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Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine. 2015. Strengthening the Scientific Foundation for Policymaking to Meet the Challenges of Aging in Latin America and the Caribbean: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21800.
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1

Introduction

Recent demographic trends in Latin America and the Caribbean (LAC) region will shape the growth and age composition of its populations for decades to come. The rapid mortality decline that began during the 1950s, and the more recent and even sharper reduction in fertility, will produce unusually high rates of growth of the older population, a large change in overall population age composition, and significant increases in the ratio of older to younger population. According to the most recent United Nations (2013) projections, the number of people aged 60 and older in LAC is expected to increase from 59 million in 2010 to 196 million in 2050, and the number of people aged 80 and older will increase from 8.6 million to more than 44 million during the same period. The proportion of population aged 60 and older is projected to increase from about 10 percent in 2010 to about 25 percent in 2050, and the median age will jump from 27.3 years in 2010 to 40.6 years in 2050 (medium variant projection). The rate of growth of the population aged 60 and older is accelerating. It has been estimated that in countries with the fastest aging, this will increase from about .015 per year to .045 per year between 2000 and 2025 (Palloni et al., 2002). Growth rates of this magnitude will generate a population dynamic with no precedent in human population history. Indeed, while many high-income countries in Western Europe and North America experienced population aging gradually over a period of 50–100 years, many LAC countries will navigate through an equivalent demographic landscape in a severely contracted interval of 20–30 years (Kinsella and He, 2009).

Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine. 2015. Strengthening the Scientific Foundation for Policymaking to Meet the Challenges of Aging in Latin America and the Caribbean: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21800.
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These trends are taking place in a dynamic environment: (1) LAC countries are experiencing high levels of poverty and inequality with large fractions of the older population living in precarious conditions; (2) regimes of health services and medical care are experiencing upheavals that may threaten existing levels of access and quality of medical care; (3) although cohorts of individuals who attain their 60th birthday after the year 2000 benefited from survival gains in the post-1950 period, their early experiences could make them vulnerable to higher levels of chronic conditions and disability; (4) most LAC countries are experiencing an increase in chronic diseases while continuing to have high rates of infectious conditions; and (5) social security programs, and social safety nets more generally, are being replaced by fully or partially privatized systems that often provide only limited coverage to low-income earners and the more disadvantaged members of a population. (For an overview of these and other trends, see Population Reference Bureau, 2014; Cotlear, 2011; Jackson et al., 2009.)

The forgoing suggests that the aging process in LAC offers unique opportunities to understand mechanisms regulating health and mortality, those implicated in intrafamily transfers and support, and the individual and aggregate effects of changes in intergenerational transfers. There is a need for studying the relationship among demographic aging, individual behavior and well-being, and societal responses, as well as a need for identifying methodologies and technologies to collect, organize, and analyze information designed to inform policy. It also is important to recognize national (and subnational) diversity in the aging process throughout the LAC region; for example, the demographic landscape in Cuba and Uruguay is very different from that in Guatemala.

A broad study and data collection strategy concerning aging, individual well-being and behavior, and societal responses might focus on:

  1. Trends and determinants of health, disability, and mortality; evaluation of the effects of early-life experiences, diet, and sedentary behaviors on obesity, diabetes, and cardiovascular disease; and the prevalence and determinants of cognitive deterioration, including the most salient social differentials;
  2. Labor market participation of older populations; past labor force history and choices; retirement decisions; and differentials by social class and region of residence;
  3. Health care systems, health care access, and health care quality; and differential experiences with health care systems according
Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine. 2015. Strengthening the Scientific Foundation for Policymaking to Meet the Challenges of Aging in Latin America and the Caribbean: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21800.
×
  1. to health and disability status, family organization, residential arrangements, and locality;

  2. Pension system diversity across LAC; histories and trajectories of system reforms, population coverage, benefits and returns; assessment of economic flows across age groups; and consumption patterns among older populations;
  3. Determinants and consequences of intrafamily and societal transfers; prevalence of and changes in family support systems, including coresidence; accommodation and diversification of family support strategies vis-à-vis a changing landscape of pension systems, labor markets, and health care, and dilution of traditional ideologies regarding family support.

Assessment of data needs, data collection, and data harmonization would involve such factors as multifaceted study designs, the inclusion of biomarkers and anthropometry, the use of vignettes to elicit information on health, methods for evaluating cognitive deterioration, and the relationship of health and wealth, focusing on the role of intrafamily transfers.

