ageing in eastern europe...2017/02/13 · world health organization, active ageing: a policy...
TRANSCRIPT
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Ageing in Eastern Europe Alexandre Sidorenko
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Outline of presentation
1. Introduction. Definitions and key messages 2. Demographic transition 3. Family transition 4. Epidemiological transition 5. Distinctive features of population ageing in Eastern Europe 6. International Policy Frameworks on Ageing 7. National responses
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1. Introduction. Definitions and key messages
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EU 13
Bulgaria Croatia Cyprus Czechia Estonia Hungary Latvia Lithuania Malta Poland Romania Slovakia Slovenia
South-Eastern European Countries
Albania* Bosnia and Herzegovina** Montenegro* Serbia* TFYR Macedonia* Turkey* * EU Candidate countries
CIS+
Armenia Azerbaijan Belarus Georgia* Kazakhstan Kyrgyzstan Republic of Moldova Russian Federation Tajikistan Turkmenistan** Ukraine** Uzbekistan * Withdrew in 2009 ** Associate member
GEO-POLITICAL GROUPING:
EU 15
Austria Belgium Denmark Finland France Germany Greece Ireland Italy Luxembourg Netherlands Portugal Spain Sweden United Kingdom
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WESTERN EUROPEAN COUNTRIES
Austria
Belgium
France
Germany
Luxemburg
The Netherlands
Switzerland
Montenegro Republic of Moldova
Serbia
Turkey
Ukraine
Albania
Armenia
Azerbaijan
Bosnia and Herzegovina
Georgia
Macedonia (TFYR)
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Eastern European countries are in the process of long-term and mostly incomplete transition(s):
- Political transition - Economic transition - Social transition…
…at the very same time the Eastern European countries, like many other countries of the world, are going through various other transitions:
- Demographic transition - Family transition
- Epidemiological transition
All the above transitions are interrelated and linked to population ageing. Their challenges and opportunities have to be
addressed in coherent policy actions. Has it been happening in the Eastern European countries?
Key Messages:
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…at the very same time the Eastern European countries, like many other countries of the world, are going through various other transitions:
- Demographic transition - Family transition - Epidemiological transition
2.
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1
2
3
4
5
6
7Albania
Armenia
Azerbaijan
BiH
Georgia
Macedonia
Moldova
Montenegro
Serbia
Turkey
Ukraine
South-Eastern Asia
Western Europe
Total fertility (children per woman)
Source: United Nations, Department of Economic and Social Affairs, Population Division (2015). World Population Prospects: The 2017 Revision, custom data acquired via website. http://esa.un.org/unpd/wpp/DataQuery/
Adult mortality between age 15 and 60, 35q15 (deaths under age 60 per 1,000 alive at age 15), both sexes
combined
0
50
100
150
200
250
300
350
400
450 Albania
Armenia
Azerbaijan
BiH
Georgia
Macedonia
Moldova
Montenegro
Serbia
Turkey
Ukraine
South-Eastern Asia
Western Europe
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<=22 <=18.4 <=14.8 <=11.2 <=7.6 No data
European Region of World Health Organization: % of population aged 65+ years, 2009
Source: WHO/Europe, European Health for All Database
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0
5
10
15
20
25
30
35
0 100 200
EU 13
Japan
Qatar
Bulgaria
Slovakia
Cyprus
0
5
10
15
20
25
30
35
0 100 200
South- Eastern Europe
Qatar
Japan
Serbia
Turkey
%
Rank
Source: World Population Ageing 2015, United Nations, New York, 2015
0
5
10
15
20
25
30
35
0 100 200
Ukraine
Tajikistan
CIS+
Qatar
Japan
0
5
10
15
20
25
30
35
0 100 200
Japan
Qatar
Italy
Ireland
EU 15
Country ranking by percentage of population aged 60 or over years, 2015
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Ranking Eastern European countries by percentage of population aged 60 or over years
JAPAN
Ukraine
Georgia
Austria Serbia
Rep. Moldova Armenia
BiH
Azerbaijan
Macedonia Montenegro
Albania
Turkey
0
5
10
15
20
25
