Aging Policy Analysis and Evaluation
Aging policy analysis and evaluation is a dynamic careful, systematic, and empirical study, administering under changing social, political, and economic situations, which allows examining how the physical, the mental, and social condition of aged people changes and how public policies ought to evolve to meet the changing needs of a changing world (Anderson 2006; Dunn 2012). Aging policy analysis and evaluation play a crucial role in assisting in defining and outlining the goals of a proposed aging policy and in figuring out the gap between expected outcomes and predicted costs with competing for alternative policies (Kraft and Furlong 2012).
Aging policy analysis and evaluation is not a new and contemporary pressing issue; instead, it is a debating issue since the early nineteenth century, and perhaps it was first systematically analyzed by Tropman and McClure (1978). Throughout the world, population aging raises numerous policy issues about which gerontological researchers, policy experts, and practitioners have much to contribute because large numbers of older persons face challenges such as discrimination, poverty, and abuse that severely restrict their human rights and their contribution to society. Aging of the population was one of the most dramatic developments of the twentieth century and is already a key challenge of the twenty-first century (Doron and Mewhinney 2007, 11). The global trend of population aging is increasing more than twice, for instance, older people of 60 years or over numbered 962 million in 2017, which were 382 million in 1980. The number of older persons is expected to double again by 2050 when it is projected to reach nearly 2.1 billion. Globally, the number of persons aged 80 years or over is projected to increase more than threefold between 2017 and 2050, rising from 137 million to 425 million. The remarkable finding is two-thirds of the world’s older people live in the developing countries, where their numbers are growing faster than in the developed nations. In 2050, it is expected that nearly 8 in 10 of the world’s older persons will be living in the developing regions (UN 2017, 1).
Therefore, this is a very alarming and concerning global discourse especially for the developing world which needs much attention and research to overcome the challenges related to aged people. With this aim, since World War II, many national and International bodies including the United Nations (UN) have concentrated additional attention on global aging. Over the past few decades, several documents regarding the rights and status of the aged people are prepared globally. These efforts have an extensive impact on policymaking relevant to older people throughout the world. In this entry, some significant policies and documents have been mentioned, analyzed, and evaluated to examine the current status of aged people and their wellbeing.
International Documents on Aging Policy
In this section, the significant international policies, declarations, and documents related to the aging population has been listed but not discussed as space is limited for this entry. Israel Doron and Kate Mewhinney (2007, 25–444) in their book on “The Rights of Older Persons: Collection of International Documents” have analyzed significant policies and documents related to population aging till 2007. Some are mentioned here:
Draft Resolution on a Declaration of Old Age Rights, 1948; World Population Plan of Action, 1974; Resolution 36(20) of the General Assembly on the Question of the Elderly and the Aged, 1981; Resolution 37(51) of the General Assembly on the Question of Ageing, 1982; Vienna International Plan of Action on Ageing, 1983; General Assembly Resolution 45(106) on the Implementation of the International Plan of Action on Ageing and Related Activities, 1990; General Assembly Resolution 46(91) on the Implementation of the International Plan of Action on Ageing and Related Activities, 1991; General Assembly Resolution 47(86) on the Implementation of the International Plan of Action on Ageing: Integration of Older Persons in Development, 1992; General Assembly Resolution 48(98) on the Implementation of the International Plan of Action on Ageing, 1993; General Assembly Resolution 49 (162) on the Integration of Older Women in Development, 1994; General Assembly Resolution 50 (141) on the International Year of Older Persons: Towards a Society for All Ages, 1995; The Economic, Social and Cultural Rights of Older Persons (General Comment 6), 1995; International Federation on Aging (IFA) Declaration of Rights and Responsibilities of older persons 1990; International Federation on Aging (IFA) Montreal Declaration, 1999; American Declaration of the Rights and Duties of Man, 1948; American Convention on Human Rights “Pact of San Jose, Costa Rica, 1969; Additional Protocol to The American Convention on Human Rights in the Area of Economic, Social and