WPC{ %$*FG>^6uryžY_ħM/>q wi-[[T(an"فe..%R>T^7\uKQ3Ͻt'Dffc gDk)%rhѩIֵG-ݣvD W_J԰]}gϙTlC0YK U#eJKU1Uʹiiz߽^|p^׃(@T7n4__ rRK\!S :HOAhh`PepP!W;z;s@1~o~z62ػ;1jHKZ_c<)S)Ő,mX&鍊=ڵowCx+s -CPɫ˚ESJf fb0u:y# UN % 0( 0%  0= AQ 0\< 1 UUB-/ h$\f 0C 1m B1"NVp 0Cr 0} DM C\ D Cv 1 U?aM h a D+' h A'%25 hW5 hD p5f?$? hCcfd hh d hym+m$m B-V h 0lf af"a$ 0D8a|aV BEj+UB AM 0KA D3fafեaץfafa_ 0Dvvv2U!BUB..UBpUBw@ 0cL44f C  ###UB9\\FS17\TED1WINSPOOL,,,,,,0 (hH  Z 6Times New Roman RegularX($<.footerfooter   %"W \  `*Times New RomanTTW     UK  US     W \  `*Times New RomanTTW>4X` hp x (#>Ӄ Level 1 Level 2 Level 3 Level 4 Level 5($    5;C<< cP8page numberpage numberXXXW \  `*Times New RomanTTW        W \  `*Times New RomanTTW$359=AEIMQ2""""""""\  `*Times New RomanTT ##.Xd#@C  C"  K7uM% ]5 mE "XK   5555UNFPAIMPLEMENTATIONOFTHEICPD  PROGRAMMEOFACTION hh  : XXRoleoftheUNFPA  #XX  :B#MXXII  HealthCareofOlderPersonsinLessDevelopedRegions ff   ResponsestoSurveyQuestiononHealthCareofOlderPersons #XXM# ||  From:ReportoftheSecretaryGeneralontheMonitoringofPopulationProgrammes: r r  ProgrammeExperienceinImplementingHealthandMortalityActivities,SincetheInternationalConferenceonPopulationandDevelopment,1994  R R  7XXDuring1997,anSurveywasconductedamongcountriesofthelessdevelopedregionstodetermine 22  developmentswhichhadoccurredsinceICPD.TheSurveyfocusedonawiderangeofissuesmostofwhichareofnodirectrelevancetothispaper,butpartofonequestiondealtwiththehealthcareofolderpeople.Thefollowingsummaryhasreferencetotheresponsesofsome80governmentsandanadditionalnumberofNGOs,tothequestion: Somepopulationgroupsareatgreaterrisktosufferapoorqualityofhealth.Whatactionshavethe  GovernmentandNGOstakensinceICPDtoStrengthentheprovisionofhealthcareforpersonsattheolderages?  rr @=@(2C$ !  # e37=CIQYag1.a.i.(1)(a)(i)1)a) d    (2C$ !  <FFDŽ:QuickFormat1 XXX     XXX      C)  q! a%"X!USUS.,    XX K4X` hp x (#a%"K  qK7uM% ]5 mE "XK99E"Thin Right/Leftdxd d,,,,7Hairlinedxd$359=AEIMQ1 555Table_A$k$?C$C$x@C$Ȟ@C$,@C$@C$C$7@C$5@C$ffffff9@C$fffff>@C$C$<@C$>@C$fffffA@C$E@C$C$L5@C$3@C$3333337@C$=@C$@C$ffffff3@C$fffff1@C$fffff1@C$L5@C$C$333332@C$1@C$fffff1@C$L5@C$ C$ fffff3@C$ /@C$ 3@C$ fffff;@C$ C$ 333331@C$ ffffff0@C$ ffffff/@C$ 1@C$ C$ fffff5@C$ 333333@C$ 333338@C$ 33333?@C$ C$ L6@C$ =@C$ 33333C@C$ 333333G@C$ C$ 3@C$ 3@C$ 333333=@C$ fffffC@C$C$333333=@C$33333?@C$B@C$ffffffE@C$C$33333A@C$fffff&A@C$ C@C$G@C$C$=@C$ffffff@@C$ C@C$YH@C$C$4@C$333332@C$3333337@C$>@C$C$333339@C$ffffff;@C$ffffff;@C$333333@@C$C$L7@C$L6@C$333333>@C$333333E@C$C$=@C$<@C$fffff&A@C$YC@C$C$33333;@C$:@C$YA@C$D@C$C$fffff;@C$9@C$fffff=@C$ A@C$C$ffffff>@C$;@C$@@C$ffffffC@CTable_D$'dxd''@C'C'Ȟ@C',@C'@C'C'C'B@C'ffffff?@C'3333339@C'C':@C'3@C'333330@C'C'fffffD@C'333333A@C':@C'@C'fffff&F@C'33333E@C'̌B@C' C' ffffffF@C' fffffE@C' ̌B@C' C' fffff&D@C' ?@C' 7@C' C' L9@C' 3@C' /@C' C' 333333E@C' @@C' fffff9@C' C' <@C' 6@C' ffffff3@C'C'fffff&@@C':@C'6@C'.@C'C' K@C'̌M@C'N@C'C'M@C' O@C'M@C'C' J@C'fffff&M@C'fffff&O@C'@C'LI@C'fffffI@C'L@C'C'I@C'I@C'33333sL@C'C'J@C'N@C'O@C'C'M@C'O@C'fffffM@C'C'I@C'33333sM@C'fffffN@C'C'L@C'N@C'L@C'C'L@C'N@C'M@C'N@C'C' @C'#@C'333333*@C'C'-@C'L2@C'9@C' C' ffffff@C' 333333@C' %@C'!@C'!ffffff@C'!333333@C'!@C'#C'#@C'#@C'#@C'$C'$@C'$ffffff @C'$333333)@C'%C'%/@C'%fffff2@C'%3333339@C'&C'&@C'&@C'&(@C''C''+@C''L0@C''7@C'(C'(ffffff%@C'(*@C'(1@CTable_E'  5#  11C3b3@C3C3Ȟ@C3,@C3N@C3C3ףp= @C3ףp= @C3C3RQ?C3Q?C3C3)\(@C3ffffff@C3@C3(\@C3= ףp=@C3 C3 Gz@C3 333333 @C3 C3 p= ף@C3 333333@C3 C3 \(\?C3 (\?C3 C3 \(\@C3 RQ @C3 C3 (\?C3  ףp= @C3C3RQ@C3Gz@C3T@C3C3(\ @C3\(\@C3C3zG@C3?C3C3(\ @C3(\ @C3@C3Q @C3ffffff @C3C3\(\ @C3q= ףp @C3C3Q@C3(\ @C3C3 ףp= @C3\(\?C3C3= ףp=@C3 @C3C3)\(@C3Q?C3C3333333 @C3q= ףp@C3C3C3Q?C3333333?C3C3333333?C3{Gz?C3 C3 (\@C3 zG?C3!@C3!Gz@C3! ףp= @C3#C3#(\@C3#\(\@C3$C3$Gz?C3$(\?C3%C3%zG?C3%)\(C3&C3&p= ף@C3&p= ף?C3'C3'Gz?C3'?C3(C3({Gz?C3()\(?C Table_H3 $ C"  K7uM% ]5 mE "XK $! XX   Ӏ#XX  $!f# $! XXInternationalConferenceforPopulationandDevelopment,1994    SummaryoftheProgrammeofActionforOlderPersons#XX  $!# $! XX     #XX  $!#}XX Basisforaction   N:uM% ]5 mE "N#XX}#;XXXX;9X;X[G  [G݀"0   ݀#9;9##XX9#SXXXXfertilityandmortalitydecline:increasinglymatureagestructure:expandingnumbersand  proportionsofelderly#XXXSX#[G ݌ll Ќ  C  $#CT:uM% ]5 mE "uT;XXXX;9X;X[G  [Gv݀"0   #9;98##XX9W#T:uM% ]5 mE "uTӀ0ll anadvancedprocessindevelopedcountries[Gv݌ ll Ќ  T:uM% ]5 mE "uT;XXXX;9X;X[G  [G{݀"0   #9;9=##XX9\#0ll anincipienttosubstantivefeatureoflessdevelopedcountries[G{݌v v ll Ќ  T:uM% ]5 mE "uT;XXXX;9X;X[G  [GA ݀"0   #9;9 ##XX9" #0ll genderissue:thelongerlifeexpectancyofwomen;elderlywomenareoftenpoor[GA \ ݌f f ll Ќ  ;XXXX;9X;X[G  [G ݀"0   #9;9 ##XX9 #SXXXXfiscalissue:constraintsconsequentuponexpansionofolderpeoplerelativetoworkingage V V  Ѐpeople#XXXSXT #T:uM% ]5 mE "uT[G ݌F F ll Ќ  ;XXXX;9X;X[G  [G ݀"0   #9;9 ##XX9 #SXXXXԀtimetoreassessthepositivecontributionoftheelderly,andassistanceinmeetingtheir 66 longtermneeds#XXXSXt #T:uM% ]5 mE "uT[G ݌&&ll Ќ  Q7uM% ]5 mE "uQ}XX Objectives   N:uM% ]5 mE "N;}}#;XX;} #;9X;X[G  [G݀"0   #9;9##XX9#}XXԀ0ll #XX}#toenhanceselfreliance,optimiseindependence,promotequalityoflifeforolderpeople[G4݌  ll Ќ  T:uM% ]5 mE "uT;XXXX;9X;X[G  [G;݀"0   #9;9##XX9#SXXXXtodevelopsystemsofhealthcare,andeconomicandsocialsecurityrecognisingthespecial "" Ѐneedsofwomen#XXXSX#[G;V݌ll Ќ  ;XXXX;9X;X[G  [G݀"0   #9;9##XX9#T:uM% ]5 mE "uTӀtodevelopasocialsupportsystemenhancingtheabilityoffamiliestocarefortheirolder  familymembers[G,݌ ll Ќ  Q7uM% ]5 mE "uQ}XX Actions   #XX}#inrecognitionoftheparticularneedsandexpandingnumbersoftheelderly,governments  should:  КN:uM% ]5 mE "N;XXXX;9X;X[G  [G݀"0   #9;9O##XX9n#developsocialsecuritysystemstoensureintergenerationalandintragenerationalequity  andsolidarity[G݌ ll Ќ  ;XXXX;9X;X[G  [G݀"0   #9;9##XX9#T:uM% ]5 mE "uTSXXXXencouragemultigenerationalfamilies,andsupportservicesforgrowingnumbersoffrail  olderpeople#XXXSX#[G-݌ ll Ќ  T:uM% ]5 mE "uT;XXXX;9X;X[G  [G݀"0   #9;9H##XX9g#SXXXXpromoteselfrelianceandcreateopportunitiesfortheelderlytoleadselfdetermined, x x ! healthyandactivelives#XXXSX#[G݌h!h!"ll Ќ  T:uM% ]5 mE "uT;XXXX;9X;X[G  [G݀"0   #9;9t##XX9#SXXXXencouragetheelderlytoutiliseexistingskillsandabilities,andotherstorecognisetheir X"X"# contributionstofamilylife#XXXSXC#[G݌H#H#$ll Ќ  T:uM% ]5 mE "uT;XXXX;9X;X[G  [G݀"0   #9;9##XX9#SXXXXstrengthensupportsystemstoeliminateviolenceanddiscriminationagainstolderpersons 8$8$% especiallywomen#XXXSXy #[G ݌(%(%&ll Ќ  T:uM% ]5 mE "uT;XXXX;9X;X[G  [G"݀"0   #9;9!##XX9!#0ll promotetheinterestsoftheelderlyincollaborationwithNGOsandtheprivatesector[G")"݌&&'ll Ќ  Q7uM% ]5 mE "uQ ''( ЇSource:SummarisedfromUnitedNations(1995b)paragraphs6.166.20.@@@C Table_I@BWBCBȞ@CB,@CB@CBN@CBCB@CB8@CB`@CBCB`@CB@CBȇ@CBCB@CB@CB@CB@CB@CB@CB@CBCBЉ@CBp@CB0@CBCB@CB@CB@CB CB (@CB @CB @CB CB @CB @CB @CB CB @CB `@CB x@CB CB h@CB @CB @CBT@CBCB@CB@CB(@CBCBP@CBp{@CB@CBCB@CBȄ@CB@CB@CBЉ@CB@CB@CBCB@CBp@CB@CBCB@CB@CB @CBCB`}@CBy@CB}@CBCBh@CB@CBx@CBCB@CB}@CBx@CBCB0@CBH@CB@C Table_JBDDC !!! $ C"  K7uM% ]5 mE "XK}XX Strategicfocus   #XX}f#}XX preICPD   #XX}# datacollectionandanalysis:   PXXXXP}XPX[G  N:uM% ]5 mE "N[G݀"0    #}P}v##XX}#0  toundertakegenderspecificanalysis9XX[G݌   Ќ  P99#PXXP9#P}XPX[G  T:uM% ]5 mE "uT[G݀"0    #}P}:##XX}|#0  topromotespecialsamplesurveys[G ݌"" Ќ  PXXXXP}XPX[G  T:uM% ]5 mE "uT[GB݀"0    #}P}##XX}##0  todevelopintegrateddatabasesystems[GB݌88 Ќ  PXXXXP}XPX[G  T:uM% ]5 mE "uT[G݀"0    #}P}##XX}#topromotecooperativeeffortsincompilationanddisseminationofstatisticson NN populationageing[G^݌  Ќ  Q7uM% ]5 mE "uQ research,includingevaluativeresearch prioritising D D  PXXXXP}XPX[G  N:uM% ]5 mE "N[Gl ݀"0    #}P}. ##XX}M #0  interdisciplinarystudies9XX[Gl ݌4 4  Ќ  P99#PXXP9 #P}XPX[G  T:uM% ]5 mE "uT[GG ݀"0    #}P} ##XX}( #0  genderspecificresearch[GG ݌J J  Ќ  PXXXXP}XPX[G  T:uM% ]5 mE "uT[G ݀"0    #}P} ##XX} #0  researchusefulforplanningandpolicymaking[G T ݌` `  Ќ  Q7uM% ]5 mE "uQ policyformulationandplanning:  ff PXXXXP}XPX[G  N:uM% ]5 mE "N[G&݀"0    #}P}##XX}#0  toprovideassistancetogovernmentsandNGOsworkinginthisfield9XX[G&݌VV Ќ  P99#PXXP9h#P}XPX[G  T:uM% ]5 mE "uT[G+݀"0    #}P}##XX} #v0  toassistinenhancingtheirinstitutionalcapabilities[G+݌ll Ќ  PXXXXP}XPX[G  T:uM% ]5 mE "uT[G݀"0    #}P}##XX}#0  toassistinpreparingalternativepolicyoptions[GX݌ Ќ  Q7uM% ]5 mE "uQ training: UNFPAissupportiveof  QXXXXQ}XQX[G  N:uM% ]5 mE "N[G5݀"0    #}Q}##XX}#theinclusionofageingrelatedcontentsintrainingprogrammesonpopulationand xx development9XX[G5݌ Ќ  P99#PXXP9#P}XPX[G  T:uM% ]5 mE "uT[GH݀"0    #}P}##XX})#thepromotionofspecifictrainingactivitiesonpopulationageingfordecisionmakers ~~ andplanners[GH݌  Ќ  Q7uM% ]5 mE "uQ awarenesscreation:  tt PXXXXP}XPX[G  N:uM% ]5 mE "N[G݀"0    #}P}_##XX}~#tofurtherunderstandingofeconomic,socialandculturalimplicationsofpopulation dd ageing9XX[G݌zz Ќ  #XX9#T:uM% ]5 mE "uT0 TXXXXT}XTX[G  T:uM% ]5 mE "uT[G݀"0  #}T}##XX}#tosupporteducationandcommunicationactivitiesthroughformalandinformal jj channels[G݌  Ќ  QXXXXQ}XQX[G  T:uM% ]5 mE "uT[G݀"0    #}Q}##XX}#tointegrateissuesofpopulationageingintoexistingIECprogrammesinpopulation pp anddevelopment[GY݌  Ќ  Q7uM% ]5 mE "uQ evaluationofactionprogrammes: UNFPAtomakeassistanceavailable f"f"" КPXXXXP}XPX[G  N:uM% ]5 mE "N[Gx ݀"0    #}P}: ##XX}Y #0  formonitoringandevaluatingspecificpolicyinterventionsbygovernmentsand V#V## NGOs9XX[Gx ݌l$l$$ Ќ  P99#PXXP9!#P}XPX[G  T:uM% ]5 mE "uT[G"݀"0    #}P}@"##XX}"#forassessingthefeasibilityandeffectivenessofprogrammesmeetingthechallengeof \%\%% progressiveageing[G"#݌  Ќ  Q7uM% ]5 mE "uQ)Hairline dFFCFCFCFCFCFCFN@CFCF a@CFe@CF@n@CFr@CF|@CF@CFCFM@CFU@CFV@CF_@CF`@CFe@CFCF@S@CFU@CF@c@CFe@CFt@CF@w@CF@CF@CF @CF*@CF.@CF<@CF@@CFCF @CF$@CF0@CF3@CFB@CFE@CFCF@P@CF@R@CF`@CFb@CFq@CF s@CF CF D@CF O@CF K@CF T@CF R@CF Z@CF CF "@CF $@CF 0@CF 3@CF B@CF F@CF CF ,@CF 2@CF 5@CF <@CF B@CF F@CF CF ?CF ?CF @CF @CF @CF @CF T@CFCF$@CF1@CF5@CFD@CFF@CFS@CFCF@CF&@CF&@CF8@CF2@CFB@CFCF@CF@CF&@CF0@CF:@CFD@CF@CFCFCF?CF?CF@CF@CFCFCF?CF?CF?CF@CF@CFCF@CF@CF"@CF.@CF7@CFA@CFCF@CF@CF@CF.@CF$@CF5@CFCF?CF?CF@CF@CF@CF@CFCF@CF@CF@CF@CF@CF"@CFCFCFCFCFCFCF?CTable_LF((3$ !      0  Table_CTable_H(3$ !  Table_DLevel 1Level 2Level 3Level 4Level 5Table_E d !!!\  `*Times New RomanTT75>?A<< C( $ Figure  1  9999'dxdTable_I Table_J Table_K Table_L U C"  K7uM% ]5 mE "XK Title:  LocalLevelPolicyDevelopmenttoDealwiththeConsequencesof      PopulationAgeingLocale:  RegionalAsiaandPacific9XX  #XX92#Agency:  KoreanInstituteforHealthandSocialAffairs(KIHASA)  Objective:   C  $$C[G  N:uM% ]5 mE "N[GZ݀"0   9XXtocontributetothesuccessfulimplementationoftheInternationalConferenceonPopulationand  Development(ICPD)ProgrammeofActionthroughtheInternationalSymposiumentitledPopulationand  DevelopmentPoliciesinLowFertilityCountries:ChallengesofChangingAgeStructures.#XX9#[GZ݌XX Ќ  C  $$CQ7uM% ]5 mE "uQ(#$  0   ((G&L (\  `*Times New RomanTT\  `*Times New RomanTT\  `*Times New RomanTT\  `*Times New RomanTT EVPDE>c$"Small Circle"0 "%%"<3|x \\R3' Letter\d C"  K7uM% ]5 mE "XK Title:  CommunityParticipationinProvidingCare,ServicesandActivitiesfor  Thai    Elderly    Locale:  Thailand  Agency:  Government   9XXSurveyresultsindicatethatoveronethirdofThaielderlyfacefinancialdifficulties,anotherthirdsufferfrom  healthproblems,andmosthavelittleknowledgeorawarenessofthelimitedwelfareprogrammesavailabletothem;recognisingthesedifficulties,thispilotprojectfocusesonsettinguptheElderlySocialServiceCentresonapilotbasisbytheDepartmentofPublicWelfare.#XX9# Objectives:    [G  N:uM% ]5 mE "N[G݀"0   xXXXXx9XxXtomobiliseandutilisefinancial,physicalandhumanresourceswithinthecommunityinordertopromote   socialandeconomiccontributionsbytheelderlyThaipopulationtotheirownwellbeing#9x90##XX9O#9XX[G݌  Ќ  C $$C[G  [G.݀"0   #XX9#9XXtoassessthecurrentsituation,existingneedsandpotentialforselfhelp[G.I݌h h  Ќ  0 [G  [Ga݀"0  #XX9#9XXtocreateawarenessandunderstandingoftheneedsandcapabilitiesoftheelderlyamongpublicwelfare 0 0  officers,communityleadersandvoluntaryworkers[Ga|݌  Ќ  [G  [G݀"0   #XX9#9XXtodevelopaselfhelpschemeforprovidingservicestotheelderlyinfourselectedcommunitiesby   establishingtheElderlySocialServiceCentres#XX9L #[G݌ Ќ  C $$ CQ7uM% ]5 mE "uQ\  `*Times New RomanTT !   XXXX  K7uM% ]5 mE "XK VX XUKUS.,  5PPopulationAgeing:BackgroundReview  # XX V# X XTechnicalandPolicyDivision,UNFPA >~    # XX t# Nw X XViewedasawholetheproblemofageingisnoproblematall.Itisonlythepessimistic   wayoflookingatagreattriumphofcivilization(Notestein,1954).# XX  Nw #     Thisreviewisdividedintothreebroadparts.Inthefirstpart,thepaperaddressesthefundamentaldemographicprocesseswhichunderliethestructuralageingofpopulationsandtheoutcomesintermsofchangingageandgenderbalances,andunevenspatialdistribution.Limitationsofchronologicalageindefiningconceptsofdependencyarealsodiscussed.Parttwoaddressesthemajorissuesproducedbyageingprocessesforindividualsandnationalgovernmentsoragenciesinthecontextofdiversecultural,socialandeconomiccontexts.Theseissuesrangefromthepersonalneedsandpreferencesofolderpersonsthemselvestothesupportofcaregiversandagencies,andtoprivateandpublicobligationsandfundingforthewelfareofolderpersons.Finally,inthethirdpart,thereviewoutlinesandsummarisesUNFPAparticipationinpoliciesandprogrammesaimedatthoseundertakingtheresponsibilityofpromotingthewelfareofolderpersonsandparticularlythoseprojectsadoptingthestrategicfocusdevelopedinthepostICPDphase.  Throughoutthereviewolderpersons,orsynonymously,theelderly,aregenerallydefinedas ,l those60yearsofageandover.However,examplesarecitedinafewinstancesfromcountriesorstudieswhichhaveadopted65yearsofageasthethresholdforidentifyingthisgroupofpeople. X X   1 @  @  @ DEMOGRAPHICPROCESSESANDOUTCOMES  T   # XX # X X PopulationAgeStructure  ]  # XX  #Populationageingisincreasinglybeingrecognisedasaprocessofmajorsignificanceforallsocieties s!  astheyenterthetwentyfirstcentury.Inthesecondhalfofthetwentiethcentury,agecomposition,asanintegralelementofpopulationchange,tendedtobelargelyignoredinthepreoccupationwithrapidpopulationgrowthandtheissuesrelatedtoreducinglevelsofmortalityandfertility.Despitethewiderangeofimplicationsofyouthfulpopulations,notablyintermsofeducation,laboursupplyandunemployment,themainconcernwasperceivedtobethemomentumoftheagestructurewhichimpliedcontinuinghighnumbersofbirthsevenunderconditionsofdecliningfertilityrates.  Thescaleandextentofpopulationageinghasseenamajorshiftinfocusastheincipientageingofearlierperiodsandlocalisedcommunitieshasbecomeanemergingfeatureofpopulationsworldwide.Earlierreductionsinmortalityhadaratherdiffuseandunevenimpactontheagestructure,favouringinfantmortalityandgenerallyextendingexpectationoflife.Decliningfertility, +(+  57XXdXXd7   57XXdXXd7   57XXdXXd7  bycontrast,becauseitfocusedonasinglebirthcohort,hadamajorimpactontheagestructure,and  persistencetolowandevensubreplacementlevelshasinvertedtheagemomentumeffect,perpetuatingthelowfertilityandageingfeaturesofthesepopulations.Mostrecently,asreductionsinagespecificmortalityratesinchildhoodandyoungeradultageshaveattenuatedtolowifnotirreduciblelevels,significantimprovementsinlifeexpectancyareoccurringwithinolderpopulations.Thisdevelopmenthasfurtheraccentuatedthetrendtoexpandednumbersandproportionsofolderpersonsinthepopulation.  