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By Rita Sorio and Patricia Jara
An overwhelming majority of the countries in Latin America and the Caribbean (LAC) are experiencing a rapid graying of the population, with many people entering old age in poverty and poor health. Furthermore, changes in family composition and increasing female labor force participation mean that families are less able to provide informal care. Given these circumstances, the need to develop and implement public policies to marshal resources and foster access to quality care is clear. We invite you to continue reading and to register for a symposium on care systems led by international experts.
According to demographic and epidemiological trends, in the coming decades, we will see a substantial increase in the number of older people unable to independently perform activities of daily living. In fact, as populations age, the burden of non-communicable diseases and associated levels of disability grow.
In 2013, 69% of the burden of disease—measured in disability-adjusted life years (years of healthy life lost due to disability)—in LAC was attributed to chronic conditions. Recent studies show that the region’s population will live longer but with more health problems such as obesity, high cholesterol, and high blood pressure, all of which increase the risk of an unhealthy old age and the demand for care services. It is estimated that the number of elderly in LAC will double by 2030, reaching a total of 120 million people.
Greater Demand but Fewer Possibilities for Care
Changes in living patterns and new socio-cultural trends have reduced the availability of family support networks for elder care. For one, family structures have changed [link in Spanish]; between 1990 and 2010, the percentage of two-parent households dropped from 50.5% to 40.3%, while the percentage of non-family households (an individual living alone or with non-relatives only) grew from 11.3% to 16%.
Furthermore, there has been an increase in employment and activity rates for women, who, historically, have been the primary caregivers in families. It is currently estimated that over 100 million women in the region participate in the workforce, with more than a fifth of them having entered in the last 10 years. These trends add to an already complex situation and create pressure to implement policies that integrate appropriate care alternatives that are consistent with the varying needs of the population.
In Old Age, Focus on Living Not Just Longer, but Better
Drawing on the experiences of European countries that have already completed the demographic transition, the following lessons should be considered when implementing public policies on dependent care:
1. A range of benefits and service modalities should be provided to address the different needs and choices of individuals and families.
2. The promotion of personal autonomy (of the individual receiving care) and a progressive increase in participation in self-care should be emphasized. This approach reduces extreme dependence in the long term and improves satisfaction in the short term.
3. Improved coordination between health and social services may result in more appropriate and efficient care, which, if provided in a timely manner, can help to contain costs in the future.
Similarly, there is a clear demand for the strengthening of the child care network for children under the age of 3. Encouraging practices such as parental leave, which allows for child care duties to be split between women and men, favors the participation of women in the workforce, provides more options for child care services, and promotes shared responsibility for child care in the home.
The Cases of Uruguay, Chile and Costa Rica
Some countries have begun to include the development of national care systems or networks on their social protection agenda. In addition to expanding service coverage, Uruguay, Chile and Costa Rica are moving toward the establishment of national care systems. In other cases, there are initiatives that seek to defend the right to care through the development of policies that support the work-life balance. Fulfilling the dependent care agenda through a public policy represents a major challenge.
What institutional, economic, fiscal and public policy conditions are required to address a dependent care agenda that impacts people’s quality of life? How do we choose the right path toward building a care system? Where do we begin? Which priorities do we address first?
We know that questions abound, given that the dependent care agenda is a relatively new issue in the region and the policy options are many. To take a closer look at these issues, we invite you to a symposium entitled Uruguay’s Integrated Care System: Innovation and Challenges for Social Protection Policies, to be held in Washington, DC, on Thursday, October 27, 2016 from 11:00 a.m.–1:30 p.m. (EST). The symposium will also be broadcast live on the Internet.
If you are in Washington, DC, we hope to see you there; otherwise, join us live via our webcast. Register now!
If you are in Washington, DC, Register to attend in person here.
If you are outside the United States, Register to view the live presentation here.
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Rita Sorio is a lead specialist in the IDB’s Social Protection and Health Division (Uruguay).
Patricia Jara is a lead specialist in the IDB’s Social Protection and Health Division (Chile).