Ageing in Eastern Europe...2017/02/13 · World Health Organization, Active Ageing: A Policy...

Ageing in Eastern Europe Alexandre Sidorenko

Outline of presentation

1. Introduction. Definitions and key messages 2. Demographic transition 3. Family transition 4. Epidemiological transition 5. Distinctive features of population ageing in Eastern Europe 6. International Policy Frameworks on Ageing 7. National responses

1. Introduction. Definitions and key messages

EU 13

Bulgaria Croatia Cyprus Czechia Estonia Hungary Latvia Lithuania Malta Poland Romania Slovakia Slovenia

South-Eastern European Countries

Albania* Bosnia and Herzegovina** Montenegro* Serbia* TFYR Macedonia* Turkey* * EU Candidate countries

CIS+

Armenia Azerbaijan Belarus Georgia* Kazakhstan Kyrgyzstan Republic of Moldova Russian Federation Tajikistan Turkmenistan** Ukraine** Uzbekistan * Withdrew in 2009 ** Associate member

GEO-POLITICAL GROUPING:

EU 15

Austria Belgium Denmark Finland France Germany Greece Ireland Italy Luxembourg Netherlands Portugal Spain Sweden United Kingdom

WESTERN EUROPEAN COUNTRIES

Austria

Belgium

France

Germany

Luxemburg

The Netherlands

Switzerland

Montenegro Republic of Moldova

Serbia

Turkey

Ukraine

Albania

Armenia

Azerbaijan

Bosnia and Herzegovina

Georgia

Macedonia (TFYR)

http://en.wikipedia.org/wiki/Image:Flag_of_Armenia.svg

http://en.wikipedia.org/wiki/Image:Flag_of_Azerbaijan.svg

Eastern European countries are in the process of long-term and mostly incomplete transition(s):

- Political transition - Economic transition - Social transition…

…at the very same time the Eastern European countries, like many other countries of the world, are going through various other transitions:

- Demographic transition - Family transition

- Epidemiological transition

All the above transitions are interrelated and linked to population ageing. Their challenges and opportunities have to be

addressed in coherent policy actions. Has it been happening in the Eastern European countries?

Key Messages:


- Demographic transition - Family transition - Epidemiological transition

2.

1

2

3

4

5

6

7Albania

Armenia

Azerbaijan

BiH

Georgia

Macedonia

Moldova

Montenegro

Serbia

Turkey

Ukraine

South-Eastern Asia

Western Europe

Total fertility (children per woman)

Source: United Nations, Department of Economic and Social Affairs, Population Division (2015). World Population Prospects: The 2017 Revision, custom data acquired via website. http://esa.un.org/unpd/wpp/DataQuery/

Adult mortality between age 15 and 60, 35q15 (deaths under age 60 per 1,000 alive at age 15), both sexes

combined

0

50

100

150

200

250

300

350

400

450 Albania

Armenia

Azerbaijan

BiH

Georgia

Macedonia

Moldova

Montenegro

Serbia

Turkey

Ukraine

South-Eastern Asia

Western Europe

http://esa.un.org/unpd/wpp/DataQuery/



<=22 <=18.4 <=14.8 <=11.2 <=7.6 No data

European Region of World Health Organization: % of population aged 65+ years, 2009

Source: WHO/Europe, European Health for All Database

0

5

10

15

20

25

30

35

0 100 200

EU 13

Japan

Qatar

Bulgaria

Slovakia

Cyprus

0

5

10

15

20

25

30

35

0 100 200

South- Eastern Europe

Qatar

Japan

Serbia

Turkey

%

Rank

Source: World Population Ageing 2015, United Nations, New York, 2015

0

5

10

15

20

25

30

35

0 100 200

Ukraine

Tajikistan

CIS+

Qatar

Japan

0

5

10

15

20

25

30

35

0 100 200

Japan

Qatar

Italy

Ireland

EU 15

Country ranking by percentage of population aged 60 or over years, 2015

Ranking Eastern European countries by percentage of population aged 60 or over years

