older) num- bered 2.12 million in 1990 (United Nations 1991). In absolute numbers, the elderly Philippines population is close to that of Thailand and much more numer- ous than in Singapore or Malaysia. However, aging trends in the Philippines have been consistently slower compared to those of other Southeast Asian coun- tries. In 1970, the elderly comprised 2.7% of the total Philippines population, increasing to 3.6% in 1990 (Figure 1). By 2025, the proportion elderly is pro- jected to rise to 7.7% of the total population. In contrast, the proportion elderly in Singapore, Thailand, and Indonesia is projected to increase to 21%, 13%, and 10% of the total population, respectively. While the proportion elderly may remain low for the Philippines compared to other Southeast Asian countries, the absolute number (estimated to rise to 7.68 million in 2025) and the rate of growth will mean increasing demands on relevant services and programs for the elderly.

Much of the slower change in the percent elderly in the Philippines is due to a relatively high fertility rate. As of 1985-90, each woman of childbearing age had 4.3 children on average. Total fertility rates were lower for the other countries in Table 1, ranging from 1.7 in Singapore to 4.0 in Malaysia

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0 I I I 1970 1990 2010 2025

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Figure 1. Proport ion of populat ion aged 65 and over in 5 Southeast Asian countries: 1970 to 2025.

Journal of Cross-Cultural Gerontology U: 109-114 (March 1996) © 1996 Kluwer Academic Publishers. Printed in the Netherlands.

110 A.E. BIDDLECOM AND L.J. DOMINGO

(United Nations 1993). Life expectancy at birth in the Philippines is 2 years greater than the Southeast Asian average; a Filipino born between 1985 and 1990 could expect to live 63.5 years on average. However, the Philippines level is relatively low when compared with life expectancies of 67 years or more in Singapore, Thailand and Malaysia.

Table 1. Total fertility rates, life expectancy, and aged dependency ratios in Southeast Asian countries

Country Total fertility rate Life expectancy Aged dependency ratio at birth

(1985-90) (1985-90) (1990) (2025)

Southeast Asia 3.73 61.3 6.6 12.1 Philippines 4.30 63.5 5.5 10.5 Singapore 1.69 73.5 7.9 30.1 Thailand 2.57 67.3 6.1 16.0 Indonesia 3.48 60.2 6.5 13.4 Malaysia 4.00 69.5 6.4 12.2

Note: The United Nations Southeast Asian region comprises Brunei, Cambodia, Indonesia (including East Timor), the Lao People's Democratic Republic, Malaysia, Myanmar, the Philippines, Singapore, Thailand, and Vietnam. Source: United Nations (1993).

The aged dependency ratio - the ratio of people age 65 years and older to the population aged 15 to 64 years - will almost double in the Philippines from 5.5 elderly persons in 1990 to 10.5 elderly persons per 100 persons in the productive age range. These figures are fairly similar to those for other Table 1 countries, with the exception of Singapore. While the elderly population in the Philippines may undergo less rapid growth overall compared to some Southeast Asian coun- tries, the aged dependency ratio suggests that issues related to the care and support of the elderly are quite relevant for the Philippines now and in the near future.

HEALTH AND DISABILITY

In a 1984 Association of Southeast Asian Nations (ASEAN) survey on aging, most older (aged 60 and over) Filipinos rated their health as 'good' or 'fair', with only 11% rating their health as 'bad'. Data from the 1990 population census indicated that 3.9% of older Filipinos were disabled. Of those who were dis- abled, the majority were deaf, blind, or had an orthopedic handicap (Figure 2). There was a noticeable gender difference in the prevalence of blindness (21.1% of disabled women and 16.3% of disabled men). Despite the relatively small overall figures stated above, the gap between the existing health care needs of older Filipinos and actual health care utilization is not inconsequential. In 1984, 16% of the ASEAN survey respondents said they needed to consult a doctor but

AGING TRENDS - THE PHILIPPINES 111

did not do so. More than half (54%) stated that the reason they did not seek medical attention was that it was too expensive to do so (Domingo et al. 1994). As both the level of life expectancy and the size of the older population rise, the health care needs of older Filipinos are likely to place an increasing strain on the existing health care system and on the private resources of families.

W Mental Illness M

w Multiple Disability M

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II F, Orthopedic Handicap W "6 M

Blindness W M

Deafness W M

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Figure 2.

5 10 15 20 25

Percentage

I m Men • Women I

30

Prevalence of 5 major disabilities among disabled Filipino elderly: 1990.

EDUCATION, WORK STATUS AND INCOME

The projected educational attainment of the elderly population is linked to the ability of succeeding generations to support themselves in old age, as well as to the kinds of demands they will place on health services. In 1980, 67% of men and 76% of women aged 60 and over had less than a primary school education. By the year 2020, this proportion is projected to be less than 30% for both men and women (Table 2). The proportion with a secondary school education or more in 2020 is projected to be about one-third for older men and women. Hence, succeeding generations of the elderly will be better-educated as well as more gender-equal in terms of educational attainment. This should have far- reaching consequences for gender differences in the need for economic support among the elderly as more educated cohorts of women age. The diminishing education gap between succeeding cohorts of elderly men and women will also shape the nature of gender relations within the family (see Mason 1992).