Thesamebasicdeterminants,mortalityandfertility,havealsoinfluencedthebalancebetweenthesexesatanygiventime,butinspiteofrelativelyhighsexratiosatbirthandthereductionsinmortality,higheragespecificmortalityratesformalespersist,resultinginlargernumbersandproportionsofelderlywomenthanmen.Consequently,theburgeoningpopulationofolderpeoplealsoraisesimportantgenderissuesparticularlyinsuchareasashealth,incomeandwelfare.  Theeverchangingagestructuresofcountriesworldwideareincreasinglyportrayingcharacteristicsofageingasmostcountries,toagreaterorlesserdegree,experiencethedecliningfertilityrateswhichareaprimarydeterminantofpopulationageing.Eventheleastdevelopedcountriesdisplaytheincipientsymptomsofthistrendwhichwillbecomeanalmostuniversalfeatureofnationalpopulationsintothetwentyfirstcentury.Moredevelopedcountries,withsustainedloworsubreplacementfertility,alreadyhavelargeelderlypopulations(Golini,1997)andamongothercountriesnowfollowingthispaththerapidityoffertilitydeclineisdeterminingtheunprecedentedspeedoftheageingprocess(UNFPA,1998). }X X Medianage # XX }#ԀAsummarymeasureofagestructure,suchasmedianage,reflectsthegeneralshift P inagedistributionwhichhasaccompaniedchangesinfertilitylevels(Table1).Attheworldscale,increasinglyyouthfulpopulations(withthemedianfallingtolessthan22yearsofage)characterisedthe1960sand1970sduringthephaseofrapidgrowth,afeaturestronglyapparentinlessdevelopedregionsbutnotinmoredevelopedregionswherelowbirthrateswerealreadycommon.Throughthe1980sand1990s,medianageshavebeenrisingalmosteverywhereaslowerfertilityhasbecomemoreandmorewidespread,andevenleastdevelopedcountries(whichareasubsetofthelessdevelopedcategory)withamedianageof17.9yearsin1995,hadjoinedtheoveralltrend.SpecificAfricancountries(Table1)arestillveryyouthfulalthoughmost,likeAlgeria,havepassedtheirnadir.InmanycountriesofAsiathemedianage,asinKorea,isalreadyintothelatertwentiesandthisisalsotrueofmorematurepopulationsinLatinAmericaandtheCaribbean,suchasArgentinaandCuba.  Bytheturnofthecenturythemedianageincountriesinthe moredevelopedregions is %!$ expectedtoexceed37yearsofage,alevelofmaturitycharacteristicofbothEuropeandNorthAmericaandexceededbyJapan(theleadingexample)withamedianageofnearly41.Theshiftinagedistributionwillbecomeevenmoreextensiveandfundamentalthroughthefirsttwodecadesofthetwentyfirstcenturyasmoredevelopedregionsreachamedianofabout42yearswithsomeothercountriessuchasGermanyandItalymatchingorovertakingJapan.Even lessdevelopedregions  V*&) move,onaverageoverthefiftyyearperiod1970to2020,fromamedianageof19yearstoamedianexceeding29years. 6,v(+ Ї  Asameasureofcentraltendency,themedianageisnotaparticularlysensitivemeasureofthemajorchangesoccurringattheextremesoftheagedistribution,sinceitisattheyoungestandoldestagesthatthegreatestimpactoccurs.Asyoungercohortstendtobecomeproportionately(andinthelongertermevennumerically)smallerthanpreviously,adultgroupsofworkingageexpand,stabiliseandevenshrinkastheperistalticeffectofsuccessivebirthcohortsmovesthroughtoexpandolderagegroups. }X X Functionalagegroups # XX } #ԀIntheperiod19702020thechildshareoftheworldstotalpopulation P  isexpectedtohavereducedbymorethantwelvepercentagepoints,threefifthsofthatdifferenceaccruingtothe1559agegroupsandtheremainderbeingreflectedintheexpansionoftheelderlyagegroups.Consequently,asearlyas2020,thepopulation60yearsofageandoverisexpectedtoexceed13percentofthetotalworldpopulation(Table2).Intermsofabsolute numerical growth 6v  thechildpopulationisexpectedtohavegrownby545million,orabout39percent,19702020,theworkingageadultpopulationby2,730million(136percent),andthe60andoverpopulationby694millionor223percent,toreachatotalofabout1,005millionolderpersons.  Theshiftinagedistributioncontinuestobegreatestinthelowfertilitycountriescomprisingthe moredevelopedregions wheretheworkingagepopulationalreadycomprisesabout62percent  ofthetotalandolderpersonsmorethan18percent(1995).By2020theworkingagesharewillhavedeclinedtoabout58percentandthoseaged60andoverwillcompriseonequarterofthepopulation,asdemonstratedbyEuropeandNorthAmerica,thetwomajorcontinentalregionscontributingtothemoredevelopedregions.By2020,the lessdevelopedregions willalsohaveabout62percent  oftheirpopulationsintheadultworkingages,butthechildcomponentwillstillexceedaquarterofthetotalandtheelderlyabout11percentlessthanhalfthecomparableproportionsinthemoredevelopedregions.Withinthisgroupoflessdevelopedregions,in2020,the leastdeveloped f countries areexpectedtohaveafunctionalagedistributionsimilartothatofthetotalworld V populationfiftyyearsearlier,in1970.  Thespatialdistributionoftheworldspopulationamongthemajorworldregionsisevenmoresignificantintermsoftheimplicationsfortheprovisionofbasichumanneeds.In1970,thepeoplein lessdevelopedregions alreadycomprisedabout73percentoftheworldstotalpopulationand  F thissharehadrisentoabout79percentin1995,andcanbeexpectedtoreachabout84percentby2020.Consequently,irrespectiveoftheproportionalagedistributionwithinregions,theless !&  developedregionshavemorechildren,moreadultsofworkingageandmoreolderpersonsthanthemoredevelopedregionsbyawidemarginandtheshareofallgroupswillcontinuetoincrease.Specifically,in1995,thelessdevelopedregionshad87percentofthechildren,78percentofthoseofworkingage,and61percentoftheelderly.By2020,thisshareisexpectedtoincreaseto89percent,85percentand70percentrespectively,withmajorimplicationsfortheprovisionofeducation,productiveworkandsupportoftheaged,inadditiontosuchbasicneedsasfood,clothingandhousing.  Inviewofthissituation,anassessmentofimpliedneedsandappropriatepolicymeasuresforparticularagecategoriesofthepopulationmustfocusparticularlyonthesituationinthecountriescomprisingthelessdevelopedregions.Furthermore,theoverwhelminglypredominantshareofthe 6,v(+ worldspopulationatallagesandtheissuesandproblemsassociatedwitheachrequiresthat,evenwhereoneagecategoryissingledoutforanalysisandevaluationofspecialneeds,policydecisionsmustadoptamoreholisticview,andparticularsubgroupsandremedialmeasuresmustberesynthesisedwiththoseofthewidercommunitytopromoteandsupportasocietyforallages.   }X X OlderPersons  p  Growthofolderpopulations# XX }/#Ԁ Giventhemajorandincreasinglyuniversalshifttowardsolder   populationsitishardlysurprisingtodiscoverthatthescaleandspeedofchangeinpopulationsattheseagesisexceptional.Overthelast25yearsto1995,inallbuttheleastdevelopedcountriesthepopulationaged 60andover hasbeenincreasingat,orfasterthan,thetotalpopulationgrowthrate |   (Table3).IfthetwolargelyoverlappingregionsoftheleastdevelopedcountriesandAfricaareexcluded,thegrowthrateoftheelderly60yearsofageandovereverywherehasbeenmuchmorerapidthanforthetotalpopulations,andinthemostextremecase,thatofEurope,theratewasthreetimesasfast.  Intheperiod19952020,thedifferencebetweenthe60yearsofageandoverandtotalgrowthratesisexpectedtoincreasesubstantially.Attheworldscale,thegrowthratefortheelderly60andoverisdoublethegeneralrate.Inthelessdevelopedregions,includingAfricaandLatinAmerica&Caribbean,theaverageannualrateisinexcessofthreepercentagain,asmuchasdoubletheoverallgrowthrate.Inregionswherethetotalgrowthisverylow,theelderlycomponentisgrowingatmanytimesthetotalpopulationrate.  Evenmorenoteworthy,however,istherateofgrowthintheolderagedpopulation, 80years  andover .Ratesfortheseagesworldwideexceededthreepercent,19701995,reflectingincreased  lifeexpectancyfortheoldestageswhichhasalreadybeenmakinganimpactoverarelativelysustainedperiod.Inthe moredevelopedregions ,notablyEuropeandNorthAmerica,theserapid | growthratesforthe80andoverpopulationsdropbyfiftypercentthroughthe19952020period,butinotherregionsratesofincreaseintheoldestpopulationswillbemaintainedatsimilarhighlevelstothosefor19701995(Table3). }X X Sexratios # XX }K8#ԀDespitethesubstantialgrowthtrendsforbothsexes,thesexratioscontinuetoreflect , l theestablished,strongpredominanceofwomenatallolderages(Table4).Thesexratioswithinthe B! elderlyagegroupsarelowestinthoseregionswiththelargestandlongestestablishedproportionsofolderpersons.Forage 60andover ,the moredevelopedregions withpersistentlowfertilityand "#b! relativelylargeolderpopulationsaveragedsexratiosaslowas645malesperthousandfemales(inEurope)in1970,whileNorthAmericahadsomewhathigherratiosatabout760malesperthousandfemales.Amodestrecoveryintheproportionsofmalesisexpectedtooccurinmoredevelopedregionsby2020toatleast725perthousand(inEurope)andtolevelsabove800elsewhere.In1970, lessdevelopedregions collectivelyrecordedratesaround880malesperthousandfemalesandwere '$& expectedtomaintainthesethroughto2020.  Sexratiosforpopulationsaged 70andover reflectedtheincreasingpreponderanceofwomen *&) attheseageswithlevels,particularlyinmoredevelopedregions,about100pointsperthousandlowerthanforthecorrespondingyearforthepopulation60andover.Thedifferenceinsexratios ,(+ betweenthe60andoverand70andoverpopulationstendstobesmallerforthelessdevelopedregions.Atages 80andover ,theworldaverageisbelow600malesforeverythousandfemales.  Inthe moredevelopedregions womenin1970outnumberedmenbytwotooneand,withsome  oscillation,thispatternwillpersistto2020.Inthe lessdevelopedregions a1970ratioofabout750  hasdroppedabout100pointsbutislikelytomaintainthislevelsubsequentlyataround650malesperthousandfemales. }X X OverallDemographicAppraisal  P  # XX }L@#Ingeneral,theestablishedpatternofsubstantiallylargernumbersofwomeninolderpopulationswill f  continueandbecomeprogressivelygreaterascohortsadvanceintoolderages.Overtime,theUnitedNations(1997b)projectionssuggestthat,forthe moredevelopedregions ,sexratiosamongolder F  populationsmayhavereachedtheirnadirtowardstheendofthetwentiethcenturyandmightbeexpectedtoriseagaininthefollowingdecades,revertingtolevelssimilartothosepertaininginthe1970s.Inthe lessdevelopedregions ,sexratioshadnotsunksolowand,enteringthetwentyfirst V  century,aremorelikelytoremainatlevelscharacteristicofthe1990s.Womenthereforecomprisebyfarthegreaterproportionofolderpopulationsatanyadvancedage,andalthoughtheproportions 6 ofelderlywomenarelargestinmoredevelopedregions,muchlargernumbersofelderlywomenare & locatedinlessdevelopedregions. }X X Spatialvariations # XX }D#ԀThespatialdistributionoftheelderly,astheendproductofthedifferential  growthratespreviouslydiscussed,reflectsnotonlytheburgeoningnumbersofolderpersonsinlessdevelopedregionsbutalsothevaryingdegreesofconcentrationandpredominanceofthefemalecomponentoftheaged.Alreadyby1970,thepopulationaged 60andover inlessdeveloped  regionswasdistinctlylargerthaninmoredevelopedregionsalthoughthefemalecomponentwasaboutthesame(87millionineachofthetworegions;Table5).By2020,thelargenumbersofolderpersonsinlessdevelopedregionswillnotonlybesubstantiallymorethandoublethoseinmoredevelopedcountriesbutwillcompriseover40millionmorewomenthanmen.Over80percentoftheelderly,bothmaleandfemale,inlessdevelopedregionswillthenbelocatedinAsia(Neville,1992)  Inthe1990s,thepopulationaged 80andover isstillconcentratedinmoredevelopedregions, , l anditisthelargefemalenumberswhichaccountforthis(Table5).By2020,however,thepredominanceofthelessdevelopedregionsasthemainlocaleoftheelderlywillhaveprevailedattheseagesalso,forbothmenandwomen.Again,attheseolderages,mostoftheelderlyidentifiedaslivinginlessdevelopedregionswillbeinAsia:theprojectionsindicatethisconcentrationtobeabout88percentforeachsex.Infact,itisanticipatedthatmorethanhalfofthemalesandabout46percentofthefemalesaged80andoverworldwide,willbelivinginAsia. }X X Limitationsofageasanindicator# XX }K#Ԁ Whiletheprecedingdiscussionhasadoptedaseriesof '#& simplestatisticalmeasurestoassistinidentifyingthebroadparametersoftheolderpopulationsdistributedworldwide,bothintherecentpastandfortheimmediatefuture,thatsuchananalysisisonlyafirststepindeterminingthefundamentalcharacterandneedsofolderpersons.Asasurrogateforidentifyingtheparticularneedsofamajorclusterofpeoplewithinapopulation,ageprovidesarathercrudetool.Althoughcertainproblemsandneedsarestronglyassociatedwithage,groups ,(+ definedbyagecanbeextremelyheterogeneousintermsofeducationalattainment,healthstatus,incomeandmanyothermajorvariables.Justasthereisacommonelementtogetherwithadiversityofneedsforthethirtyyearagecategory030years(whichwouldneverbetreatedasasinglehomogeneousunit),sotoothereisimmenseheterogeneityinthecharacteristicsandneedsofpopulationsaged6090andover.Recognitionofthisdiversityisessentialifthemainstreamofolderpeopleistoachieveasatisfyingqualityoflifethroughactiveageingwhilethemostmarginalisedandneedyaresimultaneouslyandeffectivelyincludedinrelevantpolicydecisionsandappropriateprovisions.  Forsimilarreasonsthenotionalconceptofthedemographicdependencyratio,inwhichchildrenandolderadults,togetherdefinedasdependents,areoffsetagainstthoseostensiblyofworkingages,isextremelyunsatisfactory(Dean,1993).Differencesbetweencountriesinageofcommencementandcurtailmentofparticipationineconomicactivityvarywidely,thedefinitionandvariablenatureofworkundertakenatallagesandtheheterogeneitywithinsuchbroadagecategoriestotallydefeatanyusefulinterpretation.Additionally,themeetingofneedsoftheelderlybytheirownendeavours,byvoluntaryactivitiesofcommunityorfamilycaregiversoftenwithoutremuneration,confusesmorethanitclarifiesanddefaultstoadependencystatusnotonlyinappropriateandunacceptabletomanyolderpersonsbutunreliableandmisleadinginitsreflectionofreality.   }X X 2@..CULTURAL,SOCIALANDECONOMICISSUES # XX }T# p    }X X MaritalStatusandLivingArrangements  1 # XX }iU#Thepatternofmaritalstatusofoldermenisverydifferentfromthatofolderwomenthroughoutthe G world.Althoughwidowhoodisincreasinglyprobableforbothsexesasageadvances,marriedmenusuallyoutnumberwidowersevenatquiteadvancedages.Bycontrast,womenaremuchmorelikelytobewidows,andwomenofwidowedstatuscommonlyoutnumbermarriedwomenatolderagesinmanysocietiesalthough,inthecaseofEnglandandWalesin1991,forexample,thisdidnotoccuruntiltheageof73(Grundy,1998).Thereasonsforthisgenderdisparityarereadilyapparent.Womenhaveagreaterlifeexpectancythanmen,andinmostsocietiesarelikelytobeyoungerthantheirspouses,increasingtheprobabilityofsurvivingthem.Similarly,inmostsocieties,menaremorelikelythanwomentoremarrypartlybecausethepaucityofavailablemalesreducestheoptionofremarriageforwomen.Inaddition,significantdifferencesoccurfromonesocietytoanotherinnumbersnevermarryingordivorced,andthiscomponentisasignificantsubgroupamongolderpersonsinsomeinstances.  Althoughmaritalstatusprovidessomeindicationoffamilyrelationships,ofgreatersignificancefortheelderlyistheextenttowhichgenerationsarecoresident.Withescalatinglifeexpectancyandtheincreasinglycommonoccurrenceoffourgenerationfamiliesinmanysocieties,especiallyinAsia,NorthAmericaandEurope,expectationsthattraditionalfamilypracticesincaringfortheelderlywouldbeexpandedandelaboratedmightwellbeanticipated.Forexample,inFrance +7(+ P  P  P  26percentofthewomenbornin1930werepartofafourgenerationfamilyattheageof60andeventheleastfavourablesurvivorshiphypothesisinflatesthisproportionto33percentintheforeseeablefuture(Pennec,1997).Evenwherethreegenerationsarestillpredominant,postponementofchildbearingbycareerwomeninlowfertilitycountriestendstoresultintheirmovinginshortorderfromasituationofdependentteenagechildrentodependentelderlyparents.Despitetheapparentadvantagesofmultigenerationalcoresidence,inmostlowfertilitysocietiesthetrendistowardsseparatelifestylesandgreaterindependence.  