A workshop entitled “Strengthening the Scientific Foundation for Policymaking to Meet the Challenges of Aging in Latin America and the Caribbean” took place at the National Academy of Medicine in Mexico City, May 28–29, 2015. The purpose of the workshop was to present scientific research emphasizing what is unique about aging in LAC and what is similar to other processes around the world, to highlight the main areas where many experts believe knowledge of the aging process in LAC is insufficient and new research is required, and to consider data collection that will produce information for policymaking while being responsive to the needs of the research community for harmonized, highly comparable information. (See Box 1-1 for the project steering committee’s statement of task.) The workshop follows, in part, from a previous U.S. National Institute on Aging-supported study of aging in Asia (National Research Council, 2012).

The Mexico City workshop afforded participants an opportunity to think about strategies for articulating data collection and research in the region so that country-based teams can reap the benefits from being part of a larger enterprise while simultaneously maintaining their own individuality and responding to particular needs of each country. To a large extent, the workshop was focused on the collection and production of household microdata as found in the global family of Health and Retirement Study (HRS)-type surveys (see Chapter 2), rather than on improving other types

Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine. 2015. Strengthening the Scientific Foundation for Policymaking to Meet the Challenges of Aging in Latin America and the Caribbean: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21800.
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BOX 1-1
Steering Committee’s Statement of Task

The National Research Council will appoint a steering committee of international experts to plan and conduct a public workshop on the process of rapid aging in Latin America and the Caribbean (LAC) region. The workshop will feature presentations and discussions of the main areas where knowledge is insufficient and new research is required, will consider scientific research emphasizing what is unique about aging in LAC and what is similar to other processes around the world, and will review a data collection strategy that is cognizant of the uniqueness of the LAC aging process while being responsive to the needs of the research community for harmonized, highly comparable information. The workshop participants will be selected and invited by the steering committee in cooperation with international nongovernmental organizations and national academies of science in various Latin American countries. The workshop will be held in a country in Latin America. A workshop summary report prepared by a rapporteur will be published by the National Academies Press.

of survey, macroeconomic, or administrative data such as vital statistics systems that could serve as complements to HRS-type data for studying aging in LAC.

There were six topical sessions and a roundtable conducted by members of the project steering committee and invited speakers. Each of the following chapters is dedicated to one of these workshop components. Sets of slide presentations made during the workshop are available at http://sites.nationalacademies.org/DBASSE/CPOP/DBASSE_166698 [August 2015].

This report was prepared by a rapporteur as a factual summary of what occurred at the workshop. The steering committee’s role was limited to planning and convening the workshop. The workshop agenda can be found in the Appendix at the end of this report. The views contained in the report are those of individual workshop participants and do not necessary represent the views of other workshop participants, the steering committee, the U.S. National Academies, or the other organizations involved in funding the workshop.

Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine. 2015. Strengthening the Scientific Foundation for Policymaking to Meet the Challenges of Aging in Latin America and the Caribbean: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21800.
×
Page 1
Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine. 2015. Strengthening the Scientific Foundation for Policymaking to Meet the Challenges of Aging in Latin America and the Caribbean: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21800.
×
Page 2
Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine. 2015. Strengthening the Scientific Foundation for Policymaking to Meet the Challenges of Aging in Latin America and the Caribbean: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21800.
×
Page 3
Suggested Citation:"1 Introduction." National Academies of Sciences, Engineering, and Medicine. 2015. Strengthening the Scientific Foundation for Policymaking to Meet the Challenges of Aging in Latin America and the Caribbean: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21800.
×
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Recent demographic trends in the Latin American and Caribbean (LAC) region will shape the growth and age composition of its populations for decades to come. The rapid mortality decline that began during the 1950s, and the more recent and even sharper reduction in fertility, will produce unusually high rates of growth of the older population, a large change in overall population age composition, and significant increases in the ratio of older to younger population. According to the 2013 United Nations projections, the number of people aged 60 and over in LAC is expected to increase from 59 million in 2010 to 196 million in 2050, and the number of people aged 80 and over will increase from 8.6 million to more than 44 million during the same period.

To explore the process of rapid aging in the LAC, a workshop took place at the National Academy of Medicine in May 2015. Participants of the workshop presented scientific research emphasizing what is unique about aging in LAC and what is similar to other processes around the world, highlighted the main areas where knowledge of the aging process in LAC is insufficient and new research is required, and proposed data collection that will produce information for policymaking while being responsive to the needs of the research community for harmonized, highly comparable information. The workshop afforded participants an opportunity to consider strategies for articulating data collection and research in the region so that country-based teams can reap the benefits from being part of a larger enterprise while simultaneously maintaining their own individuality and responding to the particular needs of each country. Strengthening the Scientific Foundation for Policymaking to Meet the Challenges of Aging in Latin America and the Caribbean summarizes the presentations and discussions of the workshop.

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