Nelly García is 65 years old, and for 30 years she has been selling flowers at a market in Lima because she was unable to return to her profession as a nurse technician after taking a break from work to raise her children when they were young. She says sadly that “if the government does not care about children, it cares about us even less. They must think ‘let these old people die because they’re no good for anything anymore’.” CREDIT: Mariela Jara/IPS

By Mariela Jara
LIMA, Feb 6 2023 (IPS)

Latin America and the Caribbean is no longer a young region and it will be one of the regions with the largest aging populations by 2050, which poses great challenges due to the social inequalities the countries face, but also opportunities to overcome them.

“Currently in the region an estimated 8.1 percent of the population is over 65 years of age, and this percentage is projected to increase to 17 percent by 2050, higher than the global average,” said Sabrina Juran, a regional technical advisor on population and development for Latin America and the Caribbean of the United Nations Population Fund (UNFPA).

In 2022, the region was home to 658 million people, of whom some 52 million were older adults, creating great challenges for the countries in terms of work, health and pensions, in a context in which according to international organizations the economic slowdown will deepen in the region in 2023.

“I am 65 and employers already saw me as too old to hire at 35, and I did not manage to get another job as a nurse technician,” says Nelly García, who moved to the capital, Lima, with her parents when she was 10 years old from her hometown of Huancayo, a city in Peru’s central Andes highlands.

The case of García illustrates the labor problems faced by many older adults in Latin America, especially women whose job opportunities are often hindered by motherhood and their responsibilities to care for family members.

“Imagine at this age what chance of insurance or pensions exist for people like me or people who are even older and work in the informal sector,” she told IPS with bitterness, adding that “if the government does not care about children, it cares about us even less. They must think ‘let these old people die because they’re no good for anything anymore’.”

García lives in Breña, a working-class district of 75,000 people that is one of the 43 districts in the department of Lima. Since she failed to find work in any hospital 30 years ago, she has been selling flowers.

She had taken a break from her work as a nurse technician to raise her four children. When she sought to return to her profession, the doors of the hospitals slammed shut on her. “I was already seen as old at the age of 35,” she repeated several times.

She has social health insurance from her husband, who is about to retire from a book import company. “But his pension will be less than 200 soles (52 dollars); that will not even cover the electricity bill,” she lamented.

Peru, a South American country of 33 million people, is facing a severe economic, political and social crisis, with a poverty level that climbed during the pandemic to a national average of 30 percent, although in rural areas it is 45 percent.

There are more than four million people over 60 according to official figures, only one third or 35 percent of whom were in a pension system. And although 89 percent have access to public health insurance, coverage and quality do not go hand in hand

“I try to save up for when I’m older, although the truth is I don’t think I’ll reach the age of 75 because in my family we suffer from heart disease. But I’m not going back to the public health insurance system,” García said emphatically.

She talked about her experience of the system: “It’s an ordeal, you have to go to the hospital at dawn to make an appointment, they order tests for several months later and who knows when you’ll get the results back. If I go through the same thing now, I’ll surely die before they call me, so when it’s my time, I hope to leave in peace.”

García is referring to the Social Health Security, a public system that covers 35 percent of people over 60, which draws harsh criticism for its poor facilities, shortage of medical personnel and poor quality of care.

A group of Peruvian women take part in a demonstration for the rights of the elderly in Lima. Latin America and the Caribbean will become one of the regions with the most aging populations by 2050 due to advances in medicine and the decrease in the birth rate. Life expectancy at birth was 72 years in 2022. CREDIT: Wálter Hupiú/IPS

An irreversible path

On Jan. 12, the Division for Inclusive Social Development of the United Nations Department of Economic and Social Affairs (DESA) presented the World Social Report on demographic change, which ratifies the global tendency that the population over 65 is growing faster than younger age sets and that people are living longer.

Greater life expectancy at birth due to the advancement of medicine and the decline in the fertility rate, which stands at 2.1 births per woman, are factors contributing to this trend.

Sabrina Juran of UNFPA told IPS from Panama City, where the U.N. agency’s regional headquarters is located, that the birth rate in Latin America is 1.85 and regional population growth is below 0.67 percent per year, both of which are lower than the global rates.

She said that according to the latest U.N. projections, there would be around 695.5 million inhabitants in the region in 2030 with a peak of 751.9 in mid-2050, after which the population would constantly decrease until reaching 649.2 million in 2100.

