Abstract:
The Philippines' aging population represents a distinctive point of junction between demographic shifts and cultural dynamics. The Philippines is unique among nations due to its own cultural values and customs that influence older persons' lives. Filipino culture places a significant focus on multigenerational support and close family ties. Although familial assistance is traditionally encouraged in Filipino culture, urbanization and changing socioeconomic dynamics can put a strain on these structures. It is necessary to strike a balance between cultural beliefs and the changing requirements of the elderly population as the nation rapidly modernizes. This involves tackling the problems that an aging population brings about in terms of healthcare access, social assistance, and economic expectations.
Background
The Philippines is an island country of Southeast Asia in the western Pacific Ocean. It is an archipelago with more than 7,000 islands and islets lying about 500 miles off the coast of Vietnam. The Philippines has the thirteenth-highest population in the world. Over 117.3 million people call the Philippines home as of 2023 and the UN Population Fund predicts that number will double by 2069. As for the percentage of the old population, there are 6 percent aged 60 and older given the high fertility rate of 5.7, a relatively high rate compared to many other countries worldwide.
According to the United Nations Population Fund (UNFPA), in 2023, the life expectancy at birth is 70 years for men and 74 years for women, while the mean age is 67. With a relatively high population density, averaging 393.53 per km, the population is concentrated in urban regions, with about 45% of people residing there compared to 55% in rural areas.
Like many other countries, the Philippines is experiencing a rapidly aging population with the number of older people in 2050 expected to double in size - from 7 million to approximately 14 million in less than thirty years. This can strain healthcare systems, social welfare programs, and families who may struggle to care for older adults as their care needs increase.
Who are the older Filipinos?
According to the Economic Research Institute for ASEAN and East Asia, 48% percent of the old population live in rural areas while women comprise 60 percent of this age group in the Philippines. As for the gender gap in life expectancy of four years, old women are more likely to be widowed. In contrast to their male counterparts, who are more likely to stay married, 56 percent of old women in the Philippines are widowed compared to a limited 20 percent among men. Women are more likely to live alone or move in with their adult children as they age to mitigate the risk of poverty and loneliness in the last stage of the life course.
Giving Value to Human Worth
The Philippines has a unique culture and set of circumstances that can impact the process of aging and how older adults are perceived and cared for. With a robust family-oriented culture, families traditionally revered and cared for their older members. This is often reflected in how living arrangements are structured, with multiple generations living under one roof or near each other. Taking care of parents, especially in their old age, is considered a traditional and cultural practice in the Philippines.
In Filipino culture, respect for older adults and family is highly valued, and caring for aging parents is considered a responsibility of adult children. As a result, older adults in the Philippines often rely on their families for financial and emotional support.
A Filipino term for this practice is "Pagpapakatao", which translates to "giving value to human worth". It refers to the obligation of children to take care of their aging parents as a way of honoring them for the sacrifices they made to raise and provide for their children.
While this tradition is not strictly enforced by law, it is deeply ingrained in Filipino culture and is often seen as a moral obligation. Many families choose to live together or near each other to make caregiving more manageable, and it is not uncommon for adult children to financially support their parents by providing for their basic needs or helping with medical expenses.
As shown in the graph below, 58 percent of the older adults in this country, depend on their children as the primary source of financial support and an additional 15 percent depend on remittances from children outside the country.
From a social welfare perspective. the solid family-oriented culture is a compensatory mechanism for the low retirement income provided to older adults by the state. The culture of “financial caregiving” by the offspring makes it difficult for older adults to afford healthcare, housing, and food. In a survey conducted by the Economic Research Institute for ASEAN and East Asia, 57% of older Philippines report insufficient income. Among those with poor economic well-being, 46 percent request more money from children to meet income shortfall.
Promoting the well-being and quality of life of senior citizens in the Philippines
Despite the fact that public pension is very low, the Philippine state has also enacted a few crucial laws to support the old population's welfare and quality of life. For example, the Senior Citizens Act aims to promote the well-being and improve the quality of life of senior citizens by recognizing their contributions to society and providing them with the support they need.
The Republic Act 7432, also known as “The Senior Citizens Act,” was enacted on April 23, 1992, and amended in 2010 and later in 2013. Under the said law, senior citizens who are 60 years old and above are entitled to various benefits and privileges, such as a 20 percent discount on goods and services in restaurants, hotels, and other establishments; exemption from the value-added tax (VAT) on the sale of goods and services; and a 5 percent discount on basic necessities and prime commodities. The law also provides for establishing the National Coordinating and Monitoring Board, which is responsible for ensuring the proper implementation of the law, and the creation of the Office of the Senior Citizen Affairs in each city and municipality to assist senior citizens in availing of their benefits and privileges.
Organizations in Aging
Several organizations and government agencies in the Philippines focus on aging and longevity issues. Here are some of the key leaders and organizations in this field:
1. Coalition of Services of the Elderly (COSE) - COSE is a non-government organization that provides services and support to older adults in the Philippines. They work on health care, social services, and senior citizens' rights.