Historically,formanyculturesinAsia,multigenerationalaccommodationarrangementshavebeenintegraltosocialorganisationwhereasthishasbeenlesscommoninEurope,althoughsomeconsiderthatthedifferencesmayhavebeenoverstated(Goody,1996).InChinaandKorea,forexample,olderpeoplemostcommonlylivedwithamarriedeldestson,orfailingthat,withanothermarriedsonoranunmarriedchild.However,thecurrentevidencesuggeststhatincountrieswherethispatternoflivingwithadultchildrenhasbeenwidespreaditisundergoingrapidmodification.Whiletheformoflivingarrangements,whethercoresidentorindependentisoftenaddressed,what   iscommonlyneglectedisdeterminationofthefunctionofcoresidenceornoncoresidence.  Coresidencemaysignifysupportflowingfromtheelderlyparentstotheiroffspringintheformofchildcare,shoppingandmealpreparationratherthanassistancetotheoldergeneration.Withincreasesinincome,noncoresidencemaysignifyagreaterpreferenceforprivacyandindependenceonthepartofparentsandadultchildren(Hermalin,1997).  InKorea,theproportionofolderpeoplelivinginhouseholdscomposedonlyoftheelderlyrosefrom23percentin1985to42percentin1995(Chung,1998).Resultsofthe1997KoreanNationalFertilityandFamilyHealthSurveyindicatedthatover70percentofwomensaidthattheydidnotwanttocoresidewiththeirchildreninoldage,whereasundereightpercentsaidtheydid.Ontheotherhand,somewhatunusually,averylargeproportionindicatedthattheywouldpreferinstitutionalcaretohomecareinoldage(Lee,1998).Whetherpracticewillactuallycorrespondtothisexpressionofintentremainstobeseen.  AlthoughcoresidencecontinuestobethecoreofsupportrelationshipsbetweenparentsandadultoffspringinChina,levelsofcoresidencethemselveshavedeclinedovertime.Despitemostparentsstilllivingwithoneoftheiradultoffspring,noncoresidentchildrenmaintainhighlevelsoffacetofacecontactwithparentsandprovidehelponaregularbasisevenininstanceswheretheparentslivewithanotherchild.Thereisalsoabiastowardlivingclosertosonscomparabletothegenderbiaspreviouslyfoundforcoresidence(Bian,LoganandBian,1998).Thisstudyofintergenerationalrelationships,undertakenintwomajorChinesecities,foundnoeffectsofparentsageorhealthonproximity,contact,orhelpbutrather,suggestedthatsupportofparentsrepresentsnotsomuchparentalneedsasfilialobligation.Somekindsofhelp,suchasfinancialaidtoparentswithnopensionoronlyasmallretirementincome,haveastronginstrumentalcomponent,butweeklyvisits,atokengiftorregularhelpwithsomeaspectofshoppingorhouseholdcarecanbemoresymbolicthaninstrumental,expressingpubliclytheideologyofrespectandfilialpiety.  FortheChinese,majoradjustmentsstilllieinthefutureastheChinesefamilyisenmeshedinprocessesforwhichimpactsremaintobeassessed.Thefirstcohortoftheonechildfamilyerais ,P(+ nowreachingadulthood,andparentsandchildrenwillgraduallybegintoexperiencetheconsequences.Certainlygenderpreferencesareunsustainableifparentshaveonlyadaughter.Choiceswillalsohavetobemadeastowhetherparentslivewiththeironlyadultchildoracceptthecontemporarytrendawayfromcoresidence,andliveapartfromtheiroffspring.Theadjustmentstofamilyarrangementsforageingparentsarelikelytobeasfundamentalastheeconomicandsocialadjustmentstolowfertilitylevelsachievedbytheonechildfamilypolicy.  Japan,representsaparticularlysignificantexamplebecause,whileperceivedtobesharingmanydemographicandeconomicfeatureswiththemoredevelopedsocietiesofEuropeandNorthAmerica,inmattersoffamilydemographyitiscommonlybelievedtosharemorewiththenewlyindustrialisingsocietiesofEastAsia.Certainly,thetraditionofsupportwithinthehomehasnotbeenentirelylostandattemptsarebeingmadetoencouragetheretentionofthissystem.Reportedly,increasingnumbersofoldermenandespeciallyolderwomenarelivingaloneor,inmuchsmallerandquitestablenumbers,inhospitalsorinstitutions.Theproportionofolderpersonsinonepersonandcoupleonlyhouseholdsisontherisebutisstilllowerthaninothercountriesinmoredevelopedregions(Kojima,1998).Ofthepopulationaged65andover,56percentlivedinthreegenerationhouseholdsasrecentlyas1972,butthisproportionhadfallento33percentby1995(OgawaandRetherford,1997).However,astheseauthorsnote,populationageing,thegrowthofthesocialsecuritysystem,andtheweakeningoffamilycareoftheelderlyinJapanconformtoapatterncommontoallcountriesthatmoderniseandundergodemographictransition.  Japandiffersinthespeedandextentofpopulationageingandtheinitialstrengthoftraditionaljointfamilyarrangementsandvaluesoffilialpiety.Althoughchangesinvalueshavetendedtolagbehindchangesinunderlyingeconomicandsocialconditions,theoryandevidencesuggestthatthegovernmentseffortstoshiftsomeoftheresponsibilityforcaringfortheelderlyfromthesocialsecuritysystembacktofamilieswillnotbeverysuccessful.Thereasonsarefamiliarintheexperienceofotherdevelopedcountries:declinesincoresidence,increasesinwomenseducationandfulltimepaidemployment,increasesintheratioofimpairedelderlytoavailablecaregivers,andweakeningvaluesoffilialpiety.  Bycontrast,inThailand,wherethepreferenceforlivingwithadultsonsislesspronounced(andisactuallyhigherformarrieddaughters),widespreadabandonmentofobligationstoThaielderlybytheirchildrenorkinisviewedasunlikely,althoughtheimpactofrapidfertilitydeclineandsocioeconomicchangemaymodifythesituationinthefuture(KnodelandNapaporn,1997).InSingapore,thegovernmentconsidersthatprimaryresponsibilityforolderpeoplestilllieswiththefamilyandvariousschemeshavebeenintroducedtoencouragethis.Publichousingprovisionsnowincludegrannyflats,multigenerationalaccommodation(inpublichousingpreviouslyrestrictedtonuclearfamiliesonly),orpriorityforelderlyparentstoliveincloseproximity(Yap,1998).A1995surveyrevealedthattherehadbeennodeclineintheproportionofelderlycoresidingwithatleastonechild.Amongthoseaged60andover,morethan85percentlivedwithoneoftheirchildren(Chan,1997).    TheexperienceofsomesocietiesinwesternEurope,althoughsignificantlydifferentintheevolutionofmarriagepracticeandfamilystructuresfromcountriesinAsia,isproducingasomewhat ,P(+ similarresulttosomeofthemoreaffluentAsiansocietieswherecoresidenceappearstobedecliningτeverlargernumbersofolderpersonslivingalone,withwomenmuchmoreaffectedthanmenattheoldestages.TheincreasingautonomyofolderpeopleisillustratedbythecaseofFrancewheretheproportionofpeopleaged60andoverwhoarelivingontheirown(withaspouseoralone)hadrisento85percentby1990,andfewerandfewerolderpeoplearelivinginahouseholdheadedbysomeoneelse(Toulemon,1997).  ThemainchangeinadultfamilylifeinFranceisthedecreasingproportionofmarriedpeopleatallages.Sincetheearly1970s,cohabitationwithoutmarriagehasemergedasthecommonwayofunionformation,asnineoutoftenunionsnowbeginwithoutmarriage(Toulemon,1998).Thisarrangementisnotconfinedtoyoungadults,butisoccurringamongtheover60swherecohabitationmayalsotakemorenovelformssuchasintermittentoralternatingcohabitation.Suchconjugallifestyleshelpresolveproblemsspecifictotheoldergeneration:theexistenceofchildrenandgrandchildrenwithwhomtheywishtoremainongoodterms;ownershipofproperty,especiallyhousestowhichtheelderlyareparticularlyattached;andtheexistenceofapastthatmustneitherbeforgottennordisowned(Caradec,1997). }X X EmploymentandRetirement   # XX }s#Issuesrelatingtoageofretirementandretentionofolderworkersinthelabourforcehavebeen  widelyandfrequentlydiscussedinmanyofthesocietieswhichcomprisethe moredeveloped  regions .Thereisaconsiderabledegreeofconsistencyinaddressingtheageingchallengesthathave  emergedinmoredevelopedregions.Thegeneralconsensuspointstothedesirabilityofincreasingtheeffectiveageofretirementbyremovingbarrierstoworkinginlaterlife,preferablybyenablingwithdrawalonagradualbasis,involvingmoreflexiblerulesandmoregradualtransitionssuchasthoseprovidedforbyparticipationintheparttimelabourforce.Thenatureandscaleofsupportofanolderpopulationdependsontheextenttowhichthepopulationingeneral,andolderworkersinparticular,participateinthelabourmarket.Higheremploymentratesreducefiscalpressuresassociatedwiththefinancingofpensionsandhealthcarewhilealsoincreasingrealincomesforthepopulationasawhole,significantlycontributingtothedifficultpolicytradeoffbetweenhighertaxesandlowerbenefits(OECD,1997).  Unemploymentratesarerelativelyhighinmostmoredevelopedregionsandmanycountrieshaverecordedasignificantdeclineinlabourforceparticipationofolderworkers,particularlymales.Whereasmostofthesecountriesinthemid1970srecordedparticipationratesformaleworkersaged55to64atlevelsfrom70percenttoover80percent,bythemid1990sFrance,theNetherlandsandGermanywererecordingratesofabout40percent,Italywasaslowas30percent(arelativelysmalldropfromjustover40percentparticipation),butothercountriessuchasAustralia,Canada,Ireland,Spain,theUnitedStatesandtheUnitedKingdomwerearound60percent.Bycontrast,SwedenandNorway,atover70percent,haddeclinedonlyafewpercentagepointsfromtheir1970slevels.ThehighestandmostconsistentoverthetwentyyearperiodwasJapanwhereparticipationratesformalesaged5564hadremainedatover85percent,despitetheadoptiononlyin1998ofanearlierdecisiontoadopt60asthestandardageofretirement.Theparticipationrateformales65andoverwasreportedtohavedroppedto37percentbythemid1990s,whereastheproportionofwomen65andovereconomicallyactivein1995wasonlyabout16percent.Slightlylessthan60percentof 6,v(+ bothmenandwomencombinedwereactiveaseitherselfemployedorfamilyworkers(Westley,1998;Kojima,1998).  Arecurrentandmajorexplanationforfallingemploymentisthatemployersappeartobereluctanttoemployoreventoretainolderworkersonthegroundsthattheirskillsandcompetenciesareobsolete,ageingimpairsperformanceandreducesproductivity,andsenioritybasedremunerationraisesthecostofemployingolderworkers.Evidencefortheseassertionsismixed,andwithearlyretirementprogrammestargetedatolderworkers,employeesreactionsmaymakethemselffulfilling.Measuresofproductivitysuggestthatwhatolderworkersmaylackinresponsetotestsofcomplexmemoryandphysicalreactionmaybemorethancompensatedforbyexperienceeffectsandworkhabits.  Anotherreasonforthedeclineinparticipationratesofolderworkersisanincreasedpreferenceforretirement,butotherfactorssuchasretirementpolicies,socialsecuritysystemsandlabourdemandarelikelytobeofgreaterfundamentalimportanceastheunderlyingfactorsinfluencingtheactualtimingofretirement.IntheUnitedStates,theaccelerateddecreaseinlabourforceparticipationcorrespondsroughlytotheintroductionofSocialSecurityandtheadoptionofemployerprovidedpensionplanswhichhavebothbeenshowntoconstitutesubstantialincentivestoleavethelabourforceearly(Wise,1997).Inaddition,suboptimalhealthcanalsobeapredisposingelementinfavourofretirementintheUnitedStates,whereaspersonalsavings,becausetheyarerelativelylow,donotencourageretirement.  Provisionsofpensionschemesandthepresenceofearlyretirementpoliciesoftenreduceincentivestoprolongparticipationevenwhenindividualsmaywishtopostponetheirdeparturefromthelabourmarketortohaveamoreflexibletransitionfromworktoretirement.Despitetheevidencesuggestingthatthereisnorelationshipbetweenthefallinparticipationratesofolderworkersandrecordedunemployment(OECD,1997),earlyretirementisoftenencouragedintheexpectationthatitwillimprovejobprospectsfortheyoungunemployed,andmanyEuropeancountrieshavesocalledunemploymentpensionswhichfunctionasearlyretirementschemes.However,withdrawalofolderworkersfromthelabourforcedoesnotnecessarilyresultindirectsubstitutionofyoungerworkers,andevenifsuitablereplacementscanbefoundtheolderworkersmaywellundertakealternativeemploymentelsewhere.Insituationswheresocialsecuritybenefitsaresufficientlygeneroustodiscourageactivesearchingforanotherjobtheeconomyisthendeprivedofvaluablehumanresources.Theprovisionsofsocialsecurityschemesmaycreateahighreservationwageforolderworkersandinsteadofreducingunemployment,forcedearlyretirementmayaggravatetheproblemoverthelongerterm,asearlyretirementisoftenfinancedbyhighertaxes.  Inanalternativeapproach,invalidityandsicknessbenefitshavealsobeenusedinmanycountriesassurrogateschemesforearlyretirementplans,particularlywhenunemploymentrateshavebeenhigh.Suchmeasuresnotonlyaffectcurrentflowsintowhatiseffectivelyearlyretirement,butalsohaveanimpactonthebehaviouroffuturecohortsofolderworkersbyraisingtheirexpectationsofanearlyexitfromthelabourforceandpossiblyreducingtheircurrentworkeffort. ,P(+ Ї  Anincreaseintheageofentitlementtoretirementbenefitsinordertoalignworkincentiveswithfiscalprovisionswouldhaveadirectimpactonthelabourmarket.Insomeinstancespensionbenefitsarenotactuariallybasedandthereforearenotreducedwhenpublicpensionsareobtainedbeforethestatutoryage,providingworkerswithanincentivetoretireearlier.Insomesystems,publicpensionshaveanearningsruleattachedtothemsothatanyearningsaboveacertainlimitmayresultinasubstantialreductioninpensionpaymentsor,ineffect,higheffectivemarginaltaxratesonearnedincome,disadvantaginganyonewhoworksbeyondthestatutoryretirementage.Suchprovisionsmayalsoaccountfortheabruptnessofthetransitionfromworktoretirement.Limitedportabilityofmanyprivatepensionplanshasaninhibitingeffectonlabourmobilitywhichisparticularlyacuteforschemesorganisedatthecompanylevelratherthanatthewidereconomicsectorlevel.Olderworkersmayalsosufferotherdisadvantages,includinglackofaccesstoretrainingprogrammes,anddifficultiesinsecuringjobsoncetheybecomeunemployed(Grundy,1998).  In lessdevelopedregions theabilityoftheolderpopulationtobeselfsupportingforatleast   someoftheirlateryearsisoftenoverlookedandonlythegovernmentsofthemoreeconomicallyanddemographicallyadvancedcountrieshavereallyrecognisedtheproductivecapabilitiesoftheelderlyandbeguntoinstituteprogrammestoencouragecontinuedeconomicactivityalbeitwithmixedsuccess.IntheRepublicofKorea,forexample,inordertoencourageretentionofolderworkersintheindustrialsector,thegovernmentenactedtheAgedEmploymentLawin1991requiringestablishmentswith300ormoreemployeestoemployatleastthreepercentolderworkers(Song,1998)althoughreportedlysomefirmswouldratherpayfinesthanconformtotheserequirements(ChoandByun,1998).Followingtheenactmentofthislaw,publicenterprisesincreasedthemandatoryretirementageto60,explicitlyattemptingtoemploymoreolderworkers,anexamplewhichleadingprivateenterprisesfolloweduntildivertedbythefinancialandforeignexchangecrisesof1997.Somecommentatorsconsiderthatmoredecisivegovernmentmeasuresarerequiredtoenableagreaterproportionofhealthyandactiveolderpopulationstocontinueworking.Employmentintheformofretrainingisparticularlydesirablesincethisallowsolderworkerstotakeupnewoccupationsandtocopewithrapidtechnologicalchange.  