Demography of Aging (1994) / Chapter Skim
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10 Research on the Demography of Aging in Developing Countries
10 Research on the Demography of Aging in Developing Countries
Pages 356-404
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From page 356... ...
Demographers were motivated by population projections indicating that declining fertility and mortality, particularly in Asia and Latin America, were resulting in population aging. Their interest was also motivated by the The authors are grateful to John Knodel, George Myers, Beth Soldo, and Richard Suzman for advice.
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From page 357... ...
analysis of the relative contribution of fertility and mortality change, as well as initial age structure, to population aging in more and less developed countries, and Zeng's (1986, 1988) projections of family structure in China.
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From page 359... ...
359 Lo [11 ~.:.2: : :::::::::: I:::::::::::::: i1 1 lo lo ~cO a, ~ At ax l ~ Lo o ~ no o o ~ .
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From page 360... ...
Demographers have played an important role in compiling and summarizing the basic characteristics of elderly populations (e.g., marital status, urban/rural residence, labor force participation)
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From page 361... ...
And as fertility decline induces population aging, national mortality and health profiles begin to reflect the growing importance of chronic and degenerative ailments associated with greater numbers of older individuals (Frenk et al., 19891. In the last few years, there has been considerable attention paid to the emerging health issues in developing countries (Caldwell et al., 1990; Jamison and Mosley, 1991; Feachem et al., 1992~.
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From page 362... ...
Clearly, mortality decline has been greater in East and Southeast Asia than in South and West Asia. In Singapore, life expectancy at birth rose 30 years in barely one generation, from 40 years in 1948 to 70 years in 1979 (Bureau of the Census, various years)
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From page 363... ...
For example, Adlakha and Arriaga (1992, compared patterns of mortality in Guatemala and Costa Rica to identify areas of dissimilarity and highlight realistic targets for scarce health resources. They found that of 25 causes examined, just four-intestinal infection, pneumonia, conditions originating in the perinatal period, and nutritional deficiency were generally responsible for the large mortality differential for both sexes between the two countries (14-year longer life expectancy at birth in Costa Rica in the mid-1980s)
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From page 364... ...
Noncommunicable Disease prevention program, which sponsored cross-sectional surveys focused on cardiovascular disease risk factors such as cholesterol and blood pressure in six developing countries (see Dowd and Manton, 19901; and risk factor surveys in Brazilian cities (see Briscoe, 19901. Perhaps surprisingly, the last indicate that risk factors for chronic diseases are higher among people of lower socioeconomic status than among those of higher status.
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From page 365... ...
Several surveys of the elderly in developing countries (e.g., those listed in the appendix table that have been conducted by the Association of Southeast Asian Nations (ASEAN) , WHO Regional Offices, the United Nations University, and the University of Michigan and the Taiwan Provincial Institute of Familv Planning)
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From page 366... ...
Data on disability have been used to estimate years of healthy life expectancy in developing countries.3 For example, although female life expectancy at birth and at age 65 is usually greater than that of males, analysis based on data from the WHO Regional Office surveys of the elderly in Asia indicate that the percentage of lifetime expected to be spent in a healthy state is lower for women than for men (Lamb and Andrews, 1991; Myers, 19934. A multivariate procedure called graded order of membership has also been applied to disability data from developing countries to identify distinctive patterns of disability and the subgroups of the population that manifest them (Manton et al., 1986, 19871.
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From page 367... ...
They also found that less education is associated with poorer health, but that long-run household income has no effect. This type of analysis is needed for other developing countries, and researchers at RAND are investigating the measurement of health and its determinants as part of the Indonesian Family Life Survey.
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From page 368... ...
They combined these cross-sectional statistics on utilization of services with projections of changes in age structure and concluded that barring major changes in utilization patterns, the elderly in the future are likely to make disproportionate use of hospital services and, accordingly, demand for such services will increase dramatically as a result of population aging. In a similar exercise, Dowd and Manton (1992)
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From page 369... ...
An ideal data set might include not only numbers and relationships, but data on age, marital status, number of children, and labor force participation of each person. Most data sets do not provide so much, but a considerable amount of research has been done on the family demography of aging, especially in Asia (see, e.g., the special issue of Asia-Pacific Population Journal (Volume 7~3)
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From page 370... ...
. Some scholars have argued that it is not necessarily the number of children that matters for family support as long as there is at least one (although, as discussed below, research on the determinants of living arrangements in Asia provides some evidence that number of children does indeed matter, and the special issue on childlessness of the Journal of Cross-Cultural Gerontology (Volume 2~1)
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From page 371... ...
. Although assistance can be given across household boundaries, living arrangements of the elderly have been the focus of much of the initial analysis of their family relations.