2. Department of Social Welfare and Development (DSWD) - The DSWD is a government agency responsible for implementing social welfare programs and services for vulnerable groups, including older adults.
3. National Center for Geriatric Health - The NCGH is a specialized hospital that provides medical and rehabilitation services to older adults under the Department of Health.
4. Philippine Medical Association (PMA) - The PMA is a professional organization of physicians in the Philippines. They have a section dedicated to geriatric medicine, which focuses on the health and well-being of older adults.
5. University of the Philippines Manila (UP) - The University has a Center for Aging and Geriatric Health, which conducts research and provides education and training on aging and geriatric health issues.
These organizations are actively working to address the challenges and opportunities presented by aging and longevity in the Philippines.
Public Health Care
The public health insurance programs in the Philippines aim to provide universal health coverage to its citizens, especially those marginalized and vulnerable. These programs play a crucial role in ensuring that all Filipinos, including older adults, have access to quality and affordable healthcare services. The Philippine healthcare system is a mix of public and private healthcare providers. The government provides health care services through the Philippine Health Insurance Corporation (PhilHealth), a social health insurance program that covers around 95% of the population. PhilHealth covers various healthcare services, including hospitalization, outpatient and preventive care. However, access to health care services varies depending on location and socio-economic status, with many rural areas having limited access to health care services.
Importantly, PhilHealth provides financial assistance to its members for medical expenses, such as laboratory tests, medications, and surgeries. Members of PhilHealth are required to pay a monthly contribution based on their income and employment status.
Aside from PhilHealth, there are other public health insurance programs in the Philippines, such as the Philippine Charity Sweepstakes Office (PCSO) medical assistance program and the Department of Social Welfare and Development medical assistance program (DSWD). These programs provide financial assistance to individuals who cannot afford medical expenses and require urgent medical care.
Access to health care services in the Philippines is highly dependent on location. Urban areas generally have better access to healthcare services than rural areas. This is due to several factors, including the concentration of healthcare facilities in urban areas, better transportation infrastructure, and higher levels of education and income. In contrast, many rural areas have limited access to healthcare services, with many people traveling long distances to access healthcare facilities.
In addition to location, access to health care services is also influenced by socio-economic status. People with higher education and income generally have better access to healthcare services than those with lower education and income. This is due to various factors, including the cost of healthcare services, the availability of healthcare facilities, and the quality of healthcare services.
Challenges of Elderly in Accessing Healthcare
The elderly population in the Philippines faces several challenges in accessing healthcare. Some of the key challenges include:
1. Limited healthcare facilities: There is a shortage of healthcare facilities, especially in rural areas, which makes it difficult for the elderly to access quality healthcare services. Many healthcare facilities are concentrated in urban areas, making it challenging for rural elderly individuals to receive timely and appropriate care.
2. Financial constraints: The cost of healthcare services can be a significant barrier for the elderly, especially those who have limited or fixed incomes. High medical expenses, including consultation fees, medication costs, and hospitalization expenses, can be challenging to afford for many elderly individuals and their families.
3. Lack of health insurance coverage: Not all elderly individuals have access to health insurance coverage. While there are government healthcare programs such as PhilHealth, coverage may be limited or insufficient to meet the healthcare needs of the elderly. This lack of insurance coverage can deter the elderly from seeking necessary medical care.
4. Transportation issues: Limited access to transportation can hinder elderly individuals' ability to reach healthcare facilities, particularly in remote or rural areas. Many elderly individuals may face difficulties in traveling long distances to access medical services, which can result in delayed or inadequate healthcare.
5. Age-related health conditions: The elderly population often experiences age-related health conditions that require specialized care. However, there is a shortage of geriatric healthcare professionals in the country. The lack of trained healthcare providers and geriatric specialists can affect the quality and availability of healthcare services for the elderly.
6. Health literacy and awareness: Many elderly individuals may have limited health literacy or awareness regarding their healthcare needs, available services, and preventive measures. This can lead to a lack of understanding of proper health practices, delayed healthcare seeking, and ineffective management of chronic conditions.
Addressing these challenges requires a comprehensive approach involving improving healthcare infrastructure, expanding health insurance coverage, enhancing transportation options, increasing the availability of geriatric healthcare professionals, and promoting health literacy and awareness among the elderly population.
The Philippines is experiencing demographic changes that significantly affect its healthcare system. With a rapidly aging population, health insurance has become vital to the country's health care system. However, access to health care services varies widely between rural and urban areas, resulting in significant health outcomes disparities. Addressing these disparities will require a comprehensive approach that includes improving the availability and quality of healthcare services, addressing socio-economic inequalities, and investing in healthcare infrastructure in rural areas.
In conclusion, the aging population in the Philippines presents a distinctive cultural context that intertwines with the challenges and opportunities of an aging society. By leveraging its cultural strengths and implementing targeted measures to address the evolving needs of older adults, the Philippines can navigate the demographic shift with resilience, ensuring a dignified and supportive environment for its aging population that is rooted in its unique cultural heritage.