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  Ageing in Asia: The growing need for social protection  

Table of Contents 
Executive summary 

Foreword 

Abbreviations 

Part 1. Introduction 

Part 2. Population ageing worldwide 

The aged in Asia and other regions 

Global 'dependency ratios' 

A growing proportion of the aged is very old 

Sex ratios of the elderly 

Implications of demographic shifts 

The aged in Asia today 

Health status and capacity 

Living situation 

Economic activities 
 

Part 3. Ageing and developments in social protection in Asia 

Ageing in the context of social and economic change 

Development and population ageing are connected 

Retirement trends 

The changing Asian family system 

Limit to family support; growing collective provision 
Supplementing family support 

Approaches to collective economic security 

Social assistance schemes 

Provident funds 

Social security 
 

Part 4. Policy issues and options for the aged 

Helping the elderly poor 

Poverty and declining work opportunities for the aged 

Poverty: Loss of family support 

The aged without spouses 

The childless 

Migration of family members 

When the family cannot provide support 

Social protection: What mix of programmes? 

Living options: Meeting the needs of changing life circumstances of the aged 

It's not a choice between family and government support 

Institutional versus at-home living arrangements 

The 'crisis' of population ageing 

Executive summary

Most countries in Asia have a relatively young population at present. By 2025, however, the majority of the elderly in the world will be living in Asia. Several Asian countries will experience a rapid change from young to old in their demographic structure. What are the consequences of the change? Is the reliance on strong family structures, in which it is considered a duty and a privilege to take care of the aged in the family, sufficient to cope with the increasing numbers of the elderly? What is happening to the elderly today? Which are the social protection measures presently in place? What are the issues that need to be tackled when a large part of the population  is older? What are the policy options?

The study provides an overview of the demographic changes taking place in Asia and raises a number of important issues related to the growing proportion of the elderly population. Based on the study, ILO member states and workers' and employers' organizations should be able to review their social protection schemes in order to minimize the hardships of the elderly.
 

Foreword
 

This study is the outcome of efforts by the ILO to address the consequences of the rapid demographic changes predicted for most Asian countries. Given the amount of alarmist writing on population ageing, there was a clear need to take a closer look at available information. The book examines a wide range of concerns regarding the growing number of the elderly in Asia, but the focus is on the topics that are at the core of the ILO's mandate: employment and social protection.
 

Clearly the ageing of the population results from successes in the overall development process in Asia. Population growth has slowed down, fewer children are born but with a higher chance of survival, and people live longer and healthier lives. However, a number of major issues arising from this positive trend need to be carefully considered as countries 'age'. The social partners should be aware of, anticipate, and develop policies to deal effectively with these issues. The publication provides a starting point in evolving such a strategy.
 

The study has been prepared under the technical responsibility of Mr. Sjoerd Pieter Hoekstra, Associate Expert on Social Security, ILO/EASMAT. We would like to thank Mr. James H. Schulz, Professor of Economics and Kirstein Professor of Aging Policy, Policy Center on Aging, Heller School, Brandeis University, Waltham, Massachusetts, United States, who drafted the document and shared his ideas and knowledge in his capacity as ILO consultant.

 

  We hope the publication will contribute to a better understanding of the issue of ageing in the region.             William R. Simpson Director ILO East Asia Multidisciplinary Advisory Team (ILO/EASMAT)

Bangkok

February 1997

Abbreviations
 

ASEAN     Association of South-East Asian Nations

AWPS      Agriculture Workers' Pension Scheme, Kerala, India

ESCAP     United Nations Economic and Social Commission for Asia and the Pacific KDPS      Kerala Destitute Pension Scheme, India WHO      World Health Organization

 
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 Introduction
 

The population profile of the world in the future poses a daunting problem to many people today. The world of many children, short lifespans, and little time for leisure and recreation is disappearing. In its place is a new world of fewer children, longer lifespans, and a more relaxed retirement. This is generally characterized as the 'ageing of populations'.
 

Described this way, however, the new world does not seem to be too alarming. In fact, Kerschner mentions " ... in recent years ... the ageing of the world has been viewed by many as a reason for celebration. Global aging is widely heralded as the public health success story of the 20th century."(1) Increasing numbers of people born throughout the world will survive the childhood diseases and disabilities that ravaged their predecessors. They can look forward to life expectancies that no one dreamed about centuries ago. And they can expect to live long enough to reach a period of life when the demands of full-time work can give way to the leisure and retirement opportunities of what are often called the 'golden years'.
 

But both individuals and governments are very worried. Individuals know that even in relatively prosperous countries older people all too frequently face age prejudice, a waste of their experience and productive capacity, poverty, and loneliness. And governments today fear the potential breakdown of traditional support networks and the rising costs of pensions and health care as populations grow older. For example, a recent report by the World Bank is called Averting the old age crisis: Policies to protect the old and promote growth.(2)
 

Certainly, important demographic changes associated with ageing (and other age-related changes) are taking place all over the world. Whether they are likely to create crises in many countries is a matter of dispute. Publications on the matter tend to be long on rhetoric but short on data analysis. There are never-ending presentations of basic demographic data since a large amount of such data is available for almost all countries. The data provide details of the composition of national populations and how they are evolving over time. But in trying to interpret future trends, very little information can be found that directly addresses socioeconomic ageing issues arising throughout the world. This dearth of information is especially severe for developing countries.
 

The situation for Asia is no exception. Almost every publication on ageing begins with a review of demographic data. Little else in the way of empirical information is presented, especially in terms of comparative data (except for a few studies for some countries). Even in-depth studies of particular countries are few and far between.
 

