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[PDF] World Population Ageing 2020 Highlights - the United Nations

23 sept 2020 · How and with whom older people live is especially relevant for the SDGs related to ending poverty in all its forms everywhere (SDG 1), ensuring

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Population

Ageing

2020

Highlights

United Nations Department of Economic and Social Aairs, Population Division

?e Department of Economic and Social Aairs of the United Nations Secretariat is a vital interface between

global policies in the economic, social and environmental spheres and national action. e Department

works in three main interlinked areas: (i) it compiles, generates and analyses a wide range of economic,

social and environmental data and information on which States Members of the United Nations draw to

review common problems and take stock of policy options; (ii) it facilitates the negotiations of Member

States in many intergovernmental bodies on joint courses of action to address ongoing or emerging

global challenges; and (iii) it advises interested Governments on the ways and means of translating policy

frameworks developed in United Nations conferences and summits into programmes at the country level and, through technical assistance, helps build national capacities. e Population Division of the Department of Economic and Social Aairs provides the international

community with timely and accessible population data and analysis of population trends and development

outcomes for all countries and areas of the world. To this end, the Division undertakes regular studies of

population size and characteristics and of all three components of population change (fertility, mortality

and migration). Founded in 1946, the Population Division provides substantive support on population and

development issues to the United Nations General Assembly, the Economic and Social Council and the Commission on Population and Development. e Division leads or participates in various interagency

coordination mechanisms of the United Nations system. It also contributes to strengthening the capacity of

Member States to monitor population trends and to address current and emerging population issues.

Suggested citation

United Nations Department of Economic and Social Aairs, Population Division (2020). World Population Ageing 2020 Highlights: Living arrangements of older persons (ST/ESA/SER.A/451).

is report is available in electronic format on the Division"s website at: www.un.org/development/desa/pd/.

For further information about this report, please contact the Oce of the Director, Population Division,

Department of Economic and Social Aairs, United Nations, New York, 10017, USA, by Fax: 1 212 963 2147

or by email at: population@un.org.

Copyright information

Front cover: Benin, West Africa, Porto Novo, Older women in her living room" by Eric Laorgue, 2015

Back cover: Older couple with masks bracing COVID-19" by United Nations/Karoline Schmid, 2020

United Nations Publication

Sales No.: E.20.XIII.19

ISBN: 978-92-1-148347-5

eISBN: 978-92-1-005193-4

Copyright © United Nations, 2020.

e gures and tables in this publication can be reproduced without prior permission under a Creative Commons license (CC BY 3.0 IGO), available from http://creativecommons.org/licenses/by/3.0/igo/.

ST/ESA/SER.A/451

Department of Economic and Social Affairs

Population Division

World Population Ageing 2020 Highlights

Living arrangements of older persons

United Nations

New York, 2020

Acknowledgements

?is report was prepared by Yumiko Kamiya, Nicole Mun Sim Lai and Karoline Schmid. ?e authors wish to

thank John Wilmoth, Jorge Bravo, Bela Hovy and Stephen Kisambira for their inputs in reviewing the dra.

e assistance of Neena Koshy, Bintou Papoute Ouedraogo, and Donna Culpepper in editing and desktop publishing is acknowledged.

Executive summary ........................................................................ ................................1 Introduction ........................................................................

Living arrangements of older persons ....................................................................7

COVID-19 mortality among older persons ........................................................17 Policy implications and recommendations .......................................................25 References ........................................................................ Annex tables ........................................................................ Notes on regions, development groups, countries and areas

e designations employed in this publication and the material presented in it do not imply the expression

of any opinions whatsoever on the part of the Secretariat of the United Nations concerning the legal status

of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or

boundaries. e term country" as used in this report also refers, as appropriate, to territories or areas.

