Transcript Dr. Jennifer Rouse - UWI St. Augustine

POPULATION AGEING IN TRINIDAD AND TOBAGO
CHANGES IN THE AGE STRUCTURE AND ITS IMPLICATIONS
Jennifer Rouse (Ph.D.)
Director, Division of Ageing
Ministry of the People and Social Development
March 5, 2013
Introduction
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T&T’s older persons (i.e., aged 60 yrs and over) represent
12% or 156,000 of the total population, of which 9% are
over 65 yrs (CSO, 2011)
The elderly population is projected to be 17.7% in 2025 and
expected to increase to 30.1% in 2050
Economic indicators reveal that institutional arrangements in the
region are untenable to bear this exponential growth rate of
seniors
A proactive approach is needed to address the challenge of
population ageing
Dynamics of Population Ageing
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The Potential Support Ratio (PSR)
Number of persons aged15-64 yrs able to support a person aged 65+
Caribbean PSR ratio: 10:1. Expected decrease: 3:1 by 2050
1/3 of all Caribbean elderly receive government support
The Dependency Ratio
Number of persons under 15 & over 65 per 100 persons 15-64 yrs
Dependency Ratio assumes dependency on working age population
T&T Dependency Ratio : 9.7 and expected to increase to 44.4 by 2050
Caribbean Dependency Ratio: 10 & expected to increase to 31 in 2050
The Parent Support Ratio (PSRi)
Ratio of persons 85 yrs and over to every 100 persons aged 50-64yrs
Current PSRi 4.8 and expected to increase to 19.3 persons by 2050
Informal community-based support and family network as primary forms of care
in the Caribbean
Dynamics of Population Ageing (cont’d)
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Loneliness
Loneliness a major issue for elderly in T&T
33% of surveyed group (n=845) felt lonely, despite only 16% living
alone (Rawlins, 2008)
Old-age depression linked to loneliness
Life expectancy
Avg. in 2009 is 74.8 yrs & projected increase is 80.5 in 2050
Caribbean avg. is 75.5yrs & projected increase is 77.6 in 2050
Increased demand for gender-based healthcare and geriatric services
“Feminization of poverty” as avg. life expectancy for women is 81 yrs
compared to 78 yrs for men
Dynamics of Population Ageing (cont’d)
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Labour Force Participation
Male participation exceeds female participation
Illiteracy rates much higher among women
Women overrepresented in the informal sector and few employed
in the formal sector
Women most likely to be left out of pension schemes
Women more dependent on men and a smaller informal network
41% of women name the family as an important source of income
Ageism and mandatory retirement age of 60-65 yrs fosters social
exclusion
THE FIRST WORLD RESPONSE
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The United States
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Low fertility & high life expectancy combine for slow growth rate
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17.9% of Americans are elderly persons (UN, 2009)
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2.7% annual elderly growth rate exceeds total population growth rate 1%
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‘Baby boomer’ generation to severely affect PSR due retirement in 2011
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PSR to decrease to 3.4% in 2025 and 2.9% in 2050
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Growing fiscal gap due to low PSR will affect Social Security support
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“Oldest-old” 38% and growing at fastest rate (long-term care increase)
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7.7% of GDP is spent on pensions in developed countries & 15% by 2050
Approx. 25% of GDP will be spent on pension and healthcare by 2050
First World Response (cont’d)
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United Nations
Vienna International Plan of Action on Ageing (1982)
Governments of developed countries to take primary responsibility
for ageing initiatives
Madrid International Plan of Action On Ageing (2002)
Specific focus on developing countries
Growing areas of concern: HIV/AIDS; violence and abuse; access
to health services; and social protection
Challenges faced in T&T
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Income and Social Security
Two pension systems – a contributory National Insurance Scheme
(NIS) and non-contributory for monthly-paid public sector workers
Informal sector workers (patronage) and self-employed are
excluded from NIS and reliant on Senior Citizens Pension at 65yrs
Administrative problems arise from the operation of both schemes
such as inadequate funding; delays between application and
payment; resistance to change to direct deposit
Challenges faced in T&T (cont’d)
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Health Protection
A change in demand that requires new services and treatments
Region’s shortcomings in terms of equal access to healthcare; lack
of human and financial resources; problems of articulation
between various levels of the healthcare system and the public
and private sectors
Increased need for primary healthcare
A dearth of care-giving services for the elderly
Inadequacy of elderly care institutions
Challenges faced in T&T (cont’d)
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Socio-Economic
A shortage of housing and the existence of poor living
arrangements affecting quality of life (multigenerational homes)
Disparity between rural and urban needs and responses
Financial pressures due to grandparents parenting
Impact of HIV/AIDS among females aged 15-45 yrs: in 2005,
GDP reduced by 4.2%; savings by 10%; and investment by
15.5%
Issues affecting male population aged 15-45yrs – homicide, drug
abuse, vehicular accidents, incarceration and social displacement
Developments in Policy
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Income Security
Periodic increments to Senior Citizens Pension made by the
Government where the minimum quantum was shifted twice in
2010 from $2,500 monthly to $3,000 monthly
In 2008 & 2011, an increase in the minimum Social Security to
$2,000 and $3,000 per mth respectively
Pension in Trinidad and Tobago theoretically falls within a large
enough safety net from the poverty line, representing a relatively
low level of indigence amongst the elderly
Developments in Policy (cont’d)
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Health and Social Support Networks
Chronic Disease Assistance Programme (CDAP)
Continuum of Health & Social Support Systems for Older Persons
Annual Public Open Forum for Older Persons
Commemoration of World Elder Abuse Awareness Day
Commemoration of International Day of Older Persons
A National Policy on Ageing
Legislation on Homes for Older Persons enacted
Retirement Programme for Public Officers
Geriatric Adolescent Partnership Programme (GAPP)
Developments in Policy (cont’d)
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The Social Welfare Division
Public Assistance
Food Subsidy
Free Bus Passes
Free Medical Equipment
Burial Assistance
Home Improvement Grant
Household Items Grant
Dietary Grant
Homecare Grant
Recommendations
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Developments in Social Security
Devise mechanisms to ensure that the dignity of older persons is
maintained
Developments in Income Security & Employment
Ensure collaboration among relevant agencies to bring about
sustainable purchasing power and employment options
Review the Senior Citizens Bureau
Developments in Health
Training in Geriatric Care for family members, care providers
and healthcare workers & degree programmes for the region
Geriatric hospitals and Residential long-term care facilities
needed
Recommendations (cont’d)
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Developments in Social Suport
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Initiatives for older persons to acquire affordable property
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Trinidad & Tobago Association for Retired Persons’ (TTARP) role
to be defined/bolstered
National Plan of Action on Ageing
Conclusion
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First World response classifies ageing phenomenon primarily as
an economic issue
T&T ageing is multi-faceted requiring participatory approach
Ageing issues should be integrated into national development
plans which are culturally sensitive
Continuous review and evaluation of social and legislative policy
objectives to incorporate measures outlined in ageing policy