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Mexico, rest of Latin America get grayer

By Marla Dickerson
Los Angeles Times

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Her charm is singular but not her age. At 102, Delgadillo is one of several centenarians living at the government-run facility in Mexico's capital.

If demographers are right, there are a lot more like her on the way.

Aging is old news in the industrialized world, but the age wave is sweeping toward developing countries as well. Within a few decades, Mexico and other Third World nations may not know what hit them.

Although it is still relatively youthful compared with much of the rest of the world, Latin America is graying quickly. In Chile, Costa Rica, Mexico and Venezuela, the percentage of elderly in the population is projected to double between 2000 and 2025.

Rapid emigration of young workers to the United States is accelerating the trend, particularly in the tiny countries of Central America and the Caribbean.

For some, the future is already here.

The Western Hemisphere's oldest country isn't the United States or Canada. It's Uruguay, where more than 17 percent of the population is older than 60.

Within a couple of decades, more than half the elderly people in the hemisphere will live south of the U.S. border, said Marta Pelaez, an expert on aging at the Pan American Health Organization.

"It's a huge shift that no one wants to look at, because it's going to take a massive effort to prepare," Pelaez said. "But it's happening. And it's happening fast."

Developing regions of Asia are seeing a similar trend. China will be home to about 332 million senior citizens by midcentury.
 
Experts say the rapid transition will put tremendous strain on developing countries to provide for their old and frail. It's a task that's bedeviling even the world's wealthiest nations.

In contrast to the United States, Europe and Japan, which are trying to preserve existing old-age retirement and medical systems without bankrupting their youth, many poor countries lack even bare-bones protection for their seniors. In Mexico, for example, the vast majority of the elderly lack pension benefits and nearly half have no health-care coverage.

Working past 65

The lack of old-age security already is evident in the streets of the capital. Here seniors routinely can be seen begging or working, mostly in subsistence jobs in the underground economy. Nearly half of Mexican men 65 or older are still in the work force, compared with 18 percent in the United States. Among elderly Mexican women, about 15 percent are still at it as well.

Observers say the biggest transformation for some poor nations may come in how they perceive themselves. Age discrimination, senior health and the retrofitting of public facilities for a mature population are largely new territory for places still preoccupied with infant mortality and creating jobs for the young.

"The real challenge will be psychological," said Dr. Sergio Valdes Rojas, a gerontologist and director of the Arturo Mundet nursing home. It's recognizing that "we're not as young as we think we are."

The graying of immigrant-sending regions such as Latin America could have implications for the United States as well. Waves of newcomers have put the United States in a better position than many European nations and Japan to keep its work force growing and its pay-as-you-go Social Security system solvent.

But the aging of America's southern neighbors could eventually slow the flow of working-age immigrants.

"If you don't raise living standards now and begin to put in place some sort of safety net for the elderly, in 2030 or 2040 you could see a humanitarian crisis of colossal proportions," said Richard Jackson, director of the Global Aging Initiative at the Center for Strategic and International Studies in Washington.

To be sure, Latin America remains one of the world's youngest regions. In 2000, nearly one-third of its 511 million people were younger than 15, compared with about one-fifth in the United States.

But advances in health care, nutrition and sanitation have boosted average life expectancy in the region to about 71 years — nearly 20 years longer than it was in the early 1950s.

Meanwhile, fertility rates have plunged. Rapid urbanization, better family planning and more women in the work force have led to a drop in Latin American fertility from an average of about six children per woman in the mid-1960s to about 2.5 today.

The twin forces of increased longevity and declining fertility have produced an elderly boom in nearly every part of the globe. It's most evident in the industrialized world, where the percentage of the population 65 and older will double to nearly 30 percent by midcentury from about 15 percent today.

Surge in older population

Most Latin American nations will remain younger for decades to come, but they are aging much more quickly. Less than 5 percent of Mexico's population, for example, was elderly in 2000. That percentage will surge to nearly 20 percent by 2050. The senior populations of some European nations took more than a century, even two, to log similar growth.

That compressed time frame worries experts, who note that most industrialized countries achieved prosperity long before their elderly began consuming a significant share of national resources. For much of the developing world, it's now a race against time to strengthen their economies to handle the mammoth social-services needs of their burgeoning senior populations.

In Jimenez de Tuel, a small rural community in Mexico's northwest Zacatecas state, most of the adult men and many working-age women have left for the United States, said Dr. Rebeca Mejia Camacho, head of the federally funded family-services agency for that municipality. Left behind are the elderly, many of whom are surviving solely on remittances sent from the north.

Mejia, a general practitioner, said so many of her patients were seniors that she had become a de facto gerontologist. She said some had grown so infirm that they should be in nursing homes or assisted-living centers.

But private facilities are expensive, and government-funded beds in the region are scarce. Mexico has only 13,300 licensed nursing-home beds, or about one for every 8,000 residents; that compares with 1.9 million beds in the United States, or one for every 150.

The tranquil, manicured grounds of the Arturo Mundet nursing home belie the struggle for resources. The institution receives about $9,100 a year per patient in federal funds to care for its indigent residents, many beset with illnesses such as diabetes, arthritis and dementia, said Valdes, the facility's director. On average, a U.S. nursing home costs more than $70,000 a year per patient.

Arturo Mundet currently houses 140 residents, most of them women. The majority sleep in dormitory-style quarters, as many as eight to a room.

The fertility decline in developing nations means there will be fewer children to care for aging parents — the traditional safety net in poor countries.

Remittances, the lifeline for so many Third World seniors, tend to dry up as their offspring start families of their own in the United States. Traditional pay-as-you-go social-security systems are proving unsustainable for wealthy countries, much less in regions such as Latin America, where the underground economy is enormous and tax collection abysmal.

Like their counterparts in the industrialized world, legislators in developing nations are finding that there will be no easy way to significantly boost spending on seniors without draining other programs or raising taxes on the young.

A powerful constituency

But just as in the United States and Europe, there will be a powerful incentive to satisfy this emerging and potentially powerful constituency.

Andrés Manuel López Obrador, Mexico City's populist mayor and a 2006 presidential hopeful, has stirred intense devotion from seniors here with his health and nutrition program. In addition to free visits and prescriptions at city clinics, capital residents 70 and older receive about $60 a month on electronic smart cards they can use at major supermarket chains.

More than 350,000 seniors receive benefits, with the $263 million tab paid out of Mexico City's annual allotment of federal tax money. Economists have warned that the program is financially unsustainable even at the city level, but advocates for seniors dream of taking it nationwide.