Promoting active ageing and longer employment in Romania
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Introduction During the last decades of the 20th century humanity has witnessed a marked increase in life expectancy, and in addition to the decreased inbirth rates in many European countries, this has shifted the age structure of the population towards older people, not just in Europe, but worldwide. Ageing is traditionally associated with functional decline and loss of autonomy, while the risk profile for older adults includes several clinical conditions such as cardiovascular diseases, cognitive impairment and physical disability. The term ‘frailty’ is commonly used to indicate a high vulnerability and an inability to adequately cope with the surrounding environment at older ages. Early detection is important because frailty, differently from disability, is a reversible condition, so the health state and level of activity of individuals could be improved by proper interventions.1,2,3 Ageing and immigration flows The analysis of the statistic data provided by the World Health Organisation (WHO) shows that by 2050, the share of population aged 60 and over is expected to double, from 962 million in 2017 to nearly 2.1 billion. As stated in a report from the International Strategic Analysis, the most pressuring demographic challenges are found 1
“Carol Davila” University of Medicine and Pharmacy in Bucharest, Romania
2
The National Institute for Medical Assessement and Work Capacity Rehabilitation, Bucharest, Romania
Author for correspondence: [email protected]
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in the developed economies of East Asia and Europe, particularly in those countries which have some of the lowest birth rates in the world, as well as very low levels of immigration.4 The same trend is foreseen for Romania; in addition, the working age population, aged between 20 to 64 is decreasing (with 30% by the year 2060), showing one of the steepest declines in Europe. The phenomenon is caused by continuous fertility rate decline since the 1970s, which has accelerated in the 1990s; strong emigration flows of young people in the last decade; and a decades-long trend of increasing life expectancy.5 In reverse, in countries that are experiencing large immigration flows, the ageing process might be slowed down, since migrants tend to be concentrated in the working ages. In addition to expanding labour supply, immigration may increase the demand for labour. Migrants expand consumer demand for goods and services and in the medium to long run, immigration can be expected to lead to more investment. Both effects result in a greater demand for labour and thus increased wages and employment, resulting in a more productive and healthier economy and sustainability of social security. Statistics from different countries show that most migrants are of working age, so they can immediately contribute to the labour market, while the taxes and social security contributions they pay support the budget and welfare systems.6,7 The old age dependency ratio, defined as the ratio between the number of older people (65 and over) and the number of working age people (
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