국가전략정보포털

Title page

Contents

Acknowledgments 2

Chapter 1. Introduction 10

WHY STUDY AGING IN ASIA? 10

SCOPE AND DATA SOURCES 10

OUTLINE AND CONTENT 11

SPECIAL NOTES 11

REFERENCES 13

Chapter 2. The Demography of an Aging Asia 14

NUMERICAL AND PROPORTIONATE GROWTH OF ASIA'S OLDER POPULATION 14

The number of older Asians will nearly triple over the next 4 decades 14

Even more dramatic than the rising numbers of older Asians will be the increased proportions of people aged 65 and older 14

DRIVERS OF POPULATION AGING-LOW FERTILITY AND LOW MORTALITY 16

Asia has experienced a rapid demographic transition from higher to lower birth and death rates 16

Birth rates-just how low can they go? 20

Lower birth rates result in fewer children today and fewer mothers tomorrow 25

Lower mortality results in more people living to older ages, especially women 25

POPULATION AGE STRUCTURE AND OLD-AGE DEPENDENCY RATIOS 29

Median age in Eastern Asia is projected to rise well past the typical childbearing ages 29

The ratio of the older population to those at working ages will continue to increase 29

REFERENCES 33

Chapter 3. Work, Income, and Retirement 35

LABOR FORCE PARTICIPATION AND OTHER INCOME SOURCES 35

Labor force participation differs widely by region, between men and women, and across older age groups 35

The lowest labor force participation rates for women are concentrated in Western Asia and Southern Asia, with considerable diversity within the same regions 36

Education is positively associated with labor force participation, but in some high-income Asian countries, women with higher-education work far less than expected 39

As societies develop, the main source of income for older Asians typically shifts from own income and dependence on children to other sources of support 42

OLD-AGE SOCIAL SECURITY SYSTEMS IN ASIA 43

Although old-age security systems exist throughout Asia, their provisions and coverage vary widely based on each country's age structure, development,... 44

Statutory pension ages tend to rise as longevity improves, with pensions funded by payroll tax contributions from both employees and employers 47

COVERAGE AND WAGE REPLACEMENT OF OLD-AGE SOCIAL SECURITY PENSIONS 48

The proportion of the older people covered by mandatory old-age pensions varies widely throughout Asia and reflects urbanization, occupational patterns,... 48

How well do pensions replace earnings? Higher coveragevs. lower replacement rates 49

Most Asian countries have progressive net replacement rates across income levels, and sex differences tend to disappear in higher income countries 50

REFERENCES 52

Chapter 4. Health and Health Care 55

HEALTHY LIFE EXPECTANCY AT AGE 60 IN ASIA 55

The extra years of life gained were not necessarily lived in good health 55

Most Asian countries had gains in HALE60, with considerable differences based on country wealth 56

NONCOMMUNICABLE DISEASES AND THE BURDEN OF MULTIMORBIDITY 57

Total deaths for older Asians attributable to noncommunicable diseases have risen in last 2 decades. 57

Median age of onset of NCDs has been getting younger in some Asian countries 61

Some Asian countries are showing positive shifts in risk factor behaviors 62

Concurrent infectious and noninfectious diseases pose challenges of multimorbidity 62

AGE-RELATED DISABILITY IN ASIA 64

Increases in NCDs may cause considerable cognitive and physical impairments and disability 64

Living alone may lead to social isolation and is associated with multimorbidity among older Asians 71

Adult children who live with their parents might serve as a potential pool of caregivers for older people needing assistance 71

HEALTH CARE SYSTEMS 72

Health systems readiness differs widely across Asia 72

Overall gains have been achieved in health care access and quality in the past 3 decades but gaps among Asian countries exist. 73

Lower income countries face more challenges financing health systems and care 74

REFERENCES 76

Chapter 5. Summary And Discussion 84

HIGHLIGHTS 84

The Demography of an Aging Asia 84

Work, Income, and Retirement 84

Health and Health Care 84

SUMMARY 84

DISCUSSION 85

REFERENCES 87

Appendix A. List of Subregions and Countries of Asia Used in This Report 88

Appendix B. Detailed Tables 89

Table 2-1. Ten Asian Countries With Largest Populations Aged 65 and Older in World Ranking: 2020 and Projected 2060 17

