Volume II, Number 1 - 2000


  Credits - Back Issue

Aging in Cuba:
Realities and challenges

Alberta Durán Gondar and Ernesto Chávez Negrín

emographic aging is a complex issue of growing interest, complexity and importance  worldwide.

As far as we know, this phenomenon does not affect plant and animal populations--or at least does not occur spontaneously, but only in the event that human beings intentionally interrupt their life cycles.   Even in human populations, aging is a recent phenomenon, dating from the mid-19th Century when it became possible to control reproduction.  (United Nations, 1978.)

Moreover, well-researched socio-demographic studies project that the 21st Century will be the century of aging for the world's population. 

Paradoxically, despite the momentous and highly topical nature of this question, there appears to be confusion about the concept of population aging among non-specialists,  government organizations and, oftentimes, even among those with a certain level of demographic knowledge.

The first difficulty lies in the definition of population aging itself.  Often it is interpreted to refer to an increase in the number of elderly people-people over 60.  However, the key element in the definition of population aging is an increase in the proportion of elderly people in the total population, and especially in relation to children and young people under 15.  That is, population aging is not just a matter of more older people, but rather is defined by an increase in this segment of the population relative to the population as a whole. (Valentei, D., 1978).

If the degree of population aging could be determined by the number of people over 60, then China and India would be the most aged populations in the world, since theirs are the largest populations and the largest populations of elderly people in absolute terms.  However, since population aging is determined by the percentage of people above 60 in a given population, Sweden, Norway and other nations in northern and eastern Europe are the most aged nations in the world.

A second-and more serious-confusion originates from the mistaken notion that a given population ages due mainly to a decrease in the mortality rate and an increase in life expectancy at birth.  The renowned US demographer Ansley Coale, in a concise and brilliant article in 1955, demonstrated irrefutably that decreases in mortality have not produced an older population, and that the key factor explaining the notable aging of Western populations is a decrease in fertility rates (Coale, A., n.d.; page 7).

In fact, when a country or region experiences a decrease in mortality, children under five are the main beneficiaries, and to a much lesser degree, the elderly.  The reason is that the main achievements in the fight against death thus far have been those related to infectious and parasitic diseases as well as ones of exogenous origin; advances have been more discreet against diseases which are endogenous, chronic, or non-communicable, all these more commonly associated with the elderly.

Therefore, for example, while life expectancy at birth extends from 60 to 75 years-as it has in Cuba over the last four decades-this alone does not imply aging of the population.  Just the opposite, in fact:  it results in population rejuvenation, since although there is an increase in the number of older people, there is a more significant growth in the number of children and young people.

In fact, if the Cuban population has aged over the last four decades, this has occurred despite the reduction of mortality, and is due instead to lower fertility (birth rates).

Another example: in the last few years Cuban medical teams have offered medical attention free of charge in remote rural areas of many Central American countries and Haiti, all areas with high mortality rates and very low life expectancy at birth.  It is clear that mortality rates-especially infant mortality-will decrease in there in the near future.  If this is the case, then life expectancy at birth will surely increase by several years. But his will not bring with it an aging of these populations-rather, a decrease in the average age of the population, since many children who once perished will now survive.   

However, if such reductions in infant mortality should consolidate as a tendency, then decreases in the birth rates should also be observed over the medium-term, as couples will not need to have as many children to assure that at least some survive to maturity, and this would bring with it a tendency towards aging of the population.

A final example: when, according to the Bible, Herod gave orders to kill all the boys in Bethlehem and its vicinity under two years old, this resulted on the one hand in a sudden increase in infant mortality and, at the same time, a decrease in life expectancy from birth in the Kingdom of Judea.  Moreover, there was an increase in population aging, since older people suddenly occupied a greater share of the total population.  Thus, it is clear that a relatively high mortality rate in the early stages of life contributes to population aging.  A similar effect is seen as a result of a decrease in fecundity rates.

