Ageing and the human rights of older persons Twin imperatives for action

Transcription

1 Ageing and the human rights of older persons Twin imperatives for action Economic Commission for Latin America and the Caribbean Subregional Headquarters for the Caribbean

2 Twin imperatives for action Population ageing: the changing age structure of the population The human rights of older persons and states obligations to respect, protect and fulfil those rights Ageing and rights are two different starting points but inseparable and intertwined issues 2

3 6 The Caribbean population by age (millions)

4 Phases of the demographic transition Stage 1 High stationary High birth rate High death rate Low population growth Stage 2 Early expanding High birth rate Falling death rate Increasing population growth Stage 3 Late expanding Falling birth rate Low death rate Slowing population growth Stage 4 Low stationary Low birth rate Low death rate Low population growth Stage 5 (?) Declining Very low birth rate Low death rate Falling population Births/deaths (per 1,000 population) Population (thousands) ,000 9,000 8,000 7,000 6,000 5,000 4,000 3,000 2,000 1,000 0 Crude birth rate Crude death rate Total population 4

5 Caribbean population by age and sex, selected years (thousands) Male 1990 Female

6 Caribbean population by age and sex, selected years (thousands) Male 2000 Female

7 Caribbean population by age and sex, selected years (thousands) Male 2010 Female

8 Caribbean population by age and sex, selected years (thousands) Male 2020 Female

9 Caribbean population by age and sex, selected years (thousands) Male 2030 Female

10 Caribbean population by age and sex, selected years (thousands) Male 2040 Female

11 Caribbean population by age and sex, selected years (thousands) Male 2050 Female

12 Caribbean population by age and sex, selected years (thousands) Male 2060 Female

13 Child, Old Age And Total Dependency Rates For The Caribbean (Number of persons per hundred people aged years) and over Total 13

14 Old age dependency rates by region (65+/15-64) 50 Europe 40 North America The Caribbean 30 Latin America Africa

15 Old age dependency ratio by country, 2015, 2030 and 2045 (65+/(15-64)) Antigua and Barbuda Saint Vincent and the Grenada Grenadines Belize Guyana Suriname Bahamas The Caribbean Saint Lucia Trinidad Jamaica and Tobago The United States Virgin Islands Aruba Barbados Curaçao Guadeloupe Martinique

16 The human rights of older persons United Nations human rights system International bill of human rights, for example: the right to work; the right of everyone to social security, including social insurance; the right of everyone to an adequate standard of living for himself and his family, including adequate food, clothing and housing, and to the continuous improvement of living conditions; the right of everyone to the enjoyment of the highest attainable standard of physical and mental health; and the right to take part in cultural life and to enjoy the benefits of scientific progress and its application. 16

17 United Nations human rights conventions United Nations human rights conventions addressing the rights of women, persons with disabilities, children, and migrant workers (CEDAW; CRPD; CRC; CRMWF) Insufficient consensus to enable the establishment of a human rights instrument specifically addressing the rights of older persons 17

18 Treaties, laws and agreements addressing the rights of older persons Human rights conventions have prohibited discrimination on grounds of age Progressive interpretation by treaty monitoring bodies By independent experts with thematic mandates General assembly resolutions (e.g. United Nations Principles for Older persons) Madrid International Plan of Action on Ageing San Jose Charter on the Rights of Older Persons in Latin America and the Caribbean 18

19 Lack of clarity concerning the universal human rights of older persons Independent Expert on the enjoyment of all human rights by older persons: existing arrangements do not cohere, let alone conceptualize, regulatory principles to guide public action and policies of Governments ; it is difficult to clarify the obligations of States with respect to older persons ; and procedures for monitoring human rights treaties generally ignore older persons (2014). 19

20 Advancing the human rights of older persons United Nations Open-ended Working Group on Ageing Independent Expert on the enjoyment of all human rights by older persons The new the Inter-American Convention on Protecting the Human Rights of Older Persons National legislation drafted with regard to human rights and other international commitments 20

21 Economic security for older persons Social security is a right but it has yet to be realised through universal coverage Income from pensions, employment and interhousehold transfers Labour market participation of older persons is related to pension coverage Poverty rates among older persons are similar to those for older working age adults (300 USD per month per adult male) 21

