Handbook of Asian Aging

Hyunsook Yoon, Jon Hendricks

• Publisher: Routledge
• Year: 2018
• Topic: Social Sciences
• eBook ISBN:
  9781351844086
• Subtopic: Mental Health in Psychology
• Index: Social Sciences

In western countries, the rising tide of population aging took 100 years to alter the face of societies, but Asia is experiencing comparable changes in not much more than a quarter of a century. Contributors to "The Handbook of Aging" describe the magnitude of these changes and their effects on the aged and on societies attempting to adapt to the dramatic improvements in life expectancy brought on by rapid economic and social transformations. Asia encompasses a vast reach from Pakistan and India to Japan, the Philippines, and Indonesia, and in this book including Australia. "The Handbook of Aging" provides a framework for making sense of the meeting between reverential views of the elderly and contemporary priorities as Asia arrives at the crossroads. The need for innovative approaches to social policy and personal practices is nowhere more evident than in Asian countries, where modern marketing economies have forced hard political choices. The economic tigers of the Asian-Pacific region experienced the aging of their populations ahead of other Asian countries, but solutions reached during times of financial boom are being re-examined as economies come back to earth, with soft or hard landings. "The Handbook of Asian Aging" provides an atlas of the far-reaching changes that are afoot and that will become even more pronounced in the near future.

PART 1

Asian Aging in Social Context

CHAPTER ONE

Demography of Aging Across Asia

Andrew Mason, Sang-Hyop Lee, and Gerard Russo

The year 2000 was a demographic watershed in Asia. After a century of growth, the number of children in the region peaked in 1999 and, with the turn of the millennium, has begun a slow, gradual decline. At the same time, mortality has dropped dramatically across the region. Three phenomena—the enormous, sustained baby boom that characterized the 20th century, the decline in fertility that will characterize the 21st, and the continuing, steady decline in mortality— all have major implications for the size and the age structure of Asian populations.

All across Asia, the proportions of older adults ages 65 and older in national populations are expected to grow rapidly over the next 50 years. This process of population aging is already clearly visible in the economically advanced countries of East Asia. Population aging is beginning in the Southeast Asian countries that have successfully increased life expectancy and reduced fertility, and can be anticipated even in the South Asian countries where the number of children today is still high. Population aging will present many challenges—such as providing healthcare for the elderly, assuring economic security for the elderly, and sustaining economic growth—to the societies and economies of Asian nations, and this demographic trend will have a sustained and irreversible impact on the nature of the support system on which the elderly rely.

AGING AND POPULATION CHANGE

Population aging began in Asia during the 1970s. Before then, rapid growth in the number of children was producing a younger population. Between 1950 and 1975, the percentage of the Asian population ages 15 and younger rose from 37 percent to 40 percent and the median age for the region dropped from 21.9 to 19.7. By the mid-1970s, this trend had reversed itself. Growth in the number of children slowed relative to the numbers of working-age adults and elderly (Figure 1). By 2000, if U.N. values are accurate, children accounted for only 30 percent of Asia’s population, and the percentage of Asians who were working age had risen to 64 percent. The proportion of older adults in the population had increased gradually from the 1970s to 2000 and will continue to rise for the foreseeable future. By 2050, 17 percent of those living in Asia are expected to be age 65 or older; 19 percent will be younger than 15; and 64 percent will be between the ages of 15 and 64. The median age will have reached 39 (United Nations [U.N.], 1999, medium projections).

Figure 1. Asia’s age transition.

More detailed snapshots of Asia’s projected age and sex structure are provided by the age pyramids for 2000, 2025, and 2050 shown in Figure 2. The age pyramid for 2000 is similar to those found in other relatively young populations. There is a broad base consisting of large numbers of children and a narrow top consisting of smaller numbers of older adults. In the past, new cohorts of ever-increasing size entered the population, enlarging the base. In the future, however, the base of the age pyramid is expected to remain stable while population growth will be concentrated at older ages.

The relative stability of Asia’s young population is already apparent among the youngest age groups. In 2000, the 0-to-4-year-old cohort and the 5-to-9-year-old cohort have essentially the same population size, and neither cohort is as large as the 10-to-14-year-old cohort. In the future, entering cohorts are projected to be of similar size or somewhat smaller than preceding ones. The major demographic phenomenon will be a “filling out” of the pyramid at older ages. As this occurs, all but the oldest cohorts are projected to stabilize at around 300-350 million people per five-year age group. Between 2000 and 2025, 99 percent of Asia’s projected population growth is accounted for by those ages 30 and older and only 1 percent by the population of those under the age of 30. By contrast, individuals ages 30 and younger accounted for 70 percent of the population growth between 1950 and 1975 and nearly 40 percent of the growth between 1975 and 2000.

