family and state roles in promoting the wellbeing of older filipinos
TRANSCRIPT
Grace T. Cruz Armand Camhol
UP Population Institute
Family and State Roles in Promoting the
Well-Being of Older Filipinos
AASSREC Biennia General Conference
4-6 April 2013
Cebu Parklane Hotel, Cebu City
Outline of the Presentation
The demography of aging in the Philippines
Well-being of the older Filipinos
• Economic well-being
• Health status and lifestyle
• Social well-being
Family and state roles in promoting well-being of older Filipinos
• Family as the main source of support
• Laws and programs to advance the welfare of older Filipinos
Conclusion
Sources of data
• 2007 Philippine Longitudinal Study of Aging (PLSOA)
Nationally representative sample population 60+ N of cases: 3,105 Multi-stage sampling design Response rate: 94%
Designed to be comparable to the Japanese Longitudinal Study of Aging (NUJLSOA) and Singaporean Longitudinal Study of Aging (SLSOA)
• Various census data • Related studies on aging
8 6 4 2 0 2 4 6 8
0-4 5-9
10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79
80 and over
Percentage to Population
Population Philippines 2010
4
Demography of aging in the Philippines
The Philippines has a young population with a small (6.8%) proportion of the population in the older ages (60+)
Trends in aging Philippines 1960-2010
4.32 4.49
5.28 5.26
5.97
6.76
1.17 1.65
2.54 3.19
4.56
6.23
0
1
2
3
4
5
6
7
8
1960 1970 1980 1990 2000 2010
% of pop 60+ total number of pop 60+(million)
Source: Census, 1960-1980 (total population), 1990-2010 (household population)
The Philippines is not yet an aging society, but the number of older people is substantial.
The number of older people is expected to continue to increase in the future.
Perc
ent
0
10
20
30
40
2000 2007 2010 2015 2020 2025 2030
0-14 15-29 30-49 50-59 60+
Source: CPH 2000; CPH 2007 Years 2010-2030 from 2000-based projections, medium assumption
6.2 million older people or 6.8% of total pop
By 2025, we would have 11.9 million older people accounting for about 10% of the total population. By then, the Philippines will be an
aging population by UN definition.
Percent distribution of the population by age group
Increasing number and proportion of older people is the result of the increasing longevity
Life expectancy at birth is increasing over time.
Life expectancy at birth Life expectancy at age 60
Male Female Gender Diff
Male Female Gender Diff
1970 57.3 61.5 4.2 16.3 17.1 0.8
2000 65.0 70.3 5.3 17.9 20.1 2.2
The older population is the fastest growing sector of the Philippine population since the 1960s.
3.3
4.4
2.3
3.63.2
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
1960-1970 1970-1980 1980-1990 1990-2000 2000-2010
PG
R
period
total pop 60+ <15 15-59
Well-Being of the Filipino Older People
Life satisfaction
• Level of satisfaction with present life
34.3% very satisfied
53.9% somewhat satisfied
11.8% not satisfied
Females and older cohorts are more satisfied with their present life
32.2
53.7
14.1
35.8
54.1
10.2
Very satisfied
Somewhat satisfied
Not satisfied
Male Female
By sex By age
34.3
54.0
11.6
33.1
54.8
12.1
38.0
50.4
11.6
60-69 70-79 80+
Older Filipino are in a precarious economic situtation
• 39% are working • Males: 47% (majority in the agriculture sector) • Females: 33%
• 22% receive income from pension
• Most common assets
• House they are currently residing in (77%)
• Appliances (60%)
• Farm/fishponds (21%)
• 6% have bank accounts
• 15% have liabilities
• 50% have personal loans
• 29% have loans from money lenders
• 13% have bank loans
Older Filipinos have low economic status
• Meager income although they have multiple sources of income (average of 2)
– Median monthly income: PhP3,000 (US$73)
• 53% expressed some or considerable difficulty in meeting household expenses
Most older people rely on informal sources of support, especially transfers from their children
• Sources of income Money from children within the country (58%) Earnings from work (29%) Income from farm (22%) Pension (22%) Money from children outside the country (20%)
• Most important sources of income Males Earnings from work Pensions Money from children in the country Income from farm Money from children abroad
Females Money from children in the country Pensions Earnings from work Money from children abroad Income from farm
Remittances are the main source of income, particularly for older females with children overseas
Main sources of income of older Filipinos
22
11
28
19
13
5 2
34
14 12
23
7 8
2
0
5
10
15
20
25
30
35
40
Money from kids
abroad
Money from kids
in the country
Work Pension Farm Family business
Others
Males Females
Health Status and Lifestyle
Self-assessed health status
Most older people, regardless of sex, think they have an average health status.