In this publication, data for countries and areas are oen aggregated in six continental regions: Africa,

Asia, Europe, Latin America and the Caribbean, Northern America, and Oceania. Further information on

continental regions is available from https://unstats.un.org/unsd/methodology/m49/. Countries and areas

have also been grouped into geographic regions based on the classication being used to track progress

towards the Sustainable Development Goals of the United Nations (see: https://unstats.un.org/sdgs/ indicators/regional-groups/).

e designation of more developed" and less developed", or developed" and developing", is intended for

statistical purposes and does not express a judgment about the stage in the development process reached

by a particular country or area. More developed regions comprise all countries and areas of Europe and

Northern America, plus Australia, New Zealand and Japan. Less developed regions comprise all countries

and areas of Africa, Asia (excluding Japan), Latin America and the Caribbean, and Oceania (excluding

Australia and New Zealand).

e group of least developed countries (LDCs) includes 47 countries, located in sub-Saharan Africa (32),

Northern Africa and Western Asia (2), Central and Southern Asia (4), Eastern and South-Eastern Asia (4),

Latin America and the Caribbean (1), and Oceania (4). Further information is available at http://unohrlls.

org/about-ldcs/. e group of Landlocked Developing Countries (LLDCs) includes 32 countries or territories, located in

sub-Saharan Africa (16), Northern Africa and Western Asia (2), Central and Southern Asia (8), Eastern

and South-Eastern Asia (2), Latin America and the Caribbean (2), and Europe and Northern America (2).

Further information is available at http://unohrlls.org/about-lldcs/.

e group of Small Island Developing States (SIDS) includes 58 countries or territories, located in the

Caribbean (29), the Pacic (20), and the Atlantic, Indian Ocean, Mediterranean and South China Sea (AIMS) (9). Further information is available at http://unohrlls.org/about-sids/.

e classication of countries and areas by income level is based on gross national income (GNI) per capita

as reported by the World Bank (June 2018). ese income groups are not available for all countries and areas

Further information is available at:

World Population Ageing 2020 Highlights

United Nations Department of Economic and Social A?airs, Population Division

Executive summary

?e world continues to experience an unprecedented and sustained change in the age structure of the global

population, driven by increasing levels of life expectancy and decreasing levels of fertility. People are living

longer lives, and both the share and the number of older persons in the total population are growing rapidly.

Globally, there were 727 million persons aged 65years or over in 2020. Since women live longer than men,

on average, they comprise the majority of older persons, especially at advanced ages. Over the next three

decades, the number of older persons worldwide is projected to more than double, reaching over 1.5 billion

in 2050. All regions will see an increase in the size of the older population between 2020 and 2050. Globally,

the share of the population aged 65 years or over is expected to increase from 9.3per cent in 2020 to around

16.0 per cent in 2050.

Population ageing is occurring alongside broader social and economic changes taking place throughout

the world. Declines in fertility, changes in patterns of marriage, cohabitation and divorce, increased levels

of education among younger generations, and continued rural-to-urban and international migration, in

tandem with rapid economic development, are reshaping the context in which older persons live, including

the size and composition of their households and their living arrangements. In Western European countries

and the United States of America, intergenerational co-residence has declined dramatically, and most older

persons now live either in single-person households or in households consisting of a couple only or a couple

and their unmarried children. Despite the persistence of traditional family structures and cultural norms

that favour multi-generational households, many countries of the less developed regions are experiencing

a slow shi in family and household composition towards smaller families and household types. Family

structures and household living arrangements can change quickly in response to major events or crises

aecting family members and kin relations. For example, multi-generation households re-appeared in the

United States of America and in some European countries in response to the economic crisis of 2008, while

skip-generation families have become more common in sub-Saharan Africa as a means of caring for millions

of children orphaned by the HIV/AIDS pandemic since the 1980s. roughout the world older women are more likely than older men to live alone. Older women are also

more likely to live in skip-generation households or in extended-family households, whereas older men are

more likely to live with a spouse only. Further, older men are more likely than older women to live with

children under age 20, while older women are slightly more likely than older men to live with older children.

ese dierences are explained to a large extent by the typical age dierence between spouses and by the

reproductive life spans of women and men. Since husbands are typically older than their wives, and since

there is no male equivalent of menopause, men are more likely than women to co-reside with children under

age 20 when they reach older ages.

Co-residence with adult children is a common mechanism of support for parents at older ages, which may

be triggered by a decline in their physical or mental health and an increased need for personal care. In other

cases, co-residence is a way for parents to support adult children who never le the parental home or have

returned to cope with economic hardship or adverse life events. Yet another situation is an older person who

moves into the household of an adult child to help care for grandchildren. e living arrangements of older people are an important determinant of their economic well-being as

well as their physical and psychosocial health and life satisfaction. Research has also found an association

between mortality risks at older ages and an individual"s living arrangements. Older persons living alone or

in institutions, for example, have higher overall mortality risks than those living with a spouse or other family

members. e living arrangements of older persons can also have important macroeconomic implications by shaping the demand for housing, social services, energy, water and other resources.

