"It Is Not the Length of Life, But Depth of Life": A Brief Survey of Aging Around the World
Number: 00S08. Issue: Spring 2000
Author[s]:
Jennifer Co and Charity Kirk
Keywords:
Abstract:
At the end of World War II, population growth rates
skyrocketed in the less developed countries (LDCs) of Africa, Asia (with the exception
of Japan), and Latin America. There was
also a relatively small surge in population in some of the industrialized
countries which had experienced a postwar "baby boom" much like the United
States had.
Within the
next 50 years, it is believed that the world will age much more rapidly than
ever recorded in history. This
phenomenon is attributed largely to the fact that, worldwide, fertility rates
continue to decline at the same time that life expectancy continues to rocket
upward. The median age globally has
increased by 2.6 years, from 23.5 years in 1950 to 26.1 years in 1998, and is
projected to increase by another dozen years or so by the year 2050 (Table 1).
Let us
consider a few scenarios currently taking place around the world:
The Dutch government
barred official care institutions from selling special packages to the elderly
promising them that they can ?leapfrog waiting lists or guaranteeing extra
care--at a price.? Government officials
said that ?most of the country?s older citizens already had sufficient care
coverage policies but were being pressured into buying extra packages to make
doubly sure they could get appropriate care when the need arose.?
The
Netherlands have also drawn the world?s attention because of their
controversial policies allowing the legalization of both euthanasia and
physician assisted suicide. Most
countries, and 44 of America?s 50 states ban both. Religion oftentimes plays a significant role in this debate
inasmuch as many of the world?s major religions, including Catholicism,
Buddhism, and Hinduism, strictly forbid euthanasia and assisted suicide.
In South
Africa, the next few years look particularly grim to those concerned about
issues surrounding the elderly, according to the South African Council for the
Aged. The country is projected to
experience a sharp increase in the number of elderly, particuarly among those
that are traditionally the most vulnerable: women and blacks. The AIDS pandemic that is currently raging
through Africa is not about to leave South Africa alone either, with experts
predicting that the disease will take a crippling toll on family care patterns
in the region. The pandemic is expected
to create an overwhelming number of orphans in the region, turning older people
into primary caregivers at the same time that it deprives them of support from
their adult children, the most common victims of AIDS.
However,
with the recent exception of Africa (because of the impact of HIV/AIDS),
practically all nations have experienced and continue to show improvement in
life expectancy. For example, the
National Council on Aging reports that, in Japan, life expectancy at age 60
rose nine years for women and nearly seven years for men between 1950 and 1990.
Europe has
traditionally been the area of the world most affected by the aging
process. As the proportion of elderly
continues to rise in the region, the proportion of those categorized as
children (those aged 15 and younger) declines in size. Of the five oldest countries in the world in
1998 (those countries with the highest proportions of elderly), four of them
are European: Italy, Greece, Japan, Spain, and Germany being the five. The trend is not expected to change within
the next half-century, with Spain and Italy still expected to be the oldest
countries in the world when 2050 rolls around.
The other regions expected to be most touched by aging are, in
decreasing order, North America, Oceania (Australia and New Zealand), Asia, and
Latin America and the Caribbean nations.
In
contrast, Africa is considered to be the youngest major area of the world with
Eastern Africa holding the title as the world?s youngest region and three
African countries at the top of the list of the world?s youngest nations:
Uganda, Zambia, and Yemen. By the year
2050, it is projected that Africa will still have a relatively youthful age
structure, with two children for every older person (those aged 60 and
over). These statistics are, in part,
attributable to the economic maturity of the regions involved.
More developed
regions have, for the most part, reaped the rewards of greater wealth and
greater access to resources. With such
economic advantages, such nations suffer less from the effects of disease and
poverty, which regularly take a toll on citizens of LDCs. For example, it has often been said that,
although 90% of the world?s AIDS sufferers reside in Third World nations, 90%
of the world?s funding set aside for AIDS research and treatment remain with
institutions in developed nations. The
differences between more developed and less developed regions of the world are
reflected in their economic maturity and, in correlation, in their age
structure. More developed regions tend
to have a population that is more evenly distributed across the age intervals
while less developed regions have a significantly larger proportion of their
population under the age of 15. Figures
1 and 2 illustrate the differences in age structures for the two types of
regions.
Even with
this large difference in economic maturity and age structure, life expectancy
worldwide has risen and is expected to continue to rise in every region of the
world. This is attributed to the sharp
decline in premature mortality at the hands of many of the infectious and
chronic diseases catalogued over this past century. Global improvements in sanitation, housing, nutrition, and
medical innovations, including vaccinations and the discovery of antibiotics
have all contributed to the steep increase in the number of people reaching old
age. Although many of these innovations
have come about in developed nations, technology transfer allows such
information to be spread worldwide, a process made even more feasible with the
recent boom in communication efficacy.
