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The Worst Countries to Grow Old In

Thomas C. Frohlich
The completed Canadian flag made out of lego bricks is pictured at the Canada Day LEGO Flag Build, on Monday July 1, 2013 at Parc Jacques-Cartier Park in Gatineau, Quebec. For Canada Day, children could help build a Canadian flag made out of 128,000 LEGO bricks. (Francis Vachon / AP Images for LEGO Systems, Inc.)

The world’s older population is growing. According to a report released last week, 11% of the current world population is 60 and older. By 2050, more than one in five will be at least 60 years old. In the United States, more than one in four will be over 60.

HelpAge International’s “Global AgeWatch 2013 Index” ranked the well-being of the older population of 91 countries around the world. The report rated each country based on factors, including income security, health care and employment. Sweden was rated as the best country for older people to live in, while Afghanistan was rated the worst.

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Wealth appears to be one of the biggest factors determining the overall quality of life for older residents in these countries. GDP per capita in the highest-ranked countries was the equivalent of at least $30,000 in all but one case. For nine of the 10 worst-scoring countries, GDP per capita was lower than $10,000. In Afghanistan, GDP per capita was less than $1,000.

While low income is itself part of Global AgeWatch’s measure, the group also noted that wealth tends to bleed into many other areas that affect older people. “A lack of resources also impinges on other social domains, and combines with factors associated with the ageing process to produce wider inequalities.” Income and overall economic prosperity influence health care and education, both important quality of life factors for the ageing population.

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The report notes, “It is no surprise that the countries where older people fare best are nearly all in the high-income bracket.” However, wealth doesn't always explain why certain countries treat their older population better than others. Some countries score well despite being less wealthy.

New Zealand, for example, is 24th out of 91 countries in GDP per capita, but it ranked higher than some of the wealthiest countries in the world -- including the United States -- for quality of life of its older residents. Global AgeWatch explained that this has to do with the country’s low poverty rate for its ageing population, as well as the strong quality of health care.

Not surprisingly, life expectancy made a big difference for the countries doing best or worst. The average resident of all the best countries who makes it to the age of 60 can expect another 23 years of life or more. Among the worst 10 countries, life expectancy past the age of 60 is as low as 16 years. In Afghanistan, the average person who lives to be 60 is only projected to live another 9.3 years in good health.

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As a result, the worst countries to grow old in also tend to have a much smaller proportion of older residents. In a majority of the countries that ranked worst overall for the well-being of ageing populations, less than 5% of the population was 60 or older. In most of the 10 highest-ranked countries, at least 20% of residents were 60 or older. In Japan, among the best countries in which to grow old, it was more than 31% of the population.

To identify the best and worst countries to grow old in, 24/7 Wall St. reviewed HelpAge International’s 2013 Global AgeWatch Index of 91 countries. Included in the report are data from the United Nations, the World Bank, Eurostat and the Organisation for Economic Co-operation and Development. Each country was graded based on four measures: income security, health status, employment and education, and the overall environment for older residents. All data are for the most recent available period at the time the report was put together.

These are the worst countries to grow old.

 10. Honduras
> Total population: 7.9 million
> Pct. population 60+: 6.4% (66th lowest)
> GDP per capita: $3,519 (58th lowest)
> Life expectancy at 60: 21 years (46th most)

In Latin America, the proportion of the older population is expected to double by 2050. Among countries in the region, most of which scored relatively well, Honduras scored worst. Older residents of Honduras had the worst income security out of every country in Latin America and the Caribbean -- only 3.8% of people over 65 received a pension. Further, the relative poverty rate of the ageing population in Honduras was among the highest in the world, at more than 27%. Despite its poor ranking, the reported mental well-being of older Hondurans was above that of the United States.

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9. Montenegro
> Total population: 600,000
> Pct. population 60+: 18.4% (45th highest)
> GDP per capita: $10,157 (71st highest)
> Life expectancy at 60: 20 years (63rd most)

Montenegro was the worst country in which to be older in Europe. Its good pension coverage rate, however, helped lower the poverty rate among older residents, which was at 10.1%. The country's older population was also relatively healthy, with high life expectancy at 60 years of age. Only 22.7% of older people were employed in Montenegro, however, compared with more than 60% in the United States.

8. Occupied Palestinian Territory
> Total population: 4.2 million
> Pct. population 60+: 4.5% (23rd lowest)
> GDP per capita: $2,654 (48th lowest)
> Life expectancy at 60: 18 years (tied for 62nd least)

Just over half of people older than 50 from the West Bank and Gaza said they were happy with their access to public transport, and just 66% said they felt safe walking alone at night, compared with 73% of people over 50 in the United States. The Palestinian Territory had a comparatively young population, with just 4.5% of the population at least 60 years old. As of 2012, more than one-fifth of the labor force was unemployed. For older residents, just over a quarter were employed.