The Aging of the Cuban Population

In the 20th Century, Cuba's population has become increasingly older, due to a change in the population's reproductive patterns, a process known as "demographic transition".  During the first half of the 20th Century, this increase in the proportion of older people was small (from 4.6% in 1899 to 6.9% in 1953), and remained so from 1953 to 1970 (9.1%  in 1970), and until 1990 (A. Durán and E. Chávez, 1997).  However, from 1990, the aging of the population has intensified, so that by 1998,  older people constituted 13.6% of the Cuban population (Cuban National Statistics Office, 1999 "a").  Numerically speaking, in 1899 there were only 72,000 older people in Cuba, while in 1998 the number had grown to over 1,518,000 (Cuban National Statistics Office, 1999 "b").

Currently, urban areas have more elderly (14.1%); and women represent the greater share of older people in Cuba, 14.1% of whom are already 60 years old.. Elderly people represent over 15% of the population of Villa Clara, City of Havana and Sancti Spiritus Provinces.  The population of the Isle of Youth Municipality-deserving of its name-has less than 8% elderly among its population.  In the rest of Cuba's provinces, the numbers fall between these two extremes: 10.5% in Guantánamo Province to 14.6% in Havana Province.

In the long run, the fact that the fertility rate has remained low since the late 1970s-and especially in the 1990s-allows us to predict an acute increase in the aging of the Cuban population in the future.  Consequently, in the year 2015 the proportion of elderly people in Cuba is expected to be as high as one of every five people; one of every four in 2025; and one of every three by 2035-a proportion not yet attained in any other country of the world.  This proportion is expected to remain almost invariable until the year 2050, when, according to current projections, the Cuban population will include over a million octogenarians, representing almost 10% of the country's population (CELADE, 1997).

We do not regard such an advanced demographic aging process as catastrophic.  But neither do we do we side with those who disregard it, or with those who consider it a positive event because it reflects a population dynamic similar to that of economically developed countries.

In this sense, we consider two observations appropriate: first, it is important to remember that many rich countries experience several negative phenomena such as high rates of contaminating emissions, traffic accidents, violent crimes, etc.  Thus, it is unacceptable to adopt developed countries' patterns as paradigms without distinguishing between the beneficial and prejudicial.

It is clearly positive to see that Cuba has achieved levels of infant mortality similar to those of Western Europe; yet, we cannot make the same positive comparative assessment for Cuba's low fertility rate.  To congratulate ourselves for such an achievement would be similar to taking pride in an increase in environmental pollution or traffic accidents, because such increases would bring us closer to the patterns of rich nations.         

Second, there is growing concern, even in the European countries, about the future consequences of the aging of their populations.  For instance, according to a recent report from the Center for Economic Investigations and Business in London, as a result of the aging of Europe's population, the labor force could begin to decline by the year 2005, and consequently economic growth will be hampered and state pension and health care programs in near bankruptcy. The same press report cites the Center for Economic Research and Business' warning that, as a result, the European Union could experience a major economic crisis whose aftermath could destabilize governments and cause distortions in the Euro (CNN, 1999).

Turning to Cuba, let us examine the possible consequences of the tendency towards population aging that we have described.

In the economic field, the consequences include an accelerated demand for the funds to cover social security expenditures.  In fact, since 1970 funds budgeted for old-age, disability and death benefits have quintupled.  National budget expenditures for social security are higher than those of any other sector (e.g. education, health, defense, etc.) (Cuban National Statistics Office, 1999 "c").

At the same time, as the average age of Cuba's workforce increases over the coming years, we will see a deficit of workers for labor requiring greater physical effort, especially for agriculture, construction and industry, among others.  Consequently, the main economic difficulty Cuba faces today-as it did during the colonial period and at the beginning of the 20th century-is an insufficient workforce.

Another important consequence of population aging is an increase in the demand for goods and services required by older people, especially medical services and medications.  Although old age is a natural stage of life and not a pathology in itself, it is also quite true that especially after 75, people experience greater sensorial losses and more frequent chronic disorders of both mind and body, all of which may require prolonged medical treatment (Durán, A. and Chávez, E., 1998).    

Within the family, population aging is associated with a reduction in the average household size due to low fertility rates and an increasing number of households with only one or two older people who live alone.

In accordance with Cuban family tradition, whenever feasible elder members of the family live in their own homes and with their own family for as long as possible.  However, because a growing number of older people either never had children or live far from their offspring, more elderly people live in old-age homes (12,333 in 1997) (Cuban Ministry of Public Health, N.D.).  At least another 5,000 are waiting to be admitted (Latin American Center for the Elderly, 1996).

