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A recent article in the Economist discussed some of the challenges facing China in developing their elder care system. The article highlighted a the Hangzhou City Christian Nursing home,  a facility with 1,400 licensed beds, with a  waiting list of over 1,000 persons. According to Sun Xiaodong, the government provides about 80% of long-term care beds, but is unable to keep up with demand and encourages development of facilities by approved religious and non-profit groups. Interested in learning more about elder care in China? Consider attending the  China International Senior Services Expo.

Photo courtesy  Matthew Wilkinson

Today the Pan American Health Organization hosted a symposium on health ageing. With speakers from the Americas including Argentina, Mexico and the United States, the event  highlighted the importance of social connectedness and support across the lifespan. Speakers including Dr Luciano Di Cesare, Dr Linda Fried, and Dr Michael Hodin spoke on the importance of facing the social stigma associated with old age in order to be able to actively address health behaviors across the lifespan and promote a new vision of old age. Check out the video message from Dr. Mirta Roses Periago on the PAHO website.

U.S. Secretary of Health and Human Services, Kathleen Sebelius addresses delegates.

There is a great opinion piece in the online version of the Lancet that highlights many of the economic and health complexities of ageing. Specifically the authors point out that economic methods of evaluating the impact of aging are based on assumptions that may no longer be true.  Specifically, they take on the assumptions that people over the age of 65 are no longer productive and that spending on management of chronic non-communicable diseases will be cost-prohibitive in lesser developed countries. Want the full store? Just click here.

Photo courtesy of Julie70

On World Health Day (7 April), the World Health Organization calling for urgent action to ensure that people reach old age in the best possible health. In the next few years, for the first time, there will be more people in the world aged over 60 than children aged less than five. By 2050, 80% of the world’s older people will be living in low- and middle-income countries.

The main health challenges for older people everywhere are non-communicable diseases, such as heart disease, stroke, cancer, diabetes, and chronic lung disease.  “People in low- and middle-income countries currently face up to four times the risk of death and disability from non-communicable diseases than people in high-income countries,” says Dr Margaret Chan WHO Director-General. “Yet most of these conditions are largely preventable or inexpensive to treat.”

The risk of developing non-communicable diseases can be significantly reduced by adopting healthy behaviors, such as being physically active, eating a healthy diet, avoiding the harmful use of alcohol and not smoking or using tobacco products. The earlier people adopt these behaviors, the better their chance of enjoying a healthy old age. “Healthy lifestyles from the very beginning of life is key to a healthy and active old age,” says Dr John Beard, Director of the Department of Ageing and the Life-course at WHO.

WHO has outlined four key actions that governments and societies can take now to strengthen healthy and active ageing.

  • Promote good health and healthy behaviors at all ages to prevent or delay the development of chronic diseases.
  • Minimize the consequences of chronic disease through early detection and quality care (primary, long-term and palliative care).
  • Create physical and social environments that foster the health and participation of older people.
  • “Reinvent ageing” – changing social attitudes to build a society in which older people are respected and valued.

Poor health is not the only concern people have as they grow older. Stigmatizing attitudes and common stereotypes often prevent older people from participating fully in society. Older people make important contributions as family members, volunteers and as active participants in the workforce and are a significant social and economic resource. “When a 100-year-old man finishes a marathon, as happened last year, we have to rethink conventional definitions of what it means to be ‘old’,” says Dr Chan. “Past stereotypes developed in past centuries no longer hold.”

Photo courtesy  Adam Jones, Ph.D.

By the year 2050, the number of seniors in China will exceed the entire population of the United States. As the government of China comes to terms with this reality, private investors are sizing up the market for senior housing and services. Recently, Columbia Pacific and Emeritus Corporation joined with Cascade Healthcare to develop assisted living and senior housing facilities in China.

“The need for senior care in China is staggering,” said Dan Baty, a principal investor in Columbia Pacific Advisors and Chairman of Emeritus. “Over the next 10 years, China’s senior population will grow to 280 million people according to its census, and there are virtually no senior care facilities. It has long been a tradition in China that the family cared for the elderly in the home, but the rapidly expanding economy dictates that people now need more help to provide for the elderly.”

