Introduction

Over the past few years, the world's population has continued on its remarkable transition path from a state of high birth and death rates to one characterized by low birth and death rates. At the heart of that transition has been the growth in the number and proportion of older persons. Such a rapid, large and ubiquitous growth has never been seen in the history of civilization.


Millions of older people across the world face chronic poverty, untreated illness, homelessness or inadequate shelter, violence and abuse, lack of education, little or no access to the law, fear and isolation.


We live in an era of unprecedented, rapid and inexorable population growth. Growing old, once the sole prerogative of 'developed' countries, is now a shared benefit of development worldwide.


A revolution in global life expectations

A person born in 1950 could expect on average to live for 46 years. By 2050 average global life expectancy will have risen to 76 years

By 2050, one in five people worldwide will be over 60

In every region except sub-Saharan Africa, the rate of population increase among the over-65s is higher than that for the under-14s. Even in sub-Saharan Africa the number of older people is growing faster than the number of children.

Older women outnumber older men. In 2000, there were 83 men for every 100 women worldwide. In developing countries, where gap was less wide, the ratio will have increased to 86:100 by 2030.


Age discrimination

All societies discriminate against people on grounds of age. Ageism and stereotyping influence attitudes, which in turn affect the way decisions are taken and resources are allocated at household, community and national level.

Policies that deliberately or by default exclude people from active contributions to society because they are 50, 60, or 80 years old are not only in breach of human rights principles but are a waste of human and social resources.

A change in mindset is needed to welcome older people's contributions and participation, and take a fresh view of relations between the generations.


Poverty and exclusion

In developing countries and in eastern and central Europe, most older people live in chronic poverty. This material poverty not only denies older people the basic necessities - food, adequate shelter, access to health care and medicines. It also prevents the effective participation of older people in society at all levels.

Social exclusion distances older people from the mainstream of their society, making it less likely that they can participate in decision-making and planning in their communities. Younger generations lose access to the valuable knowledge, skills and experience of older people.


Health

In poor countries, lifetime exposure to health problems means that many people enter old age already in ill health. This is particularly so for women who, after years of physical hard labour, poor nutrition and many pregnancies are on the threshold of old age by the end of their reproductive years.

Barriers to good health include lack of access to healthcare and its cost. Treatment is often unaffordable for older people even when it is nominally free. Hospitals are concentrated in towns, far from the rural areas when the majority of older people live. Public transport is poor and sometimes too expensive to allow easy access to health facilities.

For many poor older people, physical health is their single most important asset. It is closely linked to their ability to work, to function independently and to maintain a reasonable standard of living. Illness in old age is an ever-present threat.

Healthcare and social protection systems face future difficulties in supporting growing numbers of older people in need of long-term care. In developing countries, the rapid increase in the numbers of older people needing healthcare, combined with the high levels of absolute poverty make this a formidable challenge.


Income

Most older people in developing countries work until very old age, or until they die. Very few are eligible for pensions or social assistance and, at the same time, they face discrimination in obtaining credit and training. Older women are less likely to qualify for state support, as they mostly work outside the formal sector. Women are less likely to have assets, and if widowed, may not have access to their husband's property.


HIV/AIDS

Older people are both affected and infected by HIV/AIDS. They are at risk when they care for those who are infected, and when they are sexually active. Older women, often in severe poverty, nurse their dying children and care for their orphaned grandchildren.


Violence and abuse

Abuse of older people can range from physical violence to psychological pressure, and is a major unacknowledged problem, especially within families. At the other end of the scale, public violence, lawlessness and conflict expose the frail, the isolated and the poorest older people, especially older women, to abuse.


Rights

Old age is frequently presented as a matter of special pleading rather than basic human rights. In practice, poverty among older people is accepted as the norm; routine discrimination against older people, for example, in health care, is tolerated. Policy change has to be based on equal rights for older citizens.

(HelpAge International, State of the World's Older People 2002 Executive Summary)