The coming decade will witness an acceleration of
population aging, as discussed earlier. The global population aged
60 will increase to 755 million in 2010 and to 1,170 million in
2025. The growth of the population aged 80 and above will be even
more rapid, and women will comprise the majority of this group.
Worldwide, most of the elderly will be living in urban areas. In
developing countries, however, the majority of the elderly will
still be residing in rural areas. The roles of the private and
public sectors in caring for the elderly, traditionally performed
by the family and the local community, will probably have to
increase. This support will be particularly needed in rural areas
of developing countries due to the rural- to-urban exodus of the
young and the consequent "aging" of these areas. Rural development
strategies aimed at providing employment opportunities for aging
men and women and at strengthening family and community support for
the aging, could help to secure the well-being of this large
segment of the world's elderly population.
Social expenditures incurred by the aging of
populations are high and rising in many industrialized countries.
Income security and health care provisions will pose a challenge to
public and private sectors well into the next century. Mitigating
actions could include efforts to raise national saving and
investment rates, collection of higher social welfare contributions
from workers and employers, reduction of benefits, and introduction
of complementary public and private pension systems.
Flexibility of retirement age may also be considered, but early
retirement as a means of opening up employment opportunities for
the young— a trend observed in several countries—may
aggravate the financial and social problems of the elderly. The
provision of more genuine choices for older workers, which is
especially needed in some of the developed countries, could help
ensure participation of able elderly in the economic and social
life of their countries.
The elderly are occupying an increasing
proportion of general hospital beds, with wide variations between
quality of care and length of stay from country to country and
within countries. Unnecessarily long periods and high costs of
hospitalization could be reduced by more effective management and
the establishment of broader-based community support. Geriatric
training and institutions that provide long-term care for the
frail, dependent elderly are inadequate in most countries and
urgently need to be improved in anticipation of the rapid expansion
of this population group. To contain health care costs and ensure
that providing care for the frail elderly is not left unduly to any
one sector or group, a broader system of geriatric care is
required. Geriatric care should incorporate provisions for acute
and chronic illnesses, training, community support, and service
delivery. National and local governments, professional and
voluntary organizations, the family, and the elderly themselves can
collabourate in supporting and delivering the care.
Like the elderly, the young also have special
needs. The ages of 15 to 24 are critical, when young people become
integrated in their communities as adults. In times of rapid social
and economic change, family bonds weaken as traditional values of
parents seem less relevant to problems of the young. Employment
opportunities are critical for the absorption of the next
generation. Where generations of young men and women come to
maturity without opportunities to work and make reasonable lives
for themselves, a seething pool of discontent invariably forms
among energetic and talented young people. A particularly daunting
prospect is that the majority of the youth facing limited
employment opportunities today will be parents in the year 2025,
with only a tenuous hold on the economic ladder.
High unemployment of youth in most developing
countries can be tackled effectively only in a context of more
vigorous economic growth. At the same time, public and private
programmes can be geared towards making youth employable. Suitable
training, in and out of school, and provision of initial employment
opportunities are essential. In many countries, the past 10 years
have been especially difficult for youth employment, as a growing
youth cohort coincided with recession, slow economic growth and
economic restructuring. Although the youth cohort is already
declining and will be considerably smaller in the 2000s, thereby
reducing the likely levels of youth unemployment, youth with low
skills will have increasing difficulty finding entry-level jobs. In
most developing countries, many young people find only a series of
casual jobs, often in the informal sector. There is in many
countries a serious mismatch between the skills acquired in school
and the needs of employers: young people without skills face
particularly bleak futures, especially in urban areas.
The most critical needs are faced by rural youth.
A general lack of basic amenities in rural areas is combined with
few organizations specifically for young people, contradictions
between aspirations and traditional values and systems, and often
limited access to land. Efforts directed at improving rural
conditions in general, with special emphasis on rural youth, can be
an important element in slowing down migration to urban areas and
providing greater opportunities for youth in general.
Yet another special population is the disabled.
The economic as well as human costs of disability are very large.
While no single, precise estimate of the number of disabled persons
exists, a conservative estimate puts the global number of people in
the world suffering from all types of disability at over 500
million. Even relatively minor types of disability are closely
associated with the incidence of poverty in many developing
countries. Prevention and rehabilitation can yield potentially
widespread social and economic benefits.
Despite strained economic circumstances,
Governments are making increasing political commitments to the
prevention of disability and to rehabilitation and equalization of
opportunities for disabled people. These commitments frequently are
contained in legislative measures or constitutional clauses.
Disability can affect all aspects of life. Policies at all levels
aimed at dealing with disability issues should, therefore, be an
integral part of the larger efforts aimed at promoting a better
life for all. These policies should form an integral part of each
country's development efforts and should enhance a society's
overall productive capacity.
Financial limitations and the need for trained
human resources in dealing with a disability have been identified
as the two major obstacles in implementing goals of the World
programme of Action Concerning Disabled Persons. With lack of
expertise identified as the next greatest obstacle in implementing
disability programmes, training and education have been identified
by a large proportion of developing and least developed countries
as a priority in future technical assistance programmes.
Mental disabilities have a uniquely unfortunate
impact on society. In both the developed and developing world,
mental illness has reportedly been increasing. Since the mentally
ill and mentally retarded are among those receiving the least
coverage in vocational training schemes and rehabilitation
services, especially in the least developed countries, concerted
research efforts, as well as increased provisions of treatment, are
urgently called for.
The World programme of Action Concerning Disabled
Persons recommends the integration of mentally retarded and other
severely disabled children into the general school system. Special
attention needs to be drawn to this challenge in the light of the
discovery that over 70 per cent of countries at all stages of
development in all regions report that school authorities have the
discretion to exclude some categories of disabled children from the
school system.
The vast majority of the world's disabled persons
live under conditions of deprivation, without access to social
assistance, especially where infrastructural conditions are
rudimentary. The extension of social security on a universal basis
would be an important step towards alleviating the problems of
disabled persons since, today, such coverage is largely
concentrated among developed countries.
Effective community-based rehabilitation requires
a network of community services, as well as specialized referral
services. Concerted efforts appear to be essential in this area, if
a strategy of community-based rehabilitation is to be successful in
offering the services required by many disabled people. The
integration of disabled people within the community also requires
access to public buildings and transportation. While living
conditions in largely rural countries may not immediately demand
the same measures to improve accessibility required by more
urbanized countries, it is nonetheless important that appropriate
legislation evolve in view of anticipated needs.
Research capacity on disability is distributed
unevenly among countries. Many countries have expressed a need to
enhance such research capacity. Accelerating research and saving
resources as well may be possible, if increases in national
research capacity were accompanied by co-operation through
regionally-based disability research institutes.