JAPAN

Ukraine

Georgia

Austria Serbia

Rep. Moldova Armenia

BiH

Azerbaijan

Macedonia Montenegro

Albania

Turkey

0

5

10

15

20

25

30

35

0 50 100 150 200

% 60+

Rank

Source: World Population Ageing 2015, United Nations, New York, 2015

Qatar (201st)

-15

-13

-11

-9

-7

-5

-3

-1

1

3

5

Albania BiH

Montenegro Serbia

TFYR Macedonia Western Europe

BiH

Net migration rate (per 1,000 population), 2010-2015

-15

-13

-11

-9

-7

-5

-3

-1

1

3

5

Armenia Azerbaijan Belarus

Georgia Kazakhstan Kyrgyzstan

Moldova Russia Tajikistan

Turkmenistan Ukraine Uzbekistan

Western Europe




0

3

6

9

12

15

1990 2000 2010 2020 2030

Albania

Bosnia andHerzegovina

Montenegro

Serbia

Macedonia

Turkey

South-Eastern Asia

WesternEurope

0

3

6

9

12

15

1990 2000 2010 2010 2030

Armenia

Azerbaijan

Belarus

Georgia

Kazakhstan

Kyrgyzstan

Moldova

Russia

Tajikistan

Turkmenistan

Ukraine

Uzbekistan

South-Eastern Asia

Western Europe

Tajikistan

Ukraine

Potential Support Ratio (20-64/65+), 1990-2030

South-Eastern Europe CIS+




From extended family to nuclear family


- Demographic transition

- Family transition - Epidemiological transition

3.

Proportion (%) of persons residing alone or with their spouses only among population 60+ years old (2013)

0

10

20

30

40

50

60

70

80

90

100

Women Men

? ? ? ? ?

Source: Profiles of Ageing, 2013. United Nations. http://esa.un.org/unpd/popdev/AgingProfiles2013/default.aspx

0

10

20

30

40

50

60

70

80

90

100

Women Men

? ?

Proportion (%) married, 60+ years old (2013)

http://esa.un.org/unpd/popdev/AgingProfiles2013/default.aspx




shift in cause-of-death patterns from predominance of communicable diseases to predominance of non-

communicable diseases

+

over-all decline of death rates


- Demographic transition - Family transition

- Epidemiological transition 4.

0

100

200

300

400

500

600

700

800

900

Communicable diseases Non-communicable diseases Injuries

Age-standardized mortality rates by causes (per 100 000 population), 2012

Source: World Health Statistics 2015 http://www.who.int/gho/publications/world_health_statistics/2015/en/

http://www.who.int/gho/publications/world_health_statistics/2015/en/




35

40

45

50

55

60

65

70

75

80

85 Albania

Armenia

Azerbaijan

BiH

Georgia

Macedonia

Moldova

Montenegro

Serbia

Turkey

Ukraine

Western Europe

South-Eastern Asia

Источник: United Nations, Department of Economic and Social Affairs, Population Division (2017). World Population Prospects: The 2017 Revision, custom data acquired via website. http://esa.un.org/unpd/wpp/DataQuery/

35

40

45

50

55

60

65

70

75

80

85

Total Men

Life Expectancy at Birth

50

55

60

65

70

75

Men

Women

UN Population Division. World population Ageing 2015. http://www.un.org/en/development/desa/population/publications/pdf/ageing/PopulationAgeingAndDevelopment2015.pdf

Healthy Life Expectancy at Birth (years), 2015

http://www.un.org/en/development/desa/population/publications/pdf/ageing/PopulationAgeingAndDevelopment2015.pdf




5. Distinctive features of population ageing in Eastern Europe

Distinctive features of population ageing in various Eastern European countries:

Ageing ‘from the bottom’

Demographic deficit

Accelerated ageing

Peculiar features of demographic changes in the CIS+ countries

Ageing ‘from the bottom’