InrecentyearsSingaporehasinitiatedsignificantchangesinanattemptnotonlytoprovidepositiveopportunitiesfortheelderlybutalsotoensurethatthepaucityofyoungadultsenteringthelabourmarketdoesnothaveadeleteriouseffectonproduction.Apartfromtheinfluxofforeignworkers,measurestakentoenhancethesizeofthelabourforceincluderaisingtheretirementagefrom55to60yearsofagein1993,andprogressivelyto62in1999andto67in2003;andencouragingwomengenerallyandolderpeopleinparticularnotcurrentlyintheworkforcetoreturntowork.Thisisconsistentwiththegovernmentspromotionoflifelongemployabilitythroughlifelonglearningbywhichcontinuedeconomicactivitycanbeachievedonthebasisofretrainingandupskillingthroughoutthepopulation.Here,too,concernisbeingexpressedbyemployersovertherisingcostoflabourinthecontextofanageingworkforcewherethesenioritybasedsystemofremunerationhasprevailed.AdjustmentsarebeingmadetoincorporatesuchfeaturesasamoreflexiblesystemofpaymenttoreflectproductivityandtoreducerequirementsforcontributionstotheCentralProvidentFundforworkersover60. ,P(+   Focusingontheformalsectorofthemorehighlyurbanisedsocietiesinthelessdevelopedregions,especiallyinAsia,canbesomewhatmisleadingsincesuchobservationssuggestthatissuesofemploymentamongolderpeoplearebeingmetbyofficialmeasuresanalogoustothoseinvokedbycountriesinEuropeandNorthAmericaatanearlierstageintheageingprocess.However,formostofAsia,thegreaterproportionofopportunitiestoremaininthelabourforceoccurinasignificantlydifferentform:theyareconcentratedinservicesandagriculture,andratherthanrelyingonthepublicsectororlargecorporations,olderworkersaremorelikelytobeselfemployedoractiveinfamilybusinesses.Whileofficialmeasuresarelargelygeareduptotheparticularcircumstancesofurbanemployees,themajorityoftheactuallyorpotentiallyeconomicallyactiveareinruralareas,insmallfamilybusinesses,andintheinformalsectorinbothitsruralandurbanmanifestations.  Outsidethemodernandpredominantlyurbanbusinesssectortheconceptofretirementmayhavelittlecurrencyandfamilyrolesandeconomicactivitiesmerge.Forolderpeople,whetherurbanorrural,contributingtothecollectiveneedsofthefamily(asdistinctfromcontinuingtofollowapersonalcareerorevenpursuingindividualemploymentoutsidethehome)maynotgiverisetoaneedtodifferentiatebetweenactivitiescommandingremunerationandfulfilmentofobligationsanddutiesinthehome.Childcareandhousework(moreespeciallyforwomen),andfinancialassistanceandconsultationonfamilyorbusinessmatterswithinthehouseholdmaycontributejustassignificantlytofamilywellbeingasparticipationinproductiveprocessesidentifiableaseconomicactivity.Thisalsoprovidesareminder,aspreviouslynoted,thatcoresidenceneednotimplydependenceonthepartofolderpersonsbutintergenerationalsupportflowingfromparentstochildrenandgrandchildren.Thisagainraisesissues,particularlyforwomenbutalsoforallolderpeople,relatingtothedefinitionofwork,andthevalueofactivitiesundertakenwithouttherecognitionthatremunerationprovides.  Giventhesecircumstancesitisthereforehardlysurprisingthat,inthemanysurveysoftheelderlywhichhavebeenmadeinAsiancountriesinrecentyearsandtherangeofthemesaddressed,onetopicnotincludedisthatofworkandretirement.Althoughmanyofthesurveyscontainsomecurrentinformationonlabourforceparticipation,thecloselyrelatedtopicsofwork,wealthandretirementasstudiedinEuropeandNorthAmerica,havebeenlargelyabsentfrommostAsianstudiestodate(Hermalin,1997). }X X HealthandHealthCare  "! # XX }#Thehealthcharacteristicsofmostpeopleintheirsixtiesandseventiesarebroadlysimilartotherest # " oftheadultpopulation.Thestereotypethatcloselylinksageingwithinfirmityisunfounded.Thereareenormoushealthvariationswithineacholderagegrouprangingfrompersonswithvirtuallynoimpairmenttothosewithseveredisability.Beingsickandlimitedinlifechoicesistheantithesisofactiveageing.Thefactthatmostolderpeoplearereasonablyhealthyisasoundreasonforpursuingactiveageingpolicieswhichproactivelyencourageparticipationinthewidestpossiblerangeofactivitiesincludingemploymentand,asfaraspossible,removingbarrierstoworkandlearningforpeoplewhohavereachedsomenotionalageofretirement.Beyondthat,withthelargegrowthinthenumberofveryoldpeople,dependentcareforthefrailelderlybecomesastageoflifethatwarrantsrecognitionbyexistingpublicpolicymakers. 6,v(+ Ї  Althoughthemajorityofolderpeopleenjoygoodhealth,ageingisaccompaniedbybiologicalchangeswhichincreasetherisksofillness,disabilityandtheprobabilityofdying.Healthexpectancymaybeusedtodescribedisabilityfreeyearsoflifeandprobabilitiesdeterminedonthebasisofdecrementtablesderivedusingamethodologysimilartothatofthelifetable.Prevalenceofchronicillnessriseswithageand,asonewouldexpectin lowfertilitycountries where  degenerativediseasesprevail,comprisessimilarillnessesordisabilitiesinsuchcontrastingculturesasEnglandandJapan:musculoskeletalconditionsanddisordersoftheheartandcirculatorysystem.Whilechronicillnessmaynotamounttodisabilityorfrailtyandhavelittleinhibitingeffectontheactivitiesespeciallyoftheyoungerelderly,theprevalenceofdisabilitiesisstronglyagerelatedandreacheshighratesatmoreadvancedages(Grundy,1998).  Despitewomenhavingadistinctlylongerlifeexpectancythanmen,inmostmoredevelopedcountriestheyalsospendlongerinastateofimpairedhealth.However,whilethereappearstobeanincreaseintheprevalenceoflightandmoderatedisabilitiesaspeoplegrowolder,thisisaccompaniedbyalevellingorfallintheoccurrenceofseveredisabilities(Mertens,1994).Theincreaseinlifeexpectancyhastobepartlyexplainedbyaslowingintherateofprogressionofchronicdiseases.So,althoughthedeclineinmortalityleadstoanincreaseintheprevalenceofchronicdiseasesthesediseasesaregenerallymilderincharacterandtheseverityofdysfunctionisdeclining.Nevertheless,arecentanalysisprovidesevidencefortheUnitedStatesthatinthe1980sincreasesinlifeexpectancywereconcentratedinyearsspentwithoutdisability.Thisstandsinremarkablecontrasttotheprecedingdecadewhenalmostalloftheincreaseinlifeexpectancywasinolderyearscharacterisedbydisability.Whilethisoutcomewastrueforbothmalesandfemales,theincreasesinbothlifeexpectancyandlifeexpectancyfreeofdisabilityformaleshavebeenmuchlargerthanthoseforfemales(Crimmins,SaitoandIngegneri,1997).Morerigorousevidenceaboutthelinkagesamongmortality,health,dysfunctionandageingwouldenablegreaterprecisionintheassessmentoftheeffectsofchangesinepidemiology,medicalinterventionsandhealthpolicy.  Ageingpopulationspresentamajorchallengetosystemsofhealthandlongtermcare.Inmostsocieties,despitetherelativelygoodhealthofmanyoftheelderly,thereisaheavyconcentrationofhealthproblemsandlongtermcarecostsamongolderpeople,particularlytheveryelderly,andinsomemoredevelopedcountriesasmuchasonehalfofallhealthcareexpenditureoccursinthelasttwoyearsoflife(OECD,1997).Whereaspersonalhealthcareexpenditureincreasesonlymoderatelybeforetheageof60whenmortalityisstillrelativelylow,preliminaryestimatesindicatethatpercapitaexpendituresaroundage70aretwicetheaverage,peakingtofourtimeshigherforthoseaged80andover.Theconcentrationoflongtermcareuseamongtheveryelderlyisevenmoredramatic.  OtherrecentresearchcarriedoutintheUnitedStatesbutwithanapparentwiderapplicabilitysuggeststhathealthoutcomesatoldageareinfluencedbyhealthattributesofpastandconcurrentgenerationsofrelatives.Inparticular,parentsageofdeathandnumberofsurvivingsiblingsarebothcorrelatedwithdiseaseprevalenceandabilitytofunction.Stilltobedeterminediswhetherthiscorrelationreflectssharedgeneticendowments,wheresomefamiliesarehealthierthanothers,orthecumulativeimpactofcommonsocial,economic,andgeographicenvironments(SmithandKington,1997).Otherfindingsalsoindicatethatthegreaterinabilityofsomegroupstofunctioneffectively ,P(+ duringoldagehaslesstodowithethnicitypersethanthejointinteractionofsocioeconomicstatusandhealth.Furthermore,comparedtomen,womenofeachethnicgrouphavemorefunctionallimitations.Theseappeartoreflectarelationshipbetweenparityandgeneralhealthamongwomenover50yearsofage;differencesbetweenmenandwomeninhowtheyreportsymptomsandhealthoutcomes;and,giventheirrelativelyhighmortalityrates,agreaterdegreeofselectivityamongmalessinceonlythemorerobustsurvivetoolderages.  Inthemajorityof lessdevelopedcountries governmentsprovideverylimitedhealthservices P  ormedicalcaresothattheneedsofthelowerandmiddleincomesegmentsoftheelderlypopulationτpreventive,curative,restorativeandrehabilitativeremainlargelyunmet.Mostolderpeoplehavetodependontheirlimitedsavingsoronthesupporttheirchildrencanprovidefortreatmentandgeneralhealthcare.Statesupportedpublichealthservicesarelimitedintheircoverageandaremainlyconfinedtourbanareas.Thesefacilitiesareoftenovercrowded,unevenlydistributedandoverstretchedduetopaucityoffundingandqualifiedpersonnel,shortageofspace,poormaintenanceandindifferentservices(Bose,1996).  Gradualimprovementsinmostcountriesincludeseparateaccessandconsultationhoursfortheelderly;specialisationingeriatricmedicineandhospitalwards;mobilefacilities,andexpandedfacilitiesfortreatmentofhealthproblems,suchascataract,whichareaparticularproblemoftheaged.Thebulkofthepopulationinlessdevelopedcountriesisnotcoveredbymedicalinsurancewhich,inmostinstances,catersonlytothemoreaffluentsectionsofsocietyandreceiveslittleornosupportfromthestate.Evenwhereavailableandaccessibletoolderpeople,medicalinsurancegenerallydoesnotcoverpreventivehealthmeasures,personalhealthcareordomesticancillarysupportservices,aidsorappliances.  TheRepublicofKoreaisoneofthefewwealthiercountriesinlessdevelopedregionswherethereiscomprehensivemedicalprovisionforthewholepopulationsinceeveryoneiscoveredbyhealthinsuranceormedicalassistanceprogrammes.Asof1995,nearly97percentofthoseaged65andoverwerecoveredbyhealthinsuranceandtheremainderwerecoveredbymedicalassistance(Chung,1998).Aselsewhere,healthinsurancecoverageismorefocusedoncurativehealthcareratherthanpreventivecare.Furthermore,patientshavetopay20percentofhospitalisationfees,andanevenmoresubstantialproportionofoutpatientfeessothattheoutgoingsconfrontingtheelderlycanstillrepresentquiteafinancialburden.Asrecentlyas1996,thelimitationonthereimbursabletreatmentperiodfortheelderlywasabandonedtothebenefitofthechronicallyillandlongcarepatients.InSingapore,wherepartofCentralProvidentFundsavingscanbeusedformedicalexpenses,theobligationsoffilialpietyandthesafetynetofmedicalinsurancearecombinedintheFundsprovisionforparentshospitalisationchargestobedeductedfromtheirchildrensmedicalsavingsaccounts(Yap,1998).  Wherevertheyareprovided,publichealthsystemsandhealthinsuranceschemesarefacingfundingproblemspartlybecauseoftheescalatingnumbersofolderpeoplewhomakemorefrequentuseofhealthserviceprovisions,butalsopartlybecausetheelderlyaremorelikelytorequireproceduresbasedontheuseofexpensivetechnology.Whetherinsocietieswherethemainresponsibilityforcareoftheagedisundertakenbythefamily,bythecommunityorbythestate,the ,P(+ majorcostsrelatetothelongtermcareofthefrailelderlyandthemainissueisbalancingindividualorprivateresponsibilitiesagainstcollectiveorpublicresponsibilities.Inmanysocieties,notconfinedtomoredevelopedregions,longtermcarehasbecomeanormalriskinsocietyanditsfinancingrequiressomeformofcollectiveriskpoolingmechanism.Suchmechanismsmusttakeintoaccountthemajorcosts,suchaslongtermnursingcare,aswellasthemoreminorcoststhatnowtendtobecoveredinamorecomprehensiveway.Atpresent,mostoftheseriskpoolingmechanismsareinthepublicratherthanintheprivatesector. }X X EconomicSecurityandIncomeSupport # XX }# @  Adequateincomesupportatolderagesisamatterofprimaryconcernforthosewhowishtoensuresomedegreeofindependence;absenceofasufficientandreliableincomereducestheelderlytovaryingdegreesofdependence.Themostvulnerablearethosewhohavenoproductiveassets,littleornosavingsorinvestments,nopensionsorretirementfunds,andeitherhavenofamilytocareforthemorwhoarepartoffamilieswithloworuncertainincomes.Forthemajorityofworkersinlessdevelopedregionswhoareintheunorganised,smallscaleandinformalsectorinurbanareas,orinagricultureandalliedsectorsinruralareas,theabsenceofpensionschemes,providentfundorothersuitablesavingsinstruments,thelackofinformationandforesightwithregardtoproblemsofolderages,theirregularflowofincomeduringtheirworkinglivesandtheconstantpressurestomeetcurrentneedsguaranteeahighdegreeofdependenceontheirchildren(Bose,1996).Thosewithoutchildrenrunasevereriskofjoiningtheindigentandhomeless.  Inallbutthewealthiestsocietiesinlessdevelopedregions,themajorityofagedpeopledonothavetheresourcestosupportthemselvesandsochildrenarethemainmeansofsupportbydefault.Eventhen,theelderlyareunlikelytoreceivecashdirectlyfromtheirchildrenforpersonalspending.Thisproblemofincomesecurityisfarmoreacuteinthecaseofelderlywomensinceeveninthenormalcourseofeventswomenhavelimitedcontrolofhouseholdresources.Womenconstituteasmallproportionofthelabourforceintheorganisedsectorand,therefore,onlylimitednumbershavethebenefitofanindependentpension.Whilesomemaybenefitfromahusbandspensiononhisretirementorafterhisdeath,otherslosetheirentitlementoncetheirspouseisdeceased.Womenwhoareunmarried,widowedordivorcedareparticularlydisadvantagedbecauseoftheirlongerexpectationoflifeandperiodofwidowhood,andtheirearlierwithdrawalfromeconomicactivity,especiallyselfemployment.  Incountriesinlessdevelopedregions,providentfundsestablishedforthebenefitofcivilservantsandotherbeneficiariesofthe(mainlyBritish)colonialsystemhave,inmanyinstances,evolvedintomoregeneralpensionprovisionsforthoseintheformallabourforceandtheseprovisionshavebeencomplementedbyprivateschemesaccessibletothemoreaffluent.Nationalprovidentfundsareemploymentbasedsocialsecuritysystemsprovidingprimarilyforurbandwellingworkersintheformalemploymentsector.Employersandemployeespaytothecentralgovernmentagencypredeterminedproportionsofapersonswageorsalarywhicharethencreditedtotheindividual.  Nationalprovidentfunds,inoneformoranother,constituteoneofthemostpopularformsofsocialsecurity.Theyarepopularwiththeirmemberswhoidentifywiththeirdeposits,andwith 6,v(+ sponsoringgovernmentswhichperceivethemasselfhelpvehiclesfortheprovisionofbasicretirementincomeprotectionwhileatthesametimemobilisingsubstantialdomesticsavingsforlowcostpublicuse(Dixon,1995).However,becausethefundsareemploymentrelatedandfocusonwageandsalaryearnersintheformalsector,thosewhohaveneverundertakeneconomicactivityasofficiallydefined,whohaveworkedintheinformalsector,orcomprisepartoftheverylargeandmainlyselfemployedworkforceinruralactivitiessuchasagriculture,areunlikelytobebeneficiariesofsuchasystem.Evenbeneficiariesareunlikelytofindtheiroldagepaymentsfromtheprovidentfundsadequatetosupportthematanythingliketheleveloflifestyletowhichtheyhavebeenaccustomed.Furthermore,broadeningofthebasicfunctionsoftheprovidentfundstoincludefundingforhousing,healthcareandeven,inthecaseofSingapore,investmentinthestockmarket,hasdilutedthesuperannuitantfunctionofthefunds.  Examplesofthenationalprovisionofpensionsandofthealternativewaysofsupplementingthemorsubstitutingforthemwheretheyarelackingarediverseandvaried.InMalaysia,despitetheprovisionsoftheofficialprovidentfundforthosewhowerecontributingemployeesinthelabourforce,thereisbroadevidencefortheenduringimportanceoftheprovisionofoldagesecuritythroughthefamily,particularlyforwidowswhoareelderlyandinillhealth,andthereisevenstrongerevidenceinfavouroftheconceptofadultchildrenrepayingtheirparents.Transfersfromparentstochildrenserveprimarilytofinancethechildrenseducation,andadultchildrenstransferstoelderlyparentsareastronglyincreasingfunctionofthechildseducation.InsharpcontrasttoasocietylikethatoftheUnitedStates,whereemployerprovidedpensions,healthinsurance,publicsocialsecurityandMedicarehavereplacedthefamily,thedominantdirectionofmonetarytransfersbetweennoncoresidentparentsandtheirchildrenisfromtheyoungertotheoldergeneration(LillardandWillis,1997).FamilyfinancingofinvestmentintheyoungergenerationshumancapitalhasplayedasignificantroleinfacilitatingMalaysiasrapideconomicgrowth,butnationaleconomicdevelopmenthasnotreducedeithertheobligationortheneedforchildrentocontinuetoreciprocatewithmonetarytransferstotheirparentsastheyreacholderages(Leete,1996).  