Population Ageing

The ICPD Programme of Action calls for governments to develop social security systems and social services that will be able to provide for the growing numbers of older persons.  It also seeks to enhance their self-reliance and facilitating both formal and informal networks and safety nets.  The Port of Spain Declaration acknowledges the particular needs and requirements of vulnerable groups, including older persons.  It notes that ‘older age groups within all Caribbean countries are growing rapidly’ and ‘this will place a heavy demand on the social services’.  In a similar vein, the Caribbean Plan of Action stresses the need for population policies that would specifically address issues and concerns relating to older persons in society.

In 1999, CARICOM adopted the Caribbean Regional Charter on Ageing and Health, which calls on all governments in the region to acknowledge ageing as an issue of priority in the areas of health and social planning.  In response to these calls for action, ECLAC/CDCC conducted in 1999 an expert group meeting on ageing and has recently embarked on a study on the situation of older persons in the Caribbean sub-region.

More recently, in 2002, at the Second World Assembly on Ageing, governments agreed to the implementation of a global action plan which calls for improvements in living conditions of older persons, poverty eradication, social inclusion, individual self-fulfillment and gender equality, as well as intergenerational solidarity, employment, social security, health and well-being.

Over the years, the Caribbean has witnessed a steady increase in the proportion of population of 60 and over years old.  The Ageing Index ¹⁶ in the sub-region was 21.2 in 1975, compared to only 15.7 for Latin America.  The index increased to 41.1 (2000) in the Caribbean and, according to ECLAC data, it will climb to 87.8 in 2025.  In 2050, the population aged 60 and over will be 1.5 larger than that aged 10-14.  In 2000, there was one older adult per each 6.5 economically active person (15-59).  In 2025 there will be one older adult per each 3 active person and, in 2050, one per each two.  This poses significant challenges on the health and social security systems throughout the Caribbean sub-region

At present, many countries have adopted explicit policies on ageing and on older persons.  At the institutional level, national councils on ageing have been established in many countries to advise on and develop programmes to improve the quality of life of older persons.

Along with the erosion in the value of lifetime savings and pension benefits, many in the Caribbean have lived their lives at or below the subsistence level ¹⁷ .  This situation affects in particular women, unskilled workers, small-scale farmers and the disabled.  In spite of the economic downturn and the scarce resources available, governments in the region have generally shown a strong commitment to providing basic social services free of charge for all.  However, due to the lack of sufficient resources, the quantity as well as the quality of the services rendered is suffering.  Most of the countries in the sub-region provide assistance to older persons through one or several safety-net programmes, such  as social security schemes, non-contributory old-age pensions, in-kind assistance and residential homes.

Traditionally, social insurance schemes in most Caribbean countries do not cover individuals employed in the informal labour market, the self employed, rural workers and the non-economically active group.  Over the last decade, however, several governments have embarked on additional social-assistance programmes for older persons.  In many countries in the Caribbean formal government pension schemes came into being in the 1960s and 1970s.  A considerable part of the population is self-employed or works in the informal sector, and, as a result, has never contributed to any established pension scheme.  More women than men have been excluded from such pension schemes, since the percentage of unemployed women, or women working in the informal sector in the sub-region, is generally higher than that for men.  Caribbean countries vary considerably in the degree to which their citizens are covered by pension schemes, ranging from five percent to over 80%.  Governments have recently taken various initiatives to enhance pension schemes and to improve coverage of those previously excluded.

Many older persons in the Caribbean have recourse to other sources of funding, such as support from family and relatives as well as own economic activity to secure sufficient income to survive. Relatively little is known about labour market participation of older persons in the sub-region.  A survey conducted in 1999 found that five per cent of those surveyed were employed at the time of the survey (ECLAC, 2002) and almost all were self-employed.  Although no gender specific data on employment in the informal sector are available, the disadvantageous situation of women in the labour market may eventually force more women to draw their income from such jobs than men.

With population ageing, prevailing disease patterns are changing.  This will have major implications on health care expenditures, on the kinds of institutions and formal arrangements that will be needed to support family care giving, and on the distribution of resources along the life span.  Healthcare is available free of cost to older persons in some Caribbean countries, but in general there are no specialized health care programs for  them, nor have healthy ageing and prevention behaviours been part of the general strategy to approach the elderly.  The expected return of tens of thousands of migrants, now in retirement age, which may represent an influx of pensioner funds, also will imply increasing demands for social services.  Currently, very few countries in the Caribbean have national health insurance schemes with global coverage in place, although some are currently in the process of overhauling their public social security.  Only in a minority of countries health insurance is provided by the national social-security system.

The Caribbean has a long tradition of mutual aid.  However, these informal systems, though vital they may be, cannot substitute formal support schemes, as many  individuals may remain outside of the arrangements.  Caribbean family structure and cultural practices place the major responsibility for the care of the children and the sick on women.  Increased migration of women in their productive years, women’s increased participation in the labour force and an increasing number of children orphaned by HIV/AIDS – about 80, 000 according to PAHO estimates -, are likely to place additional responsibilities on older women.

In order to address the needs of older persons with no family support networks, some countries have engaged in programmes to provide day-care facilities in homes and institutions to those in need.  In addition to families, churches and service agencies, retired professionals are also forming support groups.  There are also initiatives linking older persons in the communities with younger members.  Few countries have adopted a generalized institutional life cycle approach linking healthy lifestyles to healthy ageing.