Title: Factors influencing the living arrangements of elderly in - PDF document

Title: Factors influencing the living arrangements of elderly in South Africa Authors: Chantal Munthree (chantalmu@statssa.gov.za) and Angela Ngyende Institution: Statistics South Africa Abstract Background: The proportion of elderly is growing at a more rapid pace in the developing world. In the last 15 years the proportion of elderly in South Africa has increased (7, 1% in 1996 to 8, 0% in 2011) and will continue to do so given current levels of fertility and mortality (UN, 2015). Projections show that the older population will continue to increase and by 2030 there will be more than six and a half million elderly persons in South Africa (MYPE, 2017). South Africa is ill prepared to cater for the needs of the growing proportion of elderly in the country. Living arrangements are fundamental in old age, particularly during frail years, as it is determining factor on the extent to which elderly access health care and social support. Data and Methods: The census 2011 data as well as the General Household Survey 2005 and 2015 was used to identify the trend in living arrangements in South Africa over time. Multivariate and regression analysis using the GHS 2015 data was used to determine the socio demographic factors influencing the living arrangements of elderly in South Africa. Findings: The proportion of elderly persons living alone has grown between 2005 and 2015, particularly amongst elderly women. More than a half of elderly women (52%), live with 1 or more persons and were shouldering the responsibility of heading their respective households By 2015 a higher proportion of elderly women (26.3%) are household heads catering for the needs of more than 1 person when compared to men (9.2%). A little more than 10% of elderly in South Africa report living alone. The elderly men who by choice or circumstance reside alone are more likely to be Black African with low levels of education, unemployed and accessing a social grant. Elderly women residing alone however are likely 4 time more likely to be white than Black African, older than 64 years of age, having higher education, unemployed and accessing a social grant. Both elderly men and women residing alone are located more so in the Western and Northern Cape. Amongst elderly men living with 1 or more person as head of the household, we find they are more likely to be Black African, married, with lower levels of education, employed, and more likely to be accessing a social grant. Amongst elderly women living with 1 or more person as head of the household the pattern is rather different as we find they are find they are more likely to be Black African, never married/ divorced/ widowed of separated with even lower levels of education, unemployed with no access to a social grant. Recommendations : Home based care and mobile heath social services should target key population among the elderly in South Africa to alleviate the added vulnerability of living alone. Programs and policies should be developed to address the key factors influencing living arrangements of elderly, if such policies are to more effectively address the wellbeing of elderly. 1

Introduction The living arrangements of people vary significantly by age. The focus of this paper is to better understand the living arrangements among people transitioning into older and more vulnerable stages of life. In South Africa the age at which the people are afforded a social pension to support themselves in their old age is 60 years of age. This is also the official age of retirement (National Treasury, 2007).) Apart from a shared experience in the labour market regarding retirement, adults aged 60 and over also display similar physical characteristics and patterns of morbidity and mortality. The elderly are however not a homogenous group thus a secondary purpose of this paper is to elaborate on the diversity of the characteristics and living arrangements of elderly in South Africa. Living arrangements refers to the familial and non – familial relationships of a person to all the other people with whom they usually reside. Living arrangements are fundamental in old age, particularly during frail years, as it is determining factor on the extent to which elderly access health care and social support. Living arrangements of elderly persons continue to be largely influenced by culture, marriage, migration and urbanisation, female labour force participation, and generally, modernisation characterised by individualistic life style ( Amoateng, A.Y et al (2007) ). This is contrary to living arrangements elderly persons experienced in traditional societies, where they mostly lived with children and families, and were provided all forms of support. One of the implications of the evolving household composition is that the elderly are no longer assured of the family support structure. In South Africa, many elderly are faced with not having the necessary economic means to live independently (May,2003). Furthermore, elderly in South Africa often find themselves bearing the financial and physical responsibility of caring for others in their old age. Understanding the characteristics of elderly living alone as opposed to elderly residing with others can shed light not only on the socio demographic characteristics that influence the living arrangements of the elderly, but also the circumstances under which elderly reside in South Africa. A primary goal of the international Sustainable Development Goals (SDG’s ) is to “leave no one behind” and this includes elderly and the vulnerable. To address the African continent’s integrated plan to bring about prosperity, the African Union has placed the inclusion of the elderly as a central focus of Agenda 2063. More locally, the National Development Plan of South Africa is tasked with protecting the growing proportion of elderly in the country, catering to their social, economic, and general well-being. Healthy ageing defined by the World Health Organisation, is the developing and maintenance of functional ability among the elderly. In an effort to better understand whether the elderly in South Africa are indeed provided with an environment that allows for healthy 2

aging, this paper seeks to examine the change on living arrangements among the elderly over a decade, as well as understand the differentials in the living arrangements of elderly in South Africa to draw attention to the plight of elderly for policy intervention. Literature review The world population is reported to be ageing at a far more rapid pace than has ever been experienced (WHO, 2015). The developed world has contributed largely to the global ageing of society with life expectancy reaching upwards of 70’s and 80’s, comprising of approximately 15 % of the total population in the developed world (Global ageing, 2015). In contrast, in the developing world, the ageing of populations though at a far lower level than the developed world, is increasing at a more rapid pace than that experienced by the developed world. The forces of ageing in this context, can be attributed to declining fertility and rising life expectancies resulting in significantly higher number of elderly residing in less developing regions (WHO, 2015). The ageing of less developed regions are expected to continue to rise given the dynamics of these forces. According to the United Nations (2015) the percentage change in elderly within the more developed regions is expected to decline from 29.2% between 2000 and 2015, and to 25,6% between 2015-2030. In contrast the percentage change in elderly within the less developed regions increased from 60.3% between 2000 and 2015, to 70.6% between 2015-2030 (United Nations, 2015) . Aging in Africa and Sub Saharan Africa Ageing in Africa is occurring at a far higher rate when compared to other regions of the world (UN, 2015). According to the United Nations (2015), the number of persons in Africa aged 60 and over, increased from 42,4 million in 2005 to 64,4 million by 2015, and is said to triple by 2050 to 220,3 million. Third to Asia and Latin America and the Caribbean, Africa is experiencing the one of the highest growth rates in the proportion of elderly aged 60 and over (UN, 2015). Studies indicate that the proportion of older people living in poverty is higher than the national average, as found among 11 of the 15 countries surveyed. ( http://www.global-ageing.eu/agafrica.html). Whilst the developed world has had decades to adjust to the changing proportions and needs of the elderly, Africa’s relatively faster pace of ageing has resulted in the region being ill prepared for the needs of its elderly constituents. There is also limited data on the level and characteristic of elderly in the region as a whole. Though census data, where available, provides some information regarding the characteristics of the elderly, many surveys including the Demographic and health surveys conducted across the globe, exclude elderly age 60 and over when gathering data on heath, reproduction etc. We cannot negate the recent advancement in better understanding the social, economic and physical needs of the elderly in the last decade in the region, however such studies are often limited in their focus. Many studies tend to focus on disabilities and poverty among the elderly neglecting the social circumstances of elderly in the country. Even fewer studies explore factors influencing the plight of elderly. Ageing in South Africa 3