Understanding Ageing Populations In High-Income Countries: Lesson learned for Indonesia

Authors

  • Marya Yenita Sitohang Research Center of Population, National Research and Innovation Agency

Keywords:

ageing population, health, retirement, policies

Abstract

Ageing population resulting from the upward trend in life expectancy presents multifaceted issues across all domains, including health, financial, and social aspects. It requires additional public policy intervention to address the challenges and maintain the population well-being during the demographic phenomenon. Using a narrative review, this study delves into the implications of an ageing population in high-income countries like Finland, Germany, and Italy, as well as in Indonesia which is just beginning to experience this transition, and analyse public policies related to ageing population in those countries. The findings highlight several issues related to the ageing population, including health deterioration, housing demand accommodating age-related disabilities, and financial aspects of health insurance and retirement system funding. To address these challenges, high-income countries with ageing populations have implemented various policies. For instance, Finland has established guidelines and funding for elderly healthcare in municipalities, ensuring appropriate medical attention. In addition, pension systems and financial literacy initiatives have been introduced in some countries to support the ageing populace financially. Moreover, home-based geriatric care services in Finland and Germany enable elderly to age comfortably in their own homes. These policy implementations offer valuable insights for countries like Indonesia to better prepare themselves for the social, health, and economic implications associated with an ageing demographic. This comparative analysis serves as a crucial foundation for formulating effective policies tailored to the unique needs of ageing societies worldwide.

References

AARP. (2017). The Aging Readiness & Competitiveness Report: Germany. In AARP International and FP Analytics. https://arc.aarpinternational.org/countries/south-africa%0Ahttps://aarpinternational.org/

Ananta, A. (2012). Financing Indonesia’s Ageing Population. Southeast Asian Affairs, 2012, 135–149.

Ananta, A., Moeis, A. I. A., Widianto, H. T., Yulianto, H., & Arifin, E. N. (2021). Pension and Active Ageing: Lessons Learned from Civil Servants in Indonesia. Social Sciences, 10(11), 436. https://doi.org/10.3390/socsci10110436

Arksey, H., & O’Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology: Theory and Practice, 8(1), 19–32. https://doi.org/10.1080/1364557032000119616

Atarodi, S., Berardi, A. M., & Toniolo, A. M. (2019). Comparing local policy practices to implement ICT-based home care services for aging-in-place in Finland, France, Italy, Spain, and Sweden. Gerontechnology, 18(2), 108–121. https://doi.org/10.4017/gt.2019.18.2.005.00

Barbabella, F., Cela, E., Socci, M., Lucantoni, D., Zannella, M., & Principi, A. (2022). Active Ageing in Italy: A Systematic Review of National and Regional Policies. International Journal of Environmental Research and Public Health, 19(1). https://doi.org/10.3390/ijerph19010600

Biermann, H., Offermann-Van Heek, J., Himmel, S., & Ziefle, M. (2018). Ambient assisted living as support for aging in place: Quantitative users’ acceptance study on ultrasonic whistles. JMIR Aging, 1(2). https://doi.org/10.2196/11825

Bloom, D. E., Chen, S., McGovern, M., Prettner, K., Candeias, V., Bernaert, A., & Cristin, S. (2015). Economics of Diseases in Indonesia. World Economic Forum, April, 1–16. http://www3.weforum.org/docs/WEF_The_Economics_of_non_Disease_Indonesia_2015.pdf

Campbell, J. C., Ikegami, N., & Gibson, M. J. (2010). Lessons from public long-term care insurance in Germany and Japan. Health Affairs, 29(1), 87–95. https://doi.org/10.1377/hlthaff.2009.0548

Carpenter, I., Gambassi, G., Topinkova, E., Schroll, M., Finne-Soveri, H., Henrard, J. C., Garms-Homolova, V., Jonsson, P., Frijters, D., Ljunggren, G., Sørbye, L. W., Wagner, C., Onder, G., Pedone, C., & Bernabei, R. (2004). Community care in Europe. The Aged in Home Care project (AdHOC). Aging Clinical and Experimental Research, 16(4), 259–269. https://doi.org/10.1007/BF03324550

Chomik, R., & Piggott, J. (2013). Asia in the ageing century: Part I – Population trends. In CEPAR research brief (Vol. 01).

de Lorenzo, A., & Esposito, E. (2020). Editorial - Epidemiological transition, crisis of the Italian health system: Ethical and logical economic choices. European Review for Medical and Pharmacological Sciences, 24(8), 4616–4622. https://doi.org/10.26355/eurrev_202004_21049