7. Nigeria
> Total population: 168.8 million
> Pct. population 60+: 5.3% (43rd lowest)
> GDP per capita: $2,137 (42nd lowest)
> Life expectancy at 60: 16 years (tied for 16th least)

Nearly 169 million people lived in Nigeria, Africa’s most populous country. Roughly 8.8 million residents, or only 5.3%, were 60 years old or older. Only 5% of the population over 65 years old received a pension, among the smallest portions globally. The quality of self-assessed mental well-being among the ageing population in Nigeria was one of the best in the world. Despite the challenges facing older people in Nigeria, more residents over 50 years old thought their lives had meaning than those between 35 and 49.

6. Malawi
> Total population: 15.9 million
> Pct. population 60+: 4.9% (tied for 34th lowest)
> GDP per capita: $780 (7th lowest)
> Life expectancy at 60: 17 years (tied for 36th least)

While nearly all residents aged 55 to 64 were employed, it was out of necessity. Malawi residents had among the lowest educational attainment in the world, with less than 5% of the population over 60 having completed secondary or higher education. Only primary education was free in the country. Pension plans were virtually nonexistent. The country's GDP per capita has been among the lowest in the world in recent years.

5. Rwanda
> Total population: 11.5 million
> Pct. population 60+: 4.4% (20th lowest)
> GDP per capita: $1,077 (18th lowest)
> Life expectancy at 60: 16 years (tied for 16th least)

Only 2.8% of the Rwandan population aged 60 and over had completed secondary or higher education, among the lowest levels worldwide. When people aged over 50 were asked whether they were satisfied or dissatisfied with their freedom to choose what to do with their lives, nearly nine out of 10 respondents said they were satisfied, higher than in the United States. Recent budget increases and improvements to the country’s electoral code may help improve the conditions for future generations of older residents.

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4. Jordan
> Total population: 7.0 million
> Pct. population 60+: 5.9% (54th lowest)
> GDP per capita: $5,250 (77th lowest)
> Life expectancy at 60: 19 years (83rd most)

Like many of the worst countries for old people, Jordan’s older population is small, at just under 6%. Less than half of the people over 50 were satisfied with the public transportation system, which means many older people were less able to connect with friends and families and access services. According to the AgeWatch Index, older people fare much worse finding employment than the younger population, and they are less educated. Just one-quarter of the population aged 55 to 64 were employed and had completed secondary or higher education in the country. Otherwise, older people in Jordan felt relatively safe and free to live their own lives.

3. Pakistan
> Total population: 179.2 million
> Pct. population 60+: 6.5% (70th lowest)
> GDP per capita: $2,397 (46th lowest)
> Life expectancy at 60: 18 years (tied for 62nd least)

Older Pakistani residents reported the least freedom to live independent and self-reliant lives out of the countries analyzed in the report. Less than one in three people in Pakistan over 50 were satisfied with the freedom of choice in their life. The country also has lower levels of pension coverage than much of the world. The report also notes, "Compared with their counterparts in neighbouring countries, rankings for social connections indicate that older people in Pakistan feel less safe, less connected to the rest of society, and less able to enjoy civic freedoms."

2. United Republic of Tanzania
> Total population: 47.8 million
> Pct. population 60+: 4.9% (tied for 34th lowest)
> GDP per capita: $1,293 (23rd lowest)
> Life expectancy at 60: 17 years (tied for 36th least)

Tanzania had among the highest percentages of working older people -- nearly 95% of the country’s population aged 55 to 64 was employed. But if the older population's poverty rate there is any indication, these jobs likely offer very low wages and little opportunity to save. As many as 33% of older residents in Tanzania live in relative poverty -- the third highest after Thailand and the Republic of Korea. Education is also a problem; just over 3% of the population aged 60 and over had completed secondary or higher education of any kind. Only 3.2% of the country's residents over 65 years old received a pension of any kind. In the United States, it was 82.6%.

1. Afghanistan
> Total population: 29.8 million
> Pct. population 60+: 3.8% (8th lowest)
> GDP per capita: $977 (14th lowest)
> Life expectancy at 60: 16 years (tied for 16th least)

Afghanistan had among the smallest portion of residents at least 60 years old, at less than 4% of the total population. This low proportion is due in part to the country's low life expectancy -- 59 years for men and 61 for women. Life expectancy is 16 years for residents that are 60 years old, but only about nine of those years will be in good health. According to the AgeWatch Index, more than half of Afghan people over 50 do not feel safe walking alone at night where they live. With the American military scheduled to withdraw in 2014, the Afghan government worries the country will not be safe from foreign and domestic attacks.

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