Ageing in the Asia-Pacific region : trends and policy implications

Summary This paper reviews the background to demographic ageing in the Asia-Pacific region and discusses some of the economic and cultural features associated with it. The region includes countries exhibiting a variety of experience in demographic ageing and percentages aged 65 years or more range from 3% to 16%. Fairly distinct sub-regional ageing groupings are emerging. At the demographically older extreme lie Japan, Hong Kong, Singapore, Taiwan and Korea. With somewhat smaller percentages of elderly people come China (with huge numbers of elderly people but low per capita income), Thailand and Indonesia and which are likely to have above the sub-regional average elderly people by 2010. Finally, in Burma, Malaysia, the Philippines, Vietnam, Cambodia and Laos, ageing is not yet numerically a major policy issues although in certain of them it is becoming so. In policy terms, high percentages of older people can be very significant for social and health care and for the economies of the countries generally. The demographic and epidemiological features associated with population ageing are discussed including increasing expectation of life at birth declining total fertility rates, increasing elderly support ratios, smaller completed family size, low birth rates and low death rates. Several countries have also experienced very rapid shifts in mortality and morbidity away from infectious diseases towards chronic and degenerative diseases. This, too, is very significant for health services and social care system. Potentially, the major impacts of demographic ageing and epidemiological transition will come from the combined effects of smaller total family sizes, greater longevity and changes in household structure, with changing attitudes to family support and families’ abilities to maintain it. The paper questions whether it will be reasonable to expect families to care for older old members and to deal with often complex medical and social conditions including dementias and terminal states. Traditional Asian values of family care and filial piety are likely to come under severe strain in many of the countries. However, it is doubtful whether care in the community will be sufficiently developed or receives sufficient resources to bolster or replace traditional support networks. It is also highly questionable whether the public sector will be able to meet the challenges of demographic ageing in many Asia-Pacific countries