Older people in the Asia Pacific
The Asia Pacific region is at the forefront of population ageing and the number of older people is expected to triple by 2050 to 1,265 million. At this point, one in every four people will be over the age of 60. Leading the way will be China, with an estimated 439 million older people. Other countries that will have large populations of older people include Indonesia (74 million) and Japan (45 million). The main reasons for this demographic change are rapidly declining birth rates and longer life spans. In the most advanced countries in the region, life expectancy at birth is over 80 years.
Structural change For the first time in history, older people will form a large segment of many countries’ populations. In Japan, more than 30 % of the population are already over 60. This is expected to grow to over 41 % by 2050. Japan is not alone though – other counties where older people are expected to make up over 35 % of the population include South Korea and Singapore. This phenomenon is not limited to advanced economies; by 2050 older people will also make up significant proportions of the population in developing countries such as Thailand (32%) and Vietnam (31%).
Growth of ‘older-olds’ Another trend is the growth in the proportion of older-olds, or those 80 or older. Within member countries of ASEAN (Association of Southeast Asian Nations), one out of four older people will be over the age of 80 by 2050, while the number of centenarians will at least triple.
Women outnumber men Women tend to live longer than men, with the result there are more older women than older men, constituting the majority (53.5 %) of the population aged 60 or older in the Asia Pacific. In 2012, for every 100 women aged over 60 in Asia, there were just 90 men. The proportion of women also rises further with age. These factors create the so-called “feminisation of ageing”.
Older people’s needs
Population ageing presents challenges societies must adapt to and governments must respond to, for example by adjusting social and economic policies. Older people are often vulnerable, particularly women, many of whom are widowed. Many older women suffer poverty due to disadvantage throughout their lives, including lower levels of education, limited participation in formal work and unpaid care giving work. Three challenges facing older people in the region are income security in old age, access to health services and community recognition and participation.
Income security in old age The proportion of older people living in poverty tends to be higher than the proportion of poor in the general population. Only about 30 % of the older population in the region receives some form of pension. However evidence shows that social (non-contributory) pensions available to older people not only reduce their poverty but reduce intergenerational poverty. For example, pension income is spent on children in the household, leading to significant improvements in their education and health.
Access to appropriate health services Maintaining good health and access to health care is a concern for older people throughout the region. Ageing brings an increased risk of developing chronic disease and disability. Large numbers of older people suffer from non-communicable diseases (NCDs) such as cancer, diabetes, cardiovascular disease and dementia. NCDs are already the single largest cause of both mortality and morbidity in most developing countries. Worldwide, NCDs account for nearly 90 % of the disease burden for the over-60s. The quality and cost of health care is important. Health systems are currently set up to address communicable diseases, rather than chronic conditions. Health systems and the training of health professionals should be adapted to meet the requirements of older people.
Community recognition and participation Older people contribute to their family and community in many ways, both financially and in-kind. They can be found acting as mediators, educators, workers, volunteers, homemakers and caregivers. They are valuable sources of knowledge, history and guardians of culture. Older persons in rural areas often have expert knowledge of traditional farming practices, including ways of coping with environmental shocks and food shortages, which may be crucial for the survival of rural communities in times of crisis. In spite of the growing recognition of the role of older persons in society, there is still a long way to go. Changing support structures combined with migration are gradually weakening traditional informal support provided by family and community. In many areas, older men and women are still seen as dependants and a burden to society. Increasingly, older generations are becoming active in political processes, as well as forming their own community based organisations which enhance equitable and inclusive local development. These organisations, often known as including older people’s associations, help members to access microcredit, business loans and job training. They organise health checks, link to local health services and provide training in community based home care as well as reducing isolation and creating social support networks.
