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Associate Professor Dr. Giang Thanh Long, Director of Public Policy and Management (National University of Economics) responded to VnExpress about the challenge of Vietnam entering a period of population aging.
– How do you assess the current situation of the aging population in Vietnam?
– The golden structure of the population is that children (0-14 years) are less than 30%, people over 65 are less than 15% of the total population. Elderly population when the number of people older than 65 years represents more than 10%; very old population when people over 65 represent more than 20%; super-old population when people over 65 represent more than 30%.
In Vietnam, the aging of the population (when the proportion of the elderly in the population structure increases rapidly) began in the late 1980s, after five decades of implementation of population and family planning policies, both water has succeeded in its goal of reducing fertility. If in 1979, on average, a woman had 3.5 children, but after 10 years, only 2.6. By 2019, the total fertility rate (the number of children per woman) will drop to 2.09, lower than the replacement fertility rate of 2.1 (on average, each woman has 2.1 children).
The life expectancy of Vietnamese in recent years has improved rapidly, so the number of older people has increased rapidly. As a lower-middle-income country, the average life expectancy of Vietnamese is almost 74 years.
In the past 10 years, the country’s population has increased by 11 million, while the number of the elderly has also increased by almost 4 million. This is a very high growth rate of the aging population compared to other countries in the region, almost the same as Thailand. There are currently 11.4 million people over the age of 60, which represents almost 12% of the population. The aging index increases from 36% in 2009 to almost 49% in 2019.
As of 2026, the proportion of people over 65 will be more than 10%, Vietnam ends the golden structure of the population that existed in 2007 and enters the age of the population. By 2039, the number of people over 65 will constitute more than 15% of the total population and will continue until 2054. From 2054, the population is very old.
– How does the aging of the population affect the socio-economic development of the country?
Vietnam is currently a lower-middle-income country, so a rapidly aging population is a great challenge if it cannot sustain growth and raise median income.
Another challenge is that the average life expectancy is high, but the healthy life expectancy rate of Vietnamese is low and the number of years of illness and disease is high. The average life expectancy of the Vietnamese is as high as that of Thailand and Malaysia, but the average number of years of illness per person is higher. We live long but not well.
The main income of the elderly in Vietnam today is largely based on their workforce (30%), on their descendants (30%). The number of people who live on social security resources such as pensions, social insurance … only represents 20%. This is the risk when entering the period of an elderly population, the number of children in families is small, but many elderly people have to be cared for. If in the past each family cared for their parents with three or four children, with the current trend of having few children, in the future each family would have only one or two children to care for their parents. This is a great burden for the young, as well as for the main workforce in society.
This situation has happened in China, when implementing the policy of one child per family, the whole family is made up of paternal grandparents, maternal grandparents, the couple who care for a child. But after a few decades, when the child becomes an adult, he has to take care of only five or six elderly people. This is a lesson for many countries, including Vietnam.
I am also concerned about the fact that the population is aging rapidly but is not healthy. The evidence is that the number of people suffering from non-communicable diseases such as cardiovascular diseases, osteoarthritis, diabetes … is increasingly common. These diseases will persist throughout life, resulting in high costs as the population ages rapidly, creating a burden of disease for society.
Assoc. Dr. Giang Thanh Long. Image: Vermont
– How well are the experiences of the countries of the world adapting to the period of population aging, sir?
Many countries with a very old population but still at the top of the developed high-income countries are Japan, South Korea. In particular, Korea is leading the world in applying advanced information technology to care for the elderly, to offset the very low birth rate in this country (below 1).
In Southeast Asia, Thailand recognized the challenges early and has been proactively formulating policies to adapt to the aging population for many years. First, the government created management profiles for noncommunicable diseases prevalent among the elderly in health facilities across the country, from an early age. The medical records of each person in the system are updated, monitoring bone and joint diseases, diabetes, cardiovascular … The government expands health insurance coverage, forcing everyone to participate. . Difficult people, the informal labor sector are supported by the Government. The authorities in this country also require workers, both formal and informal, to join the social security system.
In Japan, in 1989, the Ministry of Health and Welfare issued policy 80-20, which means that when citizens live to be 80, they still have 20 healthy teeth. When there are 2/3 of the healthy teeth, the person will chew well, digest well, leading to few diseases related to digestion and stomach. In addition, good oral health will help older people to be healthy both physically and socially, since if their teeth smell bad, they will be afraid to communicate, having a great mental impact. In proposing this policy, the Japanese authorities estimate that only 7% of people over the age of 80 have 20 good teeth. However, by 2019, to celebrate the 30th anniversary of this policy, the entire country has 55% of the elderly with 20 good teeth. Therefore, Japan is a country with a long and healthy population with few diseases.
These are lessons for Vietnam to prepare itself to enter a period of population aging.
– What preparation does Vietnam need to adapt to the aging population?
– The aging of the population is both a challenge and an opportunity. If the government wants to adapt well, the government needs to have macro-level policies right now. The first is financial preparation. Vietnam is a lower-middle-income country, so after more than 30 years, the super-old population is susceptible to the challenge of low pensions, even many older people who do not have a salary because when they are young they do not participate in the social Security. Currently, the participation rate in social security is only 26% of the population. It is a fact that many young people today abuse alcohol, stimulants, sedentary lifestyle … so when they get older, it will be a serious consequence for society in terms of health.
Therefore, the authorities need to have policies that encourage people of working age to increase productivity, prepare well in terms of economic resources, accumulate old age and have a sense of health. People of working age, especially the informal sector, need support to participate in social security so that when they get older they can take care of themselves, instead of depending on their children or grandchildren. Government welfare policy.
Over the past 10 years, Vietnam has begun to prepare for an aging population. The social security system was reformed, attracting many people to join. This is an important policy to guarantee income and pensions for the elderly in the future. Some diseases that often occur in the elderly, such as blood pressure, have been incorporated into the management system of the commune health unit.
The rapid rate of population aging causes the workforce to contract. When the workforce is too small, great pressure will be placed on creating income for society and contributing to welfare resources. The risk of labor shortages in the future will not only occur in Vietnam, but also in many countries. However, developed countries in the region like Japan, Singapore … have good income conditions and facilities to attract high-quality workers from countries including Vietnam. This is also the risk that must be taken into account in developing policies that improve the skills, productivity and conditions of employees.
To limit the aging of the population, authorities must develop policies so that couples can feel safe giving birth and raising children. Because today many families, especially in large cities, tend to have few children. The main reason is that the cost of raising children is very expensive, including education, health, housing, rest, play … Designing cost reduction policies is a way to encourage childbirth.
