Older Population And Health System: A Profile Of Thailand
Older Population and Health System:A profile of ThailandI. Introduction to ThailandThe Kingdom of Thailand was established in the mid-14th Century, known as Siam until 1939.A revolution in 1932 led to a constitutional monarchy. It lies in the heart of Southeast Asia.The country shares a long border with Myanmar to the west and the north, Lao P.D.R. to thenorth and the northeast, Cambodia to the east and Malaysia to the south. Thailand is dividedinto four distinct geographical regions: the mountainous North, the fertile Central Plains, thesemi-arid plateau of the Northeast and the peninsula South At present, there are around 62.3million people, of which 32% live in urban areas. Although most of Thailand is agricultural,the social and economic developments have changed the economy rapidly to industrializedproductions and service sectors.After enjoying the world’s highest growth rate from 1985 to 1995 – averagely almost 9%annually – increased speculative pressure on Thailand currency in 1997 led to a crisis thatuncovered financial sector weakness and forced the government to float the value of theBaht. Thailand entered a economic recovery stage in 1999. Nevertheless, the economicordeal has a significant impact on country’s labor structure, population migration, urbanizationand life styles. The Gross Domestic Product (GDP) per Capita is 7,248 in 2002. GDPcomposition by sector is 11% in agriculture sector, 40% in industry and 49% in services.Average consumer price index (CPI) in 2001 is only 1.6%. The CPI in food and non-food are0.4% and 2.2% respectively. More than 50% of the total population (32.17 million) is in thelabor force, of which 42% in agriculture and the rest 58% in non-agricultural sector. Theunemployment rate is 5.16% in 2001.Currently, Thailand is experiencing among the most rapid rates of population ageing in thedeveloping world. The demographic shift from younger to older population age structure inThailand is a recent phenomenon. The rapidity of the current change in Thailand stands incontrast to historical developments in most Western countries. This implies that the countrywill face emergent issues related to social security, health care costs and intergenerationalequity and so on in a far shorter time span than that happened in the West. These issuesrequire appropriate policies and programmes development to deal with. Hence, it isimperative that Thailand has a well prepared National Policy and Programme on ageing aswell as for long-term care services for older persons.II. Population ageing in Thailand1. Demographic Trends of Population AgeingDuring the past several decades, Thailand has been one of the most successful countries inbringing down its fertility level within a short period of time. The total fertility rate has declinedfrom over 6 births per woman in the mid 1960s to below 2 in the mid-1990s (Table 1). Duringthe same period, life expectancy at birth increased from 55.2 years to 69.9 years for men and61.8 years to 74.9 years for women. In the coming decades, besides the lowering of thegrowth rate, a major demographic consequence of this rapid fertility reduction will be aninevitable ageing of the population. Even more dramatic will be the rapid increase in theabsolute size of the older population (aged 60 and over), a result of past high fertility levelsand substantial declines of mortality.19
A demographic transition can be indicated by age profiles or “Population Pyramid”. Figure 1shows actual age profiles of the population of Thailand in 1960 and 1980, and projectedprofiles in 2000 and 2020. These four age profiles depict changes in population structure froma pyramid in 1960 towards a bell shape in 2000 and a vast shape in 2020.Table 1Life expectancy at birth and total fertility rate, 2572.678.11.90Source:United Nations, 1999aFigure 1Age profile of the population of Thailand in 1960, 1980, 2000 and 2020.Source:1960198020002020Jitapunkul, S. and Bunnag, S., 1998Table 2 presents the past trends and future projections of key demographic indicators relatedto population ageing in Thailand for the period 1980-2050 as estimated by the United Nations(United Nations, 1999a). Three main characters of the ageing population in Thailand arenoted, namely a considerable change in the age structure of the population, a rapid increase20
in the share of the older population, and an increase in the proportion female in the older agegroups.Trends in the growth rates and the sheer size of the older population are also remarkable.The older population is growing faster than the growth of the total population. The rapidincrease in the proportion of the older population implies a sharp increase in the size of theelderly population. Thailand’s total population grew by 31 percent between 1980 and 2000,increasing from 46.7 million to just over 60 million at present. At the same time the populationgrowth declined substantially, from 3 percent around 1970 to under 1 percent currently (Table2A and 2B).Table 2AProjected trends in selected demographic measures of the older population inThailand, 561,39966,51170,97574,18860 2,5273,7165,3387,20510,76521,98165 1,6492,4083,5764,9537,16817,07675 4847981,1921,8522,5948,22285 --1983275401,946Total-19.031.442.451.958.860 -47.1111.2185.1326.0769.81) Population (in 1,000)2) % Increase over 198065 -46.0116.9200.4334.7935.575 0 3.93.63.04.00.9*3) Population growth rate4) % of total population aged: 1540.031.925.221.619.816.860 5.46.78.710.815.229.665 3.54.35.87.410.123.070 38.339.641.345.141.357.375 19.221.522.325.724.137.485 --3.74.55.08.960 54.754.855.555.855.654.975 58.559.960.060.760.659.085 --65.265.465.463.7Total83.262.951.347.953.886.5 1573.352.038.131.930.533.260 9.910.913.216.023.355.35) % of the total older population aged:6) % Female7) Dependency ratioSource:Calculated from data provided in the United Nations, 1999b(* is the average rate during 2040-2050.)21
