There is much to say about the global aging of the human population, as life expectancies tend to rise, and fertility rates tend to decline, over most of the world. While this is an international trend, different countries experience this trend in different ways. Looking at how different nations manage demographic change is useful for policy and other research regarding the well-being of older adults. A forthcoming article in The Gerontologist provides an overview of what demographic and economic change in Chile might mean for Chilean older adults.
Chile is twice the geographic size of Japan and has about 17 million people, most of who live in urban areas. Chile stretches for over 2,600 miles (with an average width of just over 110 miles) along much of the west coast of South America, and is therefore extremely geographically and climactically diverse. Like much of the world, Chile is experiencing a profound demographic transition. Currently, about 13 percent of Chileans are aged 60 and better, a proportion expected to increase to over 20 percent over the next three decades.
Chile has become a wealthier country in recent years, and is now considered an upper middle income country by the World Bank, with the second highest Gross Domestic Product in Latin America. Chile’s demographic transition is similar to other relatively wealthy nations, with low fertility rates and decreasing yearly mortality rates. However, Chile is extremely high in economic inequality, and lacks systematic approaches to the health and social needs of older adults. Much of this is due to the legacy of the dictatorship of Augusto Pinochet. This military dictatorship, which took power in a violent coup in 1973 and ruled until 1990, dissembled the existing National Health Service in favor of an unregulated health market that allowed extreme health inequalities.
Although Chile’s more recent elected governments have instituted reforms that increased health care access, the health system is relatively uneven and segmented. Some of these reforms mandated that private and public insurers provide coverage for a set of 69 targeted diseases, including some chronic conditions that are associated with aging. However, individuals in different regions and at different socioeconomic levels have very different health care experiences. Further, the authors state that there is a lack of epidemiological research on older Chileans. As a result, little is known about the overall health behaviors and needs among older adults in the country, especially in rural areas.
The authors point out that the rapid economic and demographic changes taking place in Chile might make it a useful case study for other regions undergoing such transitions. Given the relative deficit of research on the current health state of older Chileans, it is difficult to predict whether these changes are causing social, psychological, and medical stress among the older adult population, or whether they will afford new possibilities and benefits for older adults.
Gitlin LN and Fuentes P. The Republic of Chile: an upper middle-income country at the crossroads of economic development and aging. The Gerontologist, (2012). 52(3):297-305.