30
35
0 50 100 150 200
% 60+
Rank
Source: World Population Ageing 2015, United Nations, New York, 2015
Qatar (201st)
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-15
-13
-11
-9
-7
-5
-3
-1
1
3
5
Albania BiH
Montenegro Serbia
TFYR Macedonia Western Europe
BiH
Net migration rate (per 1,000 population), 2010-2015
-15
-13
-11
-9
-7
-5
-3
-1
1
3
5
Armenia Azerbaijan Belarus
Georgia Kazakhstan Kyrgyzstan
Moldova Russia Tajikistan
Turkmenistan Ukraine Uzbekistan
Western Europe
Source: United Nations, Department of Economic and Social Affairs, Population Division (2015). World Population Prospects: The 2015 Revision, custom data acquired via website. http://esa.un.org/unpd/wpp/DataQuery/
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0
3
6
9
12
15
1990 2000 2010 2020 2030
Albania
Bosnia andHerzegovina
Montenegro
Serbia
Macedonia
Turkey
South-Eastern Asia
WesternEurope
0
3
6
9
12
15
1990 2000 2010 2010 2030
Armenia
Azerbaijan
Belarus
Georgia
Kazakhstan
Kyrgyzstan
Moldova
Russia
Tajikistan
Turkmenistan
Ukraine
Uzbekistan
South-Eastern Asia
Western Europe
Tajikistan
Ukraine
Potential Support Ratio (20-64/65+), 1990-2030
South-Eastern Europe CIS+
Source: United Nations, Department of Economic and Social Affairs, Population Division (2017). World Population Prospects: The 2017 Revision, custom data acquired via website. http://esa.un.org/unpd/wpp/DataQuery/
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From extended family to nuclear family
…at the very same time the Eastern European countries, like many other countries of the world, are going through various other transitions:
- Demographic transition
- Family transition - Epidemiological transition
3.
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Proportion (%) of persons residing alone or with their spouses only among population 60+ years old (2013)
0
10
20
30
40
50
60
70
80
90
100
Women Men
? ? ? ? ?
Source: Profiles of Ageing, 2013. United Nations. http://esa.un.org/unpd/popdev/AgingProfiles2013/default.aspx
0
10
20
30
40
50
60
70
80
90
100
Women Men
? ?
Proportion (%) married, 60+ years old (2013)
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shift in cause-of-death patterns from predominance of communicable diseases to predominance of non-
communicable diseases
+
over-all decline of death rates
…at the very same time the Eastern European countries, like many other countries of the world, are going through various other transitions:
- Demographic transition - Family transition
- Epidemiological transition 4.
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0
100
200
300
400
500
600
700
800
900
Communicable diseases Non-communicable diseases Injuries
Age-standardized mortality rates by causes (per 100 000 population), 2012
Source: World Health Statistics 2015 http://www.who.int/gho/publications/world_health_statistics/2015/en/
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35
40
45
50
55
60
65
70
75
80
85 Albania
Armenia
Azerbaijan
BiH
Georgia
Macedonia
Moldova
Montenegro
Serbia
Turkey
Ukraine
Western Europe
South-Eastern Asia
Источник: United Nations, Department of Economic and Social Affairs, Population Division (2017). World Population Prospects: The 2017 Revision, custom data acquired via website. http://esa.un.org/unpd/wpp/DataQuery/
35
40
45
50
55
60
65
70
75
80
85
Total Men
Life Expectancy at Birth
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50
55
60
65
70
75
Men
Women
UN Population Division. World population Ageing 2015. http://www.un.org/en/development/desa/population/publications/pdf/ageing/PopulationAgeingAndDevelopment2015.pdf
Healthy Life Expectancy at Birth (years), 2015
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5. Distinctive features of population ageing in Eastern Europe
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Distinctive features of population ageing in various Eastern European countries:
Ageing ‘from the bottom’
Demographic deficit
Accelerated ageing
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Peculiar features of demographic changes in the CIS+ countries
Ageing ‘from the bottom’
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+
“NORMAL” POPULATION AGEING:
LOW FERTILITY
LOW MORTALITY
“ACCELERATED” POPULATION AGEING:
LOW FERTILITY
HIGH MORTALITY OF “WORKING AGE” POPULATION
EMIGRATION OF YOUNGER PEOPLE
+
+
Accelerated ageing
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0
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
4,500
1980 2015 2030 2050
0
200
400
600
800
1,000
1,200
1,400
60+ All population
All population (х10⁶)
Population 60+ years old (х10⁶)
Changes in sizes of total population and population 60+ years old in Bosnia and Herzegovina, 1980 – 2050
Source: UN population Division, Profiles of Ageing 2015
http://esa.un.org/unpd/popdev/Profilesofageing2015/index.html
Demographic deficit
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-3
-2
-1
0
1
2
3
4
Albania
Armenia
Azerbaijan
BiH
Georgia
Macedonia
Moldova
Montenegro
Serbia
Turkey
Ukraine
Western Europe
Average annual rate of population change (percentage)
Source: United Nations, Department of Economic and Social Affairs, Population Division (2017). World Population Prospects: The 2017 Revision, custom data acquired via website. http://esa.un.org/unpd/wpp/DataQuery/
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Demographic Deficit: Two demographic processes of population decline and population ageing may lead to DEMOGRAPHIC DEFICIT with negative effects on economic growth
and employment. Sarah Harper, 2014
Factors of Demographic Deficit:
Labour force declines Population basis for taxation shrinks Number of receivers of old age pensions increases, and they receive their pensions for longer
time Budgetary spending grows Labour force ages Productivity declines Labour force ages Potential for innovations declines
Budget Revenue
Budget Expenditure
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6. International Policy Frameworks on Ageing
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GOAL:
Reaching a society for all ages
CONTENT:
Adjustment to an ageing world
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I. Older Persons and Development
II. Advancing Health and Wellbeing into Old Age
III. Ensuring Enabling and Supportive Environments
Adjustment to an ageing world is measured in terms of:
Social development
QoL of older persons
Sustainability of support systems
PRIORITY DIRECTIONS
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Implementation of MIPAA in the region of the United Nations Economic Commission for Europe (UNECE) is guided by the Regional Implementation Strategy for the Madrid International Plan
of Action on Ageing (UNECE RIS/MIPAA)
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10 Commitments of UNECE RIS/MIPAA
COMMITMENT 1
• TO MAINSTREAM AGEING IN ALL POLICY FIELDS WITH THE AIM OF BRINGING SOCIETIES AND ECONOMIES INTO HARMONY WITH DEMOGRAPHIC CHANGE TO ACHIEVE A SOCIETY FOR ALL AGES
COMMITMENT 2
• TO ENSURE FULL INTEGRATION AND PARTICIPATION OF OLDER PERSONS IN SOCIETY
COMMITMENT 3
• TO PROMOTE EQUITABLE AND SUSTAINABLE ECONOMIC GROWTH IN RESPONSE TO POPULATION AGEING
COMMITMENT 4
• TO ADJUST SOCIAL PROTECTION SYSTEMS IN RESPONSE TO DEMOGRAPHIC CHANGES AND THEIR SOCIAL AND ECONOMIC CONSEQUENCES
COMMITMENT 5
• TO ENABLE LABOUR MARKETS TO RESPOND TO THE ECONOMIC AND SOCIAL CONSEQUENCES OF POPULATION AGEING
UNECE RIS/MIPAA is based on MIPAA, but its structure and content are designed specifically for the countries of the UNECE Region:
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COMMITMENT 6
• TO PROMOTE LIFE-LONG LEARNING AND ADAPT THE EDUCATIONAL SYSTEM IN ORDER TO MEET THE CHANGING ECONOMIC, SOCIAL AND DEMOGRAPHIC CONDITIONS
COMMITMENT 7
• TO STRIVE TO ENSURE QUALITY OF LIFE AT ALL AGES AND MAINTAIN INDEPENDENT LIVING INCLUDING HEALTH AND WELL-BEING
COMMITMENT 8
• TO MAINSTREAM A GENDER APPROACH IN AN AGEING SOCIETY
COMMITMENT 9
• TO SUPPORT FAMILIES THAT PROVIDE CARE FOR OLDER PERSONS AND PROMOTE INTERGENERATIONAL AND INTRA-
GENERATIONAL SOLIDARITY AMONG THEIR MEMBERS
COMMITMENT 10
• TO PROMOTE THE IMPLEMENTATION AND FOLLOW-UP OF THE REGIONAL IMPLEMENTATION STRATEGY THROUGH REGIONAL CO-OPERATION
10 Commitments of UNECE RIS/MIPAA
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“the process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age” World Health Organization, Active Ageing: A Policy Framework, 2002