TheKoreangovernmenthasputconsiderableeffortintodevelopingwelfarepoliciesfortheelderlyincludinglivelihoodprotection,althoughoverall,lessthanfivepercentoftheMinistryofHealthandWelfareexpenditurein1997wasdevotedtotheelderly.Theoldageallowancecomprisednearlytwothirdsofgovernmentexpenditureonprogrammesforolderpeople,withafurtherquarterdevotedtoinstitutionalcareoftheaged(Chung,1998).EveninthemorewealthyAsiansocietiessuchasKorea,HongKongandSingapore,thewidespreadexpectationoffamilysupportoftheagedisstillpassively,andsometimesquiteactively,encouraged.Forexample,in1995,SingaporeintroducedtheMaintenanceofParentsActwhichprovidesforparentstosueneglectfulchildrenforfinancialsupport(Yap,1998).  Inothercountriesinmoredevelopedregionsgovernmenttransferpaymentsandpersonalsavingsarethemajorpillarsofincomemaintenance,andincontrasttomanysocietiesinlessdevelopedregions,relativelylittlesupportcomesdirectlyfromchildren.Expenditureonpensionshasbecomeaverysignificantproportionofgovernmentexpenditure(andconsequentlyofGDP)inmostcountries.Manyrelyheavilyonpayasyougoschemeswhichoperateeffectivelyinthecontextofanexpandinglabourforcethatisproducingafavourablebalancebetweencontributors ,P(+ andrecipients.However,aspopulationsage,thelabourforcestabilisesinsizeorevenshrinks,andtheratiobetweentheeconomicallyactiveandpensionersdeterioratesatrendaccentuatedbythetendencytoearlyretirementuntilveryrecentlyincountriessuchastheUnitedStates.Increasesinpensionexpenditureshavebeenmoreaffectedbychangesinbeneficiaryratiosthanbydemographicageingalone,aconsequenceofearlylabourmarketexitforarangeofreasonsalludedtoearlier.Governmentreactionstendtobemixedasspecificprovisionfortherecognisedneedoftheolderpopulationistradedoffagainstsuchissuesasyouthfulunemploymentandprovisionsforothertypesofbeneficiarypaymentstoadultsofallages.  InJapan,theaverageincomeleveloftheelderlyisreportedtobesimilartootherhouseholds(Atoh,1998),butdifferentialsamongelderlyhouseholdsarelargerthanfortheremainderofthepopulationintermsofthevalueofincome,savingsandownershipofrealestate.Consequently,publicpensionsareextremelyimportantforthoseolderpersonswithsmallincomesandassets.Publicpensionschemeshavebeenprovidedforeveryonesince1991,andin1994benefitscomprised55percentoftheaverageannualincomeofelderlyhouseholds.However,maintenanceofthislevelofsupportisbecomingincreasinglyproblematicasestimatesindicatethatby2025contributionsperworkerwouldhavetorisefromthepresent17.4percentto34percentofwagesandsalaries.Modificationswhichwilleasethisandotherheavydemandsonthesocialsecuritysystemarelikelytobeintroducedatthetimeofthenextscheduledreviewofpublicpensionsin1999.  Inmostlowfertilitysocietiestherealproblemwithmaintainingoldagepensionsatorabovesubsistencelevelisnottheratiooftheworkingagepopulationtotheelderlybutthereluctanceofmodernpopulationstoexpendresourcesontheoldratherthanontheyoung(Caldwell,CaldwellandMcDonald,1998).Thenotionoftheoldasdependentshaslargelybeensupersededatthefamilylevelandincreasinglythereareintergenerationalresentmentswhensubstantialincreasesoccuringovernmentexpenditureontheaged.Theobviousoption,tocuttherealvalueofpensions,isbecomingprogressivelymoredifficultastheolderpopulationbecomeaneverlargerproportionoftheelectorate.Suchameasureisbecominganincreasinglydifficultoptionasmanyolderpersonswhostandtobenefitfrompayasyougosystemsconsiderthat,havingpaidtheirtaxesasemployees,theyhaveearnedtherighttoreceivepensionpaymentsasretirees.IntheUnitedStates,greypowerhaseffectivelyinfluencedincreasedgovernmentspendingontheold.Thistrendcanbemademorepalatabletotheelectorateatlargebycreatingtheillusionthattheelderlyaresupportingthemselves,anoutcomewhichcanbecontrived,asintheUnitedStates,byseparatingnormaltaxationfromsocialsecuritypaymentsandsteeplyincreasingonlythelatter(Caldwell,CaldwellandMcDonald,1998).Alternatively,individualsandtheiremployersmayberequiredtocontributetoprivatepensionorsuperannuationschemeseffectivelyasaformoftax,andotherssuchastheselfemployedmayvoluntarilycontributetosuchplans.Theissuewhichthenarises,particularlyinthecaseofgovernmentfunds,ismakingtheappropriateinvestmentswiththehugesumsinvolved. }X X WomenandPoverty  @)%( # XX }#Formanyoftheelderly,particularlyinlessdevelopedregions,thegreatestissueispoverty.The V*&) issueismoreacuteforwomen,notonlybecauseoftheirprogressivepredominancenumericallywithage,butalsobecausewomenaredisadvantagedinthepredominantlypatriarchalsocietiesinwhich 6,v(+ mostofthemlive.Itiswhentheybecomeoldthattheconsequencesofgenderroles(menasbreadwinners,womenashousekeepersevenininstanceswheretheyhavebeeneconomicallyactive)isexplicitlyrevealed.Insituationswherepensionschemesaccruemainlytoemployees,womenwhohavenotworkedformostoftheiradultlivesbecomeevenmoreheavilyreliantontheirhusbandsstatusandpensions.Thelargenumbersofwomenwhoaresingle,widowedordivorcedareespeciallyvulnerable,receivingfewornoneoftheentitlementsofmenandinsomeinstancesevenlackingcomparablestatusinthecommunityandthefamily.  Theproportionsofmarriedolderpeopleowningtheirownhousescanbequitehighbutownershipamongwomenlivingalonetendstobemuchlower.Womenlivingaloneincludethosewhomayoncehaveownedtheirhomeswiththeirhusbands,butwhosecustomsofinheritancedictatepartialortotalforfeituretochildren,orsaleofthehometoshareouttheinheritanceortocoverimpositionofdeathduties.Evenincircumstanceswheretheelderlycontinuetoowntheirownhomes,shrinkingincomesanddeterioratinglifestylesmaymakemaintenanceofthehousingstockimpossibleandtheseekingofmoreappropriatealternativesimpracticalastateofaffairswhichislikelytobemoreacuteforwomenthanformen.  Thestatusofwomencurrentlyunmarriedmayalsobedifferentfromthatofthosewiththehusbandpresent,andeveninfamilysituationswheretheseniorwomanhasauthorityandrespect,theirpositionwithinthefamilyisnoguaranteeoffreedomfrompoverty.Approvedgenderroles,statusinoldageandlimitedopportunitiesduringtheirlifetimesforassetformation,makewomenmorevulnerablethanmeninthesamesocietyandmorelikelytobeatthemercyoftheirfamilieswhichmaythemselvesbepoorlyresourced. }X X ` # XX } #  Provisionofbasicneedsisanissueaffectingmanyolderpersonsbutparticularlythelargernumberofwomenatadvancedages.Housingespeciallyconstitutesaproblemwhichhasmoreseriousconnotationsfortheelderlythanformostothergroups,especiallyintheurbanareasoflessdevelopedregions.Difficultiesrangefromhomelessness,toabsenceofadequatemaintenanceofhousingstockandinappropriatenessofdesignforthosewhoarefrailorpartlyimmobilised.Inmoreaffluentsocieties,debatefocusesmorespecificallyonthedesirabilityofinstitutionalisationofparticularcategoriesoftheneedyaged,andoftherespectivemeritsofretirementhomesfortheelderlyandstagedretirementvillageswhichofferowneroccupiersarangeoflifestylefacilitiesandprogressivelymorecomprehensiveservicestocaterfortheescalatingneedsofresidentsastheyage.  Theparticularissuesfacingwomenrunthegamutofproblemsconfrontingallolderpersons.Asnotedearlier,deteriorationinhealthmaybeafeatureofadvancingageandsincesometypesofdegenerativediseasearestronglyassociatedwithage,incidenceamongwomenisinevitablyhigh.Dementiaisanexampleofonesuchillness,andosteoporosis,towhichwomenareparticularlyprone,isanexampleofasexlinkeddisorderwhichdevelopsitsmostdebilitatingsymptomsatolderages.Similarly,problemsofloneliness,isolationandabandonmenttendtobemoreacuteforwomen,asincreasinglyfrailsurvivorsofshrinkingcohortsgraduallywithdrawevenfromactivefamilyroles.Theacuityofthesedifficultiesisaccentuatedduringtheiradvancedyearsbytheconstrainedresourcesavailabletomostwomenintheirownright,becauseoftheoftenlimitedtimespentintheformallabourforceorintheacquisitionofassetsindependentofspousesorfamilies. ,P(+ Ї  Theinvolvementofwomenwiththeageingprocessisnotconfinedtotheirownoldagebutoftenincludesresponsibilitiesascaregiversfortheirelderlyparentseveninsocietieswherecoresidenceisdeclininginpractice.Notonlyisamuchgreatershareofagedcareshoulderedbywomenbutmanywomenwhohavebeeneconomicallyactivereducetheirworkparticipationorquitaltogetherinordertoundertakesuchobligations.Withincreasedlifeexpectancyworldwide,theelderlywhoarefrailandinneedoflongtermcarearelikelytobedrawingfamilysupportfromwomenwhothemselvesarealreadyinmiddletoearlyoldage.Thelongertermimpactonthemderivesfromlossofincomeandtheconsequentcurtailmentoftheperiodofassetformation,andaccumulatedstressanddeteriorationintheirownhealth.Sincemostofthissupportisprovidedwithinthefamilyorthroughvoluntarycommunityagencies,theimpactsonthecaregivingwomenfortheirownprospectivehealthandwellbeinginoldagearelargelynegative. }X X PolicyandProgrammeImplications # XX }# @  Anumberofthemoreaffluentcountriesinlessdevelopedregions,particularlyinAsia,haverecognisedfromarelativelyearlystagethesymptomsofincipientageingintheirownsocieties,andhaverespondedbyinitiatingresearch,conferencesandconsultation.Alreadythemajordeclinesinfertilityandmortalityhavehadamarkedeffectontheagestructureofthesepopulations,withsignificantimplicationsforfullemploymentandtheprovisionofservicessuchaseducationandhealth.Theseincreasinglywidespreaddemographictrendshaveoccurredinthecontextofrapidlychangingeconomicandsocialparameterswhichtendtoexacerbateratherthanamelioratetheimpactofthecontinuingpopulationtransition.  Theexperiencetodateofcountriesinthemoredevelopedregions,asbrieflytoucheduponinthispaper,hasbeensalutary.Mostothercountriesareatpainstoavoidemulatingthatexample,particularlyintermsofthehighcostanddifficultiesofeffectivedeliveryofofficialsocialwelfareprogrammesforolderpopulations.Therearemarkeddifferencesinthenationalexperiencesoftheprocessofpopulationmaturationwhichcanbeascribedtocontrastsinculturalandsocialmores,inlevelsofeconomicdevelopment,inthedegreeofgovernmentinvolvement,butabovealltothespeedwithwhichfertilitydeclineisalreadyageingthepopulationsofmanyoftheworldsmostpopulousnations.Approachesarethereforebeingsoughtwhichwillaccommodatesuchdifferencesanddelivertherequisiteservicesatmuchlowercost,perhapsbymeldingmodifiedversionsofestablishedsupportsystems,improvedinfrastructuresandmodestpubliclyfundedprogrammes(Hermalin,1997).  Astheproportionofthepopulationinolderagegroupsincreasesthefactorsofdevelopmenthave,inmostrespects,consortedtocompromisethestatusandviabilityoftheaged.Technologicalandotherchangestrapthemintraditionalandlessrewardingjobs,impedeaccesstomoredesirablealternatives,necessitateearlyretirementfrompreferredcareersorevenwithdrawalfromthelabourforcealtogether.Socialchange,economicsuccessandincreasedmobilityamongtheyoungercohortswhohavebenefitedfromopportunitiesunavailabletotheirparents,tendtodistanceolderpeoplefromtheirfamiliesanddeprivethemofmeaningfulfamilialroles.Itisthereforeinevitablethatthesocial,economicandhealthneedsofvulnerableolderpersonsshouldemergeaspriorityconsiderationsforanalystsandpolicymakers(Hermalin,1997). 6,v(+   Althoughthemajorityofcountriesinlessdevelopedregionsarealreadyshowingclearsignsofageingpopulationsandthisprocessisproceedingataspeedgreaterthanthatexperiencedinmoredevelopedregions,thereisgenerallysufficientleadtimebeforetheemergenceoftheprojectedandgreatlyenlargedproportionsofolderpersonsforpolicyanddecisionmakerstoadoptanuancedapproachinthedevelopmentofappropriatepoliciesandprogrammes.Whilethechangingproportionsconcentratedinolderagesreflecttheshiftingageandgenderbalancewithin p populations,withmajorimplicationsforsubstantialadjustmentsintheresourcebase(especiallyforanyeffectivefiscalmeasures),itisthehugenumbersofolderindividualswithwhichgovernments, P  agencies,communitiesandfamilieswillhavetodealthatmustcommandattention.  Withthelargenumberofsurveysandresearchprojectsalreadycompletedorunderway,particularlyinAsia,thestructuralfeaturesoftheagedcomponentinsociety,andthecircumstancesandneedsofolderpeopleinthesesocietieshavebecomeincreasinglyapparentandwillcontinuetodosoasconcernedfundingagenciesandresearchinstitutionsperseverewithinvestmentofresourcesintheseinvestigations.However,whiletheprocessofchangeintheformofsocial,economicand   demographicstructurestheseolderpeopleareexperiencingintheirsocietiesisbeingcomprehensivelyanalysedandbetterunderstood,theunderlyingrationalefortheseadaptationsand  peoplesperceptionsofwhatneedstobedoneinresponseislesswellunderstood.  Thefactofdecliningcoresidenceinmanysocietiesiswellknown,butisthemotivationpositiveonthepartofboththeelderlyandthefamily,isthegoalgreaterprivacyandindependenceforeitherorboth,aretheobjectiveswhatevertheyarebeingachievedtothesatisfactionofall,someornone?Earlierwithdrawalfromthelabourforceisarecurrentphenomenon,butintheirownparticularsocietalcontexts,isthisexpressingarealpreferenceforopportunitiesotherthanemploymentfortheolderworker,astrategicresponsetogovernmentpolicyandprogrammesasthesimplestwayofachievingaparticularlifestyle,acalculatedpreferenceforrecreationandleisureratherthanwork,orsimplyanoutcomebydefaultratherthanbychoice?Identifyingtheunderlyingmotivationforexercisingchoiceinachievingchangeisequallyappropriate,notonlyforcoresidenceandeconomicactivitybutformostareasofhumanactivityrelatingtotheageingphenomenonwheresuchissuesaspoorhealth,disabilityorfrailtyarenotthedeterminantsofbehaviour.  Inattemptingtodevelopnewpoliciesandprogrammestherealneedsandpreferencesofolderpeopleneedtobedeterminedandboththedirectandindirectconsequencesoftheirimplementation(includingthesideeffectsofunrelatedpolicies)evaluated.Forsuchpoliciesandprogrammestobeeffective,adoptionofanholisticapproachwillensurethatindealingwithoneparticularissuethebroaderneedsoftheelderlyandofthewidersocietyarerecognised,thattheinfluenceofearlierlifeexperiencesofthecurrentlyagedareacknowledged,andthattheprospectsformeetingtheneedsoffutureoldercohortsarenotcompromised.  P($'    }X X 3@..UNFPAPARTICIPATIONINPOLICIESANDPROGRAMMES # XX }U/#    ItisprimarilythisforwardlookingperspectivethattheUNFPAhasadoptedinsupportingactivitiesinthegeneralfieldofpopulationageing.ThestrategicfocusoftheFundsapproachhasemphasiseddatacollectionandanalysis,especiallyforgenderissues,andrelatedresearch.Emphasishasbeenplacedonpolicyformulationandplanning,togetherwiththecreationofawarenessofthedistinctivecharacteristicsofsocietiesandolderpersonsthemselvesincountrieswhereageingisemergingasanissue.SuchactivitieshaveincludedtrainingandothersupportfortheimplementationandevaluationofactionprogrammesincludingspecificpolicyinterventionsbygovernmentsandNGOs.  InthepostICPDperiodtherehasbeenashiftinemphasistomorecloselyalignthestrategicobjectivesoftheFundwiththoseoftheProgrammeofAction.Advocacyisbeingemphasisedinordertodrawtheattentionofpolicymakerstothesocialandeconomicissuesassociatedwithageing,topromotecoordinationofprogrammesandtomobiliseresources.Technicalassistanceisbeingofferedtoassistinpolicydevelopment,tohelpstrengthennationalinstitutionalcapacityforintegratedapproachestoageingandtoemphasisethespecialneedsofwomen.Trainingisaimedatachievingeffectivedatacollectionandapplicationinordertooptimiseefficientpolicyformationbyresearchersandpolicymakers.TheFundisalsosupportingresearchonpopulationsatrisk,onachievinghealthylifeexpectancyandonthepersonalandfamilycircumstancesofolderpersons.  