Ageing and vulnerability in ASEAN countries

Eduardo Klien5th ASEAN GO-NGO Forum, 22 November 2010, Brunei Darussalam

Demographic Shift

• Condensed in time• Irreversible in nature• Comprehensive in scope

ASEAN population

Source: World Population Prospects: The 2008 Revision Population Database, United Nations Population Division http://esa.un.org/unpp/index.asp?panel=2)Compiled by HelpAge

80

60

14

ASEAN population

Source: World Population Prospects: The 2008 Revision Population Database, United Nations Population Division http://esa.un.org/unpp/index.asp?panel=2)

Growth of the old and older old

Source: World Population Prospects: The 2008 Revision Population Database, United Nations Population Division http://esa.un.org/unpp/index.asp?panel=2) Compiled by HelpAge

Population ageing in ASEAN countries

Year60+ 80+

male Female male Female

1990 45% 55% 39% 61%

2015 44% 56% 40% 60%

2050 44% 56% 37% 63%

(%)

http://esa.un.org/unpp/p2k0data.asp

• Reduction of proportion and absolute number of children

• Increase of people over 60 years• Increase of older olds• Feminisation of old age

Challenges on social and economic policy

• How to ensure income security• How to provide adequate Health

services• How to enhance Community care

and inclusion

Dependency ratios (Total, Child, Old-age)

1985 2005 2025 2050

Tota

lChild

Old-age

TotalChild

Old-age

Tota

lChild

Old-age

TotalChild

Old-age

Brunei 68 63 5 47 43 5 41 30 11 51 28 23

Cambodi

a86 80 5 67 62 5 52 44 8 46 31 15

Indonesi

a72 66 6 51 43 8 43 30 13 56 27 29

Lao PDR 91 84 7 78 72 6 56 49 7 48 34 14

Malaysia 74 67 6 56 49 7 48 35 13 53 28 25

Myanmar 78 70 8 50 42 8 46 33 13 55 28 27

Philippin

es82 76 6 65 59 6 53 43 10 51 32 19

Singapor

e42 34 7 39 27 12 55 19 35 78 20 58

Thailand 63 56 7 43 33 10 48 29 19 60 28 32

Viet Nam 83 75 8 55 45 10 44 30 14 58 27 32

Compiled by HelpAge

Dependency ratio in ASEAN

Source: World Population Prospects: The 2008 Revision Population Database, United Nations Population Division http://esa.un.org/unpp/index.asp?panel=2) Compiled by HelpAge

Income security

More consumption than income

Income security

• 21% of older people have formal pensions

• Expansion of contributory pensions: limited option

• Role of non-contributory pensions

Life expectancy after 60 and years of ill health

Health

Ageing and Non communicable diseases

– 75% of the deaths in the region are attributable to NCDs compared to 14% of deaths from communicable diseases

– NCDs represent 92% of the burden of disease (DALYs) in high income countries and 63% in middle and low income countries.

Main NCDs of older peopleAdults Aged 60+

Rank Diseases

123456789

10

Ischaemic heart diseaseCerebrovascular diseaseChronic obstructive pulmonary diseaseLower respiratory infectionsTrachea, bronchus, lung cancersDiabetes mellitusHypertensive heart diseaseStomach cancerTuberculosisColon and rectum cancers

Source: WHO, 2006

Health

• Rethink health systems to cover NCDs• Self-care approaches• Access to health services for older people

(2 approaches to achieve universality)

– Bismark: social insurance

– Beveridge: tax funded free health care

Nursing Home

Home Care Volunteer& family

Difficulties of ADL

& IADL of OP

Cost

of

Care

Community based care Institutional care

Care giving - Continuum of Care

Day Care

PaidHome Care

Short Stay

Home for the Aged

Source: HelpAge Korea

Community care and inclusion

• Older people in work (family care)

• Family and community care for older people

• Inclusion and mainstreaming ageing

• OPA development