亚开行-亚洲老龄化状况良好：亚洲发展政策报告（英）-2024.6-162页_6mb

Summary of Aging Well in Asia (Asian Development Policy Report, May 2024)

Core Content

This report, Aging Well in Asia, addresses the challenges and opportunities associated with the aging population in Asia and the Pacific. It outlines the need for proactive and tailored policies to enhance the well-being of older people, focusing on four key dimensions: health, productive work, economic security, and social engagement. The report emphasizes the importance of a life-cycle and lifelong approach to aging, highlighting the role of governments, institutions, and communities in supporting older citizens.

Main Viewpoints

• Rapid Aging: Asia is aging rapidly, with some economies experiencing faster demographic change than expected. By 2050, older people (aged 60+) are projected to make up 25.2% of the population in Developing Asia, up from 13.5% in 2022.
• Health Challenges: Extended life expectancy comes with increased health burdens. Older people, especially women, face high rates of noncommunicable diseases (NCDs) and depression. The report shows that 57% of older people in nine economies have at least one NCD, but only 40% receive regular health checks.
• Economic Security: Many older people in Developing Asia lack adequate economic security. Only 21% of older people in India have health insurance, and the poorest quintile in the Philippines and PRC constitute a large share of the uninsured. Pension systems are underdeveloped, and informal employment is widespread, with 94% of older workers in the region working in the informal sector.
• Social and Family Dynamics: Family support and social engagement are crucial for the well-being of older people. However, social isolation and loneliness are prevalent, especially among those with limited access to health services and social activities.
• Policy Recommendations: The report calls for comprehensive policies to promote healthy aging, improve access to universal health coverage, reform pension systems, enhance labor protections, and foster lifelong learning and social engagement.

Key Information

1. The Well-Being of Older Asians to the Fore

• Aging Population: Developing Asia is experiencing rapid aging, with some economies, such as the Republic of Korea and the People's Republic of China, seeing birth rates drop and aging accelerate.
• Poverty Trends: Absolute poverty among older people has declined, but relative poverty remains significant. In 2016–2022, extreme poverty among those aged 65+ dropped to 3.2% from 13.1%.
• Well-Being Dimensions: Four key dimensions of well-being are highlighted: health, productive work, economic security, and social engagement.
• Vulnerability: Older people are more vulnerable due to physical and mental health issues, limited access to health services, and economic insecurity.

2. Health of Older People

• Health Burden: The disease and injury burden for older people has increased, with NCDs accounting for over 80% of the burden in all subregions. Dementia is now the seventh most prevalent condition among older people.
• Mental Health: Mental health challenges are widespread, with 31% of older people reporting elevated depressive symptoms. These are linked to illness, social isolation, and economic insecurity.
• Universal Health Coverage (UHC): UHC is essential for older people, but access is uneven. The ROK and Thailand have achieved UHC, while others, like the PRC and Philippines, have low coverage for poor older people.
• Health Services: Regular health checkups and access to essential services are critical. Only 40% of older people with functional limitations receive long-term care.

3. Work and Retirement of Older Persons

• Labor Force Participation: In 2021, the labor force participation rate for older people (aged 65+) was 32.0% for men and 15.2% for women, both higher than in advanced economies.
• Informal Employment: A large share of older workers are in the informal sector (64%–99% of older workers in the region). Women and those with less education are disproportionately represented in informal jobs.
• Work Capacity: There is significant untapped work capacity among older people, especially men aged 55–69, who have an estimated additional work capacity of 0.3–2.2 years. This could contribute up to 1.5% of GDP in the region.
• Retirement Trends: Actual retirement ages vary widely, from 51 to 63 years, with some economies seeing a shift toward later retirement.

4. Economic Security in Old Age and Pensions

• Income Sources: Older people rely on various income sources, including family transfers, wages, and social pensions. However, many lack access to formal pensions.
• Pension Systems: Pension coverage and adequacy vary significantly. In the PRC and Philippines, the poorest quintile constitutes a large share of the uninsured. Social pensions are often inadequate and require reform.
• Policy Actions: Governments should reform pension systems, promote financial literacy, and support private savings initiatives. Policies should also address the gender gap in economic security and retirement options.

5. Family, Care, and Social Engagement

• Living Arrangements: Older people's living arrangements and family relationships have changed over the past two decades. Many live with their children or in other family settings.
• Informal Care: Family and informal care play a vital role in supporting older people, but there is a growing need for formal care systems.
• Social Isolation: Loneliness and social isolation are significant concerns, particularly for those without family support or access to social activities.
• Social Engagement: Regular social and religious activity is linked to better well-being, and policies should encourage such engagement.

6. Living Well and Aging Well

• Holistic Approach: Aging well requires a holistic approach that integrates health, work, economic security, and social engagement.
• Policy Integration: Policies must be integrated across sectors to ensure that older people can maintain their quality of life and contribute to society.

Conclusion

The report underscores the need for a comprehensive and proactive policy approach to address the aging challenge in Asia and the Pacific. It highlights the importance of universal health coverage, pension reform, labor protections, and social engagement in ensuring that older people age well. The Asian Development Bank (ADB) is positioned to support these efforts through data, analysis, and collaboration with governments and stakeholders.