Finnish institute for health and welfare. (2022). Home care - THL. Ageing. https://thl.fi/en/web/ageing/older-people-services-undergoing-a-change/home-care

Fornero, E., & Monticone, C. (2011). Financial literacy and pension plan participation in Italy. Journal of Pension Economics and Finance, 10(4), 547–564. https://doi.org/10.1017/S1474747211000473

Genet, N., Boerma, W. G., Kringos, D. S., Bouman, A., Francke, A. L., Fagerström, C., Melchiorre, M., Greco, C., & Devillé, W. (2011). Home care in Europe: A systematic literature review. BMC Health Services Research, 11. https://doi.org/10.1186/1472-6963-11-207

Germany Federal Ministry of Health. (2018). Germany’s latest reforms of the long-term care system (Issue January). http://ec.europa.eu/social/home.jsp?langId=en

Harfina, D., Purwaningsih, S. S., Prasetyoputra, P., Hafsari, T. A., Sitohang, M. Y., Feneteruma, L., Rahadian, A. S., Vibriyanti, D., Seftiani, S., & Hidayati, I. (2019). JKN dalam kacamata pekerja sektor informal. Yayasan Pustaka Obor Indonesia.

Hull, T. H. (2009). Caught in Transit: Questions About the Future of Indonesian Fertility. Population Bulletin of the United Nations: Completing the Fertility Transition, 1985, 516. http://hdl.handle.net/1885/57143

IHME. (2019a). Finland | Institute for Health Metrics and Evaluation. https://www.healthdata.org/finland

IHME. (2019b). Germany | Institute for Health Metrics and Evaluation. https://www.healthdata.org/germany

Kalache, A., & Gatti, A. (2003). Active ageing: a policy framework. Advances in Gerontology = Uspekhi Gerontologii / Rossiiskaia Akademiia Nauk, Gerontologicheskoe Obshchestvo, 11, 7–18. https://doi.org/10.1080/tam.5.1.1.37

Kertzer, D. I., White, M. J., Bernardi, L., & Gabrielli, G. (2009). Italy’s path to very low fertility: The adequacy of economic and second demographic transition theories. European Journal of Population, 25(1), 89–115. https://doi.org/10.1007/s10680-008-9159-5

Lehto-Niskala, V., Jolanki, O., Valvanne, J., & Jylhä, M. (2021). Standardised functional assessment in long-term care for older people: perspective of Finnish care workers. Nordic Journal of Social Research, 12(1), 27–47. https://doi.org/10.7577/njsr.3734

Lutfiah, U., Besral, B., & Herdayati, M. (2017). Individual and Regional Factors that Affect Fertility Rates in Five Provinces of Indonesia. Makara Journal of Health Research, 21(1), 6–12. https://doi.org/10.7454/msk.v21i1.6067

Makinen, E. (2017). Controlling Nordic municipalities. European Public Law, 23(1), 123–147.

Mazzola, P., Rimoldi, S. M. L., Rossi, P., Noale, M., Rea, F., Facchini, C., Maggi, S., Corrao, G., & Annoni, G. (2016). Aging in Italy: The need for new welfare strategies in an old country. Gerontologist, 56(3), 383–390. https://doi.org/10.1093/geront/gnv152

McDonald, P. (2008). Very Low Fertility Consequences, Causes and Policy Approaches. The Japanese Journal of Population, 6(1), 19–23.

McKeown, R. E. (2009). The Epidemiologic Transition: Changing Patterns of Mortality and Population Dynamics. American Journal of Lifestyle Med, 3(1). https://doi.org/10.1177/1559827609335350.The

Mercer, A. J. (2018). Updating the epidemiological transition model. Epidemiology and Infection, 146(6), 680–687. https://doi.org/10.1017/S0950268818000572

Ministry of Social Affairs and Health Finland. (2008). National framework for high-quality services for older people. Ministry of Social Affairs and Health. http://pre20090115.stm.fi/ka1212393066110/passthru.pdf

Ministry of the Environment Finland. (2013). Housing development programme for older population for 2013-2017.

