On 1 October, the international community marks the United Nations International Day of Older Persons. The theme of this year’s International Day is the “Journey to Age Equality”. The choice of this theme reflects the United Nations Sustainable Development Goal (SDG) 10, to reduce inequalities. This article considers this “journey” through the prism of social protection systems.
As the United Nations outline, the aim of placing a focus on equality is to:
- Draw attention to the existence of old-age inequalities and how this often results from cumulative disadvantages in life, and highlight intergenerational risk of increased old-age inequalities.
- Bring awareness to the urgency of coping with existing – and preventing future – old-age inequalities.
- Explore societal and structural changes in view of life course policies: life-long learning, proactive and adaptive labour policies, social protection and universal health coverage.
- Reflect on best practices, lessons and progress on the journey to ending older age inequalities and changing negative narratives and stereotypes involving “old age”.
What is the scale of the old-age challenge?
The United Nations Department for Economic and Social Affairs (UN-DESA) state that, globally, persons aged 65+ now outnumber children younger than age 5. By 2050, the global number of persons aged 65+ is projected to more than double, while the number of children under five is projected to remain relatively unchanged. This means that by 2050 there will be more than twice as many older persons (1.5 billion) as children younger than age 5. Among older people, women outnumber men at older ages owing to their longer average life expectancy. In 2019, women comprise 55 per cent of those aged 65+ and 61 per cent of those aged 80+ globally.
What does this mean for social protection systems?
Demographic trends see increased longevity and thus rising numbers of older people and declining rates of fertility and thus fewer children. These trends contribute to increasing old-age support ratios (the number of people of working age (ages 25–64) to older people (aged 65+)). As the International Social Security Association (ISSA) has observed, among other global challenges for social security, this has led to increased pressure placed on the sustainable financing of many social protection systems worldwide.
Social protection programmes for older people are the commonest form of social protection worldwide. The International Labour Office (ILO) report that 68 per cent of older people (defined by a legal retirement age) receive some form of a pension. However there are important inequalities globally in effective access to such pension income. As the ILO additionally report, in most low-income countries less than 20 per cent of older people receive a pension.
Inequalities also exist as regards the adequacy of the cash benefits provided. For many countries with wide pension coverage the challenge is to balance the financial sustainability of pension programmes and the cash adequacy of benefits. To mitigate financing challenges, active labour market polices, life-long learning and age-friendly workplaces may offer ways to encourage active ageing. Such policies may enable delayed retirement, increase earnings and pension contributions, and also support healthy ageing and well-being. For other countries with more limited pension coverage, the challenge is more likely to lie with strengthened measures to address old-age poverty. These also support social and economic inclusion and confront negative narratives about old age. Tax-financed social pension programmes represent one increasingly commonplace response.
Another important inequality as regards social protection is access to affordable, quality health care. As the World Health Organization (WHO) state, over half of the world’s population do not have effective coverage for essential health services, many of whom are older people. For this reason, SDG Target 3.8 aims to achieve universal health coverage (UHC).
Importantly in ageing societies, a further source of inequality for older persons is access to long-term care (LTC). The formal provision of LTC remains “work in progress” for most social protection systems. Very few countries (e.g. Germany, Israel, Japan, Luxembourg, the Netherlands, and the Republic of Korea) have mandated provision of LTC. Consequently, data from the ILO show that 5.6 per cent of the global population lives in countries where LTC coverage based on national legislation is provided to the entire population. A related factor is a global shortage of around 14 million formal LTC workers.
As a result of this workforce deficit, the burden of providing care falls on family members and other informal carers, typically women. This acts to highlight multiple inequalities that characteristically confront women. Not only are women confronted in many societies with inequalities in access to education and labour markets, lower levels of pay, more interrupted work histories, and resulting lower levels of contributions to social security (and thus lower future benefits levels), but they also bear a greater share of the care burden, and (owing to their longer average life expectancy), are more at risk of poverty in old age and more likely to need, at some future date, long-term care.
The persistent nature of many of these inequalities demands that a heightened emphasis be given to achieving SDG Target 5.4, to support the realization of gender equality, to remove gender bias across the life course, through the proactive design of social protection and caregiving policies. One response is to offer contribution credits to unpaid carers. Given that Chile and France provide contribution credits to women for raising children, one might envisage a comparable mechanism for elder care.
Social protection: Supporting the journey to age equality
When considering the “journey to age equality” through the prism of social protection the message is clear. In addition to looking to address the needs of the current older population there is equally a need for policy action to address the future needs of the even more numerous next generation of elders (the current working-age population). Also, for all age groups, social protection must necessarily incorporate a gender dimension. And policy responses must necessarily be country-specific.
Two positive messages can be drawn about the role of social protection in addressing the inequalities faced by older people. First, they help to mitigate the financial risks and insecurities that accompany ageing and support healthy ageing and improved well-being. Second, when innovatively designed, they can also proactively contribute to broader initiatives to address structural inequalities in society that may leave older people, and older women especially, socially and economically excluded.
ILO. 2019. Long term care. Geneva, International Labour Office.
ILO. 2018. ILO report shows progress on global pension coverage but benefits are low. Geneva, International Labour Office.
ISSA. 2019. Reports “Ten challenges for social security”. Geneva, International Social Security Association.
UN. 2019. International Day of Older Persons. New York, NY.
UNDESA. 2019. World population prospects 2019: Highlights. New York, NY.
WHO. 2019. Universal health coverage: Data sheet. Geneva, World Health Organisation.