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Ageing Europe:21st century implications

Ageing Europe:21st century implications. Demographic Challenges for the 21 st Century: A State of the Art in Demography. Colloquium in honour of Prof. Dr. Ron Lesthaeghe. Emily Grundy London School of Hygiene & Tropical Medicine, UK. Research supported by the ESRC (UK)& EU.

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Ageing Europe:21st century implications

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  1. Ageing Europe:21st century implications Demographic Challenges for the 21st Century: A State of the Art in Demography. Colloquium in honour of Prof. Dr. Ron Lesthaeghe Emily Grundy London School of Hygiene & Tropical Medicine, UK Research supported by the ESRC (UK)& EU.

  2. % 65+ selected countries, 2000 and 2020

  3. Long term fertility trends in England/ England & Wales Sources: E Wrigley & A Schofield The Population History of England 1981; ONS Series FM1 various years.

  4. Age at which further expectation of life equals 15 years by period, England & Wales, 1841-1991 Sources: Grundy E (1997) The health of older adults 1841-1994. In:J Charlton & M Murphy (eds). The Health of Adult Britain 1841-1994, Vol. II, The Stationery Office, updated with GAD Interim Life Tables 2002-4

  5. % of the population aged 65 and over, Japan, E&W, and the USA, 1900-2020 Source: Grundy E (2003) The epidemiology of aging in: Brocklehurst’s Textbook of Geriatric Medicine eds. R Tallis & H Fillit, Churchill Livingstone (from national and international series).

  6. Population ageing Non-worker to worker Ratio

  7. “No advanced country in modern times has ever experienced such a calamity, a contemporary version of a medieval plague” Population ageing Italy’s low birth rate: commentary by Will Hutton, The Observer, 26.9.2004

  8. Health & well-being in later life: macro and micro challenges and influences Policy concerns in ageing societies • Finance • Family support for older people • Fitness: Health and disability Gender Environment Policy

  9. Ratio persons 15-64 to persons 65+ (aged support or ‘dependency’ ratio)

  10. Ageing and the Second Demographic Transition • Very low fertility driving further population ageing (together with increased longevity • Family related behaviour and values impinge not just on relationships and decisions of men and women of reproductive age, but also on relationships between older parents and adult children and wider social and kin interactions • Cohort succession: older ‘low marriage’ cohorts now being replaced by interwar ‘marriage boom cohorts’; from 2020 will be succeeded by ‘lowest marriage’ 2nd demographic transition cohorts.

  11. Macro factors influencing family support for older people • Demographic factors • Economic factors • Policy factors • Cultural factors Family support State support Well-being of older people

  12. Family & social support • Assumed to be in decline because of demographic & socio-economic/cultural change • “A family and social revolution…the very basis of the family has changed. The family, in the past an institution and means of social integration, has become a pact between two individuals looking for personal fulfilment” European Commission 1995

  13. Parent support ratios in 4 world regions: 1950, 2000 & 2030(ratio of people aged 80 and over per 100 people aged 50-64) Source: Kinsella & Velkoff 2001

  14. Numbers and projected numbers of men and women aged 75 and over by marital and parenthood status, 2000-2030, all FELICIE countries combined. Source: Analysis of FELICIE data in Tomassini, Grundy et al 2007.

  15. Cohort Total Fertility Rate, selected European countries, birth cohorts 1905-1945 Source: FAMSUP data in Grundy Ageing & Society 2006.

  16. % women nulliparous (age 45) by birth cohort, selected countries Source: FAMSUP data in Grundy Ageing & Society 2006

  17. Proportion of women at selected ages with no living child Source: Murphy et al Eur J Pop 2006

  18. Proportion of men and women without children alive, age 75+, %: all FELICIE countries combined. Source: Analysis of FELICIE data in Tomassini, Grundy et al 2007.

  19. Distribution of the childless population aged 75 and over by gender and marital status, FELICIE countries, 2000-2030.(Belgium, Britain, Czech Rep, Finland, France, Germany, Italy, Neths, Portugal). Source: analysis of FELICIE data (Tomassini, Grundy and Kalogirou)

  20. Proportion (%) of elderly men and women living in households with two or more generations, England and Wales, 1971 and 2001(private household population). Men Women Source: Analysis of ONS LS data.

  21. Living arrangements of Europeans aged 60+ and 80+ by region. Source: Analysis of ESS 2002/4. North: DK, Fin, Norw, Swe; West: Aust, Belg, Ger, Neths, UK; East: CzR, Est, Hung, Pol, SlovK, Sloven, Ukr; South: Gre, Port, Esp.

  22. Odds of living with spouse and others v. spouse only, married people aged 60+, 18 European countries 2002-4. Men Women Controlling for age, education, income, feelings about income and health. Analysis of ESS (Young & Grundy 2007)

  23. Odds of living with others v. alone, unmarried people aged 60+, 18 European countries 2002-4. Men Women Controlling for age, education, income, feelings about income, and health. Analysis of ESS.

  24. % parents aged 80+ with daily contact with a child Source: SHARE 2004, Release 0

  25. Parents aged 60-75 receiving help from/ giving help to children, by tenure and number of children, GB 1994 Giving help to child/ren Receiving helpfrom child/ren Number of. children Source: Grundy E. (2005). Reciprocity in relationships... The British Journal of Sociology, 52,233-255 (analysis of ONS RS)

  26. Distribution of fathers by exchange relationship with child(ren), GB 1988/9 & 1994 Source: Grundy E. (2005). Reciprocity in relationships... The British Journal of Sociology, 52,233-255 (analysis of ONS RS)

  27. Kin availability intergenerational exchange • Nearly all people in Britain have either a living parent or a living child and many have both. The proportion lacking one or other of these relatives is highest among those aged 70 and over • Half of those with a mother/father/child/grandchild alive see them at least weekly • A third of grandmothers and a quarter of grandfathers see their eldest grandchild once a week • Most older parents receive help from adult children AND provide help to adult children; children provide more help when parents are in poor health; parents provide more help if they have higher incomes • Lower family contact and exchange for divorced fathers and more highly educated groups • Among late mid life adults with both a parent alive and at least one adult child helping parents is positively associated with helping a child. • No evidence of declines in support from adult children to parents 1986-1999.

  28. From children: Low education + Female gender + Few siblings + Parental disability + Mother a widow + Father divorced – Within Britain, living in South rather than North Reciprocity + From parents: Higher income + Home owner + Low disability + Being a divorced man – Children’s age and proximity Reciprocity Kin availability & family support Intergenerational support associated with:

  29. Future scenarios of proportion of older people with at least weekly contact with a child Italy and Finland 2000-2030. Source: Analysis of FELICIE data in Tomassini, Grundy et al Eur J Ageing 2004.

  30. Family, household and social support: implications • For use of services (and so costs of state mediated services) • For older people’s health and well-being.

  31. Usual source of help for people aged 65 and over unable to do various tasks unaided, Britain 2001 Lives alone Lives with other(s)

  32. % of women aged 65+ in 1991 in a communal establishment by 2001 and odds of transition to a communal establishment by parity. Odds ratios (95% CI) % changing from private household in 1991 to communal establishment by 2001 Source: Analysis of ONS Longitudinal Study data controlling for age, marital status, household type in 1991, health indicators and housing tenure.

  33. Odds of home death among people aged 50 and over dying 1991-95 by whether cancer/other cause of death and availability of a co-resident in 1991 (ref. group is living alone) Source: Grundy E et al. (2004) Living arrangements and place of death of older people with cancer in England and Wales: a record linkage study. British Journal of Cancer, 91, 907-912 (analysis of ONS LS data)

  34. Factors associated with indicators of poor health, England 1990s (age & smoking status controlled) Analysis of HSfE; Grundy & Sloggett 2003

  35. Possible effects of living alone: interactions with other domains Type of effect Negative Positive / neutral Psychological If living alone seen as stigmatising (? Lower educated in S Europe) Low income elderly loose opportunities for economies of scale (E Europe, Greece) No effect high income elderly Economic Services / care Elderly lacking domestic skills (‘traditional’ men); elderly with short interval care needs. No effect ‘competent’ elderly Social support If few other social ties (childless widowers/divorced men, especially Northern Europe; recent migrants; housebound) No effect on well-supported Source: Grundy 2002

  36. Associations between living arrangements and happiness (higher=better) by region; ref. group=living alone: results from analysis of ESS 2002-4. ***P<.001, *P<0.05 Controlling for age, education, income, feelings about income, social meetings, social activities, long term illness, availability of confidante, widowhood.

  37. What is associated with happiness in the older population of Europe? • Region: N(best)W S E (worst) • Comfortable income • Frequent social meetings and social activities • Availability of confidante • No long-term illness • Older age • Lower education Analysis of ESS, combined sample 18 countries fully adjusted ordinal logistic regression.

  38. Conclusions • Kin resources: proportions of older people with at least one child increasing (also proportion with a spouse), although will decrease post 2025 • Levels of intergenerational contact & support high- but large variations between countries, socio-economic groups, families and between men and women – demography an influence but not the major determinant • Family contacts, social support and living arrangements important influences on health, well-being and use of services.

  39. Aging in 21st century Europe: Prospects • Health of older people: indications of some declines in serious disability, but insufficient to offset growth in numbers of older old. • Kin availability: Short term prospects good, longer term less so. • Will families still care, ‘what are families for’ and what is the right balance between family, market and state? Largely unknown – growing evidence on what interventions work – less on how to implement them. Evidence based health promotion and social care should be a Europe wide priority. • Will ‘friends be the new family’? Evidence from US suggests not. • Will we be happier? Mental illnesses now the largest component of work disability; higher expectations may have a downside –expanding opportunities for some for self actualisation and the ‘post Second Demographic Transition’ lifestyle. • Growing diversity – and growing inequality? • Older people a major resource – guardians of family and social capital?

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