Because mortality rates are higher in men, women often live a good share of their later lives-sometimes over a decade-as widows.  Moreover, women are the ones who most often care for elderly family members, which overburdens their household chores, especially when these are not adequately shared by other members of the family (Chávez, E., 1998).

Characteristics of Population Aging in Cuba

Although the process of population aging in Cuba is similar to that of other countries, there are,  some distinctive features (Durán, A. and Chávez, E., 1997).  These can be summarized in three main points:

1. Demographic aging in industrialized countries has coincided with-or at least lagged very little
    behind--economic development.  Thus, these countries have been able to deal with this
    process in conditions quite different from those Cuba faces today.  Among the differences:

  • Technological Development:  In economically developed countries, goods and services are produced with high-tech methods requiring less labor; while in Cuba, economic efficiency is still low and many activities require physical effort and abundant labor force.
     
  • Quality of Life:  The elderly in Cuba have not enjoyed the same levels of nutrition, availability of medications, housing conditions, home support services, transportation services, recreational opportunities, and general standard of living throughout their lives as, for example, the elderly of  Sweden or Holland.  And much less so, since the economic crisis of the nineties.  Thus, their later years of life will also be quite different.
     
  • Migratory Pattern: While rich countries because of their wealth attract young immigrants, this is not the case for Cuba, and it is difficult to imagine a significant influx of population in the future. In fact, Cuba has experienced a systematic negative balance of migration since the 1960s.  Between 1994 and 1998 alone, 150,000 people emigrated from Cuba (Cuban National Statistics Office, 1999 "a").

2. The velocity and intensity of Cuba's demographic aging process is far greater than that
    experienced by the European countries. While countries like France, Sweden or Germany
    took several decades or over a century to complete their demographic transition, the
    decrease in the fertility rate in Cuba has taken place much more swiftly: from a rate of 35
    births per 1,000 inhabitants in 1964 to 15.4 in 1978. (Cuban National Statistics Office,
    1999 "a").  Since 1978, the fecundity rate does not guarantee population replacement in the
    long run. This tendency has become more acute in the nineties.  If current demographic
    patterns remain unchanged over the next few years--especially the low fertility rate--the
    Cuban population is very likely to experience an absolute and systematic decrease as early
    as the year 2015.

3. The process of population aging in Cuba is not occurring in optimal international conditions,
    but in harsh times of an economic crisis resulting from the collapse of the European socialist
    bloc and the disintegration of the Soviet Union-nations with which Cuba carried out 85% of
    its trade.  This situation has been compounded by the tightening of the U.S. economic,
    commercial and financial blockade against Cuba, first through the Torricelli Act, and later
    through the Helms-Burton Act.  If the acute aging of the Cuban population over the next
    period were not accompanied by significant economic and technological development, the
    population's standard of living would decline as well as the country's defense capabilities. 
    This could become an incentive for the more conservative sectors of U.S. politicians in their
    attempt to reestablish U.S. influence over Cuba.

Some Alternatives for Future Action

In Cuba, as in all civilized societies, we must work towards increased longevity for our population, for an acceptable quality of life for the elderly, and for a more fully able and capable old age.

This does not negate the fact that the intense process of population aging in Cuba constitutes a real and serious problem with various and complex consequences for the whole society. Faced with the challenge of even more rapid aging in the next century, and a population that will not regenerate itself at current levels, we might consider three alternatives for action:

  • Leave things as they are, with the hope that sometime in the future, the fertility rate will recover on its own, as a result of an eventual improvement in the country's economic situation  or other occurrence.
     
  • Wait to act until the consequences of population aging are more tangible, such as notable deficits in the labor force or difficulty in paying the ever-increasing social security costs.
     
  • Act now to encourage demographic equilibrium.

It is clear that only the third option offers a real alternative--if applied within the principles of absolute respect for individual reproductive rights-since demographic trends have considerable inertia and are, therefore, hard to modify over the short tun, above all when reproductive behavior has become  tradition.