2World Population Ageing 2020 Highlights

United Nations Department of Economic and Social A?airs, Population Division Since early 2020, the world has been impacted by the rapid spread of COVID-19, which continues to

expand globally. By the end of September 2020, over 33 million cases had been reported worldwide, with

nearly 850,000 deaths attributed to the disease. Since COVID-19 is a new disease in humans, and since the

pandemic is ongoing, available studies of its impact on older persons remain inconclusive. Nevertheless,

a preliminary analysis of COVID-19 mortality rates at older ages has uncovered considerable variation

across countries and points toward factors that may explain the observed dierences. Among the factors

aecting mortality from COVID-19 at older ages, the main determinant is the extent to which countries

have been able to control the spread of the virus and mitigate the pandemic. In addition, frailty is a key factor

since the risk of death from COVID-19 increases with both age and the presence of co-morbidities such as

cardiovascular, pulmonary or kidney disease, as well as cancer and obesity. Living arrangements explain

part of the observed international dierences in age patterns of COVID-19 mortality, in particular for older

persons whose living arrangements aect the risk of contracting COVID-19.

In this context, the living arrangements and mechanisms of family support for older persons have become

increasingly important for policymakers, especially in countries at advanced stages of population ageing.

Understanding the interconnections between the living arrangements of older persons and their health and

well-being has particular relevance in light of the pledge made by Governments in the 2030 Agenda for

Sustainable Development

1 that no one will be le behind. In practice, this pledge implies that the Sustainable

Development Goals (SDGs) must be achieved for all segments of society and at all ages, with a particular

focus on the most vulnerable, including older persons.

How and with whom older people reside has important implications for the Goals related to ending poverty

in all its forms everywhere (SDG 1), ensuring healthy lives and promoting well-being for all at all ages

(SDG 3), and achieving gender equality and empowering all women and girls (SDG 5). Mitigating the

impact of COVID-19 on the older population will require continued eorts by the international community

to curb the spread of the virus and to put in place measures to protect the most vulnerable segments of the

population in particular, older persons with pre-existing conditions or who reside in institutions from

exposure to the disease. 1

A/RES/70/1

World Population Ageing 2020 Highlights

United Nations Department of Economic and Social A?airs, Population Division

Introduction

?e world continues to experience a sustained change in the age structure of the population, driven by

increasing life expectancy and decreasing levels of fertility. People are living longer lives, and both the share

and the number of older people in the total population are increasing rapidly. Globally, there were 727

million persons aged 65years or over in the world in 2020. Over the next three decades, the global number

of older persons is projected to more than double, reaching over 1.5 billion in 2050. All regions will see an

increase in the size of their older population between 2020 and 2050. e share of the global population aged

65 years or over is expected to increase from 9.3per cent in 2020 to 16.0 per cent by 2050 (United Nations,

2019a).

Population ageing is occurring along with broader social and economic changes that are taking place around

the world. Declines in fertility, changes in patterns of marriage, cohabitation and divorce, increased levels

of education among younger generations, and continued rural-to-urban and international migration, in

tandem with rapid economic development, are reshaping the context in which older persons live, including

the size and composition of their households and their living arrangements. In countries that have historical

data, including Western European countries and the United States of America, intergenerational co-

residence has declined dramatically, and most older persons now live either in single-person households or

in households consisting of a couple only or a couple and their unmarried children (Ruggles, 2007). A widely

held view among researchers is that the size of families decreases as a society industrializes and urbanizes

(Bongaarts and Zimmer, 2002), and available data indicate that many countries in the less developed regions

are experiencing a slow shi in family and household composition away from multi-generational households

and towards smaller families and household types (Ruggles, 2007). However, persistent dierences in the

living arrangements of older persons across countries of the less developed regions seem to reect the

continuing inuence of traditional family structures and cultural norms in the context of demographic,

economic and social change (Knodel and others, 2000; Ruggles and Heggeness, 2008).

