Policymakers need to prepare to cater for an ageing citizenry

Celebrated for almost three decades now, World Population Day on July 11 brings the focus every year to population growth rates. The world’s population continues to rise in the 21st century, but at a much slower rate compared to the recent past, alongside increases in life expectancy with differences in male and female life expectancies, a growing proportion of older people and rising median age with variations across regions and countries. As per the United Nations Statistics Division and the United States Census Bureau, Asian countries with different pace and characteristics are coming closer in population ageing to Europe and North America, but in a shorter span of time. India, the second-largest country in terms of population (China being the first), is undergoing a demographic transition which needs attention. As per the 2018 world population data, India ranks atop the list of countries with the greatest projected population increases between 2018 and 2050. China’s population will correspondingly decrease from its current size and India will lead.

Increases in current and future population figures of young adults or older people urgently remind us to take action now for sustainable solutions before it gets worse, based on the present social and economic conditions we are experiencing. The UN’s latest demographic data sheets focus on changing age structures around the world with implications for a country’s social and economic trajectory, consequences for policy agendas and budgetary resource allocations. With steady increases in the numbers of older adults both in absolute terms and as a percentage of the total population in many parts of the world, particularly in the Asian region and among middle income countries like India, challenges exist in balancing pensions, providing healthcare for both communicable and non-communicable diseases, developing social care services and creating economic benefits and facilities which help in improving the quality of life of older adults.

In addition is the question of improving conditions for the employment of the young workforce while at the same time making provisions to allow older adults to remain in the workforce longer. How to incentivise on both ends remains a challenge. As larger birth cohorts age into adulthood and the share of working age adults grows along with the 60-plus population as is happening in India, Brazil and other countries of South and East Asia as well in Latin America and the Caribbean, all going through the second phase of the demographic transition, increasing investments in the well being of younger generations along with older sections of the population are pivotal.

Recognising the changing population age structures is crucial since it has implications for national policy, planning and development agendas. For instance, India needs to think about investing sufficient resources in the development of young people’s human capital and at the same time, because of double dependency, that is, due to relatively large shares of child and older adult populations, plan for the well being of older people too. The government must address the high costs of older adults’ medical and long-term care needs. It needs to seriously review the advantages, reach out to “Modicare” and invest judiciously in younger and older generations by recognising that both face different challenges and have unmet needs.

Population ageing in India as well as elsewhere poses major challenges in the interconnected areas of health, gender and income security. The growing burden of non-communicable diseases, of multiple morbidities, the needs and vulnerabilities of an increasingly female older adult population, in terms of poverty, illiteracy, low social protection and security, widowhood, abuse and neglect, all pose serious challenges which must be addressed urgently, before India becomes an aged society as per the projections in not so far a future by the middle of this century. What initiatives are taken now to adapt to population ageing will set the path for the well being of present and future cohorts of older people and their families. Not only the government, but the private sector, civil society, and older people themselves must address the concerns emerging out of rapid population ageing. Currently, the growth rate of the number of older individuals, aged 60 and older, is three times higher than that of the population as a whole.

Current assessments of the health status of older persons reveal increases in the burden of non-communicable diseases, including mental health illnesses and substance abuse disorders, along with violence, injuries and infectious diseases. All these contribute significantly to increases in health costs and expenditures for which the country must appropriately and adequately plan. Further, the impact on economic losses must also be taken into account due to demographic shifts resulting in population ageing. India, like many other developing countries, reflects feminisation of ageing, even though there is vast variation among states in terms of the gap between male and female life expectancies at age 60. Nonetheless, governments, both at the state and Central levels, need to plan policy. Research studies across the country on older people indicate sex differences in health, ownership of property and inheritance, income security, labour force participation, living arrangements, marital status, education, support systems, coping mechanisms and dealing with old age issues.

Various governments, particularly since the beginning of the 21st century, have taken certain steps towards the well being and welfare of older people. With participation in the World Assembly on Ageing in 2002, UN member countries adopted the Madrid Plan of Action on Ageing. However, as we see in India, the implementation of many of the ageing policies has not been done efficiently and satisfactorily. Not only the outreach has been poor for many of the schemes and plans for older persons, in particular social security and protection plans, but resource allocation has also been deficient. Limited awareness of the programs among the older people and low utilisation of benefits and concessions earmarked for them means that the country needs to re-plan and improve implementation of the ageing policies. With the World Health Organisation (WHO) having designated 2020-2030 as the Decade of Healthy Ageing, there is hope for countries safeguarding and protecting the interests of its ageing populations and older people.

The writer is a sociologist, gerontologist and health and development social scientist, and an associate professor at Delhi University’s Maitreyi College