The world is rapidly ageing. Every country in the world is experiencing growth in the proportion of older people in its population.
The number of people aged 65 years or older worldwide is projected to more than double, rising from 761 million in 2021 to 1.6 billion in 2050. The number of people aged 80 years or older is growing even faster and is expected to triple between 2020 and 2050 to reach 426 million.
According to the UN, while this shift in distribution of a country's population towards older ages, known as population ageing, started in high-income countries — for example, in Japan 30 per cent of the population is already over 60 years old — it is now low- and middle-income countries that are experiencing the greatest change. By 2050, two-thirds of the world's population over 60 years will live in low- and middle-income countries.
Jamaica has a population of almost 3 million people. The data indicate that the elderly population (60+ years) represents 13.9 per cent (375,700) of the total population. Of this number 47.5 per cent are males and 52.5 per cent are females.
Given the projection that the planet will have more older people in a few decades we must be mindful of the importance of promoting lifelong health and treating illnesses throughout the entire course of life. Given the propensity to discriminate against those who are older, it is vital that societies ensure that the basic freedoms and human rights of the elderly are not taken for granted or violated.
Ageism refers to the stereotypes (how we think), prejudice (how we feel), and discrimination (how we act) towards others or oneself based on age. Half the world's population is ageist against older people. Ageism can change how we view ourselves, erode solidarity between generations, devalue or limit our ability to benefit from what younger and older populations can contribute, and impact our health, longevity, and well-being, while also having far-reaching economic consequences.
The UN has taken the charge in countering ageism. On December 14, 1990 the UN General Assembly designated October 1 as the International Day of Older Persons. The theme this year is 'Fulfilling the Promises of the Universal Declaration of Human Rights for Older Persons: Across Generations'. The United Nations states that in societies with ageing populations, it becomes imperative to adjust to the increasing number of elderly individuals who possess a diverse range of functional capacities. The capability to carry out essential functions and partake in everyday activities is influenced not solely by an individual's inherent capacity but also by the social and physical environments in which they reside. Supportive environments play a pivotal role in assisting older individuals to maintain their activity levels and independence as they progress in age.
Ageing and Health
The primary concern of growing old always surrounds one's quality of life. A longer life brings with it health challenges, many of which are costly to treat. In many societies, including Jamaica, there is not a system of universal health insurance.
Health care is expensive and without insurance to offset this expense many seniors are just unable to afford it and languish away due to ill health. As a result, many older people are forced to seek alternative treatments for non-communicable diseases, such as diabetes and hypertension, from so-called "bush" doctors. Additionally, many seniors are also forced to make a painful and often life-threatening choice between which medications they will buy. No one should be placed in such an awful position, more so our older people who have worked and contributed to nation-building over the decades.
As you age, your visibility decreases. Many people in this vulnerable group have been almost invisible and voiceless. Unfortunately, the advocacy groups for seniors are not representative of this vulnerable population and this only adds to the pain and suffering of older people.
A longer life brings with it opportunities, not only for older people and their families but also for societies as a whole. Additional years provide the chance to pursue new activities such as further education, a new career, or pursue a long-neglected passion. Older people also contribute in many ways to their families and communities. Yet the extent of these opportunities and contributions depends heavily on one factor: health. Common conditions in older age include hearing loss, cataract and refractive errors, back and neck pain, osteoarthritis, chronic obstructive pulmonary disease, diabetes, depression, and dementia. As people age they are more likely to experience several conditions at the same time.
Older age is also characterised by the emergence of several complex health states commonly called geriatric syndromes. They are often the consequence of multiple underlying factors and include frailty, urinary incontinence, falls, and delirium. Recently, my dad, who is in his 90th year, fell in the bathroom and burst his head which required stitches. He also had to do a skull X-ray. The challenges of growing old are real and exhaustive. My mom is also in her 80s.
Oftentimes no one remembers the caregiver and this is yet another layer of the issues associated with ageing. Physical and social environments can affect health directly or through barriers or incentives that affect opportunities, decisions, and health behaviour. Maintaining healthy behaviour throughout life, particularly eating a balanced diet, engaging in regular physical activity, and refraining from tobacco use, all contribute to reducing the risk of non-communicable diseases, improving physical and mental capacity, and delaying care dependency.
Supportive physical and social environments also enable people to do what is important to them, despite losses in capacity. The availability of safe and accessible public buildings and transport and places that are easy to walk around are examples of supportive environments. In developing a public health response to ageing, it is important not just to consider individual and environmental approaches that ameliorate the losses associated with older age but also those that may reinforce recovery, adaptation, and psychosocial growth.
Variations in Ageing
No two people will age the same. There is no typical older person. Some 80-year-olds have physical and mental capacities similar to many 30-year-olds. Other people experience significant declines in capacities at much younger ages. Of course, in some families their genes predispose them to living longer.
The UN adds a comprehensive public health response must address this wide range of older people's experiences and needs. The diversity seen in older age is not random. A large part arises from people's physical and social environments and the impact of these environments on their opportunities and health behaviour. The relationship we have with our environments is skewed by personal characteristics such as the family we were born into, our sex and our ethnicity, leading to inequalities in health. Older people are often assumed to be frail or dependent and a burden to society. Public health professionals and society as a whole need to address these and other ageist attitudes, which can lead to discrimination, affect the way policies are developed, and the opportunities older people have to experience healthy ageing.
The Way Forward
The population of the Caribbean, like much of the rest of the world, is ageing. Regrettably, there have been too many broken promises regarding the elderly. The Caribbean Charter on Health and Ageing launched in 1999 has not served the region well. The charter has as its guiding principle a coordinated, systematic approach for ensuring the health and full integration and participation of older people in Caribbean societies and economies.
The aged desire and require special attention. One sore point in many societies is that of night and day noise. In many communities the elderly suffer due to those who are uncaring and spiteful. Commercialisation of residential areas is yet another issue deserving of attention.
It is clear that not much consideration is given to older people in many aspects of their lives. The new denomination is also a cause for concern as many older people cannot distinguish between the $100 and $1,000 notes and the $500 and $5,000. Was there a focus group involving older people prior to some of these decisions coming into effect? Additionally, many older people cannot navigate the automated teller machines (ATMs).
Many older people are also victims of crime and violence, an area that requires urgent attention. Who speaks on behalf of the older person?
As the international community observed International Day of Older Persons there is an urgent need for societies to work harder to eliminate the various health inequalities and discrimination that directly impact older people.
Wayne Campbell is an educator and social commentator with an interest in developmental policies and their impact on culture and/or gender issues. Send comments to the Jamaica Observer or email@example.com.