Living arrangements of older people are an important determinant of their well-being. In many countries,

the living arrangements of older persons are associated with their economic well-being as well as with their

physical and psychosocial health and life satisfaction (Ong and others, 2016; Zimmer and Das, 2014; Smith

and others, 2018). Research has also found dierences in mortality associated with an individual"s living

arrangements. Older persons living alone or in institutions, for example, have higher overall mortality risks

than those living with their spouse or family (Feng and others, 2016). e living arrangements of older

persons can also have important macroeconomic implications by shaping the demand for housing, social

services, energy, water and other resources (Bradbury and others, 2014; Kowsari and Zerri, 2011; United

Nations, 2005).

e living arrangements and family support for older persons, therefore, have become an increasingly

important policy concern especially in countries at advanced stages of population ageing. Understanding

the interconnections between the living arrangements of older persons, their socioeconomic status and

their health and well-being are particularly relevant to the pledge in the 2030 Agenda for Sustainable

Development that the Sustainable Development Goals (SDGs) will be met for all segments of society and at

all ages, with a particular focus on the most vulnerable, including older persons. How and with whom older

people live is especially relevant for the SDGs related to ending poverty in all its forms everywhere (SDG 1),

ensuring healthy lives and promoting well-being for all at all ages (SDG 3), and achieving gender equality

and empowering all women and girls (SDG 5).

4World Population Ageing 2020 Highlights

United Nations Department of Economic and Social A?airs, Population Division ?e United Nations Database on the Households and Living Arrangements of Older Persons 2019, 2 hereaer

referred to as the database", is the only dataset that provides harmonized and comparable data on patterns

and trends in the household size and composition and the living arrangements of older persons at the global

level, across regions and countries, and over time. 3 Box 1 provides an overview of the data sources used to populate the database. Box 1. Data sources on the living arrangement of older persons ?e United Nations Database on the Households and Living Arrangements of Older Persons 2019 presents a global compilation of indicators to describe the household composition and living arrangements of persons aged 60 years or over. e database builds on work carried out by the United Nations more than a decade ago (United Nations, 2005). is work was updated and expanded in 2017 and 2018 (United

Nations 2017a, 2017b, forthcoming 2020).

4 e primary data sources used to populate the database were censuses and household surveys. Input data

from these sources had two distinct forms: tabulated data as well as microdata at the household level.

Microdata were obtained from the international collection of census data included in the Integrated Public

Use Microdata Samples (IPUMS-International) and from collections of internationally comparable survey data, including the Demographic and Health Surveys (DHS) and the European Union Labour Force Surveys (EU LFS). Tabulated data were obtained from the United Nations Demographic Yearbook.

Because most of these data sources rely on information collected at the household level, older persons

residing in institutions, such as nursing homes, prisons, religious facilities or dormitories, are not

included. erefore, most of the data presented here on living arrangements refer only to older persons

who live in households. In most countries, the institutional population at ages 60 and above is less than

5 per cent of the total.

e complete database draws on 738 unique data sources with reference dates ranging from 1960 to

2018, covering 155 countries or areas that represent more than 97 per cent of persons aged 60 or over

globally. For this report, however, the analysis was restricted to data with reference dates ranging from

2006 to 2015, covering 123 countries with approximately 70 per cent of older persons globally. e

reason for limiting the analysis to the decade between 2006 and 2015 is that the database includes at least

one recent observation for most countries and areas during this reference period.

Since early 2020, the world has been impacted by the rapid spread of the coronavirus that causes COVID-19,

which continues to expand globally. By the end of September 2020, over 33 million conrmed cases had been

reported, with nearly one million deaths attributed to the disease worldwide. Governments have adopted

a variety of policies to curb the spread of the virus and to cope with the socioeconomic impacts of the

pandemic, with varying degrees of success. e available data show that older persons in general are much

more susceptible to the disease and have higher mortality rates than younger age groups. 2 3

Apart from country-specic data published by national statistical oces, estimates of household size, composition and living arrangements are

published by the Organization for Economic Cooperation and Development (OECD) (www.oecd.org/els/family/database.htm) and the European

Commission (http://ec.europa.eu/eurostat/data/database). 4

e 2017 and 2018 versions of the database are no longer publicly available, replaced by the 2019 version used to prepare the present report.

