Latin America and the Caribbean

Latin America and the Caribbean (LAC) refers to the region formed by all political units south of the United States. The aging of LAC will manifest in earnest and accelerate starting around 2030. The share of the total population age 65 years and older was 5% in 2000 and is projected to reach 17% in 2050. However, by 2025, Argentina, Barbados, Brazil, Chile, Cuba, Puerto Rico, Uruguay, and Trinidad already should achieve fractions of at least 15%. Aging in LAC will occur faster and prematurely compared with previous aging in developed countries, presenting special challenges for the region.

In 2000, the age composition of the populations in all countries of LAC reflected a combination of mortality declines that began mostly after World War II, but not all countries experienced similar transitions. For example, Bolivia and Haiti still lag relatively behind in the mortality gains achieved by the region. Although fertility began to drop prior to 1945 in a few countries (Argentina, Cuba, Puerto Rico, and Uruguay), most of LAC had high fertility until the late 1960s and early 1970s. Then a decline started to spread throughout the region, launching the aging process in LAC. Uruguay is the oldest country, with 13% of the population age 65 years and older in 2000, compared with 3.5% in Nicaragua and Honduras. Societies that experienced the most rapid fertility declines will also exhibit the fastest aging. Between 2000 and 2050, the fraction of the population age 65 years and older will rise from 10% to 27% in Cuba and from 5% to 18% in Brazil.

The current elderly of LAC are a particularly important group in the global aging phenomenon. Those who reach 60 years of age between 2000 and 2025 were born between 1940 and 1965 and experienced dramatic gains in survival during their childhoods. Unlike those who aged earlier in developed countries, these cohorts are survivors of a regime in which infectious diseases were still highly prevalent and grew up in relative poverty. Their childhood survival was more a result of adoption of imported medical technologies after World War II rather than an improvement in standards of living. The likely consequences of this unprecedented pattern of aging are unknown. The issue is that, compared with old individuals in developed countries, these cohorts may exhibit higher prevalence of chronic illnesses and disability during old age because of their childhood survival regime. Another peculiar feature of the LAC aging is that many countries are experiencing a mixed epidemiological pattern in which noncommunicable diseases have begun to gain importance while mortality from communicable diseases is still prevalent. Countries with relatively low incomes and education, such as Guatemala and Haiti, have especially high mortality due to diseases such as cholera, malaria, and dengue fever, particularly among the rural and indigenous populations. The consequences for the onset of [Page 318]chronic illness and disability during old age after surviving under such a mixed regime are also unknown.

One of the concerns for the region is that aging will occur faster than in developed countries. For example, it will take Colombia, Brazil, and Chile only 20 to 25 years to get from 7% to 14% of the population age 65 years and older as a share of the total—around 2030 to 2035—whereas the United States will take 70 years to achieve a similar percentage (in 2013). This accelerated aging means that countries must face rapid growth in their absolute numbers of older adults. The portion of the population age 65 years and older will increase by a factor of 2.5 in Costa Rica between 2000 and 2030, and doubling will occur in Brazil, Chile, Mexico, and Peru over the same period.

...