22 Persons over retirement age who receive a contributory social security pension (%) Guyana (2011) Barbados (2008) Bahamas (2012) Antigua and Barbuda (2002) Grenada (2011) Saint Kitts and Nevis (2010) Trinidad and Tobago (2010) Dominica (2011) Jamaica (2003) Saint Vincent and the Grenadines (2006) Belize (2011) Saint Lucia (2007/08) 22

23 3.5 Expenditure on contributory and noncontributory pensions (% of GDP) BahamasBarbados (2012) (2008) Belize (2011) Dominica (2011) Contributory Grenada (2011) Guyana (2011) Non-contributory Saint Kitts and Nevis Saint Lucia (2010) (2007/08) Trinidad and Tobago (2010) 23

24 700 Non-contributory pensions and national poverty and indigence lines, 2013 (current international dollars (ppp) per month) Trinidad and Tobago Guyana AntiguaSaint KittsBelize Saint Jamaica and Barbuda and Nevis Vincent and the Grenadines Suriname Barbados Bahamas Dominica Grenada National poverty and indigence lines (per adult equivalent male at 2013 prices; poverty lines > indigence lines) Saint Lucia 24

25 Health care for ageing populations Epidemiological transition The number of people suffering from noncommunicable diseases (NCDs) will increase NCDs include: cardiovascular disease, cancer, type 2 diabetes, hypertension, Alzheimer's and osteoporosis NCDs can cause disability (and disability can cause NCDs) 25

26 Male Female Male Female Male Female Male Female Male Female Male Female Male Female Prevalence of disability in the Caribbean by type, sex and age, 2000s (percentages) Visual impairment Mobility impairment Upper limb impairment Persons under 60 Hearing impairment Behavioural difficulties Persons 60 and over Learning difficulties Speech impairment 26

27 Funding public health care for ageing populations Per capita health costs for older persons are much higher than younger persons Population ageing will therefore lead to increased demand for health care services Spending on public health care services in Latin America is expected to rise by 3.4 percentage shares of GDP and in the EU-15 countries by 3.2 between 2005 and 2050 It is reasonable to assume that similar increases will be required in Caribbean countries. 27

28 Public spending on health 8 7 Public health spending and GDP per capita, 2012 (spending as a percentage of GDP and GDP per capita in international dollars, PPP) OECD GUY LCA VCT BLZ SUR DMA JAM GRD KNA BRB ATG TTO BHS GDP per capita 28

29 Out-of-pocket expenditure Out-of-pocket expenditure on health and GDP per capita, 2012 (out-of-pocket expenditure as a percentage of total health expenditure) 60 GRD KNA 50 LCA TTO GUY JAM BLZ DMA BRB ATG BHS 10 SUR VCT OECD GDP per capita 29

30 Age-friendly health care Age-related functional decline Geriatric medicine Interaction with older patients. Design of medical centres Accessibility of services At least 1/3 of persons need palliative care Mostly they are persons over 60 with NCDs But palliative care services are not well developed 30

31 Social care services Independence, autonomy and choice Home help services Home nursing care Day care Activity centres Long-stay institutions Coverage and quality Monitoring and regulation 31

32 Social participation Isolation and loneliness Social participation of older persons is related to their financial situation, health and place of residence Transport a barrier to social participation National councils Associations of retired persons Education, cultural and sporting activities all have health and welfare benefits 32

33 Action to address ageing and the rights of older persons Plan for, and manage, future pension and health care costs Extend social protection against the risks associated with old age: loss of income, ill health, disability, loss of independence, isolation Social protection should be a universal right based on principles of intergenerational solidarity, pooling of risks and sharing of costs Promote active ageing: optimizing opportunities for health, participation and security in order to enhance quality of life as people age 33

34 Action to address ageing and the rights of older persons Recognise the contribution that older persons can make to economic, cultural, civic and family life End discriminatory attitudes and behaviors towards older persons Address elder abuse a violation of fundamental human rights Older persons must be advocates and agents of change Consultation, democratic debate and commitment to action 34

35 Thank you! ECLAC Subregional Headquarters for the Caribbean 1 Chancery Lane P.O.Box 1113 Port of Spain Telephone: (868) Facsimile: (868) registry@eclac.org Website: