How Do We Promote Healthy Aging in Asia? This Is What the Experts Say

Policies need to be put in place to protect older persons in Asia. Photo: Raden Masputra
Policies need to be put in place to protect older persons in Asia. Photo: Raden Masputra

By Lilibeth Poot, Aiko Kikkawa, Cynthia Castillejos Petalcorin, Donghyun Park

Older persons have vulnerabilities related to gender, family dynamics, financial and digital literacy, access to labor markets and long-term care. Policymakers should support the region’s growing elderly population to achieve healthier and more productive lives.

The pandemic has highlighted the vulnerabilities of older persons and the importance of promoting their mental and physical health, social ties, and economic security.

In response, many developing countries in Asia are scaling up social security and pension programs, but are they properly designed? We looked at some of the leading research on the issue. This is what we discovered.

In Indonesia, researchers found significant inequality in access to social programs, depending on sex, living arrangements, region, and social class. Men are three times more likely to be enrolled in the pension system than women, according to a report by Muh. Ulil Absor, Iwu Dwisetyani Utomo, Peter McDonald, Ariane Utomo, and Brian Houle.

Higher socioeconomic status and higher educational attainment are also associated with greater access. The approach and local cultural factors also affect access to social welfare programs. These factors should be taken into account when considering future programs.

In Nepal, researcher Jayash Paudel found that a nationwide senior citizen allowance program introduced in 2008 contributed to a 64.4% increase in the likelihood of receiving financial assistance among the elderly. But females eligible for the allowance are 8.8% more likely to eat fewer meals while males do not change their food consumption. This implies the need to better understand the effect of social safety nets on household resource allocation dynamics and gender equity.

In Bangladesh, researchers examined the targeting of the “old age allowance.”  They found that the program fails to target the poor because those in charge of selecting the beneficiaries have limited capacity and lacked transparency in assessing the beneficiaries’ eligibility, according to Viola Asri, Kumar Biswas, Sebastian Fehrler, Urs Fischbacher, Katharina Michaelowa, and Atonu Rabbani.

The authors conducted randomized controlled trials of the training of selection committee members and provision of data about the targeted beneficiaries. The study found that these interventions improved knowledge among the selection members but did not improve targeting. The authors recommend more research on ways to improve capacity and transparency of implementing agencies regarding beneficiary selection.

Many developing countries in Asia are scaling up social security and pension programs, but are they properly designed? We looked at some of the leading research on the issue.

In a study on financial inclusion in Thailand, MinhTam Bui using the 2017 Global Findex data for Thailand reported that 188 of the 1,000 survey respondents did not hold an account at a financial institution. More than half (50.5%) of non-account holders are 55 years and older and more than a third (36.7%) are 60 years and over.  Among those 60 years old and above, only 5% and 3.2% used mobile phones and internet, respectively.

She noted that older people are aware of the benefits of using online financial services but they do not have technical skills. The study, thus, recommends strengthening public and private partnership in promoting internet access and skills among the elderly.

Since people are living longer and healthier, older people may work longer and retire later. Longer working life also contributes to the sustainability of social security systems. In Indonesia, a large majority of the labor the force is in informal employment and not covered by the government’s retirement income policy, according to researchers George Kudrna, Trang Le, and John Piggott.

Over 80% of Indonesians aged 60 and over and employed in the formal sector switched to informal employment. Such research helps design sound social security systems and programs that influence the employment and retirement decisions of the elderly.

Older women have limited access to the labor market. Many engage in unpaid care work and therefore will not have access to pension income. Gretchen Donehower mapped the extent of unpaid care economy in the Asia-Pacific region and found that a large proportion of women specialized in unpaid care work all their working lives. Policymakers should address the challenge of providing economic security for older women who only have survivor benefits after their husband’s death.

Demand for care work is expected to increase drastically in light of rapid population aging. For example, home-based care needs for older adults are expected to soar in Sri Lanka, according to a study by Yi Zeng, Zhenglian Wang, Muqi Guo, and Lakshman Dissanayake. They project a 302% increase in disabled older adults aged 65 and over between 2012 and 2060.

The studies highlight the vulnerabilities of older persons related to gender, family dynamics, financial and digital literacy, access to labor market and long-term care. Asia’s policymakers should use the findings to support the region’s growing elderly population toward healthier and more productive lives.

The studies discussed in this blog were presented at a conference on Health and Socioeconomic Well-Being of Older Persons in Developing Asia: Role of Individual and Household Data held on 7–9 September 2021 and co-organized by ADB, ADBI, and JICA Ogata Research Institute.