Self-assessed health status Male Female
Very healthy 8.4 6.9
Healthier than average 14.9 13.4
Of average health 48.1 47.0
Somewhat unhealthy 23.0 26.9
Very unhealthy 5.7 5.8
TOTAL 100% 100%
Functional health
15% have at least one ADL (Activities of Daily Living) difficulty.
Older females exhibit greater functional disability than males.
While a considerable proportion of the OP’s life is lived in
disability, there is an improving functional health status over time.
8.0
15.4
27.2
4.4
9.2
24.0
0
5
10
15
20
25
30
60-69 70-79 80+
Pe
rce
nt
wit
h a
ny
AD
L d
iffi
cult
y
Age Group
1996
2007
Active Life Expectancy: Females live longer but experience greater disability than males
12.3
9.4
6.64.3
1.3
12.6
9.6
6.44.4
1.5
4.3
4.2
4.3
4.1
2.2
6.4
5.8
5.6
4.7
2.1
0
2
4
6
8
10
12
14
16
18
20
Male 60 65 70 75 80 Female 60 65 70 75 80
Inactive Active
Generally, older people are satisfied with their sleep.
Sleep indicators Male Female
% who are satisfied with their sleep 84.3 81.8
Average number of hours of sleep per night 6.1 6.1
% who take naps regularly 43.4 37.8
Average duration of nap (in minutes) 55.8 48.4
Males experience less sleep problems compared to older females.
Percent with loss of vision in at least one eye
6.9
5.5
Male Female
By sex By age
4.8
6.3
13.0
60-69 70-79 80+
Percent who are unable to hear in at least one ear
7.5
7.3
Male Female
By sex
5.0
7.8
19.4
60-69 70-79 80+
By age
Oral health: Low number of remaining teeth
By sex By age
22.0 32.4
32.0 31.8
21.8 19.1
24.2 16.8
Male Female
None 1 to 9 10 to 19 20+
22.1 33.4
47
31.2
32.9
33 21.7
19.5 13.7 25
14.1 6.3
60-69 70-79 80+
None 1 to 9 10 to 19 20+
Percent with health insurance
By sex By age
19.4
12.4
Male Female
16.9
14.2
9.6
60-69 70-79 80+
Percent with unmet need for health care due to financial reason
By sex By age
22.8
24.0
Male Female
24.9
22.8
17.9
60-69 70-79 80+
Percent who are currently smoking
By sex By age
38.0
18.1
Male Female
29.7
23.7
14.2
60-69 70-79 80+
Percent who are currently drinking alcohol
By sex By age
48.5
13.2
Male Female
33.2
22.6
11.6
60-69 70-79 80+
Social Well-Being
Most older people coreside with their children; only a few live alone.
Living arrangement Male Female
% Living alone 3.3 5.3
% Living with spouse only 9.9 6.8
% Living with children 74.5 73.4
% Other composition 12.4 14.4
TOTAL 100.0% 100.0%
More females than males live alone.
Social contact with noncoresident children
Active exchange of visits and communication between the older person and noncoresident children
• 82.8% exchanged visits with any noncoresident child in the past year
• 65.7% exchanged letters, calls, text messages with at least one noncoresident child in the past year
• 6% have not been in touch with any noncoresident child in the past year
• Females are more in touch with their noncoresident children compared to the males
Older Filipinos are socially connected
• 51% attend religious activities or services outside the home (weekly)
• 41% are members of an organization (religious and non-religious)
• 21% are engaged in volunteer work in church/community
• 26% hang out with friends and neighbors (daily)
• 73% feel that their family, relatives, or friends are willing to listen when they need to talk about their worries or problems
Information technology promotes social connectedness
• 12.3% know how to use cell phone to text
– of which 90% used cell phone to text
• 20.3% know how to use cell phone to call
– of which 97% used cell phone to call
• 1.2% know how to use email
– of which 83.8% used email
Family and State Roles in Promoting Well-Being of Older
Filipinos
Family: Main source of old-age support
• In the absence of a formal welfare system, the family, specifically children are the main source of old-age security.
• Strong family ties are indicated in the intergenerational exchange of support and coresidential arrangement between older people and at least one of their living children.
• The Philippine Constitution mandates the family to assume a predominant caregiving role for their elderly members.
State role in ensuring the well-being of older people
• The constitution ensures that older Filipinos receive due care not only from the family but also from the state.
– Accordingly, considerable state efforts have been exerted to advance the welfare of the elderly, most of which have centered on the need to provide healthcare.
Legislative milestones for older people
• Republic Act 7432 (1992)
An act maximizing the contribution of senior citizens to nation
building, grant benefits and special privileges and for other purposes
• Republic Act 7876: Senior Citizens Center Act (1995)
An act establishing a senior citizens center in all cities and
municipalities and appropriating funds therefore or the Senior Citizens Center Act of the Philippines
• Republic Act 9257 Amendment to RA 7432 (2004) An act granting additional benefits and privileges to senior citizens
amending for the purpose Republic Act No. 7432.
Legislative milestones for older people
• Republic Act 9994: Expanded Senior Citizens Act (2010) – grants additional benefits that essentially expand the medical cost
provisions to include free medical and dental health services
– entitlement to free secondary, tertiary, and vocational education in both private and government learning institutions
– exemption from training fees for socioeconomic programs
– avail of livelihood and training programs and self-employment assistance
– social pension for indigent elderly
• Republic Act 9336 – allocates one (1) percent of the total budget of government agencies
for the implementation of programs and services for senior citizens
– complements RAs 9994 and 7876
Legislative milestones for older people
• IRR of R.A. 9994 provides for a Social Pension as well as mandatory PhilHealth coverage for indigent senior citizens.
– monthly allowance of P500.00 per indigent senior citizen
– automatic membership to the Philippine Health Insurance Corporation or PhilHealth, the state-owned medical insurance corporation
Percent who are aware of senior citizen privileges
90.9
88.3
Male Female
By sex By age
90.6
89.7
82.5
60-69 70-79 80+
Percent with a senior citizen card
By sex By age
66.6
72.4
Male Female
63.3
82.1
77.0
60-69 70-79 80+
Richer and better educated older people are more aware and have better access to of gov’t programs re: privileges to senior citizens
80.5
48.2
87.4
61.6
88.4
68.9
92.0
77.1
94.2
84.0
Heard
Have SC card
Poorest 2 3 4 Wealthiest
76.5
69.1
88.4
65.8
91.9
73.1
97.8
86.3
No formal education Some / elem
Some / HS Some / college +
Percent availing of privileges among those with senior citizen card
53
65
9
11
5
29
60
70
13
13
9
25
Discount on medicine
Discount on fare
Discount on movies
No income tax
Exempted fr training fees
Free medical services
Male Female
53
68
12
15
8
25
61
68
12
9
7
28
61
64
6
9
6
30
60-69 70-79 80+
Senior citizen privileges that are based on discounts benefit the richer, more educated elderly
Senior citizen privileges that are based on discounts benefit the richer…
31.2
50.3
3.7
11.3
7.5
23.5
44.1
68.0
4.8
11.4
7.4
26.6
54.2
68.9
8.5
14.8
4.4
26.0
57.9
67.2
10.7
7.9
5.5
24.3
72.3
70.9
20.2
14.9
8.7
29.2
Discount on medicine
Discount on fare
Discount on movies
No income tax
Exempted fr training fees
Free medical services
Poorest 2 3 4 Wealthiest
…and better educated older people.
51.4
39.0
0.9
2.8
1.0
25.5
53.8
66.1
7.5
9.8
6.1
26.6
57.4
68.4
17.6
15.5
7.5
26.5
70.5
82.7
21.5
19.7
12.6
27.8
Discount on medicine
Discount on fare
Discount on movies
No income tax
Exempted fr training fees
Free medical services
No education Some / elem Some / HS Some / college +
Senior citizen privileges that are based on discounts benefit the more educated elderly
Conclusion • The Filipino older people are in a precarious
economic condition.
• Despite increasing longevity, there are gaps in their health status.
• BUT they enjoy high level of social well-being
– family is still the primary safety net of Filipino older people
– Strong community connectedness
• Role of the church and religion
Conclusion • Demographic change such as increased longevity,
increased preference for smaller family size and international migration can challenge the family’s continued ability to provide support for its elderly.
• Need for greater state support to enhance the well-being of older Filipinos
• fine tune the implementation of existing laws for better targeting of the most vulnerable older people
• provide more social security and health care benefit as an alternative to the possible loss of family support due to international migration
Thank you!
Other programs provided by the government and NGOs
• Department of Social Work and Community Development
– Homes for abandoned ones and neglected senior citizens
– Pre-retirement orientation program in government and private agencies
– Provide accessible microcredit/finance to senior citizens
• NGOs: Coalition of Services of the Elderly (COSE)
• Local government units
Other programs provided by the government and NGOs
• Department of Health adopted a Health Care Program for Older Persons (HCPOP) in 1998 (presently renamed Health Development Program for Older Persons)
– Establish geriatric wards in every government and private hospital
– Ensure that all caregiver training schools will require their students to provide community training and caregiving to frail senior citizens in the community
Leisure activities
• 69% watch TV daily
• 59% exercise daily
• 39% listen to the radio daily
• 26% garden daily
• 18% attend social activities monthly
• 10% gamble for leisure monthly
• 9% read daily
Active flow of economic support between the older people and their children
Males Females
Among older persons with at least one child living outside the household: % who receive economic support from non-coresident child
74.8 73.2
Among older persons with at least one surviving child: % who plan to rely on children for financial support
39.0 41.4