Thefollowingsectionssummarise,first,theICPDProgrammeofActionitself,andthenthreemainareaswhichencompassmanyofthemainactivitiesoftheFundinpromotingtheimplementationoftheProgrammeofAction.Whilenotactivelyinvolvedintheimplementationofactionprogrammesinthefieldofageing,UNFPAorientsitsassistancetosupportactivitiesaimedatdiscoveringsuitablesolutions.   *|O[E:|%!?O?;~|T) p @ET)ttl'(T\+ (#(#                                            ,P(+ `/*wddd Xdd Xdd X(#(#w,ZZ@+  /%  C/ 9X X ! '!# XX 9>#     $! X X5?5UNFPAIMPLEMENTATIONOFTHEICPD  PROGRAMMEOFACTION# XX  $!?# FX X Z ?# XX F?#  $! X X  RoleoftheUNFPA  D # XX  $!;@#Z@ FX X# XX Fҿ@# }X XIMandateandGuidelinesforUNFPAApproachtoPopulationAgeing  . # XX }A#Rationale  \  US.,UK.,[G  [GA݀"0    #XXX X7# XXXXpopulationageingisamajorchallengeindevelopingcountriesalreadyadvancedin m  thedemographictransition[GAA݌ %"%" Ќ  0 ' [G  [G-C݀"0'%"'%"  #XXX XFB# XXXXtheprocesswillbemuchmorerapidinlessdevelopedcountriesthanindeveloped n  countries[G-CHC݌ %"%" Ќ  [G  [GlD݀"0    #XXX XC# XXXXdevelopingcountrieshavefewerinstitutionalandeconomicresourcestorespondto o basicneedsoftheelderly[GlDD݌ %"%" Ќ  N7uM% ]5 mE "'N Ultimategoals   [G  N:uM% ]5 mE "N[G-F݀"0    0%"%"  topromotethewellbeingofpeoplethroughoutthelifespan[G-FF݌%"%" Ќ  [G  [GdG݀"0    0%"%"  toensureinlateryearsthateveryindividuallivesasfullalifeaspossible[GdGG݌%"%" Ќ  [G  [GaH݀"0    0%"%"  tostrengthennationalcapacityoflessdevelopedcountriestohelpmeettheneedsof  olderpopulations[GaH|H݌ %"%" Ќ  Q7uM% ]5 mE "uQ Mandate   [G  N:uM% ]5 mE "N[GI݀"0    0%"%"  UnitedNations1982InternationalPlanofActiononAgeing[GI_J݌%"%" Ќ  T:M% ]5 mE "uT0 C   C UnitedNationsPrinciplesforOlderPersonsandTargetsonAgeingfortheYear2001 C%"C%" [G  W:uM% ]5 mE "MW[GL݀"0    0%"%"  UnitedNationsGeneralAssemblyResolution46/91of16December1991[GLL݌ )%"%" Ќ  T:M% ]5 mE "uT0 C   C toensurethatageingremainsanimportantpartoftheUnitedNationsdevelopmentprogramme C%"C%" [G  W:uM% ]5 mE "MW[GAN݀"0    0%"%"  UnitedNations[GANN݌#; %"%" Ќ  T:M% ]5 mE "uT0 C   C ProgrammeofActionofthe1994InternationalConferenceonPopulationandDevelopment C%"C%" @*.*`']#1111!3?@ 9X XT7uM% ]5 mE "MT5+)']#!C  5    '%$! `/TRY 3' Letter3'3' Letter3'T  `/TRY 3' Letter3'3' Letter3'T  `/TRY 3' Letter3'3' Letter3'T  `/TRY 3' Letter3'3' Letter3'T  `/TRY 3' Letter3'3' Letter3'T  `/TRY 3' Letter3'3' Letter3'T  `/TRY 3' Letter3'3' Letter3'T  `/TRY 3' Letter3'3' Letter3'T  +;nG73~ X  p @Ee)ddR(*   *|55  *|!!  *|55  *|55  *|55  *|!!  *|!!  # XX 9yP##XXX XD# XXXX 555n"""""!5Strategicfocus    postICPD    advocacy   #XXX X_# XXXX[G  N:uM% ]5 mE "N[G'a݀"0 P   #XXX Xa# XXXXtodrawattentionofpolicymakerstosocialandeconomicissuesassociatedwithageing,  including[G'aa݌ P(#P(# Ќ  ݀needforinformationandstatisticstoguidedevelopmentplanning̀supportforcommunitybasedservicesforthoseinlateryearsoflifèimprovedknowledgeofprogrammemanagersandserviceprovidersofclients !  @   P  = perceptionsandneeds̀enhancementofserviceprovidersinterpersonalcommunicationskillsQ7uM% ]5 mE uQ0 P e [G  T:uM% ]5 mE "uT[Gd݀"0PP(#P(#  topromotecoordinationofageingprogrammesamonggovernments,agencies,NGOsandthe P  privatesector[Gd)e݌ P(#P(# Ќ  [G  T:uM% ]5 mE "uT[Gf݀"0 P   toassistpolicymakers,programmemanagers,serviceprovidersandcommunitiesmobilise 0  neededresources[Gff݌ P(#P(# Ќ  N4uM% ]5 mE uN technicalassistance   K7uM% ]5 mE K0 P e [G  T:uM% ]5 mE "uT[GLh݀"0PP(#P(#  toassistinpolicydevelopment,programmeplanningandmanagementtomeettheneedsof  olderpersons[GLhh݌ P(#P(# Ќ  0 P e [G  T:uM% ]5 mE "uT[Gi݀"0PP(#P(#  tohelpstrengthennationalinstitutionalcapacitytodevelopcomprehensive,integrated  approachestoageing[Gi/j݌ P(#P(# Ќ  0 P e [G  T:uM% ]5 mE "uT[G:k݀"0PP(#P(#  toemphasisethespecialneedsofwomen,especiallypoorwomen,mostvulnerabletothe p effectsofageing[G:kk݌ P(#P(# Ќ  N4uM% ]5 mE uN training  @ K7uM% ]5 mE K0 P e [G  T:uM% ]5 mE "uT[Gmm݀"0PP(#P(#  toassistincollectionofdataanduseofinformationforpolicyformationbyresearchersand 0p policymakers[Gmmm݌ P(#P(# Ќ  N4uM% ]5 mE uN research tosupport @ K7uM% ]5 mE K0 P e [G  T:uM% ]5 mE "uT[Go݀"0PP(#P(#  global,regionalandcountryresearchoncreationofdatabasesandidentificationofpopulations 0 atrisk[Go$p݌ P(#P(# Ќ  0 P e [G  T:uM% ]5 mE "uT[G,q݀"0PP(#P(#  innovativeresearchonhealthylifeexpectancysoastodevelopdisabilityandqualityoflife   measures[G,qq݌ P(#P(# Ќ  0 P e [G  T:uM% ]5 mE "uT[Gr݀"0PP(#P(#  dataonfamilyandhouseholdcomposition,socioculturalstudiesandtheeconomicsituationof "! olderpersons#XXX Xa# XXXXQ7uM% ]5 mE "uQ[Grs݌#"P(#P(# Ќ  @/-#$ ;`@#XXX Xs# XXXXUKUS.,5$ """"!5ӀUS.,UK., uUKUS.,#XXX Xu# XXXX $ #  #XX Xu#US.,UK.,u  p&"%  :|*|5555  5?5  UNFPAIMPLEMENTATIONOFTHEICPDPROGRAMMEOFACTION Y w $! XX  RoleoftheUNFPA#XX  $!pw#w}XXII = HealthCareofOlderPersonsinLessDevelopedRegions    = ResponsestoSurveyQuestiononHealthCareofOlderPersons #XX}w#  R 9XXDuring1997,aSurveywasconductedbyUNFPAamongcountriesofthelessdevelopedregionstodetermine k  developmentswhichhadoccurredsinceICPD.TheSurveyfocusedonawiderangeofissuesmostofwhicharenotrelevanttothispaper,butpartofonequestiondealtwiththehealthcareofolderpeople.Thesummarygivenbelowhasreferencetotheresponsesofsome80governmentsandanadditionalnumberofNGOs,tothequestion: Somepopulationgroupsareatgreaterrisktosufferapoorqualityofhealth.WhatactionshavetheGovernment  andNGOstakensinceICPDtoStrengthentheprovisionofhealthcareforpersonsattheolderages? #XX9x# XXXXUKUS.,Ԁ F #XXX X{#US.,UK., |@g1111!v@   O XXSummaryofSurveyResponses#XX O|#9XX  G |#XX9}#  Within Africa ,mostoftherespondentsgaveveryfullrepliestootherquestionsintheSurvey,but Q notthisone,indicatingaclearfocusontheotherhealthandreproductivehealthissueswhichwereofprimaryconcernthroughoutthecontinent.Clearlytheissueoftheagedandprovisionfortheirhealthcarehasnotyetassumedtheproportionsthatwouldnecessitatethemobilisationofscarceresourcestodealwithitgivenothermorepressingpriorities.Thegeneraltenorofthemainlybriefrepliesfromthosecountriesin Africa whichdidrespondwas:  N:uM% ]5 mE "N0 P e  XXXX[G  T:uM% ]5 mE "uT[G݀"0PP(#P(#  #XXX Xb#governmentsprefernottointervenebutsupporttraditionalpreferencesforfamilycareofthe   elderlyanddisabled[G݌ P(#P(# Ќ  0 P e  XXXX[G  T:uM% ]5 mE "uT[GD݀"0PP(#P(#  #XXX X%#afewgovernmentshavetrainedpersonnelresponsibleforthecareofpeoplewithdisabilitiesand " theelderly[GD݌ P(#P(# Ќ  0 P e  XXXX[G  T:uM% ]5 mE "uT[G݀"0PP(#P(#  #XXX X#generalhealthcare,oftenundertakenbyNGOs,includeshealthprovisionfortheelderly[Gp݌a$ P(#P(# Ќ  0 P e  XXXX[G  T:uM% ]5 mE "uT[G݀"0PP(#P(#  #XXX X~#insomeinstancesNGOshavebeeninstrumentalintheprovisionofgeriatrichomestopromote Q%!! thewelfareandinterestsofoldpeopleespeciallyifdisabled[G ݌ P(#P(# Ќ  0 P e  XXXX[G  T:uM% ]5 mE "uT[G݀"0PP(#P(#  #XXX Xi#afewcountriesindicatedintentionsforimplementingprocedurestoformulateanationalpolicy 1'q## todealwithissuesrelatingtotheelderly,notablyprovisionofhealthcare[G݌ P(#P(# Ќ  0 P e  XXXX[G  T:uM% ]5 mE "uT[G݀"0PP(#P(#  #XXX Xf#promotionofparticipationinactivitiesappropriatetotheirageUKUS., XXXX[G݌)Q%%P(#P(# Ќ  #XXX X#US.,UK.,  +!(( Onlytwocountriesof EasternEurope respondedtothequestionnaire.Theirresponsessuggested  increasingrecognitionoftheparticularhealthneedsoftheelderlyandthatthesearebeginningtobeprovidedformoreexplicitly.Themainpointsmentionedbytheresponsesfrom Eastern Europe included:  [G  T:uM% ]5 mE "uT[GŒ݀"0 P    XXXXofficialspecificationofthepreciseresponsibilitiesofinstitutionsprovidinghealthcareinorder p toensureappropriatecareoftheaged#XXX Xa#[GŒ1݌` P(#P(# Ќ  [G  [G݀"0 P   0=P(#P(# P transformationofamajorhospitalintoacentretocarespecificallyforolderpersons[G݌P =(#=(# Ќ  [G  [G݀"0 P    XXXXNGOsprovideservices(suchasmealsonwheels)andhomebasedmedicalassistanceto @  immobilisedpersonsincludingtheelderly[G݌ P(#P(# Ќ  #XXX X֏#About16ofthecountriesin LatinAmericaandtheCaribbean respondedtothequestionnaire, @  mostnotingthattherewaslittleornoexplicitprovisionforthehealthcareoftheelderly.Themaincommentsfrom LatinAmericaandtheCaribbean includedthefollowing:  [G  T:uM% ]5 mE "uT[G'݀"0 P    XXXXprovisionsthroughsocialsecuritymechanismsisonemeansadoptedforprovidingfortheelderly,  butthishasbeenreducedbecauseofrecentfinancialproblems#XXX Xƒ#[G'݌P(#P(# Ќ  [G  [G݀"0 P    XXXXanalternativeapproachhasbeentoprovidespecialdiscountsfortheelderly,facilitatingtheir  accesstopublichealthservices#XXX XJ#[G݌P(#P(# Ќ  [G  [Ge݀"0 P   0=P(#P(# P somestatesprovideservicestotheelderlyaspartofafreemedicalservicetoallcitizens[Ge݌=(#=(# Ќ  About20countriesin Asia respondedtotheSurvey.Becauseofthewidevariationindemographic P statusanddegreeofeconomicdevelopment,responseswerewiderangingandreflectedsubstantiallydifferentprioritiesinrecognitionandactionforthehealthoftheelderly.Themoresignificantpointsarisingfromtheresponsesfromcountriesin Asia included: P [G  T:uM% ]5 mE "uT[G݀"0 P   0=P(#P(# P inmanycountrieshealthcareisprovidedtoallirrespectiveofage[G݌@=(#=(# Ќ  0 P e  XXXX[G  T:uM% ]5 mE "uT[G݀"0PP(#P(#  #XXX Xp#someadministrationsarestillatthestageofformulatingnationalpolicyaimedatprovidinga 0 comprehensiveprimaryhealthandmedicalcareinfrastructure[G݌ P(#P(# Ќ   XXXX[G  T:uM% ]5 mE "uT[Gc݀"0 P   #XXX XD#0=P(#P(# P insomeinstancesthereisatrendforclinicsfortheelderlytobeestablishedwithinexistinghealth   centres[Gcқ݌ =(#=(# Ќ  0 P e  XXXX[G  T:uM% ]5 mE "uT[G:݀"0PP(#P(#  #XXX X#policiesandlegislationarebeingimplementedinrecognitionoftheneedsoftheelderly[G:݌"!P(#P(# Ќ  0 P e  XXXX[G  T:uM% ]5 mE "uT[Gמ݀"0PP(#P(#  #XXX X︞#voluntaryagencies,sometimeswithgovernmentassistance,aretakingresponsibilityforthe #" particularhealthneedsoftheaged[GמF݌ P(#P(# Ќ  0 P e  XXXX[G  T:uM% ]5 mE "uT[G݀"0PP(#P(#  #XXX X#insomecountriesgovernmentsareestablishingunitstoadministercentreswhicharebeingsetup, %!$ sometimeswithinexistinghealthfacilities,explicitlyforthecareoftheelderly[G݌ P(#P(# Ќ  0 P e  XXXX[G  T:uM% ]5 mE "uT[G݀"0PP(#P(#  #XXX X#otheradministrations,whileacceptingsomeresponsibility,considertheprovisionofhealthcare `'#& fortheelderlystilltobetheresponsibilityofthecommunitythroughextendedfamilylinkages[G݌ P(#P(# Ќ  0 P e  XXXX[G  T:uM% ]5 mE "uT[G݀"0PP(#P(#  #XXX X#specialhealthandcharitableprogrammeshavebeenimplementedtosupportoldpersonswithout @)%( family[G-݌ P(#P(# Ќ  0 P e  XXXX[G  T:uM% ]5 mE "uT[Gr݀"0PP(#P(#  #XXX XS#governmentinitiativesarebeingimplementedingeriatricmedicineandinotherprogrammesfor  +`'* thedisabled[Gr݌,P(+P(#P(# O[E<G&L <  ь  0 P e  XXXX[G  T:uM% ]5 mE "uT[G݀"0PP(#P(#  #XXX Xm#NGOsandothervoluntaryorganisationshaveroleswhichincludesupportofthedisabled,invalids  anddestituteoldpeople[G݌ P(#P(# Ќ  0 P e  XXXX[G  T:uM% ]5 mE "uT[GV݀"0PP(#P(#  #XXX X7#onecountryreportsgroupsoftheelderlyinseveralcitiesorganisingthemselvestolobbyfortheir  particularneeds[GVŪ݌ P(#P(# Ќ  0 P e  XXXX[G  T:uM% ]5 mE "uT[G݀"0PP(#P(#  #XXX X#insomeinstancescentresfortheelderlyhavebeensetupdrawingonresourceswithinthe  community[G݌ P(#P(# Ќ  0 P e  XXXX[G  T:uM% ]5 mE "uT[GЭ݀"0PP(#P(#  #XXX Xﱭ#thereisageneralbeliefthatincreasingattentionmustbefocusedontheparticularneedsofthe `  elderlyinordertocreateanawarenessamongstpeoplegenerally[GЭ?݌ P(#P(# Ќ  0 P e  XXXX[G  T:uM% ]5 mE "uT[Gï݀"0PP(#P(#  #XXX X勞#insomeinstancesretiredgovernmentofficialsarebeneficiariesofhealthinsuranceschemes[Gï2݌@ P(#P(# Ќ  0 P e  XXXX[G  T:uM% ]5 mE "uT[Gc݀"0PP(#P(#  #XXX XD#afewgovernmentsareabletoprovidewelfareassistancefortheagedathomeorinspecialist 0 p  hospitalswherephysicalormentaldisabilitiesseverelyaffectqualityoflife[Gcұ݌ P(#P(# Ќ  0 P e  XXXX[G  T:uM% ]5 mE "uT[Ga݀"0PP(#P(#  #XXX XB#inafewinstanceswhereauthoritiesareattemptingtoretaintheneedyelderlyinthecommunity, P  welfareprogrammesarebeingimplementedtoprovideahomevisitingservice,daycareservices,andshorttermcareservices[Gaг݌ P(#P(# Ќ  AlthoughtheSurveywasattemptingtoidentifydevelopmentsthathadoccurredwithineachcountrysinceICPD,inmanyinstancesitwasnotfeasibletodifferentiatebetweenactivitiesimplementedbeforeorafterthatdate.ApartfromthecaseofafewcountriesinAsiawhichhaveboththeneedandtheresourcestomakespecificprovisionsfortheelderly,mostcountrieslooselygroupedthedisadvantagedandthemarginalisedgroupstogether,orasonecountrysresponseexpressedit:variousprogrammesandmeasureshavebeenputinplacetotakecareoftheneedsofthedisabled,thehandicappedaswellastheseniorcitizensandagedwhoareinvalidandabandoned.Thissuggeststhat,atleastintermsofpublicpolicy,theagedasagroupareeithersmallinnumbersorrepresentwhatisperceivedtobearelativelyminorproblem,andthatitisonlywhentheneedsoftheelderlybecometooacuteforfamiliestobeabletocopethatgovernmentsexpecttohavetobecomeinvolvedτaswithotherseriouslydisadvantagedgroups.9XX  ` }#XX9p# XXXX  P  #XXX X׹#FXX  555?5UNFPAIMPLEMENTATIONOFTHEICPD 1 PROGRAMMEOFACTION#XXF1#P $! XX  RoleoftheUNFPAv#XX  $!V#FXXIII = #XXFȻ#}XXRecentProjectsRelatedtoAgeing,SupportedbytheUNFPA   E #XX}#FXX #XXFҬ#}XXTypesofprojectsfunded#XX}#FXX  W  #XXFL#9XXAlthoughtheissuesofageingarenotcentraltothemainactivitiesoftheUNFPA,theFundhassupportedanumber N  ofimportantinitiativesconsistentwithitsmandateandguidelines.MosthavebeenmultifocusedintermsofthestrategicobjectivesoftheFund,combiningvariouspermutationsofadvocacy,technicalassistance,trainingandresearch.Someofthelargerandmoresignificantexamplesaregiven#XX9#&4&XXԀbelow.    Projectparticipantsandlocations    #XX&&4Ҙ#9XXProjectsareawardedtonationalgovernments,tonongovernmentorganisations(NGOs),tootheragenciesincluding  theUnitedNationsEconomicandSocialCommissions,touniversitiesandotherresearchinstitutions.Projectsvarywidelyinscale,notonlyinthegeographicalareatowhichtheprojectrelatesbutalsointhefinancialresourcescommitted.Themoresubstantiveprojectsrelatetoindividualcountries,tomoreextensiveareassuchasRegionalAsia,RegionalEurope,RegionalAsiaandthePacific,orareInterregional.Smallprojects,oftenonlypartiallyfundedbyUNFPA,andsupportedsimplytoensureforexampleappropriatecountryrepresentationatmeetings,orpublicationofmajorconferenceproceedings,havehadtodowithaPilotProjectonCommunicationstoBenefitthe G ElderlyinEcuador,ActivitiesforInternationalYearofOlderPersons1999,PublicationandDisseminationofthe O FinalReportoftheInternationalConferenceonPopulationAgeinginitiatedbytheSecretaryGeneral,and  PreparatoryActivitiesfortheSocialSummitinEurope.#XX94#9XX  #XX9#@z""""!@@1111!@ O XX   SelectedexamplesofUNFPAprojects#XX O#    55Title:  LocalLevelPolicyDevelopmenttoDealwiththeConsequencesof   P  =   PopulationAgeingLocale:  RegionalAsiaandPacific9XX ! #XX9##Agency:  KoreanInstituteforHealthandSocialAffairs(KIHASA) " Objective:  $1!   XXXX9XX[G  T:uM% ]5 mE "uT[GF݀"0 P   #9 9##XX9'# XXXX 9X XtocontributetothesuccessfulimplementationoftheInternationalConferenceonPopulationandDevelopment &B"! (ICPD)ProgrammeofActionthroughtheInternationalSymposiumentitledPopulationandDevelopment & #" PoliciesinLowFertilityCountries:ChallengesofChangingAgeStructures.#9 9##XX92#    @/Կ*["""""!@|55| @&#""""!