Cultural Rights “Protocol of San Salvador, 1988; Resolution Adopted by the General Assembly 60/135. Follow-up to the Second World Assembly on Ageing, 2006; United Nations General Assembly 19 July 2006. Follow-up to the Second World Assembly on Ageing Report of the Secretary-General; Launch of the African Union Policy Framework and Plan of Action on Ageing December 2003, Addis Ababa, Ethiopia; Latin American and Caribbean Meeting of Leaders of Organisations of Older People, 2001 (Declaration of Lima); Declaration of the Pan American Symposium on Ageing and Health: Innovative Approaches to Health and Social Services for the Elderly, 2001; Towards a Regional Strategy for the Implementation in Latin America and the Caribbean of the Madrid International Plan of Action on Ageing, Santiago, Chile, 19–21 November 2003; Bali Declaration on Population and Sustainable Development, 1992; Macau Declaration on Ageing for Asia and the Pacific, 1998; Declaration on the Rights of Elderly – An Islamic Perspective 1999; European Interim Agreement on Social Security Schemes relating to Old Age, Invalidity and Survivors, 1953; European Social Charter, 1961; European Convention on Social Security, 1972; Council of Europe Recommendation 1254 (94) of the Parliamentary Assembly on the Medical and Welfare Rights of the Elderly: Ethics and Policies, 1994; Council of Europe Recommendation No. R (94) 9 of the Committee of Ministers to Member States Concerning Elderly People, 1994; Towards a Europe for All Ages, 1999; European Conference on Independent Living of Older Persons and Persons with Disabilities, 1999; Council of Europe Policy Declaration on Ageing in the twenty-first century, 1999; Charter of Fundamental Rights of the European Union, 2000; European Association of Service Providers for Persons with Disabilities (EASPD) Declaration on Ageing and People with Intellectual Disabilities, 2001; Berlin Ministerial Declaration A Society for All Ages in the United Nations Economic Commission for Europe (UNECE) Region, 2002; Madrid International Plan of Action on Ageing, 2002; Regional Implementation Strategy for the Madrid International Plan of Action on Ageing, 2002; Recommendation 1619 (03) of the Parliamentary Assembly on the Rights of Elderly Migrants, 2003; Invalidity, Old-Age and Survivors’ Benefits Convention, 1967; World Population Plan of Action, 1974; International Labour Organization (ILO) Older Workers Recommendation R162, 1980; World Medical Association Declaration on the Abuse of the Elderly, 1989; Adelaide Declaration on Ageing, 1997; Iran’s First International Conference on Ageing, 1999; G8 Charter: Towards Active Ageing, 2000; European Association of Service Providers for Persons with Disabilities (EASPD) Verona Declaration on Ageing and People with Intellectual Disabilities, 2001; Help Age International: Ten Actions to End Age Discrimination, 2001; Final Declaration and Recommendations of the World NGO Forum on Ageing, 2002; The Toronto Declaration on the Global Prevention of Elder Abuse, 2002; World Health Organization (WHO) International Plan of Action on Ageing: Report on Implementation, 2005; World Health Organization (WHO) Resolution WHA58.16 Strengthening Active and Healthy Ageing, 2005; and Article 25 of Universal Declaration of Human Rights (UDHR), 1948.
In another study, Debbie Plath (2009, 215) mentioned a few more international documents on aging policy: Australia Aged Care Act, 1997: Provision of care and support services to assist functional capacity and enable older people to remain living in their own homes; National Strategy for an Ageing Australia, 2001: Retirement income schemes; Denmark Consolidation Act on Social Services, Part V: Adults (2007): High level of service provision offering freedom of choice for older people regarding housing options, care, and assistance; India National Policy People (1999): Strengthen the capacity of families to care for older relatives. Government services as care and housing safety net for older people without family; United Kingdom Opportunity Age (2005): Individual budgets and flexible care packages allowing older people choice in services to meet care needs; United Kingdom Independence, Well Being and Choice (2005): Strategies to increase inclusion: housing, community, social, mobility, income, information, and health.
In brief, all these documents and policies focused on older people who has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing, medical care, and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, or other lack of livelihood in circumstances beyond his control (UDHR, 1948: Article-25).
Aging Policy Analysis and Evaluation in Brief
The gist of all those international policies and documents focused on some crucial aspects such as independence, participation, care, self-fulfillment, dignity, and responsibilities of older persons mentioned by IFA Declaration of Rights and Responsibilities of Older Persons 1990.