Figure 2. Age pyramid for Asia, (light gray = females, dark gray = males.)

Figure 3. Population of Asia, 1950–2050.

The changes in Asia’s population are being driven by three interrelated demographic phenomena. The first is a sustained “baby boom” that produced the largest cohort of youth in the past and, possibly, in the foreseeable future. The baby boom led to accelerated growth in the number of children between 1950 and the late 1970s and more modest growth until 1999. The second demographic event is the emergence of relative stability in the number of children in the population. After more than a century of growth, the number of children in Asia is expected to begin a period of very slow, sustained decline. The third demographic event is the shift in the region’s mortality rates. Life expectancy at birth increased from 41 years in the early 1950s to 60 years by the early 1980s and is projected to reach 68 years in 2000-05.

The impact of these events on the age structure of the region is traced out in Figure 3, which charts Asia’s population from 1950 to 2050 separately for 15-year age groups. This representation of age structure is advantageous in that it facilitates following cohorts over time. The impact of the baby boom is evident in the accelerated growth of the child population, those ages 0-14, between 1950 and 1980 and more gradual growth during the last two decades of the 20th century. The child population more than doubled in size, increasing from about 500 million in 1950 to about 1.1 billion in 2000.

Asia’s baby boom was different than the post-World War II baby boom that occurred in the United States and many other Western countries. The Asian baby boom was much longer lasting and occurred for different reasons: The Western baby boom resulted from an increase in rates of childbearing, whereas Asia’s baby boom primarily resulted from a decline in infant and child mortality.

The Asian baby boom had an enormous impact on the age structure of the population, and its effects will continue well into the 21st century. The first group of baby boomers reached young adulthood in 1965, and in 1995 reached 45 years of age. This means that in the next few decades, the most rapid growth in Asia’s population will be among those in the prime working ages (30-59). Growth in the older adult population will accelerate beginning in 2010, when the first baby boomers turn 60.

The future age structure of Asia will be influenced by the near stability of future cohorts of children and by the rapid growth of the baby boom generation. The year 2000 produced a generation of children in Asia, the Y2K generation, that is smaller than the preceding one. As this generation ages, growth in the number of young adults and prime-age adults will stabilize and possibly begin to decline.

Concurrently, the baby boomers will continue to enlarge the absolute and relative numbers belonging to older age groups. The impact of continuing changes in mortality on age structure is less apparent in Figure 3 than changes in the size of cohorts of children. However, declining mortality at older ages will have an important impact. As life expectancy rises in the future, the gains in survival rates will be increasingly concentrated at older ages. As a consequence, older age groups grow more rapidly during their high-growth period than do younger age groups. Likewise, once growth ceases older cohorts decline somewhat more gradually than do young cohorts. Thus, declining mortality in the future will reinforce the shift to an older population.

In percentage terms, the older adult population will be the most rapidly growing segment of Asia’s population during the first half of the 21st century. The average annual rate of growth for the population ages 60-74 is projected at 2.9 percent and that of the population ages 75 and older, at 3.4 percent. By contrast, the population ages 0-14 is projected to decline at an annual rate of 0.2 percent, the size of the population ages 15-29 is projected to remain essentially the same from 2000 to 2050, and the populations of the 30-44 and 45-59 age groups are projected to increase at 0.5 percent and 1.5 percent annually, respectively.

The aggregate patterns for Asia are dominated by the region’s two most populous countries, China and India. However, the general trends and demographic forces that are influencing regional trends are also operating in other Asian countries. The speed and timing of population aging will vary considerably among the countries in the region. In general, the countries of East Asia are furthest along in the aging process, followed by Southeast Asia and then South Asia. Japan and Singapore have the oldest populations in Asia. Among Asia’s major countries, Pakistan has the youngest population (as measured by median age in 2000). There, 42 percent are under the age of 15 and only 5 percent are ages 65 and older.

For projection purposes, in this study we will take a more detailed look at seven Asian countries in each subregion. They include the Philippines, Thailand, Indonesia, India, Japan, Korea, and Bangladesh, which are at various stages of demographic transitions. Detailed data on other countries can be found in two recent surveys by the East-West Center (2002) and by Asian Development Bank (Mason, 2002). Aging measures for these study countries examined in detail in this chapter are reported in Table 1.

PROJECTED GROWTH OF THE ELDERLY POPULATION AND THE LABOR FORCE

In this section we present population and labor-force projections recently prepared by the United Nations (U.N., 1999) and the International Labour Organization (ILO, 1996).