Table 2-2. Total Fertility Rates for Asian Subregions and Countries: 2020 and Projected 2060 22

Table 2-3. Proximate or Direct Determinants of Fertility in Jordan and Egypt: 2000 to 2017/2018 24

Table 2-4. Ten Highest and Lowest Life Expectancy at Age 60 for Asian Countries: 2015-2020 25

Table 2-5. Life Expectancy at Age 60 for Asian Subregions by Sex: 1950-1955, 2000-2005, 2005-2010, 2010-2015, and 2015-2020 30

Table 2-6. Median Age for Asian Subregions by Sex: 2020 and Projected 2060 30

Table 3-1. Ten Highest and Lowest Labor Force Participation Rates for Asian Countries by Sex at Ages 60-64: 2020 or Latest Year Available 37

Table 3-2. Labor Force Participation for Adults Aged 65 and Older in Bangladesh and South Korea by Sex: 2020 37

Table 3-3. Population Aged 60 and Older by Employment Status and Age: Malaysia 39

Table 3-4. Distribution of Workers Aged 60 and Older by Industry and Sex: Malaysia 39

Table 3-5. Educational Attainment for Older Population in Selected Asian Countries: 2017-2020 42

Table 3-6. Knowledge About and Coverage of Social Safety Net Programs Among Older People in Bangladesh: 2019 45

Table 3-7. Coverage, Net Replacement, and Inequality in Old Age Social Security Pensions Systems in Selected Asian Countries: 2018 49

Table 3-8. Net Pension Replacement Rates of Average Earnings for Selected Asian and OECD Countries by Sex and World Region: 2018 51

Table 4-1. Asian Countries With Most and Least Improvement in Life Expectancy at Age 60: 2000 to 2019 56

Table 4-2. Food Preference by Centenarians in South Korea by Sex: 2015 59

Table 4-3. Leading Noncommunicable Diseases in Population Aged 55 and Older for Selected Asian Countries: 2019 60

Table 4-4. Older Population With a Disability in Selected Asian Countries by Type and Sex 69

Table 4-5. Estimated Number of People With Dementia by Region: 2020 to 2050 70

Table 4-6. Living Arrangements for Older Adults in Selected Asian Countries 72

Table 4-7. Health Systems Quality Index for Selected Asian Countries: 2018 74

Figure 2-1. Population Aged 65 and Older by World Region: 2020 and Projected 2060 15

Figure 2-2. Population Aged 65 and Over by Region: 2020 Projected to 2060 16

Figure 2-3. Total Population and Those Aged 65 and Older for Asia by Subregion: 2020 and Projected 2060 17

Figure 2-4. Population Aged 65 and Older for Asian Countries: 2020 and Projected 2060 18

Figure 2-5. Percentage of Total Population Aged 65 and Older for Asian Countries: 2020 and Projected 2060 19

Figure 2-6. Mortality Rates for Children Under Age 5 by Asian Subregions: 2020 Projected to 2060 20

Figure 2-7. Demographic Transition in Eastern Asia and Southern Asia: 1950-1955 to 2020-2025 21

Figure 2-8. Total Fertility Rates for Selected Asian Countries: 2020 Projected to 2060 21

Figure 2-9. Total Fertility Rates for Jordan and Egypt: 2000 to 2015 23

Figure 2-10. Percentage of Population Aged 65 and Older in Jordan and Egypt: 2020 to Projected 2050 24

Figure 2-11. Population by Age and Sex for Selected Asian Countries: 2020 and Projected 2060 26

Figure 2-12. Population by Age and Sex for GCC and Other Western Asian Countries: 2020 28

Figure 2-13. Old-Age Dependency Ratios for World Regions and Asian Subregions: 2020 and Projected 2060 31

Figure 3-1. Labor Force Participation Rates (LFPR) by Age and Sex for International Labour Organization Asian Regions: 2019 35

Figure 3-2. Retirement Rate for Population Aged 55 and Older in China by Urban/Rural Residence and Age: 2018 40

Figure 3-3. Population Aged 55 and Older Not Yet Retired Who Expect Never to Retire in China and the United States by Age, Sex, and Urban/Rural... 41

