In line with the global aging population trend, Jamaica has seen a rapid increase in its elderly population. This increase is now calling for continued action to address the health barriers faced by the elderly in Jamaica.
An Aging Population
In 1995, Jamaica reported having 110,430 males and 130,020 females in the 60 years and older group. This represented 9.42% of the total population in the country. By 2001, Jamaica’s elderly population consisted of 122,844 males and 141,869 females. A decade later in 2011, the census reported that the number of individuals who were 60 years or older had risen to 145,204 males and 159,979 females. These numbers indicated a 15.2% increase in the total number of people who were 60 years or older from 2001 to 2011.
Additionally, by 2011, those in this age group accounted for a greater share of the dependency ratio, a ratio measuring the number of young (0-15 years) and old (60 years or older) people in a population compared with that of the working population.
The World Health Organization has stated that this older population is mostly affected by chronic non-communicable diseases, such as cardiovascular diseases, diabetes, arthritis, hypertension and cancers. In 2018, Jamaica reported that 72% of elderly people had at least one chronic illness, with hypertension and diabetes being the most common. This contributes to the high percentage of people taking medication as well. Furthermore, persons over 60 years of age were much more likely to experience protracted illnesses in comparison to the rest of the population.
With recent progress in Jamaica’s life expectancy, the elderly are living longer. According to the World Health Organization, in 2018, the life expectancy for Jamaicans was 76.2 years. It is expected that these individuals will require more long-term care and rehabilitation services as they become increasingly vulnerable to diseases and lose physical or mental capacities.
However, there is limited access to local long-term care services in Jamaica and the number of caregivers has decreased throughout the country. Traditionally, younger Jamaicans would stay home and help care for older family members, but with the recent fall in family size resulting from a drastic drop in the fertility rate, the number of family members available to care for these individuals has significantly declined. The issue is worsened by the increasing number of young Jamaicans migrating abroad, typically to the United States, and leaving their older family members behind who frequently encounter difficulties in accessing rehabilitation services independently.
Financial Barriers to Healthcare
Many older Jamaicans also face financial barriers in accessing much needed medical treatment and services. While Jamaica has established a wide and extensive network of public primary care centers and hospitals offering free or low-cost services, the cost of medications and other health care resources has risen as most of these products are imported and the nation’s currency has undergone severe devaluation.
These financial burdens are especially felt by the country’s older population who rely on pensions to cover their living and health expenses. The Old Age Pension provided to qualifying retired Jamaicans is usually insufficient to cover the additional health costs associated with old age as the pensions do not adjust to meet the yearly changes in the cost of living.
Lack of Access to Healthcare in Rural Areas
Additionally, older Jamaicans living in rural areas experience significantly higher barriers to health as there is a lack of overall access to medical care, health and treatment services and transportation. A study conducted in 2012 found that people living in rural areas tend to have more “uncontrolled and undiagnosed disease,” evidenced by the fact that 27.5% of those surveyed who were diagnosed with high blood pressure had not previously received a diagnosis from a doctor. Furthermore, among those who had received a prior diagnosis, 72.2% had signs of the disease as being poorly controlled.
Also, health barriers are intensified by the fact that only 30% of the elderly population living in rural areas are pension recipients as compared to 44.4% in the Kingston Metropolitan Area. The elderly in rural areas also report having greater issues with food availability and adequacy as 53% stated not having easy access to the food they need.
Researchers Eldemire-Shearer, K Mitchell-Fearon and DL Holder-Nevins stated in 2014 that these difficulties in accessing treatment and food emphasize the health challenges that older Jamaicans face as the current health system is primarily engaged in reducing chronic disease and maintaining functional ability. They say a different approach is needed to better meet the new demands of older Jamaicans who suffer from prolonged mental or physical conditions.
In 2018, the Jamaican government revised the National Policy for Senior Citizens, created in 1997, to introduce new measures for supporting and improving the quality of life for the elderly. The plan outlines a multi-stakeholder approach designed to address social, economic and health barriers faced by this fast-growing population.
The document promotes universal access to quality health care for all senior citizens and acknowledges the varying medical needs within this age group. It also calls for a greater expansion of health insurance coverage since only 23% of elderly people are insured.
Furthermore, the plan outlines steps for improving income security for all senior citizens and tasks the government with providing food assistance when necessary. It also provides detailed initiatives for expanding access to health resources, including mental health services, home and respite care, physiotherapy and other rehabilitation services. All these health resources for the elderly are to be carried out under the supervision of the National Council for Senior Citizens, which monitors and evaluates the progress of senior citizen programs at both the national and regional levels.
While the existing health care system will require the full implementation of all these measures in the coming years to combat the health barriers faced by the elderly in Jamaica, this policy plan offers a comprehensive guide to start addressing some of these challenges.
– Emely Recinos