@ XXXX 9X XQ7uM% ]5 mE "uQ# XX 94##XXX X#9XXK7uM% ]5 mE "K#XX9# 55Title:  TheStatusofOlderPersonsinECECountries:EconomicConditions,Living   =   ArrangementsandGenderLocale:  RegionalEurope  Agency:  EconomicCommissionforEurope(ECE) &  9XXTheprojectwasinitiatedin1992underthetitle,TheDynamicsofPopulationAgeinginECECountries,andafter  H extensivereviewandevaluationearlyin1996,continuationwasapprovedforthe19961999financialcycle,underthenewtitle.FundingwasprovidedinitiallybyUNFPAandsubsequentlybytheUnitedStatesNationalInstituteonAgeing(NIA),enablingthePopulationActivitiesUnitoftheECEtoassembleandstandardisemicrodatafromnationalpopulationandhousingcensusesforfourteencountries.Severalworkshops,seminarsandconferenceshavebeenheldandthelastofthesewilltakeplacein1999aspartoftheUnitedNationsInternationalYearofOlderPersons.Twomajorresearchpublicationshaveresultedtodate:TheDirectoryofResearchInstitutionsWorkingin   theFieldofAgeing,and,AgeingResearchinEurope:Demographic,SocialandBehaviouralAspects.   #XX9$# Objectives:  z 9XXoverall:   99[G  N:uM% ]5 mE "N[G݀"0 P   #9 9#toenablecountriestoimplementtheInternationalConferenceonPopulationandDevelopment(ICPD) t ProgrammeofActionintheregion[G&݌ P(#P(# Ќ  C $#C[G  [G݀"0 P   0=P(#P(# P tofacilitateimplementationoftheEuropeanPopulationConference(EPC,1993)Recommendationswithrespect %e tothevulnerableolderagegroupsinthepopulation,particularlywomen[G݌ =(#=(# Ќ  C $$ CQ7uM% ]5 mE "uQinthelongerterm:  C  $$ CN:uM% ]5 mE "N0 P e  99[G  T:uM% ]5 mE "uT[G݀"0PP(#P(#  #9 9h#toassessandmonitorthesocialandeconomicconditionsofolderpersons,particularlyolderwomen,livinginthe  countriesoftheECE,asrecommendedbyseveralrecentinternationalconferences[G݌ P(#P(# Ќ  C $$C[G  [G݀"0 P   #XX9_#9XXtofocusoneastandcentralEuropeancountrieswitheconomiesintransitionplus,forcomparativepurposes, p countriesfromNorthAmericaandwesternEurope[G݌ P(#P(# Ќ  #XX9#9XX[G  [G`݀"0 P   #XX9A#9XXtoproducepolicymakerswithinformationandanalysisontheimpactofpopulationageingonpensionandhealth !a caresystemsincountriesineconomictransition[G`{݌ P(#P(# Ќ  0 P e [G  [G݀"0PP(#P(#  #XX9#9XXtoprepareaseriesofcountryreportsandcrossnationalcomparativestudiesbasedonmicrodatasamplesdrawn  fromthe1990roundofcensuses[G݌ P(#P(# Ќ  C $$ CQ7uM% ]5 mE "uQmoreimmediately:  C  $$ CN:uM% ]5 mE "N0 P e  99[G  T:uM% ]5 mE "uT[G݀"0PP(#P(#  #9 9#toprovideinputintoandsupportforthepopulationstructureandtheagedtobeincludedintheinformation l   systemforthemonitoringoftheICPDandEPCfollowupprocess[G^݌ P(#P(# Ќ  C $$C[G  [G݀"0 P   #XX9j#9XXtopromotecollaborativeresearcheffortsonthestatusofolderpersons,particularlyamongwomenandother "]" vulnerablegroups[G݌ P(#P(# Ќ  0 P e [G  [Gj݀"0PP(#P(#  #XX9f#9XXtotransferknowhowinthefieldsofpopulationageingandrelateddataprocessingandanalysisthrough#XX9# XXXX[Gj݌# $P(#P(# Ќ  |@*.*`0 p@| @2% """""!@  % "& #XXX X#55Title:  DevelopmentofResearchontheAgedforPolicyFormationPurposes " Locale:  China 3 Agency:  ChinaResearchCenteronAgeing D Objectives:  &f C  $$ C XXXX 9X X[G  T:uM% ]5 mE "uT[G݀"0 P   #9 9V##XX9u# XXXX 9X XtoconductacomprehensivesurveyontheexistingsupportsystemsfortheelderlyinChinainordertolaya 7 w scientificbasisforthegovernmenttoformulatepoliciesforthesupportoftheelderly#9 9y##XX9#9XX[G݌ ?P(#P(# Ќ  C $$C0 P e [G  [G݀"0PP(#P(#  #XX9#9XXtodevelopanappropriatemethodology,designsuitableinstrumentsandcarryoutalargescalesurveyofelderly  ( inbothruralandurbanareas[G݌ P(#P(# Ќ  [G  [G݀"0 P   #XX9 #9XXtoorganisemeetingsofexpertstoadviseandassistindeterminationofprocedures,andtoprovidetrainingfor    enumeratorsandsupervisors[G ݌ P(#P(# Ќ  [G  [Gm݀"0 P   #XX9s#9XXtoprocessandpublishthedatacollectedinordertoenablefurtherresearchandanalysistobeundertaken[Gm݌J P(#P(# Ќ  [G  [G݀"0 P   #XX9#9XXtoformulatepolicyrecommendationsfortheStateCouncilintheareasofpensionpolicy,socialsecurity,and 3s  overallwellbeingoftheelderly#XX9#9XX 99 [G݌; P(#P(# Ќ  @83#% """"!@# XX 9##XXX X# XXXX#XXX X #55Title:  SupportfortheInternationalInstituteforAgeing,Malta  Locale:  Interregional  Agency:  TheInternationalInstituteonAgeing(INIA) !  9XXTheInternationalInstituteonAgeing(INIA)wasestablishedinMaltain1988followingthesigningofanofficial C agreementbetweentheUnitedNationsandtheGovernmentofMalta.TheinitiativederivedfromthePlanofActionoftheWorldAssemblyonAgeinginVienna,1982,andaproposaltotheSecretaryGeneraloftheUnitedNationsbytheGovernmentofMaltatoestablishtheInternationalInstituteasanautonomousbodyundertheauspicesoftheUnitedNations.TheGovernmentofMalta,ashostcountry,providestherequisiteofficepremisesandtheirmaintenanceand,togetherwithothergovernments,theUniversityofMaltaandvariousagenciescontributesadditionalfundingandsupport.UNFPAhasbeensupportingINIAsince1989withcumulativecontributionsofaboutUS$1.5millionthroughtheendofthecycleto1999.FollowingtheICPD,theINIAhasattemptedtoadaptitsactivitiestotakeintoaccounttheobjectivesandrecommendationsoftheICPD. C #XX9~# Objectives:  =} 9XXprogrammesfortheperiod19961999aim N  C  $$ CT:uM% ]5 mE "uT2"3  0 P tofacilitatetherecommendationsoftheViennaInternationalPlanofActionandtheICPDProgrammeofAction 7!w  intheareaofageing P(#P(# C $$C0 P e 2"3  0PP(#P(#toincreaseawarenessofissuesinvolvedinpopulationageingthroughresearch,advocacy,networkingand "(" informationexchangeactivities P(#P(# 0 P e 2"3  0PP(#P(#todeviseappropriatestrategiesandmeasurestocounteractanynegativeeffectsofageing$ $P(#P(# 0 P e 2"3  0PP(#P(#todrawuprecommendationsandtargetstoensurethewellbeingofelderlypersons%!%P(#P(# 0 P e 2"3  0PP(#P(#tofulfilthetrainingneedsofdevelopingcountries#XX9# XXXX k&"&P(#P(# @U'#""""! M@  U'#' *O12 CddZZ@e(#e(#O,ZZ@+  /%  C/ 9X X5 5Title: *   # XX 9#AsiasPopulationFutureImplicationsforFamilyandtheElderly 9X X " Locale:  # XX 9#RegionalAsiaandthePacific 9X X 3 Agency:  # XX 9#EconomicandSocialCommissionforAsiaandthePacific(ESCAP) 9X X D Objectives:  >  inthelongerterm: ' C  $$ C[G  Q7uM% ]5 mE uQ[G݀"0 =   tosupporttheroleofthefamilyandtopromotecomplementarycommunitybasedservices,withtheactive   involvementoftheelderlyintheircareandintheeffectiveutilisationoftheirpotentialsindevelopment,inthecontextofevolvingdemographicanddevelopmentaldynamics[G ݌ =!=! Ќ  N4uM% ]5 mE uNmoreimmediately: I   K7uM% ]5 mE K0 = R [G  Q7uM% ]5 mE uQ[G݀"0==!=!  toenhancetheunderstandingoftheeffectsofsocioeconomicanddemographicchanges,including 2 r  urbanisation,onthepatternsanddynamicsoffamilycompositionandstructure[G݌ =!=! Ќ  C $$C#9 9a#[G  [G݀"0 =   #XX9#9XX 99toexaminetheeconomicandsocialconditionsoftheelderly,withspecialfocusonwomen[G݌# =!=! Ќ  C  $$ CQ7vaM% ]5 mE uQ0 + 0+!+! + 2"3  0!!#9 9# 99# XX 9# 9X X0!!  tounderstandtheirspecialneedsaswellascapabilitiesfortheirparticipationindevelopment !! C $$C0 + 0+!+! + 2"3  0!!toassessthepotentialfororganisingthemasaselfsupportinggroup !! C  $$ C--[G  T7uM% ]5 mE vaMT[Gv ݀"0 =   toundertakeoperationalresearchontheroleandfunctionsofNGOsthatcouldprovidecommunitybased   servicesforthebenefitofelderly[Gv  ݌ =!=! Ќ  Q7vaM% ]5 mE uQ0 + 0+!+! + 2"3  0!!#9 9 # 99# XX 94 # 9X X0!!  toenhancethenationalcapacityforsupportoftheelderlyO!! C $$C0 + 0+!+! + 2"3  0!!toformulatestrategiesfordevelopingfamilysupportsystemsandcommunitybasedservicesas 8x complementarymechanismsforthecareoftheelderly !! C  $$ C--[G  T7uM% ]5 mE vaMT[G݀"0 =   tocreategreaterawarenessamongseniorplannersandpolicymakersaswellaswithincommunitiesofthe ) issuesandproblemsoftheelderly,andtheroleofthefamilyandcommunitybasedservicesintheworkingdevelopmentcontext[G݌ =!=! 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F byMajorArea,RegionandCountry,DepartmentforEconomicandSocialInformationandPolicy "!  F Analysis,PopulationDivision,AnnexIIandIII.UNFPA(1995)NationalPerspectivesonPopulationandDevelopment,UNFPA,NewYork. %!$ UNFPA(1998)TheStateofWorldPopulation,1998:TheNewGenerations,NewYork. `'#& Westley,SB(1998)Asiasnextchallenge:caringfortheelderly,AsiaPacificPopulationand "  @)%(  F Policy,45,2. 0*p&)   ,P(+ Wise,DA(1997)Retirementagainstthedemographictrend:moreolderpeoplelivinglonger, "    F workingless,andsavingless,Demography,34,1,8395.  WorldBank(1994)AvertingtheOldAgeCrisis:PoliciestoProtecttheOldandPromoteGrowth,   F WorldBankPolicyResearchReport,NewYork:OxfordUniversityPress.Yap,MT(1998)CountrieswithSubstantiallyBelowReplacementFertility:SingaporeStatus, "  `   F SeminaronPopulationandDevelopmentPoliciesinLowFertilityCountries,KIHASA/UNFPA, F Seoul,unpublishedpaper.0 @  (# (#    `  oOuM% ]5 mE "#%'})U+--/0,X` Xo*O$6 CdCdZZ@12e(#e(#O, ZZ@,ZZ@,ZZ@,ZZ@,wZZ@+  .$  C .  Table1:MedianAges(years)byWorldRegions,195020201#XXX Xg # XXXX LB(C    C L Q99@(C   CQ7Area/Country ]99LC99 x@1950Cx@] 1950 99nAC x@1950 x@99 Ȟ@1970CȞ@1970 99nAC Ȟ@1970 Ȟ@99 ,@1995C,@1995 99nAC ,@1995 ,@99 @2020C@2020 =j i_GC @2020 @99 CiWorld ~=j I?C 7@23.5C7@I23.5 ka4 C 7@23.5 7@ 5@21.6C5@k21.6 ka4 C 5@21.6 5@ ffffff9@25.4Cffffff9@k25.4 ka4 C ffffff9@25.4 ffffff9@ fffff>@30.9Cfffff>@k30.9 {~ \R: C fffff>@30.9 fffff>@ C\MoreDevelopedRegions I? C <@28.6C<@I28.6 ka4C <@28.6 <@ >@30.6C>@k30.6 ka4C >@30.6 >@ fffffA@35.8CfffffA@k35.8 ka4C fffffA@35.8 fffffA@ E@42.0CE@k42.0 ({ \R:C E@42.0 E@ C\LessDevelopedRegions I?pC L5@21.3CL5@I21.3 ka4pC L5@21.3 L5@ 3@19.0C3@k19.0 ka4pC 3@19.0 3@ 3333337@23.2C3333337@k23.2 ka4pC 3333337@23.2 3333337@ =@29.1C=@k29.1 \R:pC =@29.1 =@ C\LeastDevelopedCountries2 I?` C ffffff3@19.4Cffffff3@I19.4 ka4` C ffffff3@19.4 ffffff3@ fffff1@17.9Cfffff1@k17.9 ka4` C fffff1@17.9 fffff1@ fffff1@17.9Cfffff1@k17.9 ka4` C fffff1@17.9 fffff1@ L5@21.3CL5@k21.3 {( WM:` C L5@21.3 L5@ CW 'P C C' 'P C C' 'P C C' 'P C C' :0P  C C:Africa I?@ !C 333332@18.7C333332@I! uM!18.7 ka4@ "C 333332@18.7 333332@ 1@17.6C1@k17.6 ka4@ #C 1@17.6 1@ fffff1@17.9Cfffff1@k17.9 ka4@ $C fffff1@17.9 fffff1@ L5@21.3CL5@k21.3 ({ \R:@ %C L5@21.3 L5@ C\ЀAlgeria I?0 p&C fffff3@19.9Cfffff3@I! uM!19.9 ka40 p'C fffff3@19.9 fffff3@ /@15.8C/@k15.8 ka40 p(C /@15.8 /@ 3@19.8C3@k19.8 ka40 p)C 3@19.8 3@ fffff;@27.9Cfffff;@k27.9 \R:0 p*C fffff;@27.9 fffff;@ C\ЀUganda I? ` +C 333331@17.7C333331@I! uM!17.7 ka4 ` ,C 333331@17.7 333331@ ffffff0@16.4Cffffff0@k16.4 ka4 ` -C ffffff0@16.4 ffffff0@ ffffff/@15.7Cffffff/@k15.7 ka4 ` .C ffffff/@15.7 ffffff/@ 1@17.8C1@k17.8 {( \R: ` /C 1@17.8 1@ C\Asia I?P 0C fffff5@21.9Cfffff5@I! uM!21.9 ka4P 1C fffff5@21.9 fffff5@ 333333@19.7C333333@k19.7 ka4P 2C 333333@19.7 333333@ 333338@24.7C333338@k24.7 ka4P 3C 333338@24.7 333338@ 33333?@31.7C33333?@k31.7 ({ \R:P 4C 33333?@31.7 33333?@ C\ЀJapan I?@ 5C L6@22.3CL6@I! uM!22.3 ka4@ 6C L6@22.3 L6@ =@29.0C=@k29.0 ka4@ 7C =@29.0 =@ 33333C@39.4C33333C@k39.4 ka4@ 8C 33333C@39.4 33333C@ 333333G@46.4C333333G@k46.4 \R:@ 9C 333333G@46.4 333333G@ C\ЀRepublicofKorea I?0 :C 3@19.1C3@I! uM!19.1 ka40 ;C 3@19.1 3@ 3@19.0C3@k19.0 ka40 <C 3@19.0 3@ 333333=@29.2C333333=@k29.2 ka40 =C 333333=@29.2 333333=@ fffffC@39.8CfffffC@k39.8 {( \R:0 >C fffffC@39.8 fffffC@ C\Europe I? ?C 333333=@29.2C333333=@I! uM!29.2 ka4 @C 333333=@29.2 333333=@ 33333?@31.7C33333?@k31.7 ka4 AC 33333?@31.7 33333?@ B@36.0CB@k36.0 ka4 BC B@36.0 B@ ffffffE@42.8CffffffE@k42.8 ({ \R: CC ffffffE@42.8 ffffffE@ C\ЀGermany I?DC 33333A@35.4C33333A@I! uM!35.4 ka4EC 33333A@35.4 33333A@ fffff&A@34.3Cfffff&A@k34.3 ka4FC fffff&A@34.3 fffff&A@  C@38.1C C@k38.1 ka4GC  C@38.1  C@ G@46.0CG@k46.0 \R:HC G@46.0 G@ C\ЀItaly I?IC =@29.0C=@I! uM!29.0 ka4JC =@29.0 =@ ffffff@@32.8Cffffff@@k32.8 ka4KC ffffff@@32.8 ffffff@@  C@38.1C C@k38.1 ka4LC  C@38.1  C@ YH@48.7CYH@k48.7 {( \R:MC YH@48.7 YH@ C\LatinAmerica&Caribbean I?NC 4@20.1C4@I! uM!20.1 ka4OC 4@20.1 4@ 333332@18.7C333332@k18.7 ka4PC 333332@18.7 333332@ 3333337@23.2C3333337@k23.2 ka4QC 3333337@23.2 3333337@ >@30.8C>@k30.8 ({ \R:RC >@30.8 >@ C\ЀArgentina I?SC 333339@25.7C333339@I! uM!25.7 ka4TC 333339@25.7 333339@ ffffff;@27.4Cffffff;@k27.4 ka4UC ffffff;@27.4 ffffff;@ ffffff;@27.4Cffffff;@k27.4 ka4VC ffffff;@27.4 ffffff;@ 333333@@32.4C333333@@k32.4 \R:WC 333333@@32.4 333333@@ C\ЀCuba I?XC L7@23.3CL7@I! uM!23.3 ka4YC L7@23.3 L7@ L6@22.3CL6@k22.3 ka4ZC L6@22.3 L6@ 333333>@30.2C333333>@k30.2 ka4[C 333333>@30.2 333333>@ 333333E@42.4C333333E@k42.4 {( \R:\C 333333E@42.4 333333E@ C\NorthAmerica I?]C =@29.8C=@I! uM!29.8 ka4^C =@29.8 =@ <@28.0C<@k28.0 ka4_C <@28.0 <@ fffff&A@34.3Cfffff&A@k34.3 ka4`C fffff&A@34.3 fffff&A@ YC@38.7CYC@k38.7 ({ \R:aC YC@38.7 YC@ C\ЀCanada I?pbC 33333;@27.7C33333;@I! uM!27.7 ka4pcC 33333;@27.7 33333;@ :@26.0C:@k26.0 ka4pdC :@26.0 :@ YA@34.7CYA@k34.7 ka4peC YA@34.7 YA@ D@41.5CD@k41.5 {( \R:pfC D@41.5 D@ C\Oceania I?`gC fffff;@27.9Cfffff;@I! uM!27.9 ka4`hC fffff;@27.9 fffff;@ 9@25.0C9@k25.0 ka4`iC 9@25.0 9@ fffff=@29.9Cfffff=@k29.9 ka4`jC fffff=@29.9 fffff=@  A@34.1C A@k34.1 ({ c9R:`kC  A@34.1  A@ CcЀAustralia ]9LPlC9 ffffff>@30.4Cffffff>@]! uM!30.4 9nAPmC ffffff>@30.4 ffffff>@9 ;@27.6C;@27.6 9nAPnC ;@27.6 ;@9 @@33.7C@@33.7 9nAPoC @@33.7 @@9 ffffffC@38.8CffffffC@38.8 {( 9X XWMKPpC ffffffC@38.8  ffffffC@9 WcOuM% ]5 mE "#%'})U+--/0c {1Themediumvariantoffertilityhasbeenadoptedforallprojections Hq 2Alsoincludedinthelessdevelopedregions 4ts Source:UnitedNations(1997c) `u    0w   *'8 CdCd ZZ@ZZ@ZZ@ZZ@wZZ@$6e(#e(#,c ZZ@,ZZ@,ZZ@,ZZ@+  +!  C+   # XX 9d#Table2:PercentageDistributionofFunctionalAgeGroups  byWorldRegions,1970,1995,20201 9X X#9 9&5# 99 =3C   C= 'C C' 'C" C' 'C" C' 89+C" C8# XX 9h# &4&X XArea/Country#&4&& &4h# &4&&&4 Y9LhC9 Ȟ@1970CȞ@Y  1970 {9nAhC Ȟ@1970 Ȟ@9 ,@1995C,@{  1995 {9nAh C ,@1995 ,@9 @2020C@{  2020 o9bGh C @2020 @9 Co  :9-B C9 C:014 :9-B C9 C: :9-B C9 C: G=%BC 9 CGWorld  I?\C B@37.5CB@I37.5 ka4\C B@37.5 B@ ffffff?@31.4Cffffff?@k31.4 ka4\C ffffff?@31.4 ffffff?@ 3333339@25.2C3333339@k25.2 \R:\C 3333339@25.2 3333339@ C\MoreDevelopedRegions  I?6C :@26.0C:@I26.0 ka46C :@26.0 :@ 3@19.6C3@k19.6 ka46C 3@19.6 3@ 333330@16.7C333330@k16.7 \R:6C 333330@16.7 333330@ C\LessDevelopedRegions I? C fffffD@41.8CfffffD@I41.8 ka4 C fffffD@41.8 fffffD@ 333333A@34.4C333333A@k34.4 ka4 C 333333A@34.4 333333A@ :@26.8C:@k26.8 \R: C :@26.8 :@ C\LeastDevelopedCountries2 I? C fffff&F@44.3Cfffff&F@I44.3 ka4 C fffff&F@44.3 fffff&F@ 33333E@43.9C33333E@k43.9 ka4 C 33333E@43.9 33333E@ ̌B@37.1ČB@k37.1 \R: C ̌B@37.1 ̌B@ `C\ ' C C' '  C C' ' !C C' ?5 "C ` C?Africa I? $#C ffffffF@44.8CffffffF@I44.8 ka4 $$C ffffffF@44.8 ffffffF@ fffffE@43.8CfffffE@k43.8 ka4 $%C fffffE@43.8 fffffE@ ̌B@37.1ČB@k37.1 \R: $&C ̌B@37.1 ̌B@ C\Asia I? 'C fffff&D@40.3Cfffff&D@I40.3 ka4 (C fffff&D@40.3 fffff&D@ ?@31.8C?@k31.8 ka4 )C ?@31.8 ?@ 7@23.8C7@k23.8 \R: *C 7@23.8 7@ C\Europe I? +C L9@25.3CL9@I25.3 ka4 ,C L9@25.3 L9@ 3@19.1C3@k19.1 ka4 -C 3@19.1 3@ /@15.5C/@k15.5 \R: .C /@15.5 /@ C\LatinAmerica&Caribbean I?r /C 333333E@42.4C333333E@I42.4 ka4r 0C 333333E@42.4 333333E@ @@33.6C@@k33.6 ka4r 1C @@33.6 @@ fffff9@25.9Cfffff9@k25.9 \R:r 2C fffff9@25.9 fffff9@ C\NorthAmerica I?L 3C <@28.5C<@I28.5 ka4L 4C <@28.5 <@ 6@22.0C6@k22.0 ka4L 5C 6@22.0 6@ ffffff3@19.4Cffffff3@k19.4 _U:L 6C ffffff3@19.4 ffffff3@ C_Oceania YO&f 7C fffff&@@32.3Cfffff&@@Y32.3 {qA&f 8C fffff&@@32.3 fffff&@@ :@26.0C:@{26.0 {qA&f 9C :@26.0 :@ 6@22.8C6@{22.8 g]G&f :C 6@22.8 6@ Cg 7-@ ;C C7 7-@ <C C7 7-@ =C C7 E;%@ >C  CE 7-?C C71559 7-@C C7#&4&& &4Yj# &4&&&4 7-AC C7#&4&& &4# &4&&&4 G=%BC  CGWorld  I?CC  K@54.1C K@I54.1 ka4DC  K@54.1  K@ ̌M@59.1ČM@k59.1 ka4EC ̌M@59.1 ̌M@ N@61.7CN@k61.7 \R:FC N@61.7 N@ C\MoreDevelopedRegions  I?GC M@59.5CM@I59.5 ka4HC M@59.5 M@  O@62.1C O@k62.1 ka4IC  O@62.1  O@ M@58.2CM@k58.2 \R:JC M@58.2 M@ C\LessDevelopedRegions I?hKC  J@52.1C J@I52.1 ka4hLC  J@52.1  J@ fffff&M@58.3Cfffff&M@k58.3 ka4hMC fffff&M@58.3 fffff&M@ fffff&O@62.3Cfffff&O@k62.3 \R:hNC fffff&O@62.3 fffff&O@ C\LeastDevelopedCountries2 I?BOC LI@50.6CLI@I50.6 ka4BPC LI@50.6 LI@ fffffI@51.3CfffffI@k51.3 ka4BQC fffffI@51.3 fffffI@ L@57.2CL@k57.2 \R:BRC L@57.2 L@ `C\ '\SC C' '\TC C' '\UC C' ?5\VC ` C?Africa I?