Figure 3-4. Main Sources of Income for Older Population in Selected Asian Countries 42

Figure 3-5. Percent Distribution of Source of Income of the Older Population in Vietnam by Age and Urban/Rural Residence: 2019 43

Figure 3-6. Share of People Aged 65 and Older and Public Expenditures on Social Protection for Those at or Above Mandated Pensionable Ages... 44

Figure 3-7. Number of Asian Countries With Statutory Public Pensions by Pensionable Age 44

Figure 3-8. Main Reasons for Dissatisfaction of Social Safety Net Programs by Recipients Aged 60 and Older in Bangladesh by Urban/Rural... 46

Figure 3-9. Percent Distribution of Older Population and Total Population by Urban/Rural Residence for Selected Asian Countries 48

Figure 3-10. Net Replacement Rates of Mandatory Pensions vs. Earnings for Selected Asian Countries 50

Figure 3-11. Labor Force Covered and Net Replacement Rate for Mandatory Public Pension Systems in Selected Asian Countries: 2018 50

Figure 4-1. Countries With Highest Life Expectancy and Healthy Life Expectancy at Age 60: 2019 55

Figure 4-2. Female-Male Di-erences in Life Expectancy and Healthy Life Expectancy at Age 60 for Selected Asian Countries: 2019 57

Figure 4-3. Reasons for Longevity Reported by Centenarians in South Korea by Sex: 2015 58

Figure 4-4. Health Behavior of Centenarians in South Korea 59

Figure 4-5. Prevalence of Hypertension and Diabetes Among Older Population in Selected Asian Countries 61

Figure 4-6. Health Risk Factors for Older Population in Malaysia and South Korea by Sex 62

Figure 4-7. Nutritional Status Scores for People Aged 65 and Older in South Korea by Age: 2014 and 2020 63

Figure 4-8. Age and Sex Distribution for HIV Population by ART Status in Thailand: Projected 2050 65

Figure 4-9. Sex Ratio of HIV Population Aged 65 and Older in Cambodia and Nepal: 2020 Projected to 2050 66

Figure 4-10. Percent Distribution of COVID-19 Deaths by Age for Philippines and Japan as of July 2021 67

Figure 4-11. Population Aged 65 and Older With a Disability in Jordan by Type and Age: 2017 70

Figure 4-12. Living Arrangements for Older Populations in South Korea and Vietnam by Urban/Rural Residence 73

Figure 5-1. Population by Age and Sex for China, India, and United States: 2020 and Projected 2060 86

Boxes

Box 1-1. International Database, U.S. Census Bureau 12

Box 2-1. Fertility Stalling and Aging-The Case of Jordan and Egypt 23

Box 2-2. The Many Shapes of Age and Sex Structure in Western Asia 27

Box 3-1. Active and Productive Aging: Older Workers in Malaysia 38

Box 3-2. Retirement Expectations by Older Populations in China and United States-Findings From the China Health and Retirement Longitudinal... 40

Box 3-3. Perceptions of Older People Regarding Social Safety Net Programs in Bangladesh 45

Box 4-1. Reasons for Longevity-The Case of South Korea's Centenarians 58

Box 4-2. Nutritional Status of Older People in South Korea 63

Box 4-3. Gender Variations in HIV Population Aging in Asia 65

Box 4-4. COVID-19 and Older Asians 67

Table B-1. Total Population and Percentage Aged 65 and Older for Asian Countries: 2020 and Projected 2060 90

Table B-2. Total Fertility Rate, Mortality Rate Under Age 5, and Life Expectancy at Birth for Asian Countries by Sex: 2020 91

Table B-3. Labor Force Participation for Population Aged 60-64 and 65 and Older for Asian Countries by Sex: 2020 or Latest Year Available 92

Table B-4. Pension Age, Contribution Rates, and Gross Domestic Product (GDP) Per Capita for Asian Countries: 2018 93

Table B-5. Life Expectancy (LE) and Healthy Life Expectancy (HALE) at Birth and at Age 60 for Asian Countries: 2000, 2010, and 2019 94

Table B-6. Burden of Selected Noncommunicable Diseases in Population Aged 55 and Older by Sex and Type: 2019 100