Sabrina Juran, a regional technical advisor on population and development for Latin America and the Caribbean of the United Nations Population Fund (UNFPA), poses for a picture at the organization’s headquarters in Panama. By 2050, 17 percent of the regional population will be over 65, the agency projects. CREDIT: UNFPA LAC

Juran explained that further reductions in mortality are expected to lead to a global average longevity of about 77.2 years in 2050 and 80.6 years regionally. Life expectancy at birth in Latin America and the Caribbean was 72.2 years in 2022, three years less than life expectancy in 2019 due to the impact of the COVID-19 pandemic.

This scenario means governments in the region must focus on meeting greater demands for healthcare, employment, housing, and pensions.

Juran said the growth of the working-age population – from 38.7 percent in 1990 to 51 percent today – can help boost per capita economic growth, known as the “demographic dividend”, which offers to maximize the potential benefits of a favorable age distribution.

“But this increase in the working-age population will not remain constant: it will peak in 2040 at 53.8 percent before decreasing,” she said. “This means there is a window of opportunity to be taken advantage of.”

The region faces steep inequalities. According to the U.N. Food and Agriculture Organization (FAO) on Jan. 18, 22.5 percent of the population – in other words, at least 131.3 million people – were unable to afford a healthy diet.

“Countries must invest in the development of their human capital, guaranteeing access to healthcare, quality education at all ages, and promoting opportunities for productive employment and decent work,” Juran remarked.

She added that they must take measures to adapt public programs to the growing number of older people, establishing universal healthcare and long-term care systems, and improving the sustainability of social security and pension systems.

“At UNFPA we advocate measuring and anticipating demographic changes in order to be better prepared for the consequences that arise,” said the regional advisor.

She said the commitment is “to a world where people have the power to make informed decisions about whether and when to have children, exercise their rights and responsibilities, navigate risks and become the foundation of more inclusive, adaptable and sustainable societies.”

Achieving this demographic resilience, Juran said, starts with a commitment to count not only the number of people, but also their opportunities for advancement and the barriers that stand in their way, which requires transforming discriminatory norms that hold back individuals and societies.

By Joseph Chamie and Barry Mirkin
NEW YORK, Nov 17 2015 (IPS)

Concerned with the consequences of demographic decline and population ageing, especially with respect to economic growth, national defence and pensions and health care for the elderly, a growing number of governments are seeking to raise birth rates. Whereas nearly 40 years ago 13 countries had policies to raise fertility, today the number has increased four-fold to 56, representing more than one-third of the world’s population.

The most recent and largest addition to this pronatalist group of countries, which includes Australia, France, Germany, Iran, Israel, Italy, Japan, Russia, South Korea, Spain and Turkey, is China. The Chinese government announced that it will change its controversial one-child policy to a two-child policy per couple in order to balance population development and address the challenge of an ageing population.

Assuming a slight increase in its current fertility level, China’s population of 1.38 billion is projected – according to the UN medium variant – to peak by 2030 at 1.42 billion and then decline to 1 billion by the end of the century (Figure 1). However, if fertility were to remain constant at its current level, China’s population would soon begin declining, reaching around 0.8 billion by the year 2100. If fertility were to instantly reach the replacement level, an unlikely event, China’s population would grow to 1.51 billion by midcentury.

Source: United Nations Population Division.

China’s population age structure is also becoming older than any time in the past. Whereas in 1950 less than five per cent of the Chinese were aged 65 years or older, today the proportion has doubled to 10 per cent. By 2035 China’s proportion elderly is expected to double again and reach one-third by around midcentury.

Similar to China, 82 other countries – accounting for almost half of the world’s population – are experiencing fertility rates below the replacement level of about two births per woman. As a result, the populations of 48 of those countries, including Germany, Japan, Russia and South Korea, are projected to be smaller and older by midcentury, even assuming modest gains in birth rates. If fertility rates were to remain constant at their current levels, the declines and ageing would be even more pronounced than currently expected (Figure 2).

Source: United Nations Population Division.

In an attempt to counter those two major demographic trends, many governments have adopted a variety of policies to raise birth rates. At one extreme are draconian measures such as prohibiting contraception, sterilization, abortion and the education and employment of women. As those measures violate basic human rights, few governments are prepared to take such drastic steps to raise fertility. Moreover, such measures have undesirable demographic consequences, including higher levels of unintended pregnancy, illegal abortion and maternal mortality.

