Tag Archives: Economy

Asia

Hong Kong plans for a city that’s growing older

Image 01/02/2018 Global Health Aging Leave a comment

Today, about 16 percent of Hong Kong’s population is age 65 or older. By 2064, that is expected to be 36 percent.

HONG KONG — For decades, this city of more than 7 million has been one of Asia’s most dynamic places, filled with a youthful energy that drove rapid growth in both the population and the local economy.

Planners here still see Hong Kong that way. But they also are looking at the long-term trends, and grappling with a force they cannot stop: Hong Kong is getting older. That’s true of both the city’s people and its built environment — a phenomenon planners here call “double ageing”.

Today, about 16 percent of Hong Kong’s population is age 65 and over. By 2064, that’s expected to be 36 percent — and one in ten residents will be over the age of 85.

Meanwhile, housing stock that appears middle-aged today will become outdated tomorrow. By 2047, some 326,000 private housing units will be more than 70 years old. Many of them feature long flights of stairs unfriendly to older people. More than a third of seniors live in public housing, but the two-year wait list is bound to grow longer as citizens age.

The double-ageing problem is just one issue that Hong Kong’s planners are trying to figure out as they write a comprehensive plan called Hong Kong 2030+. The plan aims to take future demographic and economic trends into account while charting a path for improving quality of life in one of the world’s most densely settled cities.

Phyllis Li Chi Miu, deputy director of the city’s territorial planning department, says buildings, roads, parks and public transport all will need rejuvenation to make the city age-friendly. “It’s a challenging task,” she says.

Alignment with New Urban Agenda

Planners are also looking at how they can align the 2030+ plan with the New Urban Agenda. That’s the 20-year plan for sustainable urbanization that nations agreed to last October at the U. N.’s Habitat III conference in Quito, Ecuador.

Alignment was the main topic of conversation at a recent “Urban Thinkers Campus” conference here. At the event, Li noted that the 2030+ plan already stresses key elements of the New Urban Agenda such as social inclusion and environmental protection.

However, there was some debate about the New Urban Agenda’s relevance in the context of a city-state like Hong Kong. Paul Zimmerman, an environmentalist and elected councilor, said that some notable issues mentioned in the New Urban Agenda, such as increasing numbers of cars on the road, growth of slums and poor utility services, are not problems in Hong Kong.

“Hong Kong is a city and also a country,” Zimmerman said. “It’s a city in which hyper-density and wilderness co-exist. Other mega-cities have no space in their periphery, while Hong Kong has a massive open space in its periphery.”

However, Professor NG Mee Kam of the urban studies programme at the Chinese University of Hong Kong, told Citiscope that the 2030+ plan “needs to strongly align with the New Urban Agenda to plug in crucial policy gaps.” For example, she said, Hong Kong’s plan could take a cue from the New Urban Agenda’s focus on the informal sector and the importance of cultural heritage.

Retrofitting and reclaiming

The 2030+ plan proposes three “building blocks” for implementation — planning for a liveable high-density city, embracing new economic challenges, and creating capacity for sustainable growth.

A major focus, particularly when it comes to dealing with the double-ageing problem, is retrofitting districts with the most old buildings. Tall buildings are likely to be renovated, while many smaller buildings will likely be demolished to make way for new construction and open space. Retrofitting public spaces is also a priority. The city intends to add curb-cuts at sidewalks to make it easier for seniors to walk, and aims to increase the amount of public space from 2 square metres per person to 3.5 square metres.

The plan also aims for compact urban growth that is highly integrated with public transport. Homes and offices are to be within 200 to 300 metres of transit; open spaces within 400 metres; and community facilities, railway stations and educational institutes within a range of 500 metres.

“We are looking at optimum land use through retrofitting,” Li said.

The plan also envisions reclaiming a good bit of land from the sea. That’s a strategy that Hong Kong has long relied on to create room for the city to grow — the city’s airport and Hong Kong Disneyland resort are both located on reclaimed land.

Under the 2030+ Plan, Hong Kong would add another 4,800 hectares (nearly 12,000 acres) of land — a little less than the area of Manhattan. The land would be used for housing, industry, transport facilities and open space. These would include a few large urban extensions such as the East Lantau Metropolis, which is to be home to as many as 700,000 people.