Moreover, while the Cuban experience indicates that fertility rates can drop without a specific policy designed to achieve this goal, it does not seem likely that the opposite will occur spontaneously:  that is, that the fertility rate will recover. Increasing fertility rates has been very difficult for developed countries, even once they have applied deliberate and expensive policies with this objective.

We believe that, in Cuba, recovery of the fertility rate should be attempted, among others,  through measures aimed at reinforcing the family as an institution and a social group.  Such measures should offer greater support to families in the fulfillment of their functions, thus contributing to their stability, especially in the case of young families.  They should also use public education and the mass media to promote the optimum of a two-child family.

Perhaps the advent of the 21st Century will bring new forms of human reproduction such as cloning, or perhaps other as yet unimaginable techniques, which will change our current concepts and predictions.  However, as long as this is not the case, we believe the best alternative is to promote "traditional" reproduction methods that guarantee generational continuity for the future of Cuba's population.

Individual Aging

Socio-psychological research on older people has advanced further than the study of population aging.  However, the results obtained do not yet offer enough to fully understand the individual and social needs of old age.  One of the starting points for this would be, for example, to change attitudes such as the use of pejorative terms to refer to old people like rusty, shriveled with age, old crock,  oldster, etc. as well as doddering, wreck, decrepit, worn out, senile, and so on.

We have successfully introduced new "milder" terms such as "third age", "the elderly", "senior citizens" to refer to older people, terms preferred by some more than others.  But we have not been able to eliminate the general negative and pessimistic sense that the general population and even some specialists associate with old age, as the last stage in life.

Moreover, although advances have been made in biological studies on aging, still little is known about the sociological, psychological and anthropological characteristics of this age group. And less even about older age as a stage in personality development, since evolutionary psychology generally treats this subject through adulthood, at best. 

Western societies put a premium on youth. Maintaining a youthful appearance and dynamic spirit are considered key to personal success.  The aging process among older individuals requires them to face a series of inevitable "losses": those who once worked now retire-for some, a time to rest from long and tiring activities; but for many, a rupture with their personal history.  Most older people experience reduced social contacts, loss of relatives and friends, economic losses, and diminished social status and self-esteem.  All this generates stress and requires numerous personal and social resources to successfully adjust to these changes.

A reduction of physical capabilities, which may be related to health problems, is an inevitable consequence of aging.  For most elderly people, these changes mean they tire more easily when carrying out daily activities, and they experience a decrease in sensory and motor capacities.  Such physiological changes have a psychological impact on older people and influence their feelings of wellbeing.  Argentinean poet Baldomero Fernández Moreno described it this way:  "old age is a tiredness that does not disappear the next morning, as we ingenuously expected upon going to bed".

The individual's response to these losses depends on their personality.  Some accept these realities in a passive-dependent way; others try to replace the lost roles with new ones-grandparent, neighbor, member of and organizations, etc., thus becoming involved in new social activities that both interest them and help them enjoy their free time.  Most specialists emphasize the importance of activity, not only physical activity, which some have defined as "the road to eternal youth", but also social activity and active involvement in family and community life.  This undoubtedly helps the aging to find renewed personal meaning for their lives and to create new expectations of their last years of life.

The individual's response to old age-adjustment, depression, or confronting and overcoming new problems-depends not only on personal characteristics, but also on the opportunities offered by society at all levels: family, community, region, country.

Various "pressures" can influence the degree of older people's social participation, such as pressures emerging from changes in their relationship to their environment, including changes in social roles in the family, at work, regarding economic status or power relationships. Other pressures may relate to symptoms of physical deterioration-aches and pains, loss of energy, memory lapses, etc.--and the "awareness... that the future is limited and death is not only inevitable but is not very far away." (Kalish, R.A. 1996; p. 122).

Social networks can provide emotional support for older people, as well as information to help them solve their problems-this is the so-called strategic support.  These networks provide practical assistance in those cases where the person is unable on their own to accomplish a task. However, the social interactions in these networks are not only of an altruistic nature:  they can also generate conflicts and lend themselves to other motivations.  Thus, it is particularly important that each person is analyzed according to their own situation and personality, and rigid and generalized solutions avoided.

All of the researchers and theoreticians consulted agree that the family is the main social group in which older people can be encouraged to carry out different roles.  The family as a social network can become the first step toward their social integration and participation.  It can become "the first resource and the last refuge" for these people.  However, the family can also generate conflicts or threatening relationships for older people.