Some governments are promoting marriage, childbearing and parenting through public relations campaigns, incentives and preferences. Such programs highlight the vital role of motherhood and its valuable contribution to the welfare and growth of the country. Australia and South Korea, for example, are among those making appeals to women to have one more child. Also, Iran is considering legislation that would encourage businesses to prioritize the hiring of men with children.

Perhaps the most common pronatalist policies aim to reduce parent’s considerable financial costs for childbearing and child rearing. Those policies include cash bonuses at the time of a child’s birth and/or recurrent cash supplements for dependent children

In Turkey, for example, parents are entitled to 300 Turkish lira (108 dollars) for the birth of their first child, 400 Turkish lira (144 dollars) for the second and 600 Turkish lira (215 dollars) for the fourth and subsequent child. One consequence of this legislation, however, has been the need for the provision of government financial assistance to needy families with large families.

Additional policies, especially popular among many Western countries, focus on making employment and family responsibilities “compatible” for working couples, especially mothers. In addition to extended maternity leave as well as paternity leave, other measures include part-time work, flexible working hours, working at home and family-friendly workplaces, including nurseries, as well as pre-school and after-school care facilities.

However, the costs of family friendly policies are not insignificant. For example, with fertility at two children per woman, France’s extensive scheme of family benefits is estimated to cost four per cent of gross domestic product, one of the highest percentages in the European Union.

Some governments are also looking to selective immigration to maintain the size of their workforce and slow down the pace of population ageing. However, a recent United Nations study concluded that international migration at current levels would be unable to compensate fully for the expected population decline. Between 2015 and 2050, the excess of deaths over births in Europe is projected to be 63 million, whereas the net number of international migrants to Europe is projected at 31 million, implying an overall shrinking of Europe’s population by about 32 million.

In addition, the financial costs, social integration and cultural impact of immigration have come to the political forefront in recent months. A growing tide of refugees and economic migrants – mainly from Syria, Afghanistan, Eritrea, Iraq, Nigeria and Pakistan, estimated at over 800,000 – have arrived on the shores of the European Union since the beginning of 2015 to escape war, repression, discrimination and unemployment.

As part of its response, the EU is considering a plan to offer aid money and visas to African countries that agree to take back thousands of their citizens who are unlawfully residing within its borders. Also aiming to stem the record inflows of refugees, various EU members have put up fences, imposed border controls and tightened asylum rules.

Other countries that are averse to encouraging immigration, such as Japan and South Korea, have instead opted to boost labour productivity as a means of compensating for a shrinking labour force. Those governments are also reviewing legislation to encourage more women to join and remain in the labour force by offering them family friendly work environments, improved career mobility and promotions to management and senior positions.

While family-oriented measures may encourage some women to have children, those policies are costly and their overall effect on fertility is weak or unclear. The many forces pushing fertility to low levels are simply too powerful for governments to overcome with dictates, financial incentives and public relations campaigns.

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By Joseph Chamie
NEW YORK, Oct 29 2015 (IPS)

Women are having fewer than two children on average in 83 countries, representing nearly half of the world’s population. And in some countries, such as Germany, Italy, Japan, Poland, Singapore, South Korea and Spain, average fertility levels are now closer to one child per woman than the replacement level of about two children (Figure 1).


Largely as a result of women’s reproductive decisions, the populations of 48 countries are projected to be smaller and have older age structures by mid-century. Looking further ahead, the prospects for those countries are compounded over time resulting in even smaller and older populations by the close of the century.

For example, if Japan’s fertility rate of 1.4 births per woman were to remain unchanged, its current population of 127 million would be 64 million by 2100 with more than 40 percent of the Japanese aged 65 years and older. Similar demographic outcomes occur in many other countries when low fertility levels remain unchanged, such as Germany, Italy, Russia and South Korea (Figure 2).

Based on the demographic trends observed over the last five decades, once birth rates fall below the replacement level, especially when less than 1.6 births per woman, they tend to stay there. And even if birth rates were to increase somewhat, the pool of women of childbearing age in many of the low fertility countries is shrinking, resulting in fewer babies being born.

Although relatively little supporting empirical research exists, countries tend to view demographic decline and population ageing as critical concerns. They believe those demographic trends will have serious repercussions on national interests affecting economic growth, military defence, cultural integrity, pensions and health care, especially for the elderly.

Some governments, including Germany, Italy, Japan, Russia, Singapore and South Korea, have concluded that intervention efforts are needed to raise their country’s birth rates in order to stem the projected decreases and rapid aging of their populations. Most recently, those twin demographic concerns have led China to announce that it is abolishing its one-child policy in favour of a two-child policy per couple.

