Old News Travels South

Consuelo Delgadillo moved into the Arturo Mundet nursing home before many of her young caretakers were born. She uses a wheelchair. Her hearing is gone. But she can still light up a room with her smile.

Her charm is singular, but not her age. At 102, Delgadillo is one of several centenarians living at the government-run facility in Mexico’s capital.

If demographers are right, there are a lot more like her on the way.

Aging is old news in the industrialized world, where nations such as the United States have tracked the steady advance of the baby boom like a looming storm on Doppler radar. But the age wave is sweeping toward developing countries as well. Within a few decades, Mexico and other Third World nations may not know what hit them.

Although it is still relatively youthful compared with much of the rest of the world, Latin America is graying quickly. In Chile, Costa Rica, Mexico and Venezuela, the percentage of elderly in the population is projected to double between 2000 and 2025. Rapid emigration of young workers to the United States is accelerating the trend, particularly in the tiny countries of Central America and the Caribbean.

For some, the future is already here. The Western Hemisphere’s oldest country isn’t the United States or Canada. It’s Uruguay, where more than 17% of the population is over 60.

Within a couple of decades, more than half of the elderly people in the hemisphere will live south of the U.S. border, said Marta Pelaez, an expert on aging at the Pan American Health Organization.

“It’s a huge shift that no one wants to look at because it’s going to take a massive effort to prepare,” Pelaez said. “But it’s happening. And it’s happening fast.”

Developing regions of Asia are seeing a similar trend. China will be home to an estimated 332 million of them by mid- century. That’s more elderly people in a single country than inhabited the entire planet as recently as 1990.

Experts say the rapid transition will put tremendous strain on developing countries to provide for their old and frail. It’s a task that’s bedeviling even the world’s wealthiest nations.

But in contrast to the United States, Europe and Japan, which are trying to preserve existing old-age retirement and medical systems without bankrupting their youth, many poor countries lack even bare-bones protection for their seniors. In Mexico, for example, the vast majority of the elderly lack pension benefits and nearly half have no healthcare coverage, which some fear will lead to swelling numbers of sick and poor as the population ages.

The lack of old-age security already is evident in the streets of the capital. Here seniors routinely can be seen begging or working, mostly in subsistence jobs in the underground economy. Nearly half of Mexican men 65 and older are still in the workforce, compared with 18% in the United States. Among elderly Mexican women, about 15% are still at it as well.

Elena Garcia Ramirez, 78, sells tortillas seven days a week from a sidewalk stand in Mexico City’s swanky Polanco district. She said that her back and legs hurt and that she would rather be taking it easy. But she has no pension or savings, and her two daughters have their own families to worry about.

“This life is hard,” she said, wrapping a dozen golden corn disks for a customer. “This work tires me out. But I have to keep going. I have to eat.”

Observers say the biggest transformation for some poor nations may come in how they perceive themselves. AARP -- formerly the American Assn. of Retired Persons -- has no equivalent in places such as Mexico, where help-wanted ads regularly solicit applicants under 30. Age discrimination, senior health and the retrofitting of public facilities for a mature population are largely new territory for places still preoccupied with infant mortality and creating jobs for the young.

“The real challenge will be psychological,” said Dr. Sergio Valdes Rojas, a gerontologist and director of the Arturo Mundet nursing home. It’s recognizing that “we’re not as young as we think we are.”

The graying of immigrant-sending regions such as Latin America could have implications for the United States as well. Waves of newcomers have put the U.S. in a better position than many European nations and Japan to keep its workforce growing and its pay-as-you-go Social Security system solvent.

But the aging of America’s southern neighbors could eventually slow the flow of working-age immigrants.

“If you don’t raise living standards now and begin to put in place some sort of safety net for the elderly, in 2030 or 2040 you could see a humanitarian crisis of colossal proportions,” said Richard Jackson, director of the Global Aging Initiative at the Center for Strategic and International Studies in Washington.

To be sure, Latin America remains one of the world’s youngest regions. In 2000, nearly one-third of its 511 million people were younger than 15, compared with about one-fifth in the United States.

But advances in healthcare, nutrition and sanitation have boosted average life expectancy in the region to about 71 years -- nearly 20 years longer than it was in the early 1950s.

Meanwhile, fertility rates have plunged. Rapid urbanization, better family planning and more women in the workforce have led to a drop in Latin American fertility from an average of about six children per woman in the mid-1960s to about 2.5 today.

