Transcript An overview ageing in the Caribbean

Ageing Challenges for the Caribbean
Kenneth S. M. George (Dr)
SMOH NCDs
Monday, 6th of May, 2013
Hotel Pommarine
Marine Gardens, Hastings. Christ Church
The Caribbean
Facts About the Caribbean
• 1st explored in 1492 - Christopher Columbus
• Archipelago of islands from Cuba and Bahamas in
the North, to Trinidad and Tobago in the South
• In addition Guyana, Surinam and Belize are on the
mainland of South and Central America
• Descendants of African, East Indian and Europeans
• Estimated population 34 million (UN 2007)
Commonalities
• Independent states that share the same
geographic space, cultures and ethnic groups
• Members of CARICOM (17 states)
• Multiparty democracies
• Low to moderate economic growth
• Fragile economies – agriculture, tourism,
manufacturing
• Similar health challenges in provision of
universal health care
International Trends
• Globalization
• Free movement of people, services and
goods (Treaty of Chaguaramas)
• Industrialization
• Urbanization
• Technological development
• Advances in health care
The concept of Active Ageing
• Active ageing is the process of optimizing
opportunities for health, participation and
security in order to enhance quality of life as
people age.
• It applies to both individuals and population
groups.
• Emphasizing a life course approach
• (WHO website)
Epidemiological Transition
Epidemiological Transition
• Falling death rates
• Falling birth rates
• Decreasing fertility rates
• Major improvements in public health
– Potable water and improved sanitation,
– Immunization
– Access to basic primary health care
• A change in infectious and communicable diseases
to non-communicable diseases over the last 50
years (HIV/AIDS is a potential threat)
Terms and definitions
• Ageing Index (Elder Child Ratio)
– Number of persons ≥ 65 per 100 youth <15 years old
• Active Ageing Index
• Life Expectancy
– The number of additional years a person is expected
to live if current mortality for that age is maintained
• Age Dependency Ratios
– Ratio of those not in the labour force to those in the
labour force. i.e. persons < 15 and 65 and greater to
those 15-65 years
• Median age of the population
Future projections
• Life expectancy is rising in all Caribbean states,
including Haiti
• By 2030 the aging index is projected to exceed
100 in all developed countries (UN 2007 Report)
• Increasing median age of the population 24.2 in
2000 to 39.2 by 2050 (Eldimire Shearer 2008)
• Dependency ratios have been increasing
Future projections
• In the English Speaking Caribbean (ESC) the
elderly now represents 10 – 13 per-cent
– 10% in Jamaica
– 11% in Trinidad and Tobago
– 13% in Barbados
• Life expectancy in the Caribbean rose from an
average of 50 in the late 40’s to and average of
70 for men and 73 for women in most ESC
countries
• Women out-live men in all Caribbean territories
Life Expectancy in Select Caribbean
Countries
(Harewood 1960 and PAHO 1990 and 2007)
1960
1990
2007
Barbados
62
75.6
77.5
Jamaica
62
73.6
72.7
Trinidad and
Tobago
62
71.6
70.1
Haiti
-
-
61.3
Observed and Forecasted Percentage
of the Population, age 65 and Over
Regions/
Countries
1950
2000
2050
World
5.2
6.9
19.3
Africa
3.2
3.3
6.9
LAC
3.7
5.4
16.9
Europe
8.2
14.7
29.2
USA
8.3
12.3
21.1
Japan
4.9
17.2
36.7
India
3.3
5.2
14.8
Magnitude and Speed of Population
Growth
Ageing and Gender
• Women make up a significant majority of
the older population and increasingly so
with age
• Studies have identified higher levels of
poverty in older females and lower levels
of literacy
• In 2000, at age 80 the ratio of males to
females was 7:10 compared to 8.5 to 10
for the age group 60+ and 1:1 at birth
• ‘Feminization of the older population’
Population 60 and > (CAREC Jan
2010)
Country
Males
Females
Barbados
17,700
24,485
Grenada
5,770
7,373
Guyana
27,976
32,566
Trinidad (2005)
64,379
76.497
Socio-Economic Issues
• Chronic poverty, especially in women
• Lack of economic security and independence
• Lack of health insurance and low pensions
• Changing cultural norms and values
• Changing family unit and structure
• Social isolation
• Limited opportunities for housing
Health and Ageing
• Goal of successful ageing is not only the
prolongation of life but the extension of life in good
health (concept of healthy life expectancy)
• Definition of Health
– Mental, physical, spiritual, emotional and socioeconomic health
• Can be achieved through the tenants of health
promotion
– creation of supportive environments, community
empowerment etc
• Adopting healthy public policy to support the elderly
History of the World’s Health
Health and Aging
• Highest prevalence of NCDs in the Region of the
Americas
• High obesity rates, especially in women
• Burden of Alzheimer's Disease and the other
dementias
• Limited psycho-geriatric opportunities for care and
treatment
• Limited home and community based policies for
managing the elderly
Looking to the Future
• Embrace the concept of healthy ageing through
the life-course
• Age friendly primary health care – moving from
episodic to continuous care
• Age and disability friendly cities
• Integration of elderly care services into NCD
prevention and control and mental health
services
Looking to the Future
• Collaborative effort to address the elderly that
harnesses inter-sectoral and multidisciplinary
approaches
– Civil society, the private sector and academia
• Support research through public health and
social science approaches
• Training and skill development in the area of
public policy and gerontology
• Exploration of new models of care e.g.
independent and assisted living
THANK YOU