Economic & Social Affairs CURRENT STATUS OF THE SOCIAL SITUATION, WELLBEING, PARTICIPATION IN DEVELOPMENT AND RIGHTS OF OLDER PERSONS WORLDWIDE United Nations Current Status of the Social Situation, Well-Being, Participation in Development and Rights of Older Persons Worldwide Department of Economic and Social Affairs United Nations New York, 2011 DESA MISSION STATEMENT The Department of Economic and Social Affairs of the United Nations Secretariat is a vital interface between global policies in the economic, social and environmental spheres and national action. The Department works in three main interlinked areas: (i) it compiles, generates and analyses a wide range of economic, social and environmental data and information on which Member States of the United Nations draw to review common problems and to take stock of policy options; (ii) it facilitates the negotiations of Member States in many intergovernmental bodies on joint courses of action to address ongoing or emerging global challenges; and (iii) it advises interested Governments on the ways and means of translating policy frameworks developed in United Nations conferences and summits into programmes at the country level and, through technical assistance, helps build national capacities. NOTE The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the United Nations concerning the legal status of any country, territory, city or area, or of its authorities, or concerning the delimitation of its frontiers or boundaries. The designations “developed” and “developing” economies are intended for statistical convenience and do not necessarily imply a judgment about the stage reached by a particular country or area in the development process. The term “country” as used in the text of this publication also refers, as appropriate, to territories or areas. The term “dollar” normally refers to the United States dollar ($). The views expressed are those of the individual authors and do not imply any expression of opinion on the part of the United Nations. Bibliographical and other references have, wherever possible, been verified. A United Nations electronic publication ST/ESA/339 December 2011 Copyright © United Nations, 2011 All rights reserved ii Explanatory notes Unless otherwise indicated, the following country groupings and subgroupings have been used in this report: Asia: China, Hong Kong Special Administrative Region of China, Macao Special Administrative Region of China, Democratic People’s Republic of Korea, Japan, Mongolia, Republic of Korea, Afghanistan, Bangladesh, Bhutan, India, Islamic Republic of Iran, Maldives, Nepal, Pakistan, Sri Lanka, Brunei Darussalam, Cambodia, Indonesia, Lao People’s Democratic Republic, Malaysia, Myanmar, Philippines, Singapore, Thailand, Timor-Leste, Viet Nam; Sub-Saharan Africa: Angola, Benin, Botswana, Burkina Faso, Burundi, Cameroon, Cape Verde, Central African Republic, Chad, Comoros, Congo, Côte d’Ivoire, Democratic Republic of the Congo, Djibouti, Equatorial Guinea, Eritrea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania, Mauritius, Mayotte, Mozambique, Namibia, Niger, Nigeria, Réunion, Rwanda, Saint Helena, Sao Tome and Principe, Senegal, Seychelles, Sierra Leone, Somalia, South Africa, South Sudan, Sudan, Swaziland, Togo, Uganda, United Republic of Tanzania, Zambia, Zimbabwe; Latin America: Argentina, Belize, Bolivia, Brazil, Chile, Colombia, Costa Rica, Ecuador, El Salvador, Falkland Islands (Malvinas), French Guiana, Guatemala, Guyana, Honduras, Mexico, Nicaragua, Panama, Paraguay, Peru, Suriname, Uruguay, Venezuela; Middle East and North Africa: Algeria, Bahrain, Djibouti, Egypt, Islamic Republic of Iran, Iraq, Israel, Jordan, Kuwait, Lebanon, Libyan Arab Jamahiriya, Malta, Morocco, Oman, Qatar, Saudi Arabia, Syrian Arab Republic, Tunisia, United Arab Emirates, Occupied Palestinian Territory, Yemen; Eastern Europe and the Commonwealth of Independent States: Albania, Armenia, Azerbaijan, Belarus, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Estonia, Georgia, Hungary, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Montenegro, Poland, Moldova, Romania, Russian Federation, Serbia, Slovakia, Slovenia, Tajikistan, Turkmenistan, Ukraine, Uzbekistan, former Yugoslav Republic of Macedonia; Small island developing States: American Samoa, Anguilla, Antigua and Barbuda, Aruba, Bahamas, Barbados, Belize, British Virgin Islands, Cape Verde, Comoros, Cook Islands, Cuba, Dominica, Dominican Republic, Fiji, French Polynesia, Grenada, Guam, Guinea-Bissau, Guyana, Haiti, Jamaica, Kiribati, Maldives, Marshall Islands, Mauritius, Federated States of Micronesia, Montserrat, Nauru, Netherlands Antilles, New