In every country, cultural traditions and the level of socioeconomic and political development establish differences in family and government responsibility for attention to older people.  In some countries, specialized services for the elderly are expanding, and in this case the family either feels relieved or replaced, as its responsibilities are taken over.  In other countries, where most older people live on their own, the family is described as a "modified extended family" where several nuclear families living apart are nevertheless united by bonds of affection and maintain frequent social relations in a form that has been termed "distance intimacy" (Bazo, M.T. 1990).  In the Latin American pattern of family relations, each family looks after their elders when they need help and only fail to do so in very special situations  (Sánchez, C.D. 1990).

In Cuba, approximately 90% of older people live with other family members, mainly with their descendants.  This situation, which differs substantially from other countries, results not only from historic cultural patterns, but also from housing limitations.  There is insufficient housing to allow young people to live on their own when they start a family.  Rather, they are obliged to live in the nucleus where they were raised, or in the home of a friend or other relative.  Therefore, whatever the  cultural pattern, most Cuban elderly people do not have the opportunity to live alone, even if they wanted to, and over one third of Cuban families have at least one member who is over 60.  This means that Cuban families are called upon to play a crucial role in the attention of older people and that further analysis is needed of this reality.  The Cuban family is not simply one of the players in the elderly's social support system:  it is the fundamental source of support for most elderly. 

At the same time, in spite of Cuba's economic crisis, social security services have been maintained, and pensions paid, unlike the situation in many other Latin American countries when faced with crisis. This, plus social assistance support offered to older people, provide for a certain degree of personal economic independence and satisfaction of basic daily needs. 

Older people in Cuba have access to free medical care at primary, secondary and tertiary levels, including general and specialized services.  This creates an important sense of security for these people and their families, who are well aware of the growing needs for medical assistance in old age.  Current efforts to increase the number of geriatric services and to provide specialized education for family doctors-who are the mainstay of primary health care-will undoubtedly improve the quality of these services in the near future.

One important achievement has been that the general public recognizes and supports the level of attention and specialized care required by the elderly. Communities carry out projects aimed at ensuring a better quality of life for their elderly members.  Moreover, "community solidarity" has made an important contribution in terms of spontaneous help offered among neighbors.  However, we believe the precise role of the family in these community and social projects is not sufficiently concretized. This constitutes a clear weakness if we consider that most elderly live with their families.

Outcomes of Sociopsychological Research on Aging

Since 1996, our workgroup has carried out several studies on the relationship between aging and the family group.  We do not yet have all the necessary outcomes to characterize this complex relationship.  However, our initial study of 60 older people conducted between 1996 and 1997 in six municipalities in the City of Havana, based on a qualitative approach, resulted in a number of interesting sociopsychological features. (See: Durán A. and Chávez E., 1997).

On the one hand, many of these elderly people did not consider the help they receive from the government as sufficient.  Some of them stated that their pensions were only enough to cover their most minimal needs, while others found their pensions completely insufficient.  Only a small group was satisfied with their pensions.  However, most of the subjects included in the study said that the elderly suffer economic hardships due to the due to the current high cost of living.

Many of those interviewed described their medical care as adequate. But they also described it in curative terms rather than preventive.  Shortages of medical supplies-mainly medicines, eyeglasses, and hearing aids-plus difficulties in maintaining adequate nutrition and solvency led many to express insatisfaction.

At the same time, it is clear that more work needs to be done to increase opportunities for older people to socialize and relate to new social contexts:  in particular, those that would help develop new personal capabilities and incentives, as well as use their accumulated experience, knowledge and interests. In our study, few of the elderly had joined or maintained their membership in Senior Citizens' Clubs; none was a member of the retirees' clubs created by some trade unions.  Yet, these are the two major social organizations for older people aimed at developing their interests and social relations.