However, despite government policies, considerable financial expenditures and various pronatalist initiatives, including national conception day, family night, “love cruises,” match-making, economic incentives, promotion of motherhood and appeals to patriotism and civic duty, efforts to raise fertility back near the replacement level have generally failed to convince women to have more children. In many low fertility countries birthrates have remained well below replacement for decades.

There are many factors or reasons why fertility levels have fallen below replacement and continue to persist at low levels. Marriage as a valued social institution has declined with divorce and separation becoming more common and acceptable. Also, marriage is no longer being viewed as just for reproductive purposes.

Opportunities for education, employment, mobility and financial independence, together with effective contraception, permit women to delay or forgo motherhood altogether. In many developed countries, especially in Europe, 10 per cent of women in their forties are childless and even in some, such as Germany, Italy and the Netherlands, the number is close to 20 per cent.

Also instead of marriage many women and men are choosing to cohabitate, thereby avoiding legal issues, social responsibilities and long-term commitments. Even if they subsequently decide to marry, many are content to continue with their partner just as a couple.

Growing numbers of young women as well as men are choosing personal self-fulfillment and career development rather than centring their lives on family and children. After years of being without children, many have become accustomed to an urban life style, higher social and economic status and unrestricted freedoms.

Women also report that they have no children because they are not able to find a suitable partner who would be willing to share equally in parenting and household chores. For example, when asked if she wanted to have a child, one young Japanese woman replied, “No, because in order to have a baby I’d have to marry a baby.”

Also, many young couples find that they cannot live on one person’s income alone and therefore both are obliged to work. The additional costs of children plus the need to save for longer years of old age place increased financial demands on household income as well as exerting powerful brakes on childbearing.

Another compelling factor accounting for low fertility in many countries is the lack of sufficient support and social services for those with children, especially single-parent families. That issue has become particularly salient given the fact that the majority of women are no longer simply mothers but are working mothers.

The demands of employment, career development and parenting combined with the costs of childrearing have also created “the hurdle of the second child.” Given those pressing circumstances, especially as childcare still falls largely on women, many mothers are reluctant to have a second child. Even if some women decide to cross the second-child hurdle, comparatively few are willing to consider having three or more children.

Some women as well as men have limited their fertility due to concerns about global overpopulation and its damaging consequences on the natural environment. They are convinced that the world would be a better and more sustainable place to live with low birthrates, which would in turn lead to a smaller future global population.

Government policies and schemes to encourage women to have more births in order to stem population decline and ageing have also encountered resistance and objections about unwarranted government interference and meddling in women’s lives. In Germany, for example, the recent introduction of a childcare allowance for stay-at-home mothers was harshly criticized for discouraging women to pursue careers as is widely promoted and expected of men and fathers.

Will governments be successful in persuading women to call off their reproductive strike and have significantly more children, thereby perhaps raising fertility rates to near the replacement level? It seems highly doubtful.

Based on their current behaviour and what they’re reporting, women in low fertility countries are not likely to increase their reproduction for the sake of the nation, limited financial incentives or other governmental pronatalist schemes. Most young women have decided not to return to the traditional, restrictive reproductive roles that their mothers and grandmothers followed. Consequently, for the foreseeable future, birthrates in low fertility countries are likely to remain below the replacement level.

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By Joseph Chamie
NEW YORK, Oct 20 2015 (IPS)

The demographic revolutions the world is experiencing are profound and far-reaching, affecting virtually every aspect of human society. Whether in politics, business, international relations, environmental affairs or even personal matters, understanding the fundamental demographic changes underway and anticipating their juggernaut consequences can contribute considerably to the setting of meaningful goals, designing effective strategies and achieving genuine progress.

Most observers would probably not go as far as some who claim “demography is destiny.” Many, however, would likely concede that demography is way ahead of anything else in second place regarding the destiny of human populations.

Among the key demographic revolutions underway perhaps first and foremost is the unprecedented growth of world population. The 20th century saw the beginning of rapid growth with the world’s population increasing nearly four-fold during the past century, from 1.6 billion in 1900 to 6.1 billion in 2000.

The world’s annual rate of growth peaked at 2.1 per cent in the late 1960s and is now 1.2 per cent. The global annual increase also hit a record high of 93 million in the late 1980s and is currently 83 million additional people annually.