Ignoring this lack of data, writers continue to describe the crisis that they think will soon confront many countries of the world as they struggle with problems of population ageing. Their assertions are based primarily on projected ratios of older persons to the working population - a measure that has little economic content (measuring the proportion of people, not economic data like production and economic output, or its distribution among various groups in the population).
 

This publication does not attempt to address comprehensively the potential 'burden of an ageing population' that is currently the subject of considerable debate. Rather, it focuses on the changing characteristics of the ageing situation emerging in Asia and presents the major issues that need to be carefully considered as countries 'age'.
 

The issues, problems, and challenges are many, but future prospects do not seem as bleak as they are made to appear. As pointed out by Susanne and James Paul in Humanity comes of age:(3)
 

"The future need not be a cruel struggle for limited resources as pessimists predict. Greater human dignity and social development are attainable in the years ahead, especially if all can contribute to the process. But that transition will not be easy or automatic. Great population shifts will require new approaches to employment, housing, health care, income support and social services. We need

to consider how decent lives can be constructed with and for older persons under these new conditions, especially in the poorest countries where resources will be scarcest. Long life must be reinvented to overcome illness, poverty, powerlessness, loneliness and isolation, to become an affirmation of human experience."
 
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Population ageing worldwide
 

The ageing of populations(4) is now a global phenomenon: manifest in several parts of the world, incipient in the rest. In demographic terms, the population

is said to be ageing when the proportion of people in the older age range increases, and the share of children and youth decreases, resulting in an ascending median age. In 1950, there were about 200 million persons aged 60 and over in the world, constituting 8.1 per cent of the total global population. By the year 2050, there will be a ninefold increase; the world's elderly population is projected to be 1.8 billion people, about 20 per cent of the total 9.8 billion people (figure 1, page 5). The median age of the world population will jump from 23.5 years in 1950 to 36.2 years in 2050 (figure 2, page 6).
 

Populations age in two ways: as a result of changes at the base of the age pyramid or at its apex. When the proportion of older persons increases as a result of a decline in fertility, there is a commensurate decrease in the proportion of young persons; this is ageing at the base of the age pyramid. Changes at the apex of the age pyramid occur with lower mortality rates among older persons. Thus, demographic transition begins when there is a secular change from a regime of high fertility and mortality to one of low fertility and mortality.
 

Irrespective of the pace of change, the demographic transition seems inevitable. The population dynamics of different countries and regions have their own particular idiosyncrasies, but all their age structures have been following, and are projected to follow, the course of demographic transition. Thus, in the developed regions of the world, the transition has already taken place. Very low levels of fertility and mortality have occurred. The resulting populations are considerably older than in other parts of the world and are projected to become even older.
 
 

Figure 1. World population, 1950-2050
 



Of the developing regions, many countries in Asia and Latin America and the Caribbean are now in the midst of demographic transition. In the 1950s and 1960s, the age structures of a majority of these countries became younger. Then, in the early 1970s, the impact of a substantial fertility decline reversed the trend. Since then their populations have been ageing rapidly and the trend is projected to become stronger.

.

In 1950, there were about 200 million people above 60 years of age in the world, evenly distributed between developed and developing regions. By 1975, there were about 340 million elderly people with a similar distribution. Projections, however, indicate that a definite change in pattern is occurring. By 2000, the total world elderly population will be about 600 million, with about two-thirds living in developing regions.
 
 

Figure 2. Median age in Asia and the world, 1950-2050
 



In 2025, the absolute number of the elderly will double to about 1.2 billion. A large majority of them - 72 per cent - will be living in developing regions. Thus, in the 75 years between 1950 and 2025, the elderly population of the world is projected to grow sixfold - double that of the total world population, which will only have tripled by that time. Within this wide demographic picture there are three important trends which have major policy implications: the increasing dependency ratios of youth and the elderly; the growing proportion of the very old; and the larger number of older women compared with older men.
 

The aged in Asia and other regions
 

The regional distribution of the population aged 60 and over reflects the growing tendency of the world's elderly to be concentrated in developing regions. The proportion of the world's ageing population was evenly distributed between developing and developed regions from 1950 to 1975 (figure 3, page 7).
 

Figure 3. Population over 60 years of age, by region, 1950-2030



By 2025, as indicated above, 72 per cent of the elderly - about 858 million people - are projected to be living in developing regions. Disaggregating these data further reveals the trend more clearly. If 1985 and 2025 are taken as two years of reference to consider the proportions of the total elderly population in different regions, it will be seen that Asia had 28 per cent of the total in 1985 but the proportion will increase to 58 per cent in 2025. Comparative figures for other regions are: Europe, 25 and 12 per cent; North America remains 7 per cent; Latin America and the Caribbean, 6 and 8 per cent; Africa, 6 and 8 per cent; Oceania, less than 1 per cent (figure 4, page 8). In terms of proportions of the whole, therefore, developed regions will have less of the world's elderly, with an actual decline in Europe. Developing regions, by contrast, will have an increasing share of the world's elderly, with proportional increases in Asia, Latin America and the Caribbean, and Africa. Table 1 (page 9) shows the proportion that older age groups represent of the total population in various Asian countries in 1990. The proportion aged 65 and over varies from a high of about 12 per cent in Japan to a low of 3 per cent in Bangladesh and Indonesia.     Figure 4. Proportion of population over 60 years of age, by region, 1985 and 2025