Old rich, old poor

Last Friday I attended a symposium on “older people” (a term preferred to “elderly”) at the Philippine Women’s University. One of the speakers was Dr. Grace Cruz of the University of the Philippines’ Population Institute (UPPI), which is part of the College of Social Sciences and Philosophy.

At the symposium Grace shared statistics from the UPPI’s 2007 Philippine Longitudinal Study of Aging (PLSOA) showing that while the Philippine population remains very young, we do find more and more senior citizens. In 2010 those aged 60 or over constituted 6 percent of the total population, or 4.5 million people. By 2025 senior citizens will account for 10 percent of the total population, or 11.8 million people, the UPPI estimates. When that happens we will be considered, by UN definitions, to have an “aging population,” although we will still be a long way off from many other countries—notably China and Japan—where more than one-fourth of the population is made up of senior citizens.

Grace shared all kinds of statistics from the PLSOA, from senior citizens having bank accounts (6 percent) to median income (P3,000 a month), from those with at least one impaired activity of daily living (15 percent) to the number of smokers (38 percent of the men and 18 percent of the women).  We learned that many senior citizens are still socially active, with 41 percent belonging to organizations and 21 percent doing volunteer work.

Sex-based differences

There were stark differences based on sex. In 2000, a Filipino male aged 60 could expect, on average, to live to be 78.  A Filipino female of the same age could, on average, live to be 80. Unfortunately, while life expectancy for women is higher, the quality of life tends to be lower. For example, while 11.8 percent of the men reported difficulty with at least one activity of daily living (for example, being able to stand or sit down, or going out of the house), the figure was 17.8 percent for women.

Even more striking than the gender differences were those based on socioeconomic status. Among those with college education, only 10 percent had problems with at least one activity of daily living. Among those with some elementary education, the figure goes up to 15 percent, and for those with no formal education, the figure shoots up to 32 percent.

We know higher socioeconomic status does increase the chances of living to a ripe old age. The latest Philippine Human Development Report shows the disparities in life expectancy across provinces. Reflecting differences in economic and social development, Metro Manila residents have an average life expectancy of 72.8 years compared to 53.6 years for those in Tawi-Tawi.

But to put it bluntly, the rich become richer as they age, and have a better chance of maintaining a high quality of life, while the poor become even more impoverished with age, accompanied by a further deterioration in the quality of their already difficult lives.

New markets

Our more affluent senior citizens bring new opportunities for businesses with their spending power. You can already see this with senior-citizen-oriented household supplies, medical aids (e.g., walking canes, wheelchairs), medicines, upscale housing, and luxury travel packages. More niches will emerge in the next few years.

The UPPI study found that only 20 percent of the respondents knew how to call on a cell phone, and only 12 percent knew how to send text messages. Only 1.2 percent knew how to e-mail. All this will change within a few years as more computer-literate Filipinos become senior citizens, and with more free time, they will be heavy users of the information technologies and services.

Our businesses can sometimes seem to be slow in recognizing the demographic changes and improving their services to capture the senior-citizen markets. My older relatives are always trading stories, in between their cholesterol counts and lipid values, about battles with their banks and financing institutions, which still require dozens of signatures for their forms that come in tiny print, and who ask the craziest security questions with phone transactions. One bank is known to ask: “How much was your last purchase with your credit card?” To which one of my elderly relatives will retort: “I have eight credit cards, hija, so which one did you expect me to remember?”

But amid all that affluence, we have senior citizens who dread retirement because of the loss of income, no matter how meager. No wonder that for the poorest quintile (20 percent segment) of those surveyed by the UPPI, only 48 percent had a senior citizen card. Among the richest quintile, 84 percent had such a card.

The disturbing inequities are found as well in the use of discounts. Only 31 percent of the poorest quintile availed themselves of discounts for medicines, compared to 72 percent for the richest quintile. The inequities come even with entertainment: Among the richest quintile, 20 percent availed themselves of discounts on movies. The figure was a mere 4 percent for the poorest quintile.

With age, the poor among our senior citizens become even more deprived in terms of housing, nutrition and health. We will see in the future many more of these senior citizens being neglected, even abandoned, by their children because the latter have to fend for their own families, while the government will find its already overburdened health and social services even more strained.

Toothless

One of Grace Cruz’s slides that most caught the attention of the audience was oral health among the elderly. The UPPI survey found that among those aged 60 to 69, 22 percent have lost all their teeth. Among those aged 70 to 79, it’s 33.4 percent, and among those over the age of 80, almost half or 47 percent.

We take it for granted that the older we get the more teeth we lose, but the UPPI study showed that even among those aged 80 and over, 6 percent still had more than 20 of their natural teeth. (A complete set of human adult teeth, including wisdom teeth, should come up to 32.)

Why all the fuss over teeth? Because more natural teeth do mean better nutrition, and enhanced self-esteem. And few people are aware that poor dental health can also mean infections in the mouth descending into and harming the heart.

Japan has launched an 80/20 campaign, aiming to have most of their over-80 citizens still having at least 20 natural teeth. There’s something symbolic about this—about our social services having enough teeth, or lacking some, or being totally, and miserably, toothless.

E-mail: mtan@inquirer.com.ph