Table 2BProjected trends in selected demographic measures of the population aged 50 years in Thailand, 1980-2050.Total50 60 65 Age50-5960-6970 050450 15.018.021.428.832.641.460 7.49.410.815.218.129.665 0150 10.860 5.065 3.2Age50-595.860-693.270 1.819902200032010420204202542050450 14.417.219.927.230.939.360 6.98.79.713.616.427.365 694.45.55.68.49.912.570-791.92.53.00.14.89.950 60 65 Age50-5960-6970 11.95.93.93.42.580 0.80.91.31.92.26.2MalesYear80 0.60.71.01.41.64.9Females19801Source:5.950 60 65 43.531.925.211.612.811.6National Statistical Office, 1984, 1994, 2001Calculated from data provided in the United Nations, 1999b80 1.01.11.72.42.77.4The proportion of the population in their elderly years (60 ) is anticipated to increase from 8.7percent in 2000 to 10.8 percent in the year 2010, 15.2 percent in the year 2020, and 3022
percent in the year 2050. The number of older persons will continue to rise, fromapproximately 5.3 million at present to 7.2 million in 2010 and will reach 11 million by 2020(Figure 2). Based on the latest projections from the United Nations, the growth rate of theThai older population is relatively high, over 3 percent per year. With the growth rate of 3–3.6percent per year, the size of the older population will have doubling times of about 19-23years. Thailand will become an ageing society within the next 10 years, according to theUnited Nations' definition.Linear graph of total number and percent of the older population in Thailand,Figure 21980 - 2050.Number (millions)Percent3030number 02000201020202050Calculated from data provided by the United Nations, 1999bNot only is the overall share of the population increasing, but the older population itself is alsoageing as evidenced by an increase in the percent of older persons who are aged 75 (Figure 3). The percent increase of the old-olds is greater than that of the overall agedpopulation.23
Figure 3Characteristics of the young olds and the old olds – Area graph 100% stack.Young-old (60-74)100%Old-old (75 ulated from data provided by the United Nations, 1999b24
2. Feminisation of the aged populationIn 1960-1965 the life expectancy (E0) at birth for males and females were 51.9 and 56.2 yearsrespectively (Table 1). Thirty years later (1990-1995), the life expectancy at birth had moreincreased to be 65.4 for males and 71.8 for females. Since the females’ advantage in lifeexpectancy is likely to continue in the future, projections indicate that the preponderance ofolder women will also continue. Among the older population, there are more women thanmen in every age group. The proportion of older females is greater at older ages (panel 6,Table 2A).In addition, female older persons also live longer than their male counterparts (Jitapunkul, S.,1998). In 1991, the life expectancies of male and female older persons at the age of 60-64were 18.79 and 21.95 years, respectively; at the age of 70-74, 12.81 and 14.79 years,respectively; and at the age of 80 and over, 9.30 and 9.81 years, respectively. The trend ofthe difference in life expectancy between sexes is more pronounced as shown by anincreasing percentage of the ratios between the life expectancy (LE) of female and male olderpersons (Table 3). This shows that women live longer than men and will share a higherproportion among the old-olds. The result is a phenomenon of feminization among the agedpopulation.Table 3Life expectancy (ex) of Thai elderly at different ages by sex in 1995-1996.AgeMaleFemalePercentage of ratios between ex of female and punkul, S., 1998Any of the very old would be women, often widowed and probably without adequate means ofsupport. They are likely to have poorer health and worse financial situation compared to oldermen (Jitapunkul, S., 1998). Older women are thus considered more vulnerable and deservea special attention and assistance.3. Trends in the dependency ratioThe dependency ratio is a numerical measure of the economic burden imposed onthe working population who must ultimately support people who are not in the labour force.The old age dependency ratio is an indicator roughly quantifies the demographic weight ofburden that the current working age population has to bear in order to support the olderpersons. Changes in age structure that are taking place in Thailand translate into changes independency ratios defined in terms of age groups. In the past children constituted the majorpart of the dependency ratio, but this is changing. By the year 2050 about 64 percent of thedependents will be older adults. The increasing dependency burden of ageing populationswould be more than offset by the falling dependency burden of young people during the earlystages of aging (1990-2000). The total dependency ratio has declined and will reach thelowest level in 2010, but will rise again in the second decade of the next century (Figure 4).The aged dependency levels, however, will steadily increase from about 13 older persons per100 persons aged 15-59 at present to 16 per 100 in 2010 and 23 per 100 in 2020 (Table 2A).The increase in the old-age dependency ratio implies that the burden of support for olderpersons will become heavier. This includes health care costs and other social and economicsupports.19