Independence includes the rights of obtaining adequate food, water, shelter, clothing, and health care through the provision of income, family and community support, and self-help. They also have the right to live in environments that are safe and adaptable to personal preferences and changing capacities and to reside at home for as long as possible.
Participation offers the rights of older persons include the process of development and the formulation and implementation of policies which directly affect their well-being, for example, to share their knowledge, skills, values, and life experience with younger generations; to seek and develop opportunities for service to the community; and to serve as volunteers in positions appropriate to their interests and capabilities. They also have the right to form movements or associations of older people.
Under care, older persons have the right to benefit from family support and care consistent with the well-being of the family; to utilize appropriate levels of institutional care that provides protection, rehabilitation, and social and mental stimulation in a humane and secure environment; to exercise human rights and fundamental freedoms when residing in any shelter, care, and treatment facility, including full respect for their dignity, beliefs, needs, and privacy and for the right to make decisions about their care and quality of life.
Self-fulfillment focused on the rights to pursue opportunities for the full development of their potential by accessing the educational, cultural, spiritual, and recreational resources of society.
Dignity is one of the fundamental human rights which mentioned by those documents are the right to be treated fairly regardless of age, gender, racial, or ethnic background; disability; or another status, and to be valued independently of their economic contributions. It also offers the right to live in dignity and security and to be free of exploitation and physical or mental abuse.
Responsibilities of older persons include: remaining active, capable, self-reliant, and useful. They have an equal chance to share knowledge, skills, experience, and values with younger generations and to participate in the civic life of their society and to seek and develop potential avenues of service to the community.
Aging Policy Evaluation
In practice, many countries of the world take policies and make laws to guarantee older rights but still a large number of older persons throughout the world lack access to the essentials of life as the aftereffect of segregation based on age, handicap, ethnicity, race, gender, religion, or in light of employment and legal boundaries. Women, as the majority of the aging population, suffer disproportionately from poverty, poor health, and isolation (Doron and Mewhinney 2007). Older people with incapacities confront social and financial hindrances which effect on their personal and social life.
Developing nations face the most rapid growth of population aging and the most significant economic difficulties but lack the necessary financial, social, and health infrastructures to address these issues. Changes in family structures and ways of life can detrimentally affect more aged people. Madrid International Plan of Action on Ageing (MIPAA) beyond 2017 discloses on 20 September 2017 that older people in Europe facing some challenges like adequacy of income for a dignified life; affordable and quality health and long-term care; and equal access to employment with the support of life-long learning (MIPAA 2002). Persisting ageism also prevents older people from access to goods and services. The report also mentioned that there is a gap between government services and the real-life experiences of older people in those countries.
Bangladesh, India, and many other countries of the world have enacted policies regarding the aging population in pursuits of MIPAA 2002. Bangladesh Government has formulated some policies, and the Parents Care Act 2013 is one of them to ensure the rights of food, cloth, shelter, medical, and companion with parents. Children are bound to take care of their parents due to this act (MoSW 2018). The enforcement of the law will ensure the safety, security, and all others opportunities of parents. However, the implementation of this Act is not visible in Bangladesh.
Besides, aged people allowance is an excellent initiative in Bangladesh. Aged people allowance is started from 1998 to 1999, and the first budget was 485 million BD TK. for the 403.11thousand beneficiaries by 100.00Taka per head monthly, which reach 24,000 million BD TK. for 4 million beneficiaries by 500.00Taka per head monthly in the 2018–2019 fiscal year (MoSW 2018). Though this is a very low amount for an older but very helpful for a poor rural over 60+ aged people in Bangladesh. This is very noble initiative but still need more investment to cover all aspects (housing, health, employment, and education) of total aged people of Bangladesh (the present number of old people is 13.98 million).
In case of United Kingdom (UK), in a study, Phillipson and Scharf (2004) mentioned that it has been less successful in challenging inequalities which are carried through into old age and which reflect the experiences of particular birth cohorts and groups within these cohorts. Moreover, the policy has been less successful in limiting problems that arise from communities affected by economic decline and high rates of population turnover. In another report of the UK Government (GOS 2016) mentioned, the average age exceeded 40 for the first time in mid-2014. Also, the report mentioned that by 2040, nearly one in seven people is projected to be aged over 75. Similarly, the Office for Budget Responsibility projects totals public spending excluding interest payments to increase from 33.6% to 37.8% of GDP between 2019/2020 and 2064/2065 – equivalent to £79 billion in today’s terms – due mainly to the aging population. Therefore, without significant improvements in health, population aging in the UK will increase the amount of ill-health and disability. At the same time, families will face increasing pressure to balance care with other responsibilities, particularly work. Thus, demand and supply of care will diverge because of needing the physical and financial support of more people but there are fewer people that would be able to fund public services and provide care (GOS 2016). The abovementioned two reports’ summary reveals that the aging population condition of UK is still not good enough and need an action plan for future older people wellbeing.