While the market may be huge, there is currently a lack of elder care facilities, regulations, and training opportunities in elder care so establishing new facilities will be a challenge. Is your organisation  considering investment in China? What obstacles do you foresee as China’s aged care sector evolves?

Photo courtesy mattwl

According to a new study from the Israel Gerontological Society nearly one in five elderly Israelis suffers from some form of elder abuse. The majority of the abusers are family members who are caregivers for the affected elder. The study questioned over 1,300 people over the age of 60. Of those surveyed,  16% reported abuse and the level of abuse was reportedly higher among people suffering from senile dementia.  Miri Cohen PhD and Gideon Friedman MD were the primary authors.  The findings will be used to develop new tools that are more effective in identifying and detecting elder abuse.

Check out this video from the Irish Health Service Executive on recognising and stopping elder abuse.

An editor of US-China Today recently contacted us to let us know about content they had developed on our website. The newspaper is operated by graduate students of the University of California in San Diego and reports on news from China as well as the US-China relationship. They recently published an interactive graph documenting population demographics based on the Chinese census.  I also found an excellent article by Brandy Au entitled “China’s Elderly Masses” that discusses pension and healthcare issues facing Chinese.  This is a easy to understand overview of ageing issues in China is useful for developers or anyone looking to enter the Chinese aged care market. 

Tibet is the first Chinese region to cover all elders with a pension, according to government officials. Tibet began a  trial pension scheme to cover people living in rural areas in 2009, and has now expanded the program to include individuals living in urban areas. Under the plan, every elder over age 60 receives 55 yuan ($8.70 USD) a month. This is neither means tested nor is it based on prior payment of contributions  to the government.  People ages 16 to 59 may contribute to a pension fund and are guaranteed a basic pension plus an annual subsidy equal to 0.7 percent of what they have contributed. Under the contribution based plan, people must contribute for a minimum of 15 years. Monks and nuns are also allowed to participate in the plan. China’s central government has established a goal of universal pension coverage by 2015.

Photo courtesy Sarah Hertzog/HelpAge International 2010

In the fall of 2011 AARP International teamed up with former Mexican president Vicente Fox and the Rand Corporation to examine issues Mexico will face as it undergoes demographic transition. Like many other low and middle-income countries, a large percentage of Mexico’s labour force works in the informal sector and doesn’t have protection of social insurance schemes.  As access to basic sanitation and health care have expanded, people are able to live longer, but may continue to work until they develop physical incapacity in order to maintain some type of income. Overall, the report estimates that the percentage of people over age 65 will increase by 232% by 2040 and that a total of 250 million people will be over age 65 and not be covered by either a pension or health scheme.  The Mexican government is working to expand social protections and increase awareness of the rights of  older people. Check out this video documenting achievements and successes to date.

Industrializing nations face a true challenge due to the global shift in ageing demographics.  China shares this reality, and is predicted to have 25% of its population be aged 65 by 2050. Naturally, this predicted change creates concerns over who will care for the elderly, how care will be financed, and how medical and social care costs will be managed.  China’s rapid economic growth since the 1980s has been accompanied by a sharp decrease in fertility. In comparison with European countries that saw declining population over 50 – 100 years, China’s dramatic shift has occurred in a time span of 30 years. The famous “1 child policy” had the unplanned effect of creating today’s 4-2-1 families. People in their 20s and 30s have two parents and four grandparents.  Because of family norms of filial support, these single children will be called upon to provide support to both of their parents, and they frequently will not have siblings or extended family that will able to assist with care tasks.

The need for proper care of the elderly is a tremendous opportunity for organizations that are looking to break into the Chinese market. While there are already many firms catering to the very wealthy, middle class and poor Chinese continue to face care that is low quality or in some cases abusive. The Chinese government has responded to the need by working across ministries to prioritise aged care issues and develop a safety net to assist elders when children are no longer able to care for them.

Is your organization working in China? We would love to hear from you. Drop us a line at and let us know what care models you follow or what you perceive as quality priorities.

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IAHSA’s Global Ageing Network Blog was created because of you!! We got your message loud and clear – “Provide us with a quick and nimble communications vehicle so we can stay connected and create community across borders".

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Virginia Nuessle, Study Tour Director

Majd Alwan, Director, CAST

Alla Rubinstein, Program Administrator, IAHSA

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