Census data from 1990 show that 66.5% of men and 28.5% of women age 60 years and older were in the formal labor force. This is reflected in gender differ- ences in sources of financial support: fewer older women than men receive money from current jobs or pensions, while many more receive money from their adult children (Domingo et al. 1994). Sources of income of the older popu- lation also vary by urban and rural residence (Figure 3). Earnings from farm or

112 A.E. BIDDLECOM AND L.J. DOMINGO

Table 2. Estimated and projected educational attainment of Filipinos aged 60 and over: 1980 to 2020 (In percent)

Sex Educational Year attainment

1980 1990 2000 2010 2020

Males

Females

Less than primary school 67.2 57.9 46.4 36.7 29.2 Primary school 20.6 24.6 30.4 34.9 36.3 Secondary school or more 12.2 17.5 23.2 28.4 34.5

Less than primary school 75.9 67.2 53.4 39.6 28.2 Primary school 16.5 20.9 29.2 36.2 38.4 Secondary school or more 7.7 11.9 17.4 24.2 33.4

Source: Christenson & Hermalin (1991).

other agricultural production are important sources of income for older rural Fi l ipinos (65%), while money from children and from pensions are much more common sources of income for their urban counterparts (60% and 23%, respec- tively). Whi le social security benefits and pension schemes have been in exis- tence in the Philippines for a number of decades, they cover less than 10% of elderly adults and virtually exclude those who farm (Domingo et al. 1994).

FAMILY SUPPORT

Financial assistance from family members is indeed an important source of support for many elderly Filipinos. Another major form of family support is

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60

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I U

I I I I

Ii I II II o I II I

fo R U R

o R U R U

None Earnings Earnings Savings Earnings Monet Pension from from from farm/ from

current job spouse's other children current job agriculture

Sources of Income

I • RURAL •URBAN I

Figure 3. Sources of income among Filipinos aged 60 and older, by place of residence: 1984. R = Rural; U = Urban.

AGING TRENDS - THE PHILIPPINES 113

coresidence. In 1988, 68% of adults aged 60 years and older lived with at least one child while only 4% lived alone (Domingo & Casterline 1992). Care must be exercised in interpreting patterns of family support from living arrangements data, since exchanges often are complex in nature and take place across house- holds. Of the elderly living with children, more than half give some form of support to their children, and the majority of those who do not live with children have at least one child who lives nearby (Domingo et al. 1994).

Retirement homes or nursing homes are uncommon and house a very small fraction of the elderly population. As the population ages, the burden on family for caring for the older generation - a generation that will number more and live longer - will rise in the absence of increases in public sources of support. However, adult children may be more able to support their elderly parents given rising levels of educational attainment and smaller average family sizes. These same trends may even lead the elderly of the future to expect less support from family members. The 1993 Philippines National Demographic Survey asked women of reproductive age (15 to 49 years) about their expectations for support in old age. More than half expect to live with one or more children, and more than a third expect to receive financial or material support from children or rela- tives (Table 3). The proportion expecting to rely on family support in old age declines steadily with increasing education. Over 70% of women with no educa- tion expect to live with a child, versus 43% of women with more than a sec- ondary school education. These data suggest that rising levels of education of succeeding elderly cohorts may make family support more strongly related to the needs of the elderly and less related to custom.

Table 3. Type of support expected from adult children, by education of resondent: 1993

Educational attainment Type of support expected from adult children** Co-residence Money or material goods

No education 71.1% 54.9% Primary 66.1 44.8 Secondary school 55.7 35.3 Higher education 43.2 23.8 Total 55.7 35.6

Note: Respondents are women of reproductive age (15 to 49 years old). ** All questions were asked of repsondents with respect to when they become old. The question on money and material support also referred to support provided by relatives. Source: 1993 Philippine National Demographic Survery [National Statistics Office (Philippines) and Macro International Inc.].

Article XV, Section 4 of the Philippines Constitution explicitly acknowledges the duty of the family to take care of elderly members. The relatively small size of the present elderly population in the Philippines ensures that elderly issues are not high priority vis-h-vis major government initiatives or resources, and that family care will continue to be the primary form of support for the needs of the

114 A.E. BIDDLECOM AND L.J. DOMINGO

elderly. However, given the existing economic strains on family resources, the economic self-sufficiency of the Philippines elderly is likely to become a critical issue.

ACKNOWLEDGMENTS

This report was prepared with the support of a National Institute on Aging Postdoctoral Fellowship, the Population Studies Center at the University of Michigan, and the Population Institute of the University of the Philippines. The authors appreciate the comments of Dr Albert I. Hermalin.

REFERENCES

Christenson, B.A. & Hermalin, A.I. (1991) Comparative Analysis of the Changing Edu- cational Composition of the Elderly Population in Five Asian Countries: A Preliminary Report. Comparative Study of the Elderly in Asia Research Report No. 91-11. Ann Arbor: University of Michigan.

Domingo, L.J. & Casterline, J.B. (1992) Living Arrangements of the Filipino Elderly. Comparative Study of the Elderly in Asia Research Report No. 92-16. Ann Arbor: University of Michigan.

Domingo, L.J., Medina, B.T. & Domingo, M.F.A. (1994) The Filipino Elderly. State of the Nation Reports, Center for Integrative and Development Studies. Quezon City, Philippines: University of the Philippines Press.

Mason, K.O. (1992) Family Change and Support of the Elderly in Asia: What Do We Know?, Asia-Pacific Population Journal 7:13-32.

National Statistics Office (NSO) and Macro International, Inc. (MI) (1994) National Demographic Survey 1993. Calverton, MD: NSO and MI.

United Nations ( 1991 ) The Sex and Age Distributions of Pop ula tions: The 1990 Revision. New York: Department of International Economic and Social Affairs.

United Nations (1993) World Population Prospects: The 1992 Revision. New York: Department for Economic and Social Information and Policy Analysis.

Ann E. Biddlecom The Population Council

Lita J. Domingo Population Institute, University of the Philippines