In the context of the United States of America (USA), the Population Bulletin of USA mentioned that in 2011, 40 million people in the United States are ages 65 and older, but this number is projected to more than double to 89 million by 2050 (Jacobsen et al. 2011). However, it is not only the number and share of older people that are important for policy and program decisions, but also their characteristics: health and disability status, living arrangements, kinship networks, and economic well-being. The report also mentioned that the health of aged people has improved over the past 30 years. Mortality has declined, disability is less prevalent at the oldest ages, and disease in old age is less likely to mean death or loss of physical or mental functions. However, the improved ability to treat diseases and chronic conditions has increased the prevalence of most diseases in the older population (Jacobsen et al. 2011). Older Americans rely on a combination of Social Security benefits, pensions, retirement savings (including Individual Retirement Account (IRAs) and 401(k)s), and earnings from full-time or part-time work.
Denmark, the Netherlands, Switzerland, and the USA attain the highest levels of well-being for people of 65 and older. The high levels of well-being observed among the older population in these countries relative to the other countries studied are also observed in the 50–64 age groups for these countries (Jacobsen et al. 2011). According to the report 2007 of the US Department of State, the National Institute of Health, and the National Institute of Aging, the experience of some countries about the average life expectancy is increased more than double during the twentieth century. In the context of developed countries, the highest life expectancy is 82 years in Japan and around 79 years in several other more developed countries (Dobriansky et al. 2007). On the one hand, in all those countries including Canada, Australia, and developing countries life expectancy is increasing. On the other hand, more changes of aged people are welcoming for which there is a need for a long-term action plan for the aging population.
Though, the aging population policies are taken and evaluated throughout the world including developing and developed nations of Asia, Africa, Australia, Europe, and America to take numerous well-being programs and projects for aged people. Some countries are a success and in an appropriate position but most of the countries are still in a vulnerable situation and far away from reaching the satisfactory position of aged people secure life.
The preceding discussion reveals that the aging population is a continuous discourse in the contemporary world. Both developed and developing countries are at risk for the aging population. Numerous policies have been introduced for the aging problem and most of the countries of the world take initiatives for older people. The UN is playing a significant role in this regard. The MIPAA 2002 is one of the most crucial and significant initiatives for global aging. Some developed and developing nations have taken policy initiatives following the MIPAA 2002. Though some countries are a success in some aspects of aging policies, but most of the developing countries are less successful to implement their policies. However, in some parts of the world people are living longer and healthier lives. This is one of the greatest achievements of the last century but also a significant challenge.
The aging population is affecting economic growth and many other issues, including trade, migration, disease patterns, and prevalence. Dobriansky et al. (2007) using data from various study reports and scholarly papers from Asia, Europe, Australia, North America, the United Nations, World Bank, US Census Bureau, and Statistical Office of the European Communities, Population Reference Bureau, and US National Institute on Aging (NIA) identified nine emerging trends in global aging. These are: the overall population is aging; life expectancy is increasing; the number of oldest old is rising; non-communicable diseases are becoming a growing burden; some populations will shrink in the next few decades; family structures are changing; patterns of work and retirement are shifting; social insurance systems are evolving; and new economic challenges are emerging.
The urgency is to raise awareness about not only global population aging but also the necessity of rigorous cross-national scientific research and policy initiatives that will help address the challenges and potentialities of an aging world. Financial supports for longer lives and finding ways to reduce aged-related disability should become national and global priorities. Several governments took the long-term plan, but most did not. The family support, government and private-public welfare service, social insurance, and pensions would be some of the programs for the future wellbeing of aged people. More gerontological research and awareness are imperative for society to develop programs and services that would be culture-sensitive and effective to address aging issues.
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