Back | Project: Ageing, Development and Social Protection
- Project from: 2001 to 2003
prepared by Peter Lloyd-Sherlock, University of East Anglia, United Kingdom
Accelerated population ageing is now a global trend. It has long been a significant issue for developed countries, and it is becoming one in many developing areas as well. There is a tendency to depict population ageing as a threat to the future. Rather, it should be recognized as one of the great achievements of the past century—albeit one which also generates a range of social, economic, political and cultural challenges. Population ageing is both part of and influenced by wider processes of development and transformation. The well-being and quality of life of elderly people are strongly conditioned by their capacity to manage opportunities and risks associated with rapid and complex change. Social protection, both formal and informal, can play a key role in mediating these relationships.
The UNRISD project on Ageing, Development and Social Protection will address three related themes.
• Development trajectories, social change and well-being in later life
Population ageing and the well-being of older people are inseparable from wider processes of development. The speed of these processes of change in developing countries is reflected in the sudden onset of population ageing there. Although the oldest population structures tend to be found in richer countries, the majority of the world's elderly people now live in the South. The relationship is bi-directional: population ageing may also influence patterns of development. However, claims that ageing simply increases the burden on productive sectors of the economy are based on over-generalized notions of consumption and dependency in later life. Development influences the capacity of societies to provide for all groups, including older people. At the same time, development may involve complex social and cultural changes representing both opportunities and threats to the aged.
The project explores these issues and relationships in different regional settings. One paper looks at the experience of Great Britain, taken as broadly representative of advanced industrialized countries. It examines long-term changes in the status of older people, including their economic well-being (both in terms of access to market production and social protection), social roles and political participation.
Papers about Brazil and the Ukraine provide a contrast in terms of development trajectories and well-being in later life. In Brazil, a relatively strong economic performance has enabled the emergence of an embracing and generous range of social programmes for older people. In the Ukraine, economic crisis has been mirrored by the collapse of formal social protection. Yet it is also possible to identify important processes that affect elders in both countries, such as changing household dynamics and shifts in cultural norms.
Another paper examines how policy makers in China are struggling to respond to processes of change, which are unprecedented in terms of their speed and scale. This is set against a recent history of fertility reduction by all means, and inattention to formal social protection, especially in rural areas. A further paper examines the general experiences of sub-Saharan Africa, where poverty and recent development setbacks have not precluded rapid social, cultural and epidemiological change. These changes have placed strains on the informal care economy, at the same time as impeding the development of formal policy interventions.
• Formal social protection and older people
In developed countries there has been a rapid growth in public expenditure concerned with the needs of older people. This has led to concerns about fiscal sustainability, and calls for a more pluralistic approach to financing and provision. The project includes a study of the rapidly expanding demand for long-term care services in Japan. This evaluates recent reforms, and considers the increasing complexity of relationships between the state, the private sector, voluntary organizations, and informal provision.
Thinking about public policy for older people in the South is strongly influenced by the experiences of the North, and has been dominated by controversies about pension reform. The project includes a comparative analysis of pension programmes in Singapore, Chile, South Africa and Brazil. It finds that administrative costs are highest and coverage is lowest in Chile's largely privatized scheme. Brazil and South Africa's non-contributory pension programmes are shown to reinforce informal social protection and to provide a significant income source for poor households. Singapore's state-run provident scheme offers a possible model of integrated financing for pensions, health insurance and long-term care.
Globally, financing and providing health services for older people has received much less attention than pension reform. One of the commissioned papers reviews an important exception to this trend: Argentina's ambitious pensioner health and social service programme. Particular attention is paid to the programme's financial difficulties, and comparisons are drawn with Medicare in the USA.
In many poor countries formal social protection pays little attention to older people, other than retired civil servants. A paper focussing on sub-Saharan Africa describes how health policy has been targeted at other groups, such as mothers, young children and "productive" workers. Health sector reforms being applied across the region, such as cost recovery, decentralization and new forms of private sector involvement, rarely, if ever, take into account possible impacts on older people.
The global nature of health policy frameworks is highlighted in a paper that describes broadly similar reform measures being implemented in a very different setting: Malaysia. Again, little reference is made to the potential impacts of these changes on older people. Ironically, population ageing is being used as a justification for promoting private financing in Southeast Asia, thereby reducing pressure on the state. Yet as is well known, private health insurance tends to avoid liabilities with "high-risk" groups such as older people.
• Older people and the care economy
The divisions between formal social protection and informal means of support are blurred, and increasing attention is now being paid to the interface between them. This is particularly significant in the area of long-term care for groups such as the very old. However, the care economy is also related to issues such as the household production of health and informal economic support. In the South it is often claimed that care and social services are not a policy priority, since traditional household and community structures are assumed to play this role. A study from Mexico shows how changes to family structures, gender roles and kinship obligations are constraining the supply of informal care for older people. These are examined using a framework of inter-generational exchange and reciprocity. The paper draws comparisons between rural and urban areas, and pays particular attention to the impact of migration on informal care and exchange.
It is often argued that strains on the care economy are linked to an erosion of traditional values and norms. Yet claims that previous generations of older people lived in a "Golden Age" characterized by stronger norms of family support and respect for elders have been questioned by historical research. Indeed, some traditional attitudes, including witchcraft beliefs, and discrimination against individuals suffering from cognitive impairment, may be very detrimental to the well-being of elders, particularly women, leading to what might be labelled an "uncare economy". One of the commissioned papers examines traditional values and widowhood in India, observing widespread social exclusion, reflected in mortality levels and income data. The paper also observes differences in the nature and degree of exclusion across regions, social class, and caste.
Many older people are themselves care-givers, perhaps providing support for an ailing spouse or a young grandchild. This has become increasingly significant in contexts of high HIV/AIDS prevalence. One of the commissioned papers studies the social and economic impacts of HIV/AIDS on older people in Thailand. It draws particular attention to the role of elders as carers for infected offspring (who are adults), while playing down the significance of care for AIDS grandchildren/orphans (the latter is not yet a significant phenomenon in Thailand).
Care-giving remains a highly gendered activity, and often the full burden of care falls on a single person, such as a daughter or daughter-in-law. A theoretical paper explores the need to both ensure the dignity of care-receivers and avoid exploitation of care-givers. This paper criticizes social contract perspectives, arguing that the capabilities framework offers a more effective approach to conceptualizing social justice in the care economy.