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From page 372... ...
DeVos and Lee (1988) analyzed Korean census data for 1970 and 1980; Martin (1989b)
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From page 373... ...
, having a larger number of children was associated with a greater probability that the older person was living with at least one of them. DeVos and Lee found that the older the person, the greater was the likelihood of living with a child, but Martin, who included a measure of ability to perform activities of daily living, which had no effect, found that for three of the countries, less coresidence was associated with older age.
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From page 374... ...
Of course, support can be given across household boundaries, so living arrangements are not the only topic of interest in studying family relations in an aging population. As mentioned earlier, both spouses and children provide assistance with activities of daily living to elderly Asians.
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. In spite of the increasingly urban nature of today's elderly populations, rural areas remain disproportionately older than
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From page 376... ...
Likewise, the percentage of all elderly women who live in urban areas tends to be higher than the percentage of all elderly men who live in cities. In some countries the gender differences in urban/rural residence for the elderly are remarkable; 1985 sex ratios for the elderly population in Colombia were 122 in the countryside versus 79 in cities (Kinsella and Taeuber, 19934.
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From page 377... ...
Migration The volume of labor force migration in developing countries has spawned considerable research in recent decades. Very little attention, however, has been directed to patterns and determinants of migration among older adults, undoubtedly due to a lack of available, comprehensive data.7 National censuses, the primary sources of information on internal migration, typically obtain mobility information from heads of households and may fail to capture information about other household members.
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From page 378... ...
It is unclear whether remittances from abroad compensate for the loss of direct support to the elderly (Tracy, 1991~.° In some Caribbean nations, years of sustained emigration have contributed to the region's status as the oldest of all developing regions of the world (Kinsella and Taeuber, 1993~. Here, the ebb and flow of migration have been significant, but to date, effects on patterns of marital status, living arrangements, and savings/consumption among the elderly have not been well documented.
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From page 379... ...
In many developing countries, retirement is less of an event and more of a process of gradual withdrawal from the labor force, so the age pattern of migration may not be so marked. no retirement peak in migration for Brazi ECONOMIC ACTIVITY AND WELL-BEING Labor Force Participation and Retirement Labor force participation declines markedly as persons approach retirement age in industrialized countries.
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From page 380... ...
Variations in labor force participation among countries highlight the effects that cultural values, governmental policies, and economic conditions exert on economic activity levels of older workers.12 Despite a worldwide trend away from employment in agriculture, jobs in this sector remained in the 1970s and 1980s the most important source of employment for the elderly in developing (and most developed) countries.
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From page 381... ...
One reason may be the lower life expectancy in some of these countries, but it could also be that in countries with still relatively rapid population and labor force growth, early retirement may represent a substitution of jobs for youth for jobs for older work ers. There has been little multivariate analysis of the retirement process in developing countries (see LeGrand, 1989, on Brazil, and Hayward and Wang, 1991, on China)
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From page 382... ...
In general, the importance of pensions for economic support of the elderly is greater in Latin America and the Caribbean than in Africa and most of Asia. For example, about 90 percent of males and 70 percent of females age 65 and over in Argentina, and more than 60 percent of both sexes in Guyana, receive some form of pension (Pan American Health Organization, 1989a,b)
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From page 383... ...
Although only small proportions of Asian elderly rely on pension income today, increasing proportions of the current labor force are participating in pension plans, so greater proportions of the elderly in the future will be fully vested in such plans. Government officials, however, are concerned about premature overreliance on public pensions and are emphasizing the necessity of strengthening families' support of the elderly (Martin, 19914.
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From page 384... ...
is surprising, given the region's relative advancement in the demographic and epidemiological transitions; increased availability of the Pan American Health Organization data sets would no doubt stimulate work in this region. There is also still much that can be accomplished worldwide in the analysis of existing data from surveys based on a broader age range (e.g., household expenditure and labor force surveys)
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From page 385... ...
Little is known about the income and wealth of the elderly in developing countries, and how their economic needs interact with social and health factors to generate dependency. More multivariate analysis of labor force participation and retirement would be helpful.
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From page 386... ...
Also deserving attention is how risk factors, functional status, and morbidity change over time. Longitudinal data collection would help illuminate many of these issues, as no doubt would the combination of qualitative with quantitative data collection strategies.
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From page 387... ...
It has also been possible to base aging research on household surveys of a broader age range of the population, including labor force and income and expenditure surveys, although to date these sources have yielded little published work. Such surveys of multiple age groups have the advantage of not looking at the elderly in isolation.
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From page 388... ...
have illustrated how census data with older-age detail can be used to analyze transitions in the life course of the elderly and to project changes in the composition of future elderly populations. For example, they have investigated retirement transitions and projected future educational composition of the elderly, as well as the number of children ever born to future cohorts of elderly women.