Population Projections, 2000-2050

This section makes detailed use of population projections from the United Nations (U.N., 1999). Any population projection is based on a set of assumptions about long-range trends in demographic variables. The reality that emerges during the coming decades may differ considerably from projected values depending on a variety of social, political, economic, and demographic forces. Political instability, new rounds of economic crisis, the emergence of new infectious diseases, and the increasingly rapid spread of HIV/AIDS could lead to substantial, unanticipated deterioration in mortality conditions and depressed levels of fertility. More optimistically, medical breakthroughs could lead to a substantial extension of life and more rapid increases in life expectancy than anticipated. The future course of fertility is very uncertain. How low fertility will decline, how long it remains at subreplacement levels, and whether new baby booms will occur are primarily a matter of speculation.

Table 1. Summary Measures of Aging for Asia, Major Subregions, and Seven Asian Countries

Note: All data employ the medium fertility variant.

Source: U.N. Population Division, 1998.

Despite these uncertainties, population projections provide an important and useful framework for thinking about the future. At this point, the authors will rely on a single projection—the medium variant—to describe the broad demographic trends in Asia. Below, alternative projections are considered in some detail. The U.N. projections do not consider alternative mortality variants, but two such variants have been prepared.

The methodology is summarized here, but the interested reader can find a more detailed explanation in Zlotnik (1999). The methodology used by the United Nations requires estimates of the population by sex and age category in a base year (1995) and subsequent trends in age-specific rates of fertility, mortality, and international immigration from 1995 to 2050. An estimate of the base-year population in each country is obtained by revising and updating the most recent population census using available data on fertility, mortality, and, in principle, immigration. Decennial population censuses are conducted in most Asian countries in years ending with 0 or 1; hence, the most recent direct data on population were collected in 1990 or 1991. In most countries, more recent estimates of fertility and mortality are available from surveys and civil registration systems. The most comprehensive data are available for fertility and child mortality. Many countries do not have recent data on adult mortality. Few countries have reliable information on international immigration. Of the 32 countries of East, Southeast, and South Asia that have populations of 150,000 or more, 21 have estimates of fertility available after 1993; 18 have estimates of child mortality available after 1993; and 5 have estimates of adult mortality after 1993. Thirteen additional Asian countries have estimates of adult mortality for the 1990-93 period (Zlotnik, 1999, Table 1).

The U.N. Population Division prepares three sets of projections used here. They differ in their assumptions about future trends in fertility. The medium variant distinguishes three groups of countries. The first consists of countries with total fertility rates (TFRs) above replacement level (2.1 births per woman). (The TFR is the average number of children women would bear were they subject to the age-specific birthrates prevailing during the period in question.) In these countries, the TFR is projected to decline smoothly until it reaches 2.1 births per woman, at which time it remains constant throughout the remainder of the projection. The second group consists of countries with a TFR between 1.5 and 2.1 births per woman. In these countries, the fertility rate is projected to converge to 1.9 births per woman. The third group consists of countries with very low fertility, that is, a TFR below 1.5 births per woman. In these countries, the TFR is projected to rise to a target level of 1.7 births per woman.

Of the seven countries examined in this chapter, four belonged to the high- fertility group. Of these seven, Indonesia is projected to reach replacement level first, in 2000-05; India five years later; and the Philippines and Bangladesh, in 2010-15. Two countries, South Korea and Thailand, are low-fertility countries where the TFR is projected to increase to 1.9 births per woman during the first part of the 21st century (Table 2).

In the low-fertility variant, the TFR for high-fertility countries is projected to decline to 1.6 births per woman. For low-fertility countries, the TFR is projected to decline to 0.4 births per woman below the target fertility level used in the medium-fertility variant; thus, the TFRs in South Korea and Thailand are projected to decline to 1.5 births per woman. In the high-fertility variant, the TFR for high-fertility countries is projected to decline to 2.6 births per woman. The TFR for the low-fertili...

Table of contents

• Cover
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• Foreword: Mapping Intersections in the Atlas of Asian Aging
• Acknowledgments
• Introduction: The Sweep of Asian Aging: Changing Mores, Changing Policies
• PART I: ASIAN AGING IN SOCIAL CONTEXT
• PART II: ECONOMIC STATUS, WORK, AND RETIREMENT
• PART III: LIVING ARRANGEMENTS, FAMILY CAREGIVING, AND SOCIAL SUPPORT
• PART IV: HEALTH AND LONG-TERM CARE
• PART V: COMMUNITY SOCIAL SERVICES
• Contributors
• Index