- The world is ageing rapidly, as a result of both longer life expectancy and declining fertility rates. This represents both challenges and opportunities for societies and governments.
- From 2000 until 2050, the world's population aged 60 and over will more than triple from 600 million to 2 billion. Most of this increase is occurring in less developed countries - where the number of older people will rise from 400 million in 2000 to 1.7 billion by 2050.
- By 2025, an estimated 70% of all people aged 60 and older will live in low- or middle-income countries, where population ageing is also occurring much faster than it did in the developed world. This means that developing countries will have a much briefer opportunity to build the infrastructure necessary to address this demographic trend.
- The ageing of the population represents an opportunity for societies. If older people can retain their health, and if they live in an environment that promotes their active participation, their experience, skills and wisdom will continue to remain a resource for societies. However, most people of very advanced age will need appropriate, accessible and effective acute and long-term care. Developing integrated service delivery models that provide seamless access to the care they require is a priority for both developed and developing countries.
- Inequities experienced in earlier life in access to education, employment and health care, as well as those based on gender and race, determine well being in old age. At the same time, older age often exacerbates pre-existing inequities based on race, ethnicity or gender. For instance, people from low-income households, due to low levels of education and training, often rely on their manual labour to earn a living. As their ability to perform such work deteriorates, finding work becomes harder. They may then take up any work available, at wages that may not meet even their basic needs.
- Data show that women in the Western Pacific Region live longer than men, on average. This, combined with the norm that men marry younger women, makes it more likely for women to outlive their partners and spend their old age as widows. This 'feminization' of ageing leaves many women alone in old age, creating challenges as their health deteriorates. Traditional practices relating to widowhood may result in violence and the abuse of older women, posing a threat to their health and well-being. Older women living alone may not know where or how to negotiate access to health care and welfare services on their own. Further, while women have the advantage of living longer, they are more likely than men to experience disadvantages in access to education, insecure work, food, meaningful work, health care, social security and political power over their lives. These cumulative disadvantages mean that women are more likely than men to be poor and to suffer disabilities in older age.
- Health is a basic human right for all, including older people. Governments, being duty-bearers, need to ensure the social arrangements that can best secure the enjoyment of this right for the elderly, who are commonly disenfranchised in society. Phenomena such as ageist attitudes, neglect, abuse and violence against older persons in various forms contribute to the violation of their right to health.
The fast ageing of populations around the world presents challenges for developed and developing countries. These include:
- Strains on pension and social security systems;
- Increasing demand for health care; for a health workforce trained in old-age care; and for long-term care, particularly in dealing with dementia; and
- Ageism, denying older people the rights and opportunities available for other adults.
These challenges can be counteracted through the following strategic approaches.
Ensuring that older persons have a basic level of financial security
- Tax-funded pensions that provide basic support to vulnerable older people are an effective way of helping them avoid poverty during their old age. These are not unaffordable.
Ensuring that effective health services are available and affordable
- In less developed countries, access to basic primary care, including the early detection and management of common conditions like hypertension and diabetes, can allow older people to maintain their health and capacity to live independently.
- In developed countries, any increase in demand for health care from population ageing is likely to be largely met by economic growth. An integrated continuum of long-term care can support older people to age in place and to provide institutional care for those with severe limitation. Several developed countries have established such systems, but a major challenge will be developing integrated long term care in less developed countries
Maintaining social patterns that influence the well-being of the elderly
- Many changing social patterns are likely to influence both the behaviour and well-being of older people. One common trend during economic development has been for a shift from extended households to more nuclear households comprising one or two generations.
- For example, in Japan, the proportion of people living in 3-generation households has fallen from 46% in 1985 to 20.5% in 2006. These patterns present some challenges for older people. Since older people living alone are less able to benefit from the sharing of goods that might be available in a larger household, the risk of falling into poverty in older age may increase with falling family size.