Figure 4Total, child and aged dependency ratios of lChildAged2000201020202050Calculated from data provided by the United Nations, 1999b4. Speed of population ageingThe speed of demographic change in Thailand is remarkable. The rapidity of populationaging in Thailand (and some newly completed demographic transition countries) is alarming.The number of years expected to spend for shifting the proportion of the older population from7 percent to 14 percent is much lower in Thailand than it was in many industrialized countries.As it is shown in Table 4, it took France 114 years, Sweden 85 years and Italy 63 years toshift from having 7 percent of its population in the 65 and over age group to having 14 percentin that category. In comparison, it took Japan only 26 years to make that change. But nowJapan has serious competitors in Asia with Thailand and Singapore all expected to take fewerthan 25 years to make the transition. The shorter time Thailand will take to become anageing society means that the country also has a shorter time to adjust to and to plan for thisrapid demographic change.Table 4Speed of population aging in selected countries.Developed countriesFranceSwedenUnited StatesItalyJapanAsian countriesSouth KoreaSingaporeThailandChina (excl. Hong Kong)Sources:Year the proportion ofpopulation aged 65 is 7%Year the proportionof population aged65 is 14%Number of yearsrequired for theproportion ofelderly to increasefrom 7% to 14%1865 11886 11941 11924 11969 21979 21971 22013 21987 21994 2114857263262001 22000 22007 22002 22023 22017 22029 22027 222172225United Nations, 1956, 1999a20
In conclusion, five notable characteristics of the rapidly growing older population in Thailandare: (a) ageing of the aged, (b) feminization of the aged population particularly among theold-olds, (c) rising of the total dependency ratio after reaching its nadir point in 2010, and (d)remarkable rapidity of population ageing.21
III. Socio-economic profile of older persons and itsimplications1. Income of Thai older persons and economic securityIn 1994, 43.9 percent of Thai older persons had their income less than 10,000 Baht or 227US (1 US 44 Baht) per year. The median income was 10,000-19,999 Baht. Only 11.5percent had income over 50,000 Baht per year. The older persons in urban areas had muchhigher income than those in rural areas. Compared with elderly men, elderly women are in adisadvantaged position (Table 5). The economic condition of older women, particularlyunmarried women, appears to be least favourable. Women tend to depend on children andreceive more indirect support than men do. Among older persons who were employed, 65.2percent had their income less than 2,000 Baht per month and 20.8 percent had an incomeranged between 2,001-4,000 Baht per month (Phananiramai, M. and Soonthornchawakarn,N., 2002).Table 5.Income of Thai older persons (Baht) by area of living and sex, 1994.BathTotal ,999 50,000MissingSource:Urban areamalefemaleRural 230.49.65.17.11.63.42.83.111.51.3National Statistical Office, 1994Children and work are the two predominant sources of income for Thai older persons. Only 4percent of older persons receive regular income from pension. Nevertheless, more than 80percent of Thai older persons had their own property or real estate. The sources of revenueare shown in Table 6.19
Table 6Sources of older persons’ revenue, 1994.Percentage(i) Sourcesof ousesSavings / InterestsRelativesPensionAssets / PropertyOthersSource:National Statistical Office, 1994Thirty-five percent of Thai older persons reported that their income was not adequate forthemselves and their family’s expenses (Figure 9). Older persons in rural areas had a higherlevel of income inadequacy when compared with those in urban area. These findings suggestthat a high proportion of the Thai older population cannot live with an acceptable quality of lifeunless they are supported by their offsprings or provided with adequate public welfare.Figure 9Adequacy of income of Thai older persons for their family’s expenses by sex andurban-rural area.Source:National Statistical Office, 199520
2. Economically active older personsA substantial share (31.9%) of older population remains economically active, especially men(Figure 7). Thai older persons living in rural areas remain economically active more thanthose living in urban areas. Economical activity of Thai older persons is concentrated inagricultural sector where most of them are self-employed (Figure 8).Table 7.Percent distribution of older persons according to duration of stay in the presentcommunity and reason for moving, by residence, Thailand, 1995.BangkokProvincialRuralTotalUrbanDuration of stay (in years)0–411.15.42.73.75–910.66.72.53.610 – 1414.28.92.03.815 – 1911.29.12.84.220 46.456.354.353.76.513.535.831.1100100100100Look for job28.439.342.740.5Follow family14.826.133.930.6Move to live with child13.66.93.45.1Help child with 1D.K.0.44.21.91.9Total100100100100Since birthTotalReasons for movingBuy/inherit/build land/houseSource:Chayovan, N. and Knodel, J., 199719