Regional policies on ageing
Maintaining health in old age has been acknowledged as a priority health challenge by the Health Ministers of Member States of the World Health Organisation (WHO) South-East Asia Region. The Yogyakarta Declaration on Ageing and Health, adopted on 4 September 2012, sets out a number of policy commitments to be implemented in each member state. The Association of Southeast Asian Nations (ASEAN) has also recognised that the rapidly ageing population presents challenges to society to adapt social and economic policies. The ASEAN Strategic Framework for Social Welfare and Development (2011 – 2015) is designed to improve the wellbeing of people in ASEAN countries and encompasses a number of initiatives to improve the lives of older people. ASEAN initiatives to improve the lives of older people
|Social pensions for older people||Modest transfers are affordable even in the poorest countries. Each Member State can study the options and costs of establishing or expanding social pensions||Actions: Regional workshop and comparative studyCountry Coordinator: the PhilippinesExpected Results: Better understanding and shared approaches on social pensions in ASEAN Member States and alternative models documented|
|Active and healthy ageing||Non-communicable diseases are largely linked to lifestyle and to a significant extent, preventable||Actions: A conference on health and ageingCountry Coordinator: Singapore and VietnamExpected Result: Strategic approaches responding to the economic, social and other impacts of ageing on health systems would be shared|
|Self-care||Self-care approaches allow older people to extend their span of life in good health or successfully manage chronic ailments. Basic training for family members, community health workers and primary care providers can bring significant extra value for early detection and control of chronic diseases||Actions: Workshop on community based self-care to develop pilot training program, and pilot programmeCountry Coordinator: VietnamExpected result: Government officials and key stakeholders of ASEAN Member States will be engaged throughout the pilot where progress, concerns, research data and other lessons learned will be shared and disseminated|
|Older people’s associations||Harnessing and nurturing the capacities of older people through older people’s associations (OPAs) has proven to be a decisive contribution to development theory and practice. In some Member States, OPAs are already legally recognised||Actions: Regional workshop to discuss best practice approaches and share experiences on the promotion and support of older people’s associations, including supportive national legislationsCountry Coordinators: Cambodia and IndonesiaExpected result: Further support for developing associations of older people in ASEAN Member States would be received|
Regional ageing initiatives
The HelpAge International and the HelpAge network spans seventeen countries in the East Asia and Pacific region, including four country offices and major projects in another six countries. HelpAge International also works at a regional level to build capacity and progress action on ageing issues by bringing people together, building capacity, conducting research and skills transfer.
Asia Pacific Regional Conference on Ageing A key event in the ageing calendar is the biannual Asia Pacific Regional Conference on Ageing, most recently held in Yangon, Myanmar in 2012. This event brings together leading practitioners, policy makers and academics on population ageing and development from over 25 countries to discuss regional priorities and approaches to improving the lives of older people. The 2014 Asia Pacific Regional Conference will be held in Chiang Mai, Thailand in September 2014.
Research and data The availability of data on older people, disaggregated by age and sex, is still limited, however HelpAge is seeking to change this. In partnership with the United Nations Population Fund, HelpAge launched Ageing in the 21st Century: A Celebration and a Challenge, a report which contains quantitative data, the voice of older people and priority actions to maximise the opportunity of ageing populations. Other reports HelpAge has launched in the region include “The Situation of Older Persons in Myanmar” and “The Changing Wellbeing of Thai Elderly”.
Recently, HelpAge East Asia/Pacific has conducted a study to document the existence of data related to ageing issues as provided by surveys of older persons, censuses, and Demographic and Health Surveys (DHS) for 25 low- and middle-income Asia-Pacific countries. This presents a larger view of survey data collection related to ageing issues in the region. The information can be found in Data mapping section.
Policy advice and support for implementation HelpAge actively engages in intergovernmental and UN initiatives to ensure older people’s voices are represented. Recent examples include consultations with ASEAN on implementation of ASEAN Strategic Framework for Social Welfare and Development (2011-2015), input to a World Bank to inform policy discussions on social pensions and participation in intergovernmental meetings on the ten year review of the Madrid International Plan of Action on Ageing.
Capacity building HelpAge is working to strengthen civil society to take a greater role in addressing the challenges of rapid ageing in South East Asia by building the capacity of the HelpAge network to address the concerns of vulnerable older people within the region more effectively. Supported by the European Commission, this initiative encompasses partner organisations in Thailand, Cambodia, Indonesia, Malaysia, Myanmar, Philippines, Laos and Vietnam as well as ASEAN and other regional bodies.
Voice of Older People The Voice of Older People Forum was held in parallel with the 2012 Regional Conference with senior citizens from all over Asia to share their personal experiences and express their views on care in old age. Their message was clear, “Ageing is challenge, but older people are also part of the solution”.
Technical education The annual course on Designing and implementing social transfers was held in Chiang Mai, Thailand in October 2013 with 61 participants, including strong delegations from Ghana, Indonesia and Vietnam as well as participants from AusAID and UNICEF. The course will be held again in Chiang Mai from 6 to 17 October 2014. For more information, please contact email@example.com
Skills transfer HelpAge International leads a skills exchange program between non-government organisations in Asia. Since 2010, over 20 staff have been placed in partner organisations, exchanging skills in project and financial management, resource development, human resources development, communications and advocacy. Six staff are currently on exchange in HelpAge International’s East Asia and Pacific Regional Office, Foundation for Older People’s Development, HelpAge International’s Vietnam office, HelpAge Cambodia, and Coalition of Services of the Elderly.
Resources UNFPA and HelpAge International, Ageing in the 21st Century ASEAN Strategic Framework on Social Welfare and Development (2011 – 2015) HelpAge International position paper: Ageing and the challenge of non-communicable diseases in low and middle-income countries