Additionally,
these marked increases in life expectancy have occurred simultaneously with
equally substantial declines in fertility rates on a global scale, a phenomenon
attributable to the advent of modern contraceptive methods. With the increase in the elderly population
and the decline in the younger community, it is not inconceivable that we are
witnessing the progressive aging of the world.
This trend by which more and more people live to reach older age while
fewer children are being born is commonly referred to as ?population
aging.? It is been particularly rapid
in developing nations.
The
developed nations of the world have, for the most part, been at the forefront
of the process of population aging since it first began at the turn of the 20th
century. Less developed countries have
traditionally experienced slower growth in their aging populations, but have
recently been ?catching up? to their more developed counterparts. Figure 3 illustrates this point, with the
trends converging in more recent years.
Social
perceptions of the value and benefits of old age vary in different
cultures. Western society, with its
emphasis on the individual and the individual?s rights, has traditionally
harbored negative stereotypes of the elderly.
Although this is not universally the case in all Western communities, it
has been made apparent that youth is valued above old age. More often than not, our highest paid
entertainers are young or have spent a great deal of money in attempting to
stay and look young. Retirement is
oftentimes enforced in favor of ?young blood?; grandparents are often sent off
to retirement homes and, as the stereotype goes, forgotten; and the image
projected over and over again in books, television, and the silver screen, is
that of an old, sexless, man or woman playing bingo and wearing ?ridiculously
outdated? clothing.
In many
African and Asian countries, however, words which describe older people
characterize them as ?someone with knowledge.?
Again, this kind of idealistic look at the elderly is not universal in
these regions of the world. In some
cultures, these traditional values are in danger of being eroded due to the
increasing influence of Western culture in this era of rapid global
communication. In general, however, the
elderly in these regions are respected for having experienced a great deal of
life and for the ?mere? achievement of having survived as long as they have in
the less than ideal conditions of these traditionally less-developed
regions. The idea of community and
socialism also tend to pervade such regions, lending even more impetus to the
idea of revering one?s elders.
Population
aging has increasingly drawn the attention of the international community,
leading to the creation of several global organizations that support and
promote the idea of healthy and successful aging. The groups provide resources and information on many different
aspects on aging including health and public policy issues.
The global
community is beginning to create organizations that focus on issues surrounding
aging and the elderly. The World Health
Organization created an Ageing and Health Programme in April of 1995. It replaces the previous program on Health
of the Elderly (1979-1995) and incorporates the following perspectives:
* life course
(elderly people are not to be
compartmentalized
but are part of the
life
cycle); health promotion (with a focus
on healthy
aging/aging well);
* cultural (the
settings in which individuals
age
determine their health status in older
age);
* gender
(differences in health as well as
behavioral
and societal attitudes);
*
inter-generational (with emphasis on
strategies
to maintain cohesion between
generations);
and
* ethical (multiple
considerations emerge as
populations
age: e.g. undue hastening or delaying of death; human rights; abuse).
Additionally,
the Geneva International Network on Ageing (GINA) was launched on October 1,
1996 as an initiative of the World Health Organization (WHO), the Swiss
Research Programme on Ageing (PNR32) and the American Association for Retired
Persons (AARP). GINA is a flexible,
informal and interdisciplinary framework for organizations and their
representatives interested in the many different aspects of aging.
The United
Nations? Principles for Older Persons (Resolution 46/91) provide the conceptual
basis for the establishment of GINA through their emphasis on:
* maintenance of
independence and autonomy;
* integration and
participation in a society for all
ages;
* human rights and
dignity for all;
* the highest
possible level of physical, mental
and
spiritual well-being.
GINA?s first activity was the celebration of the
International Day of Older Persons (October 1, 1996) in Geneva in accordance
with the 1991 United Nations Resolution.
Since then, GINA?s work has largely focused on preparing activities
towards the International Year of Older Persons 1999, an occasion for the world
to celebrate aging, not only one of the greatest achievements of the 20th
Century, but also one which presents both challenges and opportunities for the
next millennium. One of the most
important challenges the world faces in the 21st Century is responding to the
economic, financial and social implications of the changing demographics in our
aging societies.
References:
Eads, Brian. "A License to Kill." Reader?s Digest:
September 1997.
Merrick, Thomas W. "World Population in Transition."
Population Bulletin: May 1991.
United Nations 1998 Revision of the World Population
Estimates and Projections. http://www.popin.org/pop1998/8.htm.September 25,
1999.
Aging World.com. http://www.aging-world.com/. October 11,
1999.
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