Figure 7Percentage of economically active older persons by sex and urban-rural area,1994.Source:National Statistical Office, 1994Figure 8Percentage of economically active older persons by sector, 1994.9.643.936.856.163.290.4Whole countryurban areaagriculturalnon-agriculturalSource:National Statistical Office, 199419
3. Educational levelEducation is an important determinant of a person’s health and access to resources.Approximately thirty-one percent of Thai older persons have never attended school. Thaiolder women have much less opportunity to formal education compared with Thai older men.Among older men and women, 71 percent and 48 percent have finished grade 4 or higherlevel (Table 8).Older persons in rural area have a lower opportunity for formal education thanolder persons in urban area. However, being educated does not guarantee the literacy ofthem. The rate of no formal education is significant lower than the illiteracy rate.Characteristics of Thai women and men indicating a vulnerable situation forwomen.Table 8Male (%)Female (%)EducationTotalUrbanRuralTotalUrbanRuralNoLess than grade 4Grade 4Higher than grade 711.644.11.30.3Source:Jitapunkul, S., 1998Data in Figure 5 indicates that although illiteracy level among elderly declined dramaticallyfrom 56 percent in 1980 to 25 percent in 2000, older persons are considerably less educatedthan the general population. Gender difference in the illiteracy level is pronounced. In 2000,the proportion of older women who are illiterate is twice that of older men (33.2% vs. 16.1%).Figure 5Percentage illiterate of Thai older persons by sex, 1980-2000, Thailand.I itapunkul, S., 1998192000
Because of rapid social and demographic change in the past, the characteristics of olderpersons in the future is likely to differ considerably from that in the present or recent past.Previous studies have documented that future Thai older persons will differ significantly fromthe older persons of today in terms of their characteristics, needs, preferences andexpectations. This is particularly clear in the case of education and number of living children.Projection of educational composition of future Thai older persons separately for males andfemales using the cohort analysis approach by Christenson and Hermalin (Christenson, B.and Hermalin AL., 1991) indicated that proportions of illiteracy for both male and female olderpersons will decrease substantially fro
19 Older Population and Health System: A profile of Thailand I. Introduction to Thailand The Kingdom of Thailand was established in the mid-14th Century, known as Siam until 1939. A rev
When segmented by gender, more older women tend to live with their children compared to older men. In older female households, 62% of older women live together with one child, while 22% live alone. In contrast, in older men households, 45% of older men live together wi
aged 65 and older in 2015; by 2050, the older popu-lation will make up more than a quarter of Europe’s total population. The older population in Asia and Latin America and the Caribbean will grow the fastest of all regions, with Asia’s older population almost tri-pling in size from 341.4 million in 2015
older). Texas's population aged 12 or older (including those in the Houston-Sugar Land-Baytown MSA) was 19.0 million, and the State adult population was 16.9 million. The U.S. population aged 12 or older was 248.7 million, and the U.S. adult population was 223.8 million. Table 1. Estimated Numbers of Persons in the Houston-Sugar Land-Baytown
older population, as they began turning 65 in 2011. 3. By 2050, the surviving baby boomers will be over the age of 85. The aging of the population will have wide-ranging . implications for the country. By “aging,” demographers often mean that the proportion of the population in the older ages increases. As the United States ages over the
The Profile incorporates the latest data available but not all items are updated on an annual basis. 1 . The Older Population The population age 65 years or older numbered47.8 million in 2015 (the most recent year for which data are . U.S. Census Bureau, Population Division, Annual Estimates of the Resident Population for Selected Age Groups .
6th Grade Social Studies: World Geography and Global Issues SS60301 Unit 3: Population and Migration Lesson 1 Michigan Citizenship Collaborative Curriculum Page 1 of 11 Oakland Schools November 9, 2012 Graphic Organizer Population Patterns Population Growth Population Distribution Population Density . 6th Grade Social Studies: World Geography and Global Issues SS60301 Unit 3: Population and .
Every population of organisms is founded by some initial population. This portion of the module will examine how characteristics of the initial population can impact how quickly the population can grow. In sexually reproducing organisms, at least one male and one female must be present in the founding population for the population to ever grow.
Effective Population Size Census population size often inappropriate for population genetics calculations Breeding population size often smaller For genetic drift, historical events or nonrandom mating patterns might reduce EFFECTIVE size of the population Effective Population Size is an ideal population of size N in which all parents have an equal probability of being