Work on the 2030+ plan started in 2015 and is in the fourth of six phases of public consultation. The final plan is expected to be released next year.

Japan Confronts Crime Wave With Aging Population

05/10/2016 Global Health Aging Leave a comment

“It wasn’t great to get caught, but I just didn’t give a damn…” Fumio Kageyama

A crime wave among older people is underway in the world’s greyest nation. Just last year in Japan, the number of criminals over 65 overtook the number of teenage criminals for the first time since the country started publishing age-related crime statistics in 1989. Over a third of shoplifting crimes are committed by those over 60, and 40 percent are repeat offenders. Criminal offenses by those age 60 and over have also quadrupled between 1994 and 2014.

This curious phenomenon has its roots in the age-old problem of poverty and loneliness. Japan is an expensive place to live in, with even a frugal lifestyle costing 25 percent higher than the basic state pension. The cost of living simply does not match the pension rates of the elderly. Hence older people are committing crimes that result in imprisonment but assure them of food, shelter and healthcare. Loneliness is another factor that encourages crime among older people. About 40 percent of the elderly population live alone. Once released from prison, many do not have access to money, food or shelter, which perpetuates the vicious cycle of crime.

The rise in elderly crime is set against the gloomy national economy of the country. ‘Abenomics’ is a set of economic policies that are currently in place to revive Japan’s stagnant economy, and provide much-needed context to this crime wave. The impetus for these economic policies has been the two decade long stagnant national economy. Japan’s stock market and property bubble burst in the early 1990s, leading to long-term stagnant wages and markedly reduced spending. For the past two decades, the country has not seen any major economic improvement. Worsening the situation were the nuclear meltdown and natural disasters of 2011. Now Japan is caught between reducing the national debt and dealing with roughly 30 percent pensioner population.

‘Abenomics’ is a three-pronged strategy, encouraging monetary easing, government spending, and business deregulation. So far, critics remain unconvinced about the impact of these regulations, and current crime cases reiterate the ineffectiveness of these policies regarding the elderly population. The Japanese government has responded to the crime wave among older people with a short-sighted measure to increase prison capacity by a whopping 70 percent. This does little to address the crime spree that is embedded in poverty and lack of economic security. Furthermore, it takes a huge amount of resources to maintain a prison full of pensioners. A 2-year prison sentence can cost as much as USD 74,700 in a Japanese prison, compared to USD 6,900 on pension annually.

Inmates with health problems can even increase prison costs. In fact, a 2012 Justice Ministry report found that two-thirds of inmates had at least one health condition, including cardiovascular diseases, mental health illnesses, and behavioral disorders. This has resulted in prison guards often going above their disciplinary duties by changing diapers, cleaning inmates and helping them to walk. Japan can respond with long-term measures, such as prison reform, to prevent prisons from turning into dysfunctional nursing homes.

Namratha Rao recently graduated with a Master of Science in Public Health in Social and Behavioral Interventions from the Johns Hopkins University Bloomberg School of Public Health.

South America

The Impact of the Chavez Government on Pensions and Health Systems

04/22/2016 Global Health Aging 2 Comments

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.

South America

Venezuela’s Economic Crisis Puts Older Populations-At-Risk

04/15/2016 Global Health Aging 3 Comments

This article is the first part of a two-part series on Venezuela’s ongoing economic crisis. Click here to read Part 2.

Venezuela is in the midst of an economic collapse. Oil prices have plummeted and the bolivar (Venezuelan currency) has dropped in value compared to the U.S. dollar. The situation is rapidly becoming a humanitarian emergency due to inflation and devaluation of the currency, food shortages, and collapse of the healthcare system. Safety threats and violence have also escalated an already unstable event. While news coverage of these incidents focus on the impact on children or young adults, this crisis has serious implications for older adults who are often vulnerable in the face of disaster.