“active ageing means growing old in good health and as a full member of society, feeling more fulfilled in our jobs, more independent in our daily lives and more involved as citizens”
Active Ageing: Concept and Policy Framework
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Independent living: using a preventive approach in health care, making transport more accessible and making the environment more age-friendly
Employment: creating better opportunities for older workers
Participation in society: combating social exclusion; fostering active participation in society: encouraging voluntary activities; supporting informal carers
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7. National Responses
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GOVERNMENT LEVEL OF CONCERN ABOUT AGEING OF THE POPULATION (2015)
Azerbaijan (10%)
No Concern / No View
Albania (18%)
Armenia (14%)
Azerbaijan (9%)
Bosnia and Herzegovina (22%)
Georgia (20%)
Macedonia (19%)
Moldova (17%)
Montenegro (20%)
Serbia (24%)
Turkey (11%)
Ukraine (21%)
In brackets – proportion of 60+ in the population
Minor Concern Major Concern
©Alexandre Sidorenko, 2017
(Since 1963)
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Country Participation in the 2007 review and appraisal of MIPAA (report submitted to
UNECE)
Participation in the 2012 review and appraisal of
MIPAA (report
submitted to UNECE)
Participation in the 2017 review and appraisal of
MIPAA (report
submitted to UNECE)
National strategic documents on ageing
Albania Yes No Yes No
BiH No No No Under development
Montenegro No No No No
Serbia Yes Yes National Strategy on Ageing (2006-2015)
TFYR Macedonia Yes Yes Yes No
Turkey Yes The Current Situation of Elderly People and the National Plan of Action on Ageing
Implementation of UNECE RIS/MIPAA and availability of national strategic documents on ageing in South-Eastern European countries
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Country Participation in the 2007 review and appraisal of MIPAA (report submitted to
UNECE)
Participation in the 2012 review and appraisal of
MIPAA (report submitted
to UNECE)
Participation in the 2017 review and appraisal of
MIPAA (report submitted
to UNECE)
National strategic documents on ageing
Armenia Yes Yes Yes Strategy on Ageing Issues and Social Protection of Older Persons and an Action Plan on its implementation for 2012-2016
Road Map for Mainstreaming Ageing (2011)
Azerbaijan Yes Yes Yes State Program on strengthening social protection of older citizens (2014-2020)
Belarus Yes Yes Yes No
Georgia No No No Road Map for Mainstreaming Ageing (2015)
Kazakhstan No No Yes No
Kyrgyzstan No No No No
Implementation of UNECE RIS/MIPAA and availability of national strategic documents on ageing in CIS+ countries
Continuing…
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Country Participation in the 2007 review and appraisal of MIPAA (report submitted to
UNECE)
Participation in the 2012 review and appraisal of
MIPAA (report submitted
to UNECE)
Participation in the 2017 review and appraisal of
MIPAA (report submitted
to UNECE)
National strategic documents on ageing
Moldova Yes Yes Yes Programme on Mainstreaming Ageing in State Policy (2014)
Road Map for Mainstreaming Ageing (2012)
Russia Yes Yes Yes Strategy for Action to benefit older citizens of the Russian Federation (2016-2025)
Tajikistan No Yes No No
Turkmenistan No No No
Ukraine No Yes Drafted. Under consideration by the government
Uzbekistan Yes No No
Implementation of UNECE RIS/MIPAA and availability of national strategic documents on ageing in CIS+ countries
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In response to the diminishing welfare state and the week alternative players, limited policy responses to ageing have often been complemented, and to some extent even substituted, by spontaneous measures of individual, family and community adaptation in a transforming and ageing society.
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The other side of the bridge…
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Thank you