+

“NORMAL” POPULATION AGEING:

LOW FERTILITY

LOW MORTALITY

“ACCELERATED” POPULATION AGEING:

LOW FERTILITY

HIGH MORTALITY OF “WORKING AGE” POPULATION

EMIGRATION OF YOUNGER PEOPLE

+

+

Accelerated ageing

0

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

4,500

1980 2015 2030 2050

0

200

400

600

800

1,000

1,200

1,400

60+ All population

All population (х10⁶)

Population 60+ years old (х10⁶)

Changes in sizes of total population and population 60+ years old in Bosnia and Herzegovina, 1980 – 2050

Source: UN population Division, Profiles of Ageing 2015

http://esa.un.org/unpd/popdev/Profilesofageing2015/index.html

Demographic deficit



-3

-2

-1

0

1

2

3

4

Albania

Armenia

Azerbaijan

BiH

Georgia

Macedonia

Moldova

Montenegro

Serbia

Turkey

Ukraine

Western Europe

Average annual rate of population change (percentage)


Demographic Deficit: Two demographic processes of population decline and population ageing may lead to DEMOGRAPHIC DEFICIT with negative effects on economic growth

and employment. Sarah Harper, 2014

Factors of Demographic Deficit:

Labour force declines Population basis for taxation shrinks Number of receivers of old age pensions increases, and they receive their pensions for longer

time Budgetary spending grows Labour force ages Productivity declines Labour force ages Potential for innovations declines

Budget Revenue

Budget Expenditure

6. International Policy Frameworks on Ageing

GOAL:

Reaching a society for all ages

CONTENT:

Adjustment to an ageing world

I. Older Persons and Development

II. Advancing Health and Wellbeing into Old Age

III. Ensuring Enabling and Supportive Environments

Adjustment to an ageing world is measured in terms of:

Social development

QoL of older persons

Sustainability of support systems

PRIORITY DIRECTIONS

Implementation of MIPAA in the region of the United Nations Economic Commission for Europe (UNECE) is guided by the Regional Implementation Strategy for the Madrid International Plan

of Action on Ageing (UNECE RIS/MIPAA)

10 Commitments of UNECE RIS/MIPAA

COMMITMENT 1

• TO MAINSTREAM AGEING IN ALL POLICY FIELDS WITH THE AIM OF BRINGING SOCIETIES AND ECONOMIES INTO HARMONY WITH DEMOGRAPHIC CHANGE TO ACHIEVE A SOCIETY FOR ALL AGES

COMMITMENT 2

• TO ENSURE FULL INTEGRATION AND PARTICIPATION OF OLDER PERSONS IN SOCIETY

COMMITMENT 3

• TO PROMOTE EQUITABLE AND SUSTAINABLE ECONOMIC GROWTH IN RESPONSE TO POPULATION AGEING

COMMITMENT 4

• TO ADJUST SOCIAL PROTECTION SYSTEMS IN RESPONSE TO DEMOGRAPHIC CHANGES AND THEIR SOCIAL AND ECONOMIC CONSEQUENCES

COMMITMENT 5

• TO ENABLE LABOUR MARKETS TO RESPOND TO THE ECONOMIC AND SOCIAL CONSEQUENCES OF POPULATION AGEING

UNECE RIS/MIPAA is based on MIPAA, but its structure and content are designed specifically for the countries of the UNECE Region:

COMMITMENT 6

• TO PROMOTE LIFE-LONG LEARNING AND ADAPT THE EDUCATIONAL SYSTEM IN ORDER TO MEET THE CHANGING ECONOMIC, SOCIAL AND DEMOGRAPHIC CONDITIONS