Caledonia, Niue, Northern Mariana Islands, Palau, Papua New Guinea, Puerto Rico, Samoa, Sao Tome and Principe, Seychelles, Singapore, Solomon Islands, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Suriname, Timor-Leste, Tonga, Trinidad and Tobago; Developed market economies: Australia, Austria, Belgium, Cyprus, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Japan, the Netherlands, New Zealand, Norway, Portugal, Spain, Sweden, Switzerland, United Kingdom of Great Britain and Northern Ireland, United States of America. iii The following abbreviations have been used in the report: ECE (United Nations) Economic Commission for Europe EU European Union EURAG European Federation of Older Persons FIAPA Federation of Associations for Elderly People GDP gross domestic product HIV/AIDS human immunodeficiency virus/acquired immune deficiency syndrome IFA International Federation on Ageing ILO International Labour Organization (or International Labour Office) NGO non-governmental organization NTA National Transfer Accounts (project) OECD Organization for Economic Cooperation and Development SABE Salud, Bienestar y Evejecimiento [Health, Well-Being and Aging] (Survey) UNAIDS Joint United Nations Programme on HIV/AIDS UNDP United Nations Development Programme UNESCO United Nations Educational, Scientific and Cultural Organization UNFPA United Nations Population Fund WHO World Health Organization iv Contents Page Explanatory notes………………………………………………………………………………...iii Introduction……………………………………………………………………………………….1 I. Demographics of older age…………………………………………………..……………2 A. Where do older persons live? ………………………………………..………………2 B. Life expectancy………………………………………………………………………4 C. Marital status…………………………………………………………………………4 D. Living arrangements…………………………………………………………...……..6 E. Trends in living arrangements………………………………………………………..8 F. Household headship. ……………………………………………………………….10 G. Living conditions …………………………………………………………………...11 H. Older migrants and the effects of migration………………………………………...13 I. Older persons in emergency situations…...…………………………………………15 II. The economic situation of older persons: employment, income and poverty considerations……………………………………..…………………………….17 A. Employment……………………………………………..………………………….17 Labour force participation…………………………………………………………..17 Working conditions…………………………………………………………………18 Age discrimination in employment…………………………………………………19 Unemployment……………………………………………………………………...20 Retirement…………………………………………………………………………..21 B. Income………………………………………………………………………………24 Sources of income…………………………………………………………………...24 Pension systems and coverage………………………………………………………26 Access to financial services and credit……………………………………………...29 Intergenerational transfers…………………………………………………………..30 v Contents (cont’d) Page C. Consumption……………………………………………………………..………….31 D. Poverty and income security in old age……………………………………………..31 III. Health status and access to health care…………………………………………………36 A. Health and survival………………………………………………………………….36 B. Chronic conditions and impairments………………………………………………..38 C. Trends relating to chronic conditions and impairments…………………………….39 D. Mental health………………………………………………………………………..40 E. HIV and AIDS………………………………………………………………………41 F. Overweight and obesity……………………………………………………………..42 G. Access to health care………………………………………………………………..43 H. Long-term care………………………………………..…………………………….45 I. Neglect, abuse and violence………………………………………………………...48 IV. Social and civil participation among the ageing, attitudes towards older persons, and perceptions of old age………………………………………………50 A. Societal attitudes towards old age…………………………………………………..50 B. Education and literacy………………………………………………………………53 C. Organizations of older persons……………………………………………………...55 D. Political influence…………………………………………………………………...56 V. Human rights of older persons………………………………………………………….58 A. International human rights principles and standards……………………………….58 B. Non-discrimination…………………………………………………………………60 C. Vulnerabilities and special protection measures……………………………………62 vi Contents (cont’d) Page D. Special measures for specific groups………………………………………………..63 E. The right to social security and the issue of social protection………………………64 F. The right to health and the right to adequate housing………………………………65 G. Final remarks……………………………………………………………………… 66 VI. Summary and concluding remarks……………………………………………………. 68 Bibliography……………………………………………………………………………………..70 Figures I. Actual and projected global population aged 60 years or over, 1980, 2010 and 2050………………………………………..…………………………...2 II. Distribution of the world population aged 60 years or over, by development region, 1950-2050……………………………………………………...3 III. Percentage currently