The burden of dependency The burden of dependency
perspective perspective
To the extent that the ... economic contexts To the extent that the ... economic contexts will be clarified and generally understood, will be clarified and generally understood, this displeasure with the all too many old this displeasure with the all too many old people will seek for justification in a
people will seek for justification in a
reproach which will not be able to reject:
reproach which will not be able to reject:
this heavily weighing generation of this heavily weighing generation of
geriatrics has been a burdening generation geriatrics has been a burdening generation already in its vital days.
already in its vital days.
(Myrdal & Myrdal 1935, 127
(Myrdal & Myrdal 1935, 127--127;127;The The Population Crisis, free translation Population Crisis, free translation))
Demographic bomb? (SE) Demographic bomb? (SE)
YEAR 1900
YEAR 2050 15−64 years
65+ years
Tornstam
Percentage of pensioners 65+ of the Percentage of pensioners 65+ of the
population population
Prognosis of the development of Prognosis of the development of
pensioners
pensioners (% of total population) (% of total population)
Percentage 65+, 1750
Percentage 65+, 1750−2050 −2050
The Swedish population 1750
The Swedish population 1750--2050 2050
Age Groups 0
Age Groups 0--1414, , 1515--6464, , 65+65+
Year Sum 100 percent
1750 1800 1850 1900 1950 2000 2050
0 20 40 60 80 100
Source: Swedish Official Statistics 2007. Data prognosis for 2007-2050
The Swedish Age Composition
15-64 years
65+ years
0-14 years
60%
60%
Graphics Lars Tornstam
Demographic dependency ratio Demographic dependency ratio
Total population / Population
Total population / Population 2020−64−64 (SCB 2003)(SCB 2003)
Dependency ratio for the work force Dependency ratio for the work force
Total population / Population in the work force (SCB 2003) Total population / Population in the work force (SCB 2003)
“Will there be a helping hand?”
“Will there be a helping hand?”
Swedish Long
Swedish Long--term study 1999/2000term study 1999/2000 POLICYRECOMMENDATIONS
POLICYRECOMMENDATIONS
Increased childbirthIncreased childbirth
Increased participation in the work force Increased participation in the work force among immigrants
among immigrants
Introduction of ”Elderly care contracts”Introduction of ”Elderly care contracts”
Influx of foreign Influx of foreign labourlabour
Decrease of early exit from the Decrease of early exit from the labourlabour market
market
Ideal types of social structures Ideal types of social structures
(Riley & Riley 1994) (Riley & Riley 1994) AGE
AGE AGEAGE AGEAGE
DIFFERENTIATION
DIFFERENTIATION INTEGRATIONINTEGRATION
Old Old
Middle Middle--
Aged Aged
Young Young
WORK LEISURE
EDUCATION
E D U C A T I O N
W O R K
L E I S U R E
Imagined and experienced problems Imagined and experienced problems among elderly (%)
among elderly (%)
(Finns 60+, Old Age Barometer 1998)(Finns 60+, Old Age Barometer 1998) 1) Illness and functional incapacity1) Illness and functional incapacity 2) Social difficulties2) Social difficulties 3) Economical difficulties
3) Economical difficulties 4) Violence and criminality4) Violence and criminality 5) Shortage of social services
5) Shortage of social services 6) Shortage of health services6) Shortage of health services 7) Too much youth idealization
7) Too much youth idealization 8) Shortage of activities8) Shortage of activities 9) Something else
9) Something else
0 10 20 30 40 50 60 70 80 90
1 2 3 4 5 6 7 8 9
Old people generally One self
Conflicts or solidarity between Conflicts or solidarity between
generations?
generations?
”Young people get it harder ”Young people get it harder – – older people better and better”
older people better and better”
((Metro 2005 Metro 2005))
Integration at the micro level will Integration at the micro level will prevent conflicts at the macro prevent conflicts at the macro level
level
Uppsala Newspaper
Uppsala Newspaper
(UNT May 19th, 2005)(UNT May 19th, 2005)“Brisk elderly make the
“Brisk elderly make the housing shortage
housing shortage worse”
worse”
((Pigga äldre förvärrar Pigga äldre förvärrar bostadsbristen
bostadsbristen))
Ageing of the population Ageing of the population
Reflecting long term decrease in both Reflecting long term decrease in both fertility and mortality
fertility and mortality
More people live into old ageMore people live into old age
How ageing of the population changes How ageing of the population changes social relations
social relations
Changes during the 20th century of both the Changes during the 20th century of both the experience of ageing and the meaning of experience of ageing and the meaning of ageing
ageing
Changes in the life course and the relations Changes in the life course and the relations between generations
between generations
Cultural and lifeCultural and life--style changes of old agestyle changes of old age
Ageing and family life Ageing and family life
Increase of households with one and two Increase of households with one and two persons
persons
The ”verticalisation” of the familyThe ”verticalisation” of the family
More grandparents More grandparents –– less grandchildrenless grandchildren
Relations based on increased equality Relations based on increased equality (emotional bonds, free choices instead of (emotional bonds, free choices instead of tradition and obligations)
tradition and obligations)
Decreased feminization of old ageDecreased feminization of old age
Ageing and family life Ageing and family life
Postponing of timing and ”ageing” of family Postponing of timing and ”ageing” of family transitions
transitions
Increased time in marriageIncreased time in marriage
Increase of men in elderly care institutionsIncrease of men in elderly care institutions
Increase of divorced older peopleIncrease of divorced older people
Affects potentials for informal careAffects potentials for informal care
Divorced men have smaller social networks Divorced men have smaller social networks than widowed men and higher mortality than widowed men and higher mortality
Increase of new forms of intimacy Increase of new forms of intimacy
Percentage divorced people 60+
in Sweden 1970–2004
(SCB, Öberg) AGEAGE 19701970 19901990 20042004 60
60––69 years69 years 4,44,4
(39.034) (39.034)
11,2 11,2
(97.136) (97.136)
19,2 19,2
(181.643) (181.643)
70
70––79 years79 years 3,33,3
(17.190) (17.190)
7,3 7,3
(52.254) (52.254)
13,1 13,1
(86.922) (86.922)
80+
80+ 2,72,7
(5.099) (5.099)
4,6 4,6
(16.901) (16.901)
7,7 7,7
(37.052) (37.052)
Changes in Marital Status over Time for Men Changes in Marital Status over Time for Men
65+ in England and Wales, 2001
65+ in England and Wales, 2001−−2021 (%)2021 (%)
(Davidson 2006) (Davidson 2006)
MEN 65+
MEN 65+
20012001 20212021 Change Change2001
2001−2021−2021 Married
Married 7171 6666 − 5 %− 5 % Widowed
Widowed 1717 1313 − 4 %− 4 % Divorced
Divorced 55 1313 + 8 %+ 8 % Never
Never Married
Married 77 88 + 1 %+ 1 % 100%
100% 100%100%
Changes in Marital Status over Time for Changes in Marital Status over Time for
Women 65+ in England and Wales, Women 65+ in England and Wales,
2001
2001−−20212021 (Davidson 2006)(Davidson 2006)
WOMEN 65+
WOMEN 65+
20012001 20212021 Change Change2001
2001−2021−2021 Married
Married 4040 4545 + 5 %+ 5 % Widowed
Widowed 4848 3535 − 13 %− 13 % Divorced
Divorced 66 1414 + 8 %+ 8 % Never
Never Married
Married 66 55 −− 1 %1 % 100%
100% 100%100%
Theory of the Third Age Theory of the Third Age
(Peter Laslett) (Peter Laslett) 1)
1) FIRST AGEFIRST AGE
Dependency, socialisation, immaturity, Dependency, socialisation, immaturity, education
education 2)
2) SECOND AGESECOND AGE
Independency, maturity and responsibility, Independency, maturity and responsibility, earnings and savings
earnings and savings 3)
3) THIRD AGETHIRD AGE
Personal selfPersonal self--fulfilment, “crown of life”fulfilment, “crown of life”
4)
4) FOURTH AGEFOURTH AGE
WILL OLD AGE BE HEALTHIER?
WILL OLD AGE BE HEALTHIER?
1) Compression of morbidity1) Compression of morbidity
““Healthy life expectancy” increase more than life Healthy life expectancy” increase more than life expectancy
expectancy
2) Extension of morbidity2) Extension of morbidity
“Healthy life expectancy” constant “Healthy life expectancy” constant –– increase of increase of ill years of life
ill years of life
Medical paradox: the more people saved to life Medical paradox: the more people saved to life –– the more health care problems (“Survival of the the more health care problems (“Survival of the un
unfittest”)fittest”)
WILL OLD AGE BE HEALTHIER?
WILL OLD AGE BE HEALTHIER?
3) Postponement of morbidity3) Postponement of morbidity
Increase in life expectancy corresponding to increase in Increase in life expectancy corresponding to increase in
“healthy life expectancy”
“healthy life expectancy”
Decrease in mortality corresponding to decrease in Decrease in mortality corresponding to decrease in morbidity
morbidity
Support from studies in Norway, Sweden and FinlandSupport from studies in Norway, Sweden and Finland
Both ADL and IADL has improved for all age groups 65+ Both ADL and IADL has improved for all age groups 65+
in Sweden 1988/89
in Sweden 1988/89--2002/032002/03
“Heroic medicine” not only saves lives “Heroic medicine” not only saves lives –– but also reduces but also reduces the effects of the chronic disease on illness and
the effects of the chronic disease on illness and functional capacity
functional capacity
The important issue for health care costs is not how The important issue for health care costs is not how old one is
old one is –– but how many years of life one has but how many years of life one has ahead
ahead
Prognosis for the number of 80+
Prognosis for the number of 80+
people in Sweden 2010 people in Sweden 2010
((National Statistics of SwedenNational Statistics of Sweden)) Year of
Year of Prognosis Prognosis
Number of Number of people 80+
people 80+
2010 2010 1978
1978 340.000 340.000 1986
1986 430.000 430.000 1997
1997 500.000 500.000
Percentage of 75
Percentage of 75--84 year old men and 84 year old men and women with ”bad” or ”very bad” health women with ”bad” or ”very bad” health
experience (1980
experience (1980−−2003)2003)
Women Men
%
Percentage with IADL
Percentage with IADL--impairment among impairment among Swedish Women 65+ (1988/89
Swedish Women 65+ (1988/89--2002/03)2002/03)
(cleaning, cooking, buying food, laundry) (cleaning, cooking, buying food, laundry)
0 10 20 30 40 50 60 70 80 90 100
65- 69
70- 74
75- 79
80- 84
85- 89
90- 65+
1988/1989 2002/2003
Percentage with IADL
Percentage with IADL--impairment among impairment among Swedish Men 65+ (1988/89
Swedish Men 65+ (1988/89--2002/03)2002/03)
(cleaning, cooking, buying food, laundry) (cleaning, cooking, buying food, laundry)
0 10 20 30 40 50 60 70 80 90 100
65- 69
70- 74
75- 79
80- 84
85- 89
90- 65+
1988/1989 2002/2003
Percentage with higher education (>3 years) among 60-74 year old Swedes 1985–2004
(SCB, Öberg)AGE
AGE 19851985 19951995 20042004 60
60––64 years64 years MenMen Women Women
5 5 3 3
8 8 7 7
13 13 14 14 65
65––69 years69 years MenMen Women Women
5 5 2 2
7 7 5 5
10 10 10 10 70
70––74 years74 years MenMen Women Women
4 4 2 2
6 6 3 3
9 9 8 8
Percentage of Finnish households having a Percentage of Finnish households having a
car
car according to the age of the reference according to the age of the reference person
person 19851985--2001/20022001/2002
(Reference person: the highest income in the household) (Reference person: the highest income in the household)
10 20 30 40 50 60 70 80 90
%
1985 2001-2
Toothless 70 year old people Toothless 70 year old people
(H70; Sweden) (H70; Sweden) Year
Year Percentage Percentage
1971
1971 52 % 52 % 1976
1976 38 % 38 % 1992
1992 17 % 17 % 2001
2001 8 % 8 %
Smoking among 70 year old Smoking among 70 year old Swedish men and women (%) Swedish men and women (%)
Year
Year Men Men
%
%
Women Women
%
% 1971
1971 50 50 12 12 1981
1981 35 35 15 15 1992
1992 22 22 19 19
“I consider myself a youthful
“I consider myself a youthful person” (%)
person” (%)
(Öberg & Tornstam 2003)(Öberg & Tornstam 2003)0 20 40 60 80 100
20- 24
25- 34
35- 44
45- 54
55- 64
65- 74
75- 85 Age
% Men
Women
“It is important for me to be sexually
“It is important for me to be sexually active”
active” (Percentage in different ages who agree) (Percentage in different ages who agree)
(Öberg & Tornstam 2003) (Öberg & Tornstam 2003)
0 10 20 30 40 50 60 70 80 90
%
20- 25- 35- 45- 55- 65- 75-
Men Women
Image of Elderly i Nordic Countries Image of Elderly i Nordic Countries
(Eurobarometer) (Eurobarometer)
Have a good economy Have a good economy
Are active and participate in Are active and participate in society
society
Typical “Old age home” is the Typical “Old age home” is the own apartment or house
own apartment or house
Are treated with respect Are treated with respect
Are not particularly religious Are not particularly religious
Norwegian study on life course, Norwegian study on life course,
ageing and generations ageing and generations
1)
1) Will tomorrow’s elderly have other Will tomorrow’s elderly have other preferences, opinions or values than preferences, opinions or values than elderly today?
elderly today?
2)
2) Will changes in family structure affect Will changes in family structure affect the potential for informal care and the potential for informal care and support?
support?
5.600 individuals in 30 municipalities5.600 individuals in 30 municipalities
4040--79 years old79 years old
Tomorrow’s elderly
Tomorrow’s elderly (NO) (NO)
Elderly care users will be less modest, Elderly care users will be less modest, more demanding, and expect more more demanding, and expect more autonomy
autonomy
Have more individualistic values Have more individualistic values
personal achievement, pleasure, new experiencespersonal achievement, pleasure, new experiences
More consuming instead of saving for childrenMore consuming instead of saving for children
Less likely to hold traditional valuesLess likely to hold traditional values
conformity and modestyconformity and modesty
Fourth age decrease possibilities for Fourth age decrease possibilities for individualistic values
individualistic values
Tomorrow’s elderly
Tomorrow’s elderly (NO) (NO)
More divorced elderly parents may receive More divorced elderly parents may receive less care from their children
less care from their children
Less children, more childless couples, more Less children, more childless couples, more living alone, more co
living alone, more co--habitationhabitation
New gender rolesNew gender roles
“Modern” elderly men partake more in “Modern” elderly men partake more in household and care work (may lessen the household and care work (may lessen the demand on social service)
demand on social service)
Differences in health behaviour between Differences in health behaviour between men and women declining
men and women declining