World Population Ageing 2020 Highlights

United Nations Department of Economic and Social A?airs, Population Division

Since COVID-19 is a new disease in humans, and since the pandemic is ongoing, available studies of its

impact on older persons remain inconclusive. is report describes large dierences across countries in

COVID-19 mortality rates among older persons and seeks to identify factors that may explain the observed

dierences. A principal factor aecting mortality from COVID-19 among older persons is the extent to

which countries have been able to control the spread of the virus and mitigate the epidemic. In addition,

individual frailty is a key risk factor: the risk of dying from COVID-19 is positively associated both with

increasing age and with the presence of co-morbidities such as cardiovascular, pulmonary or kidney disease,

as well as cancer and obesity. Living arrangements explain part of the observed dierences in age patterns

of COVID-19 mortality, in particular the elevated levels of mortality among older persons, since their living

arrangements aect the risk of contracting COVID-19.

is report examines the living arrangements of older persons and reviews linkages with their well-being,

including their socioeconomic status and their health, in the context of the 2030 Agenda for Sustainable

Development. Aer the introduction, the rst chapter provides an overview of the living arrangements of

older men and women across countries and regions. e second chapter reports some provisional ndings

about COVID-19 mortality risks at older ages and about the factors that underlie such risks, including the

living arrangements of older persons. Lastly, the report provides recommendations for policy makers on

key challenges related to the living arrangements of older persons and their health and socioeconomic well-

being. e report also includes description of the data, denitions and measures used to characterize the

living arrangements of older persons, as well as the data used for the analysis of morbidity and mortality

from COVID-19 among older persons. Taking care of each other", by United Nations/Nicole Mun Sim Lai, 2020 7

World Population Ageing 2020 Highlights

United Nations Department of Economic and Social A?airs, Population Division

Living arrangements of older persons

?e living arrangements of older persons are the result of individual preferences and constraints (Reher

and Requena, 2018). For most older persons, the preferred living arrangements may dier from their actual

living arrangements because of health constraints and limited functional ability, nancial aordability

(income and wealth), kin availability (including the presence of spouse and/or the number of children),

housing costs and location (rural or urban). Preferences for living arrangements are also inuenced by the

prevailing cultural norms and traditions. Within Europe, older persons are more likely to live alone or with

a spouse in the individualistic" societies of Northern and Western Europe, while they are more likely to co-

reside with children in the so-called familistic" societies of Southern Europe (Reher and Requena, 2018). In

addition, the provision of social welfare programmes, such as public pensions, universal health care, public

housing programmes and social care services, inuence choices about the living arrangements of older

persons, especially in later stages of their life (Daly, 2010). e availability of such welfare programmes is

usually associated with a higher level of economic development. erefore, it is not surprising that economic

development is positively associated with older persons living alone or with a spouse only and negatively

associated with older persons living with children or with extended family. 5

In more developed countries, people tend to marry later, have fewer children and have them later in life. In

addition, a larger proportion of women than men are formerly married (separated, divorced or widowed),

which has implications for their living arrangements later in life. Social programmes in these countries

typically oer nancial assistance or health-care benets to retired adults, making it more aordable for older

quotesdbs_dbs17.pdfusesText_23

[PDF] [PDF] World Population Ageing 2020 Highlights - the United Nations

Population

Ageing

Highlights

Suggested citation

Copyright information

United Nations Publication

Sales No.: E.20.XIII.19

ISBN: 978-92-1-148347-5

Copyright © United Nations, 2020.

ST/ESA/SER.A/451

Department of Economic and Social Affairs

Population Division

World Population Ageing 2020 Highlights

Living arrangements of older persons

United Nations

New York, 2020

Acknowledgements

Contents

Australia and New Zealand).

Further information is available at:

World Population Ageing 2020 Highlights

Executive summary

16.0 per cent in 2050.

2World Population Ageing 2020 Highlights

Sustainable Development

A/RES/70/1

World Population Ageing 2020 Highlights

Introduction

65 years or over is expected to increase from 9.3per cent in 2020 to 16.0 per cent by 2050 (United Nations,

2019a).

Nations, 2005).

4World Population Ageing 2020 Highlights

Nations 2017a, 2017b, forthcoming 2020).

5 per cent of the total.

2018, covering 155 countries or areas that represent more than 97 per cent of persons aged 60 or over

2006 to 2015, covering 123 countries with approximately 70 per cent of older persons globally. e

World Population Ageing 2020 Highlights

World Population Ageing 2020 Highlights

Living arrangements of older persons