COMMITMENT 7

• TO STRIVE TO ENSURE QUALITY OF LIFE AT ALL AGES AND MAINTAIN INDEPENDENT LIVING INCLUDING HEALTH AND WELL-BEING

COMMITMENT 8

• TO MAINSTREAM A GENDER APPROACH IN AN AGEING SOCIETY

COMMITMENT 9

• TO SUPPORT FAMILIES THAT PROVIDE CARE FOR OLDER PERSONS AND PROMOTE INTERGENERATIONAL AND INTRA-

GENERATIONAL SOLIDARITY AMONG THEIR MEMBERS

COMMITMENT 10

• TO PROMOTE THE IMPLEMENTATION AND FOLLOW-UP OF THE REGIONAL IMPLEMENTATION STRATEGY THROUGH REGIONAL CO-OPERATION

10 Commitments of UNECE RIS/MIPAA

“the process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age” World Health Organization, Active Ageing: A Policy Framework, 2002

“active ageing means growing old in good health and as a full member of society, feeling more fulfilled in our jobs, more independent in our daily lives and more involved as citizens”

Active Ageing: Concept and Policy Framework

Independent living: using a preventive approach in health care, making transport more accessible and making the environment more age-friendly

Employment: creating better opportunities for older workers

Participation in society: combating social exclusion; fostering active participation in society: encouraging voluntary activities; supporting informal carers

7. National Responses

GOVERNMENT LEVEL OF CONCERN ABOUT AGEING OF THE POPULATION (2015)

Azerbaijan (10%)

No Concern / No View

Albania (18%)

Armenia (14%)

Azerbaijan (9%)

Bosnia and Herzegovina (22%)

Georgia (20%)

Macedonia (19%)

Moldova (17%)

Montenegro (20%)

Serbia (24%)

Turkey (11%)

Ukraine (21%)

In brackets – proportion of 60+ in the population

Minor Concern Major Concern

©Alexandre Sidorenko, 2017

(Since 1963)

Country Participation in the 2007 review and appraisal of MIPAA (report submitted to

UNECE)

Participation in the 2012 review and appraisal of

MIPAA (report

submitted to UNECE)


MIPAA (report

submitted to UNECE)

National strategic documents on ageing

Albania Yes No Yes No

BiH No No No Under development

Montenegro No No No No

Serbia Yes Yes National Strategy on Ageing (2006-2015)

TFYR Macedonia Yes Yes Yes No

Turkey Yes The Current Situation of Elderly People and the National Plan of Action on Ageing

Implementation of UNECE RIS/MIPAA and availability of national strategic documents on ageing in South-Eastern European countries


UNECE)


MIPAA (report submitted

to UNECE)



to UNECE)


Armenia Yes Yes Yes Strategy on Ageing Issues and Social Protection of Older Persons and an Action Plan on its implementation for 2012-2016

Road Map for Mainstreaming Ageing (2011)

Azerbaijan Yes Yes Yes State Program on strengthening social protection of older citizens (2014-2020)

Belarus Yes Yes Yes No

Georgia No No No Road Map for Mainstreaming Ageing (2015)

Kazakhstan No No Yes No

Kyrgyzstan No No No No

Implementation of UNECE RIS/MIPAA and availability of national strategic documents on ageing in CIS+ countries

Continuing…


UNECE)



to UNECE)



to UNECE)


Moldova Yes Yes Yes Programme on Mainstreaming Ageing in State Policy (2014)

Road Map for Mainstreaming Ageing (2012)

Russia Yes Yes Yes Strategy for Action to benefit older citizens of the Russian Federation (2016-2025)

Tajikistan No Yes No No

Turkmenistan No No No

Ukraine No Yes Drafted. Under consideration by the government

Uzbekistan Yes No No

Implementation of UNECE RIS/MIPAA and availability of national strategic documents on ageing in CIS+ countries

In response to the diminishing welfare state and the week alternative players, limited policy responses to ageing have often been complemented, and to some extent even substituted, by spontaneous measures of individual, family and community adaptation in a transforming and ageing society.

The other side of the bridge…

Thank you

Ageing in Eastern Europe...2017/02/13 · World Health Organization, Active Ageing: A Policy...

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