|WC I@50.2CI@I50.2 ka4|XC I@50.2 I@ I@51.2CI@k51.2 ka4|YC I@51.2 I@ 33333sL@56.9C33333sL@k56.9 \R:|ZC 33333sL@56.9 33333sL@ C\Asia I?V[C J@53.2CJ@I53.2 ka4V\C J@53.2 J@ N@60.0CN@k60.0 ka4V]C N@60.0 N@ O@63.6CO@k63.6 \R:V^C O@63.6 O@ C\Europe I?0p_C M@59.2CM@I59.2 ka40p`C M@59.2 M@ O@62.0CO@k62.0 ka40paC O@62.0 O@ fffffM@59.3CfffffM@k59.3 \R:0pbC fffffM@59.3 fffffM@ C\LatinAmerica&Caribbean I? JcC I@51.2CI@I51.2 ka4 JdC I@51.2 I@ 33333sM@58.9C33333sM@k58.9 ka4 JeC 33333sM@58.9 33333sM@ fffffN@61.8CfffffN@k61.8 \R: JfC fffffN@61.8 fffffN@ C\NorthAmerica I?$gC L@57.7CL@I57.7 ka4$hC L@57.7 L@ N@61.7CN@k61.7 ka4$iC N@61.7 N@ L@57.5CL@k57.5 _U:$jC L@57.5 L@ C_Oceania YOkC L@57.0CL@Y57.0 {qAlC L@57.0 L@ N@61.0CN@{61.0 {qAmC N@61.0 N@ M@59.6CM@{59.6 g]GnC M@59.6 M@ Cg 7-oC C7 7-pC C7 7-qC C7 E;%rC  CE 7-rsC C760+ 7-rtC C7#&4&& &4]# &4&&&4 7-ruC C7#&4&& &41# &4&&&4 G=%rvC  CGWorld  H>LwC  @8.4C @H8.4 i_3LxC  @8.4  @ #@9.5C#@i9.5 j`3LyC #@9.5 #@ 333333*@13.1C333333*@j13.1  \R:LzC 333333*@13.1 333333*@ C\MoreDevelopedRegions  I?&f{C -@14.5C-@I14.5 ka4&f|C -@14.5 -@ L2@18.3CL2@k18.3 ka4&f}C L2@18.3 L2@ 9@25.1C9@k25.1 {T \R:&f~C 9@25.1 9@ C\LessDevelopedRegions H>@C ffffff@6.1Cffffff@H6.1 i_3@C ffffff@6.1 ffffff@ 333333@7.3C333333@i7.3 j`3@C 333333@7.3 333333@ %@10.9C%@j10.9 \R:@C %@10.9 %@ C\LeastDevelopedCountries2 H>C ffffff@5.1Cffffff@H5.1 i_3C ffffff@5.1 ffffff@ 333333@4.8C333333@i4.8 i_3C 333333@4.8 333333@ @5.7C@i5.7 {T [Q9C @5.7 @ `C[ ' C C' ' C C' ' C C' ?5 C ` C?Africa H>!TC @5.0C@H5.0 i_3!TC @5.0 @ @5.0C@i5.0 i_3!TC @5.0 @ @6.0C@i6.0 {T [Q9!TC @6.0 @ C[Asia H>!.C @6.5C@H6.5 i_3!.C @6.5 @ ffffff @8.2Cffffff @i8.2 j`3!.C ffffff @8.2 ffffff @ 333333)@12.6C333333)@j12.6 \R:!.C 333333)@12.6 333333)@ C\Europe I?"C /@15.5C/@I15.5 ka4"C /@15.5 /@ fffff2@18.9Cfffff2@k18.9 ka4"C fffff2@18.9 fffff2@ 3333339@25.2C3333339@k25.2 \R:"C 3333339@25.2 3333339@ C\LatinAmerica&Caribbean H>#C @6.4C@H6.4 i_3#C @6.4 @ @7.5C@i7.5 j`3#C @7.5 @ (@12.3C(@j12.3 \R:#C (@12.3 (@ C\NorthAmerica I?|$ C +@13.8C+@I13.8 ka4|$ C +@13.8 +@ L0@16.3CL0@k16.3 ka4|$ C L0@16.3 L0@ 7@23.1C7@k23.1 c9R:|$ C 7@23.1 7@ CcOceania ]9LV%!C9 ffffff%@10.7Cffffff%@]10.7 9nAV%!C ffffff%@10.7 ffffff%@9 *@13.0C*@13.0 9nAV%!C *@13.0 *@9 1@17.6C1@17.6 @{T# XX& &4 j# 9X X g]GV%!C 1@17.6 1@9 Cg 7-0&p"C C7 7-0&p"C C7 7-0&p"C C75+)0&p"C )  5cOuM% ]5 mE "#%'})U+--/0c @1Themediumvariantoffertilityhasbeenadoptedforallprojections &8# 2Alsoincludedinthelessdevelopedregions $(d$ Source:UnitedNations(1997b)  P)% % XXX 9%% XXX X望%  Ž XXXX XXX X     Ž*  ! XXX X!*34 Cd*Cdc ZZ@ZZ@ZZ@ZZ@'8e(#e(#,P ZZ@,;ZZ@,ZZ@+  Ž*݌ .$  C .ЌXXX XXXXX   Table3:AverageAnnualGrowthRates(%)byWorldRegions  forOlderandTotalPopulations,19701995and199520201% XXXX%! XXX X! H>(C    C H 7-C  C 7 7-C"  C 7 N99=%C"   CN Area/Country# XXX X)# ;99*C99 C;19701995 ;99*C"99 C; Ž XXX X XXX X     Ž  19952020Ž݌ B8%C" 99 CBЌ XXX X XXX X    ! XXX X! ' C  C'  60andover ' C C' :0 C" C:World  I?p C ףp= @2.23Cףp= @I2.23 ka4p C" ףp= @2.23 ףp= @ ףp= @2.48Cףp= @k2.48 \R:pC" ףp= @2.48 ףp= @ C\MoreDevelopedRegions  I?` C RQ?1.52CRQ?I1.52 ka4` C" RQ?1.52 RQ? Q?1.42CQ?k1.42 \R:` C" Q?1.42 Q? C\LessDevelopedRegions I?P C )\(@2.77C)\(@I2.77 ka4P C" )\(@2.77 )\(@ ffffff@3.05Cffffff@k3.05 \R:P C" ffffff@3.05 ffffff@ C\LeastDevelopedCountries2 I?@ C (\@2.32C(\@I2.32 ka4@ C" (\@2.32 (\@ = ףp=@3.03C= ףp=@k3.03 \R:@ C" = ףp=@3.03 = ףp=@ `C\ '0 pC C' '0 pC" C' ?50 pC" ` C?Africa I? C Gz@2.71CGz@I2.71 ka4 C" Gz@2.71 Gz@ 333333 @3.15C333333 @k3.15 \R: C" 333333 @3.15 333333 @ C\Asia I? C p= ף@2.83Cp= ף@I2.83 ka4 C" p= ף@2.83 p= ף@ 333333@2.90C333333@k2.90 \R: C" 333333@2.90 333333@ C\Europe I?p !C \(\?1.21C\(\?I1.21 ka4p "C" \(\?1.21 \(\? (\?1.06C(\?k1.06 \R:p #C" (\?1.06 (\? C\LatinAmerica&Caribbean I?` $C \(\@2.67C\(\@I2.67 ka4` %C" \(\@2.67 \(\@ RQ @3.29CRQ @k3.29 \R:` &C" RQ @3.29 RQ @ C\NorthAmerica I?P 'C (\?1.66C(\?I1.66 ka4P (C" (\?1.66 (\?  ףp= @2.13C ףp= @k2.13 _U:P )C"  ףp= @2.13  ףp= @ C_Oceania YO@ *C RQ@2.29CRQ@Y2.29 {qA@ +C" RQ@2.29 RQ@ Gz@2.46CGz@{2.46 g]G@ ,C" Gz@2.46 Gz@ Cg 7-0p-C C7 7-0p.C" C7 E;%0p/C"  CE 7- `0C C7 80andover  7- `1C C7 G=% `2C"  CGWorld  I?P3C (\ @3.32C(\ @I3.32 ka4P4C" (\ @3.32 (\ @ \(\@2.67C\(\@k2.67 \R:P5C" \(\@2.67 \(\@ C\MoreDevelopedRegions  I?@6C zG@3.11CzG@I3.11 ka4@7C" zG@3.11 zG@ ?1.75C?k1.75 \R:@8C" ?1.75 ? C\LessDevelopedRegions I?09C (\ @3.62C(\ @I3.62 ka40:C" (\ @3.62 (\ @ (\ @3.62C(\ @k3.62 \R:0;C" (\ @3.62 (\ @ C\LeastDevelopedCountries2 I? <C Q @3.49CQ @I3.49 ka4 =C" Q @3.49 Q @ ffffff @3.30Cffffff @k3.30 \R: >C" ffffff @3.30 ffffff @ `C\ '?C C' '@C" C' ?5AC" ` C?Africa I?0pBC \(\ @3.17C\(\ @I3.17 ka40pCC" \(\ @3.17 \(\ @ q= ףp @3.68Cq= ףp @k3.68 \R:0pDC" q= ףp @3.68 q= ףp @ C\Asia I? `EC Q@3.84CQ@I3.84 ka4 `FC" Q@3.84 Q@ (\ @3.57C(\ @k3.57 \R: `GC" (\ @3.57 (\ @ C\Europe I?PHC  ףp= @2.88C ףp= @I2.88 ka4PIC"  ףp= @2.88  ףp= @ \(\?1.46C\(\?k1.46 \R:PJC" \(\?1.46 \(\? C\LatinAmerica&Caribbean I?@KC = ףp=@3.78C= ףp=@I3.78 ka4@LC" = ףp=@3.78 = ףp=@  @3.70C @k3.70 \R:@MC"  @3.70  @ C\NorthAmerica I?0NC )\(@3.02C)\(@I3.02 ka40OC" )\(@3.02 )\(@ Q?1.57CQ?k1.57 _U:0PC" Q?1.57 Q? C_Oceania YO QC 333333 @3.40C333333 @Y3.40 {qA RC" 333333 @3.40 333333 @ q= ףp@2.43Cq= ףp@{2.43 g]G SC" q= ףp@2.43 q= ףp@ Cg 7-TC C7 7-UC" C7 E;%VC"  CE 7-WC C7 Allages 7-XC C7 G=%YC"  CGWorld  I?ZC Q?1.72CQ?I1.72 ka4[C" Q?1.72 Q? 333333?1.20C333333?k1.20  \R:\C" 333333?1.20 333333? C\MoreDevelopedRegions  I? ]C 333333?0.60C333333?I0.60 ka4 ^C" 333333?0.60 333333? {Gz?0.16C{Gz?k0.16 {T \R: _C" {Gz?0.16 {Gz? C\LessDevelopedRegions I?!`C (\@2.07C(\@I2.07 ka4!aC" (\@2.07 (\@ zG?1.43CzG?k1.43 \R:!bC" zG?1.43 zG? C\LeastDevelopedCountries2 I?"cC Gz@2.51CGz@I2.51 ka4"dC" Gz@2.51 Gz@  ףp= @2.38C ףp= @k2.38 {T \R:"eC"  ףp= @2.38  ףp= @ `C\ 'p#fC C' 'p#gC" C' ?5p#hC" ` C?Africa I?# iC (\@2.72C(\@I2.72 ka4# jC" (\@2.72 (\@ \(\@2.42C\(\@k2.42 {T \R:# kC" \(\@2.42 \(\@ C\Asia I?$!lC Gz?1.88CGz?I1.88 ka4$!mC" Gz?1.88 Gz? (\?1.16C(\?k1.16 \R:$!nC" (\?1.16 (\? C\Europe I?%!oC zG?0.42CzG?I0.42 lb4%!pC" zG?0.42 zG? )\(-0.11C)\(lЄ0.11 ]S;%!qC" )\(-0.11 )\( C]LatinAmerica&Caribbean I?&"rC p= ף@2.08Cp= ף@I2.08 ka4&"sC" p= ף@2.08 p= ף@ p= ף?1.29Cp= ף?k1.29 \R:&"tC" p= ף?1.29 p= ף? C\NorthAmerica I?'#uC Gz?0.99CGz?I0.99 ka4'#vC" Gz?0.99 Gz? ?0.75C?k0.75 c9R:'#wC" ?0.75 ? CcOceania ]9L($xC9 {Gz?1.53C{Gz?]1.53 9nA($yC" {Gz?1.53 {Gz?9 )\(?1.26C)\(?1.26 @{T 9X XWMK($zC" )\(?1.26 ( )\(?9 W  # XX, 9S# 9h X1Themediumvariantoffertilityhasbeenadoptedforallprojections j*&{ 2Alsoincludedinthelessdevelopedregions d+'|   Source:UnitedNations(1997b)# XX 9#  ^,(}   # XXX Xy#*q@A Cd)CdP ZZ@;ZZ@ZZ@34e(#e(#q,P ZZ@, ZZ@, ZZ@, ZZ@+  .$  C.  Table4:SexRatios(malesperthousandfemales)atOlderAgesby  WorldRegions,1970,1995,20201 :0"C  C: 7-C" C7 J@%C"  CJ 7-C C7 7-C" C7 7-C" C75+)C"   5*BC CdCdP ZZ@ ZZ@ ZZ@ ZZ@@Ae(#e(#, ZZ@,ZZ@,,ZZ@,/ZZ@+  399"  C3 @Area/Country ]99L C99 Ȟ@1970CȞ@]1970 99nA C" Ȟ@1970 Ȟ@99 ,@1995C,@1995 99nA C" ,@1995 ,@99 @2020C@2020 dZG C" @2020 @99 Cd ' C C'  60andover 'C C' 'C" C' :0C" C:World  H>pC @785C@H785 i_3pC" @785 @ 8@807C8@i807 i_3pC" 8@807 8@ `@844C`@i844 [Q9pC" `@844 `@ C[MoreDevelopedRegions  H>` C `@684C`@H684 i_3` C" `@684 `@ @691C@i691 i_3` C" @691 @ ȇ@761Cȇ@i761 [Q9` C" ȇ@761 ȇ@ C[LessDevelopedRegions H>P C @886C@H886 i_3P C" @886 @ @893C@i893 i_3P C" @893 @ @883C@i883 [Q9P C" @883 @ C[LeastDevelopedCountries2 H>@ C @917C@H917 i_3@ C" @917 @ @895C@i895 i_3@ C" @895 @ @882C@i882 [Q9@  C" @882 @ `C[ '0 p!C C' '0 p"C" C' '0 p#C" C' ?50 p$C" ` C?Africa H> %C Љ@826CЉ@H826 i_3 &C" Љ@826 Љ@ p@846Cp@i846 i_3 'C" p@846 p@ 0@870C0@i870 [Q9 (C" 0@870 0@ C[Asia H> )C @888C@H888 i_3 *C" @888 @ @895C@i895 i_3 +C" @895 @ @892C@i892 [Q9 ,C" @892 @ C[Europe H>p -C (@645C(@H645 i_3p .C" (@645 (@ @657C@i657 i_3p /C" @657 @ @725C@i725 [Q9p 0C" @725 @ C[LatinAmerica&Caribbean H>` 1C @884C@H884 i_3` 2C" @884 @ @830C@i830 i_3` 3C" @830 @ @801C@i801 [Q9` 4C" @801 @ C[NorthAmerica H>P 5C @764C@H764 i_3P 6C" @764 @ `@748C`@i748 i_3P 7C" `@748 `@ x@815Cx@i815 ^T9P 8C" x@815 x@ C^Oceania XN@ 9C h@813Ch@X813 yo@@ :C" h@813 h@ @828C@y828 yo@@ ;C" @828 @ @848C@y848 f\F@ <C" @848 @ Cf 7-0p=C C7 7-0p>C" C7 7-0p?C" C7 E;%0p@C"  CE 7- `AC C7  80andover 7- `BC C7 7- `CC" C7 G=% `DC"  CGWorld  H>PEC @594C@H594 i_3PFC" @594 @ @529C@i529 i_3PGC" @529 @ (@581C(@i581  [Q9PHC" (@581 (@ C[MoreDevelopedRegions  H>@IC P@501CP@H501 i_3@JC" P@501 P@ p{@439Cp{@i439 i_3@KC" p{@439 p{@ @496C@i496 {T [Q9@LC" @496 @ C[LessDevelopedRegions H>0MC @753C@H753 i_30NC" @753 @ Ȅ@665CȄ@i665 i_30OC" Ȅ@665 Ȅ@ @656C@i656 [Q90PC" @656 @ C[LeastDevelopedCountries2 H> QC Љ@826CЉ@H826 i_3 RC" Љ@826 Љ@ @801C@i801 i_3 SC" @801 @ @754C@i754 {T [Q9 TC" @754 @ `C[ 'UC C' 'VC" C' 'WC" C' ?5XC" ` C?Africa H>0pYC @689C@H689 i_30pZC" @689 @ p@686Cp@i686 i_30p[C" p@686 p@ @701C@i701 {T [Q90p\C" @701 @ C[Asia H> `]C @736C@H736 i_3 `^C" @736 @ @639C@i639 i_3 `_C" @639 @  @644C @i644 [Q9 ``C"  @644  @ C[Europe H>PaC `}@470C`}@H470 i_3PbC" `}@470 `}@ y@411Cy@i411 i_3PcC" y@411 y@ }@464C}@i464 [Q9PdC" }@464 }@ C[LatinAmerica&Caribbean H>@eC h@749Ch@H749 i_3@fC" h@749 h@ @675C@i675 i_3@gC" @675 @ x@623Cx@i623 [Q9@hC" x@623 x@ C[NorthAmerica H>0iC @576C@H576 i_30jC" @576 @ }@473C}@i473 i_30kC" }@473 }@ x@527Cx@i527 b9Q90lC" x@527 x@ CbOceania \9K mC9 0@550C0@\550 }9l@ nC" 0@550 0@9 H@521CH@}521 }9l@ oC" H@521 H@9 @568C@}568 @{T 9X XVLJ pC" @568  @9 VcOuM% ]5 mE "#%'})U+--/0c @  1Themediumvariantoffertilityhasbeenadoptedforallprojections <r 2Alsoincludedinthelessdevelopedregions ( ht   Source:UnitedNations(1997b)  T!v  # XX 9#TR`&6A4 LandscapeY 3' Letter &6A4 Landscape3' LetterTTable5:PopulationNumbers(millions)Aged60andOverandAged80andOverbySex,WorldRegions,1970,1995,2020 1 9h X  *DE CdCd ZZ@ZZ@,ZZ@/ZZ@BCe 2e 2,P ZZ@,w ZZ@,w ZZ@,w ZZ@+  /9" x C/ # XX 9# &4&X XArea/Country Y9LxC9 Ȟ@1970CȞ@Y-uM% - 1970 Y9LAxC" Ȟ@1970 Ȟ@9 CY1995 79*xC"9 C72020 @5+)xC" 9 5*FG CdCdP ZZ@w ZZ@w ZZ@w ZZ@DEe 2e 2,P ZZ@,;ZZ@,;ZZ@,;ZZ@,;ZZ@,;ZZ@,;ZZ@+  /9" R C/ @ 79*RC9 C7Male 79*RC"9 C7Female 79*R C"9 C7Male 79*R C"9 C7Female 79*R C"9 C7Male 79*R C"9 C7Female @ E;%R C" 9 C E 7-,lC  C 7Aged60+ 7-,lC  C 7 7-,lC  C 7 7-,lC  C 7 7-,lC  C 7 7-,lC  C 7 G=%,lC   CGWorld @ H>FC  a@137C a@H! M!#137 i_3FC  a@137  a@ e@174Ce@i0 174 i_3FC e@174 e@ @n@242C@n@i33=G242 i_3FC @n@242 @n@ r@300Cr@in#n#J$300 i_3FC r@300 r@ |@461C|@i))X*461 i_3FC |@461 |@ @546C@i//e0546 ӈ [Q9FC @546 @ C[-uM% M-MoreDevelopedRegions  G= C  M@59CM@G! M!$59 g]2 C  M@59 M@  U@87CU@gTT1 87 g]2 C  U@87 U@  V@88CV@g>G88 h^2 C  V@88 V@ _@127C_@hn#n#J$127 i_3  C _@127 _@ `@132C`@i))X*132 i_3 !C `@132 `@ e@174Ce@i//e0174 {Tӈ [Q9 "C e@174 e@ C[-uM% M-LessDevelopedRegions G= #C  @S@77C@S@G! M!$77 g]2 $C  @S@77 @S@  U@87CU@gTT1 87 h^2 %C  U@87 U@ @c@154C@c@h33=G154 i_3 &C @c@154 @c@ e@173Ce@in#n#J$173 i_3 'C e@173 e@ t@329Ct@i))X*329 i_3 (C t@329 t@ @w@372C@w@i//e0372 [Q9 )C @w@372 @w@ C[-uM% M-LeastDevelopedCountries2 F< *C  @7C@F! M!uu%7 e[1 +C  @7 @   @8C @e2 8 f\1 ,C   @8  @  *@13C*@f>G13 g]2 -C  *@13 *@  .@15C.@g##K$15 g]2 .C  .@15 .@  <@28C<@g**Y*28 g]2 /C  <@28 <@  @@32C@@g@0@0f032 {Tӈ ZP8 0C  @@32 @@ `CZ 'n 1C C' 'n 2C" C' 'n 3C" C' 'n 4C" C' 'n 5C C' 'n 6C C' ?5n 7C ` C?-uM% M-Africa F< 8C   @8C @F! M!uu%8 f\1 9C   @8  @  $@10C$@fTT1 10 g]2 :C  $@10 $@  0@16C0@g>G16 g]2 ;C  0@16 0@  3@19C3@g##K$19 g]2 <C  3@19 3@  B@37CB@g**Y*37 g]2 =C  B@37 B@  E@42CE@g@0@0f042 {Tӈ ZP8 >C  E@42 E@ CZ-uM% M-Asia G= ?C  @P@65C@P@G! M!$65 g]2 @C  @P@65 @P@  @R@73C@R@gTT1 73 h^2 AC  @R@73 @R@ `@133C`@h33=G133 i_3 BC `@133 `@ b@148Cb@in#n#J$148 i_3 CC b@148 b@ q@273Cq@i))X*273 i_3 DC q@273 q@  s@306C s@i//e0306 [Q9 EC  s@306  s@ C[-uM% M-Europe G= FC  D@40CD@G! M!$40 g]2 GC  D@40 D@  O@62CO@gTT1 62 g]2 HC  O@62 O@  K@54CK@g>G54 g]2 IC  K@54 K@  T@83CT@g##K$83 g]2 JC  T@83 T@  R@75CR@g**Y*75 h^2 KC  R@75 R@ Z@104CZ@h//e0104 [Q9 LC Z@104 Z@ C[-uM% M-LatinAmerica&Caribbean F<\ MC  "@9C"@F! M!uu%9 f\1\ NC  "@9 "@  $@10C$@fTT1 10 g]2\ OC  $@10 $@  0@16C0@g>G16 g]2\ PC  0@16 0@  3@19C3@g##K$19 g]2\ QC  3@19 3@  B@36CB@g**Y*36 g]2\ RC  B@36 B@  F@45CF@g@0@0f045 ZP8\ SC  F@45 F@ CZ-uM% M-NorthAmerica G=6v TC  ,@14C,@G! M!$14 g]26v UC  ,@14 ,@  2@18C2@gTT1 18 g]26v VC  2@18 2@  5@21C5@g>G21 g]26v WC  5@21 5@  <@28C<@g##K$28 g]26v XC  <@28 <@  B@37CB@g**Y*37 g]26v YC  B@37 B@  F@45CF@g@0@0f045 ZP86v ZC  F@45 F@ CZ-uM% M-Oceania F<P [C  ?1C?F! M!uu%1 e[1P \C  ?1 ?  ?1C?e2 1 e[1P ]C  ?1 ?  @2C@e?G2 e[1P ^C  @2 @  @2C@e&$&$L$2 e[1P _C  @2 @  @3C@ea*a*Z*3 e[1P `C  @3 @  @4C@e00g04 @{Tӈ WM7P aC  @4 @ C W 7-* bC  C 7Aged80+ 7-* cC  C 7 7-* dC  C 7 7-* eC  C 7 7-* fC  C 7 7-* gC  C 7 G=%* hC   CGWorld @ G=iC  $@10C$@G$10 g]2jC  $@10 $@  1@17C1@gTT1 17 g]2kC  1@17 1@  5@21C5@g>G21 g]2lC  5@21 5@  D@40CD@g##K$40 g]2mC  D@40 D@  F@44CF@g**Y*44 g]2nC  F@44 F@  S@76CS@g@0@0f076 ӈ ZP8oC  S@76 S@ CZMoreDevelopedRegions  F<pC  @5C@Fuu%5 f\1qC  @5 @  &@11C&@fTT1 11 g]2rC  &@11 &@  &@11C&@g>G11 g]2sC  &@11 &@  8@24C8@g##K$24 g]2tC  8@24 8@  2@18C2@g**Y*18 g]2uC  2@18 2@  B@36CB@g@0@0f036 {Tӈ ZP8vC  B@36 B@ CZLessDevelopedRegions F<xwC  @5C@Fuu%5 e[1xxC  @5 @  @6C@e2 6 f\1xyC  @6 @  &@11C&@f>G11 g]2xzC  &@11 &@  0@16C0@g##K$16 g]2x{C  0@16 0@  :@26C:@g**Y*26 g]2x|C  :@26 :@  D@40CD@g@0@0f040 ZP8x}C  D@40 D@ CZLeastDevelopedCountries2 'R~C C'Є 'RC" C'Є F<RC"  ?1C?F?G1 e[1RC  ?1 ?  ?1C?e&$&$L$1 e[1RC  ?1 ?  @2C@ea*a*Z*2 e[1RC  @2 @  @2C@e00g02 {Tӈ YO7RC  @2 @ `CY ',lC C' ',lC" C' ',lC" C' ',lC" C' ',lC C' ',lC C' ?5,lC ` C?Africa 'C C'Є F<C"  ?1C?F2 1 e[1C  ?1 ?  ?1C?e?G1 e[1C  ?1 ?  ?1C?e&$&$L$1 e[1C  ?1 ?  @3C@ea*a*Z*3 e[1C  @3 @  @4C@e00g04 {Tӈ YO7C  @4 @ CYAsia F<fC  @4C@Fuu%4 e[1fC  @4 @  @5C@e2 5 e[1fC  @5 @  "@9C"@e?G9 f\1fC  "@9 "@  .@15C.@f##K$15 g]2fC  .@15 .@  7@23C7@g**Y*23 g]2fC  7@23 7@  A@35CA@g@0@0f035 ZP8fC  A@35 A@ CZEurope F<@C  @3C@Fuu%3 e[1@C  @3 @  @7C@e2 7 e[1@C  @7 @  @6C@e?G6 f\1@C  @6 @  .@15C.@f##K$15 g]2@C  .@15 .@  $@10C$@g**Y*10 g]2@C  $@10 $@  5@21C5@g@0@0f021 ZP8@C  5@21 5@ CZLatinAmerica&Caribbean F<ZC  ?1C?Fuu%1 e[1ZC  ?1 ?  ?1C?e2 1 e[1ZC  ?1 ?  @2C@e?G2 e[1ZC  @2 @  @2C@e&$&$L$2 e[1ZC  @2 @  @4C@ea*a*Z*4 e[1ZC  @4 @  @6C@e00g06 YO7ZC  @6 @ CYNorthAmerica F<4C  @2C@Fuu%2 e[14C  @2 @  @3C@e2 3 e[14C  @3 @  @3C@e?G3 e[14C  @3 @  @6C@e&$&$L$6 e[14C  @6 @  @5C@ea*a*Z*5 e[14C  @5 @  "@9C"@e00g09 `9O74C  "@9 "@ C`Oceania ;9*C9 C;Є ;9*C"9 C;Є ;9*C"9 C;Є ;9*C"9 C;Є ;9*C"9 C;Є Z9IC"9  ?1C?Z00g01# XX& &4\ # 9X X @{TӈTJHC  ?1  ?9 T  fOuM% ]5 mE "#%'})U+--/0Mf @1Themediumvariantoffertilityhasbeenadoptedforallprojections  2Alsoincludedinthelessdevelopedregions @ Source:UnitedNations(1997b) ,l   # XX 9T#