World population, now at 7.3 billion, is projected to reach 9.7 billion by mid-century and 11.2 billion by the century’s close, according to the UN medium variant projection which assumes declines in high fertility and slight increases in low fertility. It is possible, however, that world population in the future could be larger or smaller than that projection (Table 1).

Source: United Nations Population Division.

If current fertility rates were to remain constant, world population would be 10.9 billion by 2050 and 26.0 billion in 2100. In contrast, if fertility rates for all countries were instantly at the replacement level of about two children per woman, world population would reach 9.3 billion by mid-century and 10.3 billion by the end of the century. Also, if the fertility rates of countries were to fall and remain well below the replacement level, world population would peak at 8.7 billion in 2050 and decline to 7.3 billion by 2100.

Nearly all of world population growth takes place in less developed regions. India and China alone account for close to one-third of the world’s annual births, 19 per cent and 12 per cent, respectively. The increase in India’s population is so rapid that it achieves in 10 days the same demographic growth as Europe over an entire year.

Differential rates of demographic growth are contributing to a New International Population Order. Whereas six of the world’s 10 largest populations in 1950 were more developed countries, today the number is two – the United States and the Russian Federation – and by 2035 the Russian Federation is projected to be displaced by Ethiopia (Figure 1).

Source: United Nations Population Division.

Europe’s population, which was double Africa’s in 1965, is expected to be half the size of Africa’s population by 2025. Other noteworthy population changes include India surpassing China in 2022, the population of the Philippines outnumbering Japan in 2029, the United Kingdom exceeding Germany in 2049 and Nigeria overtaking the United States as the third most populous country in 2049.

In 2007, for the first time in human history, the majority of the world became urban dwellers. By mid-century the growing urban population is expected to account for two-thirds of the world’s population, which is the reverse of the world urban-rural distribution in mid-20th century. Most of the world’s projected population growth over the coming decades will be taking place in urban areas.

Another demographic revolution during the 20th century – perhaps humanity’s greatest achievement – is the decline in mortality. Mortality rates across all age groups, especially infants and children, fell remarkably resulting in dramatic increases in life expectancies.

Whereas global life expectancy at birth in 1950 was 47 years, it is projected to be 78 years by mid-century. Increased human longevity is also expected to continue or even accelerate with the current number of centenarians projected to increase 60-fold by 2100.

A further decisive demographic development during the 20th century is the remarkable decline in fertility levels in most regions of the world. Over the past 50 years the average global fertility rate declined from 5 to 2.5 births per woman.

Africa remains the only major region with relatively limited fertility declines. Consequently, the populations of 28 African countries are expected to more than double by 2050 and 10 of them are projected to increase by at least by five-fold by 2100.

In contrast, 83 countries – accounting for nearly half of the world’s current population – have fertility rates below the replacement level. As a result of those low fertility rates, the populations of 48 countries, many in Europe, are projected to be smaller by 2050.

Declining fertility and increasing longevity have resulted in older population age structures. While the 20th century was one of rapid demographic growth, the 21st century is characterized by the unprecedented ageing of population age structures.

Average ages of population, for example, have increased in most countries, with the highest now at 46 years in Italy, Germany and Japan. Among the developed countries the proportion of elderly aged 65 years and older surpassed for the first time the number of children aged 0 to 14 in 2015 and that noteworthy transition is expected among the developing countries in 2075.

The age-structure revolution is resulting in major economic and social challenges for nations. Areas of special concern for governments, households and individuals include labour force, retirement, pensions, social security, care giving and health services.

International migration will continue to impact population growth, age structure and ethnic composition, especially among the major receiving countries where it has become the dominant force of demographic growth. This in turn will result in significant social, economic, political and cultural consequences not only for receiving societies but also the sending and transit countries.

Those migratory flows are expected to include mounting numbers of refugees, asylum seekers and others displaced by conflict, political upheaval and environmental degradation in many less developed countries.

The more developed regions are expected to continue being net receivers of international migrants, with an average gain of at least two million people per year over the coming decades. The outflow of the highly skilled and educated from the less developed countries, particularly in Africa and Asia, is likely to further challenge and undercut developmental efforts in many of those countries.

The revolutionary demographic changes that the world is experiencing are impacting virtually every aspect of human life. Ignoring those weighty consequences and avoiding the needed adjustments to the changing demographic landscapes will significantly impact societal wellbeing. On the other hand, fully acknowledging the revolutionary demographic changes underway and seriously preparing for the anticipated challenges will contribute significantly to improving human existence on the planet.

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