Care needs of older people - Vietnam and Indonesia

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’]


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

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’.


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


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


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)



Percent distribution of family members who provide most help to older people who currently do not live with spouse, by sex (Vietnam)



To whom older people give support?

15


(3) Care needs for those who perform ADLs (Activities of Daily Life) with difficulty, particularly those at more advanced ages




Source: IFLS 2007

By Age Group By Gender

(4) Isolated, neglected and depressed in family life



% 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

Care needs of older people - Vietnam and Indonesia

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