Monasta, L., Abbafati, C., Logroscino, G., Remuzzi, G., Perico, N., Bikbov, B., Tamburlini, G., Beghi, E., Traini, E., Redford, S. B., Ariani, F., Borzì, A. M., Bosetti, C., Carreras, G., Caso, V., Castelpietra, G., Cirillo, M., Conti, S., Cortesi, P. A., … Ronfani, L. (2019). Italy’s health performance, 1990–2017: findings from the Global Burden of Disease Study 2017. The Lancet Public Health, 4(12), e645–e657. https://doi.org/10.1016/S2468-2667(19)30189-6

Nadash, P., Doty, P., & Von Schwanenflügel, M. (2018). The German Long-Term Care Insurance Program: Evolution and Recent Developments. Gerontologist, 58(3), 588–597. https://doi.org/10.1093/geront/gnx018

Niccoli, T., & Partridge, L. (2012). Ageing as a risk factor for disease. Current Biology, 22(17), R741–R752. https://doi.org/10.1016/j.cub.2012.07.024

OECD. (2013). Finland Highlights from A Good Life in Old Age ? Monitoring and Improving Quality in Long-Term Care (Issue June).

Paramita, S. A., Yamazaki, C., & Koyama, H. (2020). Determinants of life expectancy and clustering of provinces to improve life expectancy: An ecological study in Indonesia. BMC Public Health, 20(1), 1–8. https://doi.org/10.1186/s12889-020-8408-3

Rhee, J. C., Done, N., & Anderson, G. F. (2015). Considering long-term care insurance for middle-income countries: Comparing South Korea with Japan and Germany. Health Policy, 119(10), 1319–1329. https://doi.org/10.1016/j.healthpol.2015.06.001

Ricciardi, W., Specchia, M. L., & Marino, M. (2014). Health of the Elderlies and Healthy Ageing: Challenge for Europe. Studies in Health Technology and Informatics, 203, 1–9. https://doi.org/10.3233/978-1-61499-425-1-1

Riedel, H. (2003). Private Compulsory Long-term Care Insurance in Germany. Geneva Papers on Risk and Insurance: Issues and Practice, 28(2), 275–293. https://doi.org/10.1111/1468-0440.00223

Salgado, R. M. (2017). 2. Asia : At Risk of Growing Old before Becoming Rich? Introduction and Main Findings Demographic Trends in Asia. In Regional Economic Outlook (Issue April, pp. 43–75). International Monetary Fund.

Sitohang, M. Y., & Ghani, M. W. (2022). The Urgency of Health Insurance Literacy for Indonesian People: Between Smoking and Paying JKN Premium. Journal of Public Health for Tropical and Coastal Region, 5(3), 101–112. https://doi.org/10.14710/jphtcr.v5i3.13746

Theobald, H., & Hampel, S. (2013). Radical institutional change and incremental transformation: long-term care insurance in Germany. In C. Ranci & E. Pavolini (Eds.), Reforms in Long-Term Care Policies in Europe (pp. 117–133). Springer Science.

Tucker, S., Sutcliffe, C., Bowns, I., Challis, D., Saks, K., Verbeek, H., Cabrera, E., Karlsson, S., Leino-Kilpi, H., Meyer, G., Soto, M., Stephan, A., Renom-Guiteras, A., Sauerland, D., Wüubker, A., Bremer, P., Hamers, J. P. H., Afram, B., Beerens, H. C., … Vellas, B. (2016). Improving the mix of institutional and community care for older people with dementia: an application of the balance of care approach in eight European countries. Aging and Mental Health, 20(12), 1327–1338. https://doi.org/10.1080/13607863.2015.1078285

United Nations, Department of Economic and Social Affairs, P. D. (2019). World Population Prospects 2019 - Volume II: Demographic Profiles. In World Population Prospects 2017 - Volume II: Demographic Profiles: Vol. II. https://doi.org/10.18356/9789210001021

United Nations. (2019a). Indonesia- World Population Prospects: Vol. II.

United Nations. (2019b). Italy- World Population Prospects: Vol. II.

Valkama, P., & Oulasvirta, L. (2021). How Finland copes with an ageing population: adjusting structures and equalising the financial capabilities of local governments. Local Government Studies, 47(3), 429–452. https://doi.org/10.1080/03003930.2021.1877664

Vibriyanti, D., Harfina, D., Seftiani, S., & Sitohang, M. Y. (2019). Lansia Sejahtera Tanggung Jawab Siapa? Yayasan Pustaka Obor.

Wong, A. Y., Karppinen, J., & Samartzis, D. (2017). Low back pain in older adults: risk factors, management options and future directions. Scoliosis and Spinal Disorders, 12(1), 1–23. https://doi.org/10.1186/s13013-017-0121-3

Downloads

Published

2023-12-31