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Care Needs of Older People: Evidence from Vietnam and Indonesia
GIANG THANH LONGInstitute of Public Policy and Management
National Economics University, Hanoi, [email protected]
HelpAge Network Asia/Pacific Regional ConferenceRapid Ageing: A Caring Future
7-11 May 2012, Yangon, Myanmar
“The issue of ageing must be at the centre of the global development agenda. Today, the elderly are the world’s fastest-growing population group, and among the poorest. One person in ten is 60 years and older, but by 2050, the rate will be one person in five. We must meet the needs of the older persons who are alive today and plan ahead to meet the needs of the elderly tomorrow. In the developing world, there are almost 400 million people over age 60, the majority of whom are women, and this figure is expected to rise dramatically in the coming decade.”
(UNFPA Former Executive Director Ms. Thoraya Obaid’s address to The Second World Assembly on Ageing in Madrid in 2002)
Contents of PresentationContents of Presentation
1. An Overview of Aging Populations in Vietnam and Indonesia
2. Factors underlying Care Needs of Older People in Vietnam and Indonesia
3. Concluding Remarks
Vietnam and Indonesia are going toward the end of ‘demographic transition’ with lower (decreasing) fertility and mortality rates. Along with higher life expectancies for both males and females, populations in two countries are aging.
1. Aging Populations in Vietnam and Indonesia
CDR
Population growth rate
CBR
Time
Fert
ility
/Mor
talit
y R
ates
It will take only 20 years for Vietnam (2017-2037) and Indonesia (2020-2040) to increase older population (65+) from 7% to 14% of the total population [or moving from ‘aging phase’ to ‘aged phase’]
1. Aging Populations in Vietnam and Indonesia
115
85
73
69
45
45
26
0 50 100 150
France (1986 - 1980)
Sweden (1890 -1975)
Australia (1938-2011)
USA (1944-2013)
England (1930 -1975)
Spain (1947 -1992)
Japan (1970-1996)
27
26
23
22
20
20
19
0 50 100 150
Chile (1998 -2025)
China (2000-2026)
Sri Lanka (2004 -2027)
Thailand (2003 -2025)
Indonesia (2020-2040)
Vietnam (2017 -2037)
Singapore (2000-2019)
Source: Adapted based on Kinsella and Gist, 1995; U.S. Census Bureau, 2005; GSO (2011) for Vietnam; UN (2010) for Indonesia
1. Aging Populations in Vietnam and Indonesia
1. Aging Populations in Vietnam and Indonesia
From macro perspective, a great challenge for both Vietnam and Indonesia in taking (social, economic and health) care of older people is a status of ‘getting old before getting rich’.
1. Aging Populations in Vietnam and Indonesia
0
10 000
20 000
30 000
40 000
50 000
60 000
0 5 10 15 20 25 30 35
% of 60+
GDP/
Capit
a
Japan
Europe
USA
Australia
Korea
Singapore
China
IndonesiaViet Nam
Philippines
Malaysia
Thailand
Source : World Health Statistics 2008 as quoted by Ogawa and Toshihiro (2009)
2. Factors underlying Care Needs of Older People
(1) ‘Feminization of aging’ – care needs of older women and the oldest old.
Marital status of Vietnamese older people, 2011 Single Married Divorced/Separated Widowed Age 60-69 5.6 72.7 2.3 19.4
70-79 3.3 54.9 0.6 41.2 80+ 0.4 37.1 0.5 62.0
Gender Male 1.2 84.3 0.5 14.0 Female 5.4 42.1 1.7 50.7
Source: Calculation from VNAS (Vietnam National Aging Survey) 2011
Marital status of Indonesian older people, 2011 Single Married Divorced/Separated Widowed Age 60-69 1.0 68.4 2.4 28.2
70-79 0.8 49.3 2.3 47.6 80+ 1.1 32.5 2.4 64.0
Gender Male 0.8 84.4 1.2 13.6 Female 1.1 37.1 3.3 58.5
Source: Calculation from Susenas 2011
2. Factors underlying Care Needs of Older People
Percentage of widowed males and females by gender and age, 2009
Age group 60-69 70-79 80+ All Male 5,88 15,73 36,02 13,85 Female 36,97 57,94 81,93 53,69 All 23,04 40,56 66,25 37,12
Source: Vietnam Population and Housing Census 2009
‘Double jeopardy’ – female and widowhood
2. Factors underlying Care Needs of Older People(2) ‘Living alone’ and ‘only older couple’ – resulting from changes in living arrangements and migration.
Living arrangements of Vietnamese older people, 1993-2008 (%)
1993 1998 2002 2004 2006 2008 With children 79.73 74.48 74.27 70.65 63.74 62.61 Living alone 3.47 4.93 5.29 5.62 5.91 6.14 Only elderly couple 9.48 12.73 12.48 14.41 20.88 21.47 With grandchildren only 0.68 0.74 0.82 1.09 1.16 1.41 Other 6.64 7.12 7.14 8.23 8.31 8.37 Total 100 100 100 100 100 100
Source: Calculation from VHLSS 1992/93 – 2008
Living arrangements of Indonesian older people, 1993-2007 (%) 1993 1997 2000 2007
With children 65.80 49.45 48.24 40.13 Living alone 9.63 8.37 7.97 10.97 Only older couple 5.71 5.80 5.53 7.09 With grandchildren only 4.23 2.47 2.54 2.38 Other 14.63 33.92 35.71 39.43 Total 100 100 100 100
Source: Calculation from IFLS 1993, 1997/98, 2000, 2007/08
LIVING ARRANGEMENTS (by location of the nearest child)
12
Same house Nearby Same commune
Same ward
Same district
Same province
More than 90% of parents aged 70-79 and 80+ having at least a child who live in the same commune, and this may show a supply of care for the older people
2. Factors underlying Care Needs of Older People
Source: Vietnam National Aging Survey (VNAS) 2011
Percent distribution of family members who provide most help to older people who currently live with spouse, by sex (Vietnam)
2. Factors underlying Care Needs of Older People
Source: Vietnam National Aging Survey (VNAS) 2011
Percent distribution of family members who provide most help to older people who currently do not live with spouse, by sex (Vietnam)
2. Factors underlying Care Needs of Older People
Source: Vietnam National Aging Survey (VNAS) 2011
To whom older people give support?
15
2. Factors underlying Care Needs of Older People
(3) Care needs for those who perform ADLs (Activities of Daily Life) with difficulty, particularly those at more advanced ages
2. Factors underlying Care Needs of Older People
Source: Vietnam National Aging Survey (VNAS) 2011
2. Factors underlying Care Needs of Older People
Source: IFLS 2007
By Age Group By Gender
(4) Isolated, neglected and depressed in family life
2. Factors underlying Care Needs of Older People
Source: Vietnam National Aging Survey (VNAS) 2011
% feeling depression
Low rates of disability and
illness
Active social participation
Physical and mental activities
HEALTHSOCIAL
ECONOMIC
Successful Aging
Source: Adapted from Rowe and Kahn (1998)
3. Concluding Remarks
• Female and more advanced age older people are more needy of care in various aspects.
• Given changes in living arrangements, which influence familial support, community-based care should be considered/promoted as most feasible alternative.
THANK YOU FOR YOUR ATTENTION
QUESTIONS & COMMENTS ARE WELCOME