The twin forces of increased longevity and declining fertility have produced an elderly boom in nearly every part of the globe. It’s most evident in the industrialized world, where the percentage of the population 65 and older will double to nearly 30% by mid-century from about 15% today.

Most Latin American nations will remain younger for decades to come, but they are aging much more quickly. Less than 5% of Mexico’s population, for example, was elderly in 2000. That percentage will surge to nearly 20% by 2050. The senior populations of some European nations took more than a century, even two, to log similar growth.

That compressed time frame worries experts, who note that most industrialized countries achieved prosperity long before their elderly began consuming a significant share of national resources. For much of the developing world, it’s now a race against time to strengthen their economies to handle the mammoth social services needs of their burgeoning senior populations.

“Are they going to get rich before they get old? Or are they going to get old before they get rich?” said Ladan Manteghi, director of international affairs for AARP in Washington.

What’s clear is that some parts of Latin America already are confronting First World levels of elderly with only Third World resources to care for them.

In Jimenez de Tuel, a small rural community in Mexico’s northwest Zacatecas state, most of the adult men and many working-age women have left for the United States, said Dr. Rebeca Mejia Camacho, head of the federally funded family services agency for that municipality. Left behind are the elderly, many of whom are surviving solely on remittances sent from the north.

Mejia, a general practitioner, said so many of her patients were seniors that she had become a de facto gerontologist. She said some had grown so infirm that they should be in nursing homes or assisted-living centers.

But private facilities are expensive, and government-funded beds in the region are scarce. Mexico has only 13,300 licensed nursing home beds, or about one for every 8,000 residents; that compares with 1.9 million beds in the United States, or one for every 150.

“There are many abandoned people but no place to put them,” Mejia said.

The tranquil, manicured grounds of the Arturo Mundet nursing home belie the struggle for resources. The institution receives about $9,100 a year per patient in federal funds to care for its indigent residents, many beset with illnesses such as diabetes, arthritis and dementia, said Valdes, the facility’s director. On average, a U.S. nursing home costs more than $70,000 a year per patient.

Arturo Mundet currently houses 140 mostly female residents, the majority of whom sleep in dormitory-style quarters, as many as eight to a room. Some of the buildings date from the 1940s. But the facilities are clean, cheerful and a godsend for seniors such as Berta Carmona Alvarado. The bespectacled 80-year-old has no income beyond the occasional needlework she sells for pocket change and no family on whom she can rely.

“This is my family now,” she said, gesturing to the other women in the center’s bustling handicrafts room, where she was cross-stitching a pattern of a kitten. “Where would I go?”

Demographers are wondering the same thing. The fertility decline in developing nations means there will be fewer children to care for aging parents -- the traditional safety net in poor countries.

Remittances, the lifeline for so many Third World seniors, tend to dry up as their offspring start families of their own in the United States. Traditional pay-as-you-go social security systems are proving unsustainable for wealthy countries, much less in regions such as Latin America, where the underground economy is enormous and tax collection abysmal.

Like their counterparts in the industrialized world, legislators in developing nations are finding that there will be no easy way to significantly boost spending on seniors without draining other programs or raising taxes on the young.

But just as in the United States and Europe, there will be a powerful incentive to satisfy this emerging and potentially powerful constituency.

Andres Manuel Lopez Obrador, Mexico City’s populist mayor and a 2006 presidential hopeful, has stirred intense devotion from seniors here with his health and nutrition program for the elderly. In addition to free visits and prescriptions at city clinics, capital residents 70 and older receive about $60 a month on electronic smart cards that they can use to buy anything short of booze at major supermarket chains.

More than 350,000 seniors receive benefits, with the $263-million tab paid out of Mexico City’s annual allotment of federal tax money.

Economists have warned that the program is financially unsustainable even at the city level, but advocates for seniors dream of taking it nationwide.

Manuela Camacho is a beneficiary. The tiny, nearly toothless 78-year-old said her food benefits had made the difference between eating and going hungry some days. She can even occasionally afford what she counts among life’s little luxuries -- sugar, instant coffee, chocolate cookies and toilet paper.

Sitting in her weathered Mexico City home, she made no secret of her political leanings.

“I would vote for [Lopez Obrador] here, there and everywhere if I could,” Camacho said. “He is the only politician that has ever given me anything. I love him. We all love him.”