GLOBAL HEALTH AGING

This is Part 2 of a two-part series on Venezuela’s economic crisis. In Part 1, the main focus was food shortages. In Part 2, pension programs and health systems are emphasized.

On the surface, the status of older adults in Venezuelan society should have been secure. The Chavez government had expanded pensions to cover all older adults regardless of work history in 2011. The program was particularly beneficial to women who often participate in the informal economy or are self employed. The government also subsidized home repairs and gave older adults preferential access to food, allowing them to skip the lines at grocery stores. These new programs were termed the most generous social programs in Latin America.

By 2014, at the very beginning of the economic downturn, older adults were already at heightened vulnerability. The Global AgeWatch Index noted that the health system was showing signs of dysfunction. Older adults had problems accessing doctors or medications, infectious diseases were spiking, and there were signs of difficultly in accessing basic care. By 2015, the Index ranked Venezuela 76^th out of 96 nations in security for older adults. Despite the “generous” pension program, the nation ranked 66^th out of 96 countries for income security. Safety was most concerning since Venezuela scored only 17 percent in this category. As the economic condition deteriorates through the year, the country is likely to perform even worse in 2016.

The health system has also collapsed, leaving older adults without necessary medications and treatment for chronic or acute diseases. Moreover, the Venezuelan government nationalized the pharmaceutical industry, but is still unable to keep up with demand. While news has focused on the Zika virus, other infectious diseases such as malaria and dengue are also reappearing. These diseases can be more deadly for older adults who may have other chronic illnesses. Human Rights Watch recently found a “shortage of medications to treat pain, asthma, hypertension…”, all conditions that impact older adults.

The shortage of doctors and nurses is a long time in the making, and not solely because of low wages. According to the Wall Street Journal, over 13,000 doctors left Venezuela between 2000-2003, and current treatments are often outdated. Women do not have access to radiation, and breast cancer is often treated with radical mastectomy compared to more modern treatments. Finally, as of April 2015, only about 35 percent of hospital beds were operational in Venezuelan hospitals.

Older adults are more likely to be poor, and the poor are less likely to be able to access medical care or pay for food on the black market. The combination of food and medical shortages, and safety threats leaves older adults vulnerable to the resurgence of diseases, creating an unfortunate cycle of dependency. Life expectancy fell after the collapse of the Soviet Union, and it is likely that a similar impact may be felt in Venezuela.

Many of the bloggers and commentators on the Venezuelan imminent collapse are pro-democracy advocates who place blame on the socialist nature of the government. While the socialist nature may be the underlying cause of Venezuela’s current crisis, stable democracies can collapse when faced with economic threats. For example, the University of Michigan Retirement Research Center noted that older adults in the U.S. faced housing insecurity, and were required to work longer in order to recover from the 2007-2009 recession. In an economic collapse, work is scarce and older adults who are already near or below the poverty line become destitute.

Grace Mandel is pursuing a Master of Public Health in Health Systems and Policy at the Johns Hopkins University Bloomberg School of Public Health.