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Aging & Innovation in Other Cultures: Destination Cuba

This week’s installment features the work of Steve Minkin, and is edited by Jeffrey Rosenfeld, Ph.D. of Parsons School of Design. 

When the embargo is finally lifted, Cuba could become an emerging market for American companies concerned with the “business of aging”. The statistics are strikingly clear. Cuba has one of the oldest populations in the Americas, and demographic trends virtually ensure that by 2030 the country will be the oldest in the hemisphere.

Cuba today has about 11.1 million inhabitants. The percentage of Cubans living into old age is moving higher everyday. In 2015, one out of every five Cubans was reported to be above 60 years old. By 2025 the ratio is expected rise to 1:4. In less than 10 years 25% of Cubans will be over 60.

In 2030, less than 15 years from now, 30% of Cubans will have entered their 60+ senior years. Revolutionary Successes:  It is common demographic wisdom that healthy, educated societies have low birth rates. Pre-revolutionary Cuba was characterized by a stark contrast between the lives of the rich and poor with very little in between. The country was controlled by a dictatorial, mafia-connected, brutal and corrupt regime. The majority of the country was uneducated. Infant, child and maternal mortality was rampant.

From its inception the Castro government emphasized education and a system of free national health care. As a result, Cuba, although poor, boasts the highest literacy rates in the Americas and the lowest rates of infant, children and maternal mortality. By these demographic measures,  Cuba fares better than the United States and is demographically comparable with Canada.

Cuba only spends a fraction of what we do on health care, but average Cuban life expectancy is equal to that in the United States.

One reason for Cuba’s longevity rate, is that this island nation is a very safe place to live. There is virtually no gun violence, and drugs are not a major social and public problem. Education and health have had powerful impacts on the age structure of Cuba. Most Cuban women delay childbirth in order to continue their educations and careers. The Cuban demographic profile is nearly reverse of that of most other Caribbean and Latin American countries, where the age structure looks like a pyramid.  A pyramidic population  is a “Young Population,” which means there is a high fertility rate, and lots of kids. The pyramid-shape results from the fact that the mortality rate is very high. Most of the children in a “Young Population” will die-off before they reach adolescence.  As a result, the population narrows as the cohort gets older.

The Cuban age-structure is now comparable to that of other demographically aged nations, and not the younger Latin-American ones:  The Cuban population-base is narrow.  It “fattens” with the succession of years, because most people live longer than  ever before. Cuba’s population is aging, and along with that, a larger percentage of Cubans are approaching “advanced old age” (80+) than ever before.

cuba-grandpaThe Cuban government makes it easy to postpone having children. Family Planning is nearly free and medically safe abortions are easy to obtain. When children are born, the mother, or if the family chooses the father, is allowed one year paid leave. After that free childcare and nursery school is followed by tuition-free quality education, encompassing elementary and high school, university and professional schools. Physicians, engineers, scientists, as well as, teachers, artists, musicians, dancers and all other fields graduate debt-free. However, newly minted graduates enter a low wage job market that is still largely controlled by the state. As a result, many educated Cubans seek opportunities abroad as economic migrants in search of higher incomes. This partial brain drain contributes to the aging of the populations and creating a rift in the more comfortable patterns of elder care many Cubans have grown used to enjoying. In socialist Cuba, most families live in intergenerational homes or apartments that are owned free and clear of debt.

As a result, the Cuban family remains the most common source of support for the elderly. Cuban Seniors are culturally respected, and as required, they are cared for at home.

The government and/or the Catholic Church and other charities operate Casas Abuelos or so-called grandparents homes. These provide daytime recreational and cultural opportunities as well as meals, health and social services. The responsibility to ensure that elderly are not locked-in, ignored and depressed remains a community and governmental priority. Doctors and nurses and social workers regularly perform home visits. In the future the aging population will likely face new social dynamics as the economy opens up to private enterprise, which currently accounts for about 25% of GDP. Opportunities for buying and selling properties are increasing and  increasing numbers of mobile young Cubans are choosing to live separately or migrate in search of work abroad.

As more elderly people live alone, tools for remote care will become increasingly necessary, especially in families where the younger generation has moved overseas. Emergency alert systems will find a place and could readily be incorporated into the existing neighborhood heath care structure based on 24 hours on-call medical services. Such devices could become widely available following investments in building the necessary  technical and marketing infrastructures. The outdated US embargo, however, places US companies at a serious disadvantage. The Chinese, Canadians or Europeans are likely to dominate the field unless the Congress votes to end the embargo – the “white elephant” standing in the way of US-Cuban business opportunities.

Next week, Destination Mumbai, with  Ushma Mody. 

Contacts:  sfminkin@yahoo.com; rosenfej@newschool.edu