Food Shortage

One of the hallmarks of media coverage are the pictures of long lines at grocery stores and food banks. In response to the food shortage, the Venezuelan government has instituted a rationing system, in which individuals must appear in person to buy food on the day indicated by the last digit on their ID card. For older adults who lose mobility or cannot make it to the grocery store on their designated day, there are few alternative options. Even for individuals who make it to the grocery store, there is often no food available. In a video posted on YouTube, an older woman states that she is hungry and willing to buy anything. She says, “It is sad that at this age [old age] it has come to this”. (English translation)

A writer for Havana Times shared an experience in a Venezuelan grocery store, “I also saw many elderly people waiting for hours to be able to buy something…”. Older adults often support their family by reserving a spot in the long lines which have thousands of people waiting for hours to reach the front. Exposure to the weather alone makes the ordeal of grocery shopping in Venezuela a threat to the health of older adults. In January of 2016, the government decreed that individuals should engage in their own food production, a daunting task for older adults.

Safety has been a pressing concern, especially surrounding grocery stores and food. In August of 2015, Reuters reported the death of an 80-year-old Venezuelan woman in a supermarket, “possibly from trampling”. In addition to riots and stampedes, there are reports of shots fired and frequent assaults in lines at grocery stores. The army and national police have responded by guarding the lines, but it is unclear whether the people are being protected or controlled by security forces.

Conclusion

With recovery a long way off, there have been calls for other nations to come to the aid of Venezuela. Older adults and children can benefit from food and health assistance but President Nicolás Maduro states that the situation is not nearly as bad as portrayed in the media. For instance, Cuban doctors are helping to mitigate the healthcare crisis in Venezuela. The fact is that foreign aid may not even be enough, hence societies should have strong governments with smart fiscal policies to insure safety nets for older individuals.

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

Global

Low Birth Rates and Unemployment: The Effects of Changing Demographics in Italy and Japan

01/18/2015 Global Health Aging Leave a comment

As many already know, Japan has the largest population of people over 65 in the world at 25 percent in 2013. Since the Japanese are known for their longevity, this number may seem like an isolated phenomenon but the rest of the world is catching up. Almost every major country went through a birthing boom after World War II and people are starting to wonder how they are going to take care of the large number of elderly citizens. Italy already has a 65 and over population at 21 percent and by 2050, Americans aged 65 and above are expected to make up at least 21 percent of the population. As soon as 2025, the U.S. spending on Medicare, Social Security, and Medicaid is projected to double, which means there will be yet more strain on state and federal budgets.

If that is not food for thought, birth rates in Japan are at an all-time low. With decreased birth rates, there will be a hole in the future workforce when it comes time to take care of the elderly. Japan owns the second largest amount of U.S. debt, and with two economies so intimately connected, both can decline at the same time. The Japanese media has begun dubbing the citizenry’s lack of interest in the opposite sex as “celibacy syndrome.” While choosing a lifestyle outside of traditional marriage is a personal decision, so many people making this choice will eventually cause an economic downturn when it comes to needing resources for the elderly. Fewer babies were born in 2012 than any other year on Japanese record and not so funnily, adult diapers outsold baby diapers.

In Italy, there is a similar picture, not in terms of birth rates, but in terms of young adult employment. Unemployment is at a staggering 44.2 percent for people ages 15 to 24. An alarming statistic by itself, it is compounded by the fact that Italian pensions take up 15.6 percent of the country’s Gross Domestic Product. This rate is the highest in all of Europe and with jobs so scarce, young Italians are either moving abroad with their college degrees or have given up the job search entirely. Even those who are lucky enough to find jobs are not faring much better. The average salary for a person born post-1980s is a mere $1,375 a month, making it nearly impossible to afford home payments, car payments, and child payments. In addition, people are living in their parents’ homes longer and using their parents’ money as well. This postpones starting a family of one’s own and prevents the older generation from saving for retirement. With smaller retirement savings, older people are staying in jobs longer.

The only economies with less growth than Italy’s since 2001 are Haiti and Zimbabwe. Italy has the oldest working population out of any European nation and when that population retires, it puts enormous strain on the government because their tax base is exceedingly diminished with so many young people unemployed.

Jacob Edward is the Manager of Prime Medical Alert and Senior Planning in Phoenix, Arizona, USA. Jacob founded both companies in 2007 and has helped many Arizona seniors and their families navigate the process of long-term care planning. Senior Planning provides assistance to seniors and people with disabilities in finding and arranging assisted living in Phoenix, as well as applying for state and federal benefits.