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From page 389... ...
Agree, E.M., and R.L. Clark 1991 Labor force participation at older ages in the Western Pacific: analysis.
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From page 390... ...
Ofstedal 1991 Differences in the living arrangements of the elderly in four Asian countries: The interplay of constraints and preferences. Comparative Study of the Elderly in Asia Research Reports 91-10.
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From page 391... ...
Lozano 1991 The Epidemiologic Transition: The Latin American Experience. Paper presented at the International Union for the Scientific Study of Population Seminar on Causes and Prevention of Adult Mortality in Developing Countries, Santiago, Chile.
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Comparative Study of the Elderly in Asia Research Reports 92-14. Population Studies Center, University of Michigan.
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From page 393... ...
Comparative Study of the Elderly in Asia Research Reports 91-12. Population Studies Center, University of Michigan.
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From page 394... ...
1987 Census data for studying elderly populations. (Bangkok:ESCAP)
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From page 395... ...
New York: Oxford University Press. 1993 International research on healthy life expectancy.
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From page 396... ...
Watkins, J.F., and R Ulack 1991 Migration and regional population aging in the Philippines.
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From page 397... ...
Yu, Y.C., and S Horiuchi 1987 Population Aging and Juvenation in Major Regions of the World.
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From page 398... ...
Office for 1990 Three regions Myanmar South East Asia 1990 Ethnic Bamar Sri Lanka 1990 Western Province Thailand 1990 Bangkok + four regions Trinidad and Profiles of the Pan American c. 1985 National Tobago Elderly Health Guyana Organization 1984 Capital Argentina 1985- 1986 Urban Costa Rica 1984 National Chile 1984- 1985 Urban Barbados Brazil Colombia Cuba El Salvador Honduras Jamaica Venezuela
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From page 399... ...
DEMOGRAPHY OF AGING IN DEVELOPING COUNTRIES 399 Number of Age Group, Respondentsa Comments (especially if sample nonrandom) 4,500 households Households stratified by type of economic activity Household had respondent aged 55 or older 1,321 60+; provinces selected on basis of major language 1,254 55+; based on census frame; random 3,246 60+; also 2,111 persons 15-44 re attitudes toward elderly 1,013 60+; Two companion surveys: (1)
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From page 400... ...
? Four areas Malaysia Selected ESCAPb Asia and Pacific 1987 Melaka Sri Lanka Countries 1987 National Chile Aging WHO 1992 Mixed Nigeria and Dementia 1992 Costa Rica Indonesia Israel Jamaica Thailand Zimbabwe Brazil China Hong Kong Jamaica Nigeria National OsteoporosisC WHO Barbados Social and University of 1982 National Economic the West Indies Circumstances of the Elderly China Survey of Aged Five University 1986 Five locales Population Population Institutes China Survey of the Aged CASS Population 1987 National Instituted China Cognitive University of c.
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From page 401... ...
DEMOGRAPHY OF AGING IN DEVELOPING CO UNTRIES 40 Number of Respondentsa Age Group, Comments (especially if sample nonrandom) 541 798 372 317 5,000 5,000 5,000 5,000 5,000 5,000 5,000 414 NA 36,755 5,055 20,000 1,172 60+; purposive; two localities in Jilin Province, one in Shanghai City, one in Shanghai County 60+; three urban and one rural area; 91 intensive interviews 60+; random sample in West Peninsular state of Melaka 60+; purposive 55+; longitudinal; four developed countries also in survey; studies now in the field 55+; longitudinal; sample sizes and strategies still to be determined; country list includes Italy 50+; to include case-control, cross-sectional, and longitudinal studies 65+ One per 1,000 sample survey on aged population (presumably 60+ in localities where universities are located: Shanghai, Hubei, Jilin, Liaoning, Beijing)
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From page 402... ...
1984 Seven zones Human Sciences 1990-1991 National Research Council, University of Pretoria 1988 NA Taiwan Provincial 1989 National Institute of Family Planning and University of Michigan NOTE: Other recent surveys in developing countries that cover other age groups in addition to the elderly, but that are well suited to the study of the elderly include the Malaysia Family Life Survey II and the Indonesia Family Life Survey, both conducted by RAND. aNA = Not available.
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From page 403... ...
DEMOGRAPHY OF AGING IN DEVELOPING COUNTRIES Number of Age Group, Respondentsa Comments (especially if sample nonrandom) 403 NA 3,704 899 4,365 NA 4,049 60+; results not yet released 60+; focus on living arrangements and caretaker attitudes 58+; sample based on occupation; women underrepresented 60+ All ages 60+
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