Ageing in the Western Pacific Region
Old age dependency ratios
- The old age dependency ratio varies widely across the Region, from 35.5 in Japan to 4.8 in Papua New Guinea (2010 figures). These ratios are increasingly rapidly, and are projected to quadruple by 2050.
- These ratios show a rapidly growing older population and shrinking younger population and imply the need for a greater share of the contribution of the economically active age group (15-59 years) to be allocated to meet the needs of the growing older population.
The health of older persons in the Region
Mortality in older people
- Cardiovascular disease, malignant neoplasms (cancer), and respiratory disease rank highest among the 10 leading causes of mortality, for both men and women aged 60 years and above. Cardiovascular disease alone accounts for 46% of all deaths among both older men and women. This holds true for countries across all income levels.
- Cancer mortality rates are much higher for men than women, by about 30-50%. Lung, stomach, and liver cancers pose the biggest threat to older men, especially in the low- and middle-income countries. In high-income countries, colon and prostate cancer are also major causes of death.
- Women tend to suffer and die from lung, breast cancer, and colon cancer. However, in low- and middle-income countries, cervical cancer, along with stomach and liver cancers, ranks among the major causes of mortality for women.
Morbidity and disability in older people
- Cardiovascular disease, malignant neoplasms (cancer), and respiratory disease also rank highest among the leading causes of morbidity for people aged 60 years and above. Unintentional injuries, which include falls, rank close after these.
- The number of people living with disability steadily increases with population ageing. Because women tend to outlive men, disproportionately high numbers of older women live with disability.
- Notably, older people often have two or more concurrent health problems, which contribute significantly to increased disability. This is turn has profound effects on quality and enjoyment of life.
- Vision and hearing loss are increasingly likely in older age. In the Region, 44% of people aged 60 year and above experience vision loss, with 10% becoming blind. Ninety-three percent of those with vision loss in the Region live in low- and middle-income countries.
- Hearing loss occurs among 26% of the older population, with 25% of these experiencing severe hearing loss or deafness. Similarly, 80% of those with hearing loss in the Region live in low- and middle-income countries.
- Seventeen percent of people aged 60 years and above in the Region suffer from depression. Older women are more likely to experience depression. However, older men have higher rates of suicide attempt and success.
- Although Region-specific figures are not available, the maltreatment of older people, especially women, appears to be a common phenomenon across the Region. WHO estimates that between 4 and 6% of older people worldwide face some form of abuse.
- Older people, especially those with disability or co-morbidity, increasingly become dependent on others and thus vulnerable to abuse. This can be physical, verbal, psychological/emotional, sexual and/or financial in nature and have severe consequences for health and well-being.
- Formal workforce participation among people aged 60 years and above varies widely across the Region. In general, low- and middle-income countries report much higher workforce participation rates among older people than high-income countries.
- At 61% for men and 47% for women, the highest workforce participation rates for those aged 60 and above in the Region are found in Solomon Islands. In contrast, the corresponding figures for Australia are 7% of men and 2% of women.
- Formal workforce participation rates also vary significantly by sex. In the Region as a whole, the rate is three times higher for men than women among the older population.
- Factors such as the predominance of women in the older population, their higher incidence of widowhood, their lower workforce participation rate, and the over-representation of women in informal, lower-paid and more insecure forms of work, combine to put older women in a particularly vulnerable position.
- Literacy rates vary widely among older people across the Region. Compared to high-income countries, literacy rates are much lower in low- and middle-income countries, although they are generally increasing. People aged 60 years and above have higher literacy rates than those aged 80 and above.
- Similar to workforce participation, literacy rates show a clear gender gap. Across the Region, older men have higher literacy rates than older women, and the gap is widest in low- and middle-income countries.
- A far higher proportion of men than women in the Region are married in older age. On average, 78% of men aged 60 years and above are married, compared to only 48% of women in the same age group.
- This difference is mostly due to the fact that, on average, women live longer than men. Thus women are more likely to outlive their partners. In addition, the difference reflects the fact that men tend to marry younger women. Furthermore, widowed men tend to remarry more often than widowed women.
- Therefore, there are disproportionately higher shares of widowed women among the population aged 60 years and above, and more so among the oldest old. Since women’s education, labour force participation rates and earnings in earlier life are lower than those for men, on average, widowed women face a significantly higher risk than men of dependency, isolation, neglect, and poverty during old age.