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Confronting the age crisis

Confronting the age crisis

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Today is World Health Day, marking the anniversary of the founding of the World Health Organisation in 1948.

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Each year, a theme is selected for World Health Day that highlights a priority area of concern for the WHO. This year’s priority area is ageing and health, with the theme “Good health adds
life to years”.

The focus is on how good health throughout life can help older people lead full, productive lives and be a resource for their families and communities.

World Health Day 2012 also engages cities to become more age-friendly in order to tap the potential of their citizens of all ages.

An age-friendly city that encourages inter-generational integration can have positive outcomes. The long-term outcomes contributing to a liveable city for children and young people are the same long-term outcomes that will create a liveable city for senior citizens.

WHO Cambodia welcomes the Phnom Penh Municipal Council’s initiative to create a healthy, lively and liveable city for people of all ages.

In the very near future, it will no longer be possible to conceive Cambodia as being mainly rural. Urbanisation is increasing, and nowhere is this more visible than in Phnom Penh.

This rural-to-urban transformation will be a powerful force in shaping family, social, economic and political life over the next few decades, with implications for marriage, fertility, health, ageing, schooling and children’s lives.

Population ageing in Cambodia is taking place in the context of much lower levels of socio-economic development than is the case in developed countries.

Although less than six per cent of the population is 60 or older – the lowest proportion in Southeast Asia – almost one in four households has at least one member who is 60 or older.

Combined with projected increases in life expectancy for males from the present 59 to 69 and for females from 65 to 75 by 2050, the proportion of older people in Cambodia’s population is expected to increase to 11.7 per cent.

In Cambodia, where systems for public provision are limited, the aged are more reliant on family members for physical, material and psychological support.

But the extent to which the elderly can rely on filial resources for old-age support is increasingly uncertain.

As extended family networks wane and modern ideas about marriage, family and individualism take hold, the fastest-growing segment of the population will have to rely on public or private institutions for support.

The cost of public welfare policies will present great challenges for Cambodia, which has traditionally relied on filial care arrangements.

Economic development promotes improved health, and good health in itself contributes to more rapid economic development, particularly if senior people in good health are able to lead continuously productive lives.

If senior Cambodian citizens are to remain healthy, the environment in which they live must help them. Cities, especially Phnom Penh, play an important role in this.

Looking at the range of “elder-friendly”, “child/youth-friendly” and “family-friendly” initiatives, it’s clear that common themes exist in an age-friendly city, regardless of life stage.

Access to quality health and social services, expanding social networks, education/learning, appropriate physical infrastructure, and social and family support have been identified as important to the well-being of all ages.

In almost all cultures, segregation of the young (14 to 25 years old) from those over 65 is deeply rooted. The gap between these groups can be narrowed by a contractual scheme that provides incentives for them to co-operate.

Planning for Phnom Penh as a city for all ages recognises that the elderly are an important resource to children and families.

Good planning helps the elderly serve as assets to children and families by, among other activities, contributing to a family’s financial stability and providing child care, permanent care, volunteer services and civic leadership.

This approach also recognises that young people help support the elderly in their families and communities.

Even so, there are many challenges in making Phnom Penh a healthy, friendly city.

Increasing traffic and inadequate infrastructure contribute to mishaps on the roads, and traffic-related air pollution threatens to increase the disease burden.

Cities attract young people from rural areas in search of jobs and a better life. Many of them live on the margins of poverty, with associated nutrition problems.

At the other end of the spectrum, cities can be breeding sites for unhealthy lifestyles, with obesity already emerging as a risk.

But Phnom Penh can become a caring city for all ages, enhancing the quality of life of young and old Khmers alike. Let this World Health Day mark the beginning of that process.

Dr Pieter JM Van Maaren is the World Health Organization’s representative in Cambodia.

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