Leisure time activities, another important aspect of older people's social participation, are limited to the home, with few options.  The most common ones include watching television (in most cases) or listening to the radio (less frequent).  The vast majority of our subjects stated that their main leisure activity was "resting without doing anything" on a daily basis and for longer than they would like.  Those few involved in activities outside their homes participated in religious services, visited friends and relatives, and joined activities organized by community groups.  In very few cases people referred to attending sports or cultural events, going on excursions or eating out.  Moreover, many of them stated that they carried out most of their free-time activities alone. Only rarely did they have company, although many of them cannot-or do not wish to-carry out these activities by themselves.  Some of these people revealed that they felt lonely by virtue of a lack of communication, even when accompanied by their relatives.    

In fact, the most generalized difficulty among these people was the lack of adequate interpersonal communication with relatives regarding their needs.  This reaffirms the existence of a problem that our workgroup has already described: most Cuban families are not prepared for complex relationships among their members.  They have established positive relations of cooperation and support, but also relations of power, conflict and intimidation, either in relation to the older members or provoked by them against the rest of the family.  Thus, our study shows that the family is the main support for older people, both because of the constant contact it offers as well as the positive significance of interchanges with children, grandchildren, brothers and sisters.  Yet, in many cases conflicts arise between these elders and the relatives living with them, sometimes viewed as generational conflicts.  There may also be important interlocutors missing with whom older people would communicate.  And finally, we observe a certain tendency to idealize relationships with members of the family that do not live with them.

The world lacks sufficient scientific knowledge about the elderly-either as a social group or as a stage of psychological development.  There is a generalized lack of experience among social organizations and institutions, and above all within the family, to confront problems of individual aging and their consequences.  Thus, up to now it has not been possible to formulate strategies that prioritize attention to the psycho-social needs of these people, which involve various social actors, including the elderly themselves, without hyperbolizing the role of medical care.

Many social beliefs regarding old age reveal prejudices against this age group.  According to these beliefs, older people play a passive-dependent role in society and become objects of social attention rather that active subjects in their own development.  What's more, only in rare cases in the media are older people portrayed as capable individuals who contribute to society, images that could change negative social concepts and offer positive models both for older people and for other generations.

In our study, some interviewees complained of scarce representation of older people in social and community organizations and institutions, and of the lack of formal groups focused on their interests and that help them put their potential to use. 

According to the outcomes obtained thus far in our study, we also consider the following as characteristic features of older people in our country:

  • Among the most common sensory problems in older people, only three out of 10 complain about difficulty in hearing and six out of 10 suffer from failing vision, the latter often solved by surgery or adequate eyeglasses.
     
  • In spite of their ailments, most older people are capable of looking after their personal hygiene and care, and even of taking charge of daily household responsibilities for the rest of the family with whom they live.  Among these tasks, one out of six older people looks after his/her grandchildren, children and/or other disabled older people; one out of 10 looks after the family's pets.  The older a person becomes, the harder it is for them to clean the house, take their medications on time, wash, iron or cook-in the latter case, complicated by the fact that many homes cook with kerosene.
     
  • Older people in general experience difficulties carrying out activities outside their homes, and these problems increase with age.  Certain losses in ability affect walking and climbing stairs without assistance; and more complex activities such as visiting the doctor, running errands, or using public transport become more difficult as time goes by.
     
  • Very few old people return to gainful occupation after they retire or become employed for the first time; however, there is an increasing number of older people who wish to do so, mainly for the earnings this would represent.
     
  • None of the older people we interviewed is studying something new, although some of the religious believers study the Bible rather regularly in search of guides for understanding and dealing with their reality.  Almost four out of ten older people never read, not even newspapers or magazines.  On the other hand, the same number do read newspapers and magazines. 
     
  • Those who have a spouse do not emphasize their role. And while none of them considered their spouse to be a negative source of conflict, they made little reference to satisfaction or support from their partner.
     
  • Only one third of the older people in the study maintain relationships with old friends, mainly their contemporaries.  Another one third say they have no friends.  Most of them relate to their neighbors, from whom they perceive a source of support but also of conflict.
     
  • Older people seem to relate more with other elderly people and find more satisfaction in these relationships due to the similarities in their experiences and opinions; however, there are older people-although fewer in number-who maintain a level of relationship with their children's and even grandchildren's generations, although this kind of relationship may tend to generate further barriers in the interpersonal relationships between these generations.

The limited number of opportunities that society and the family offer for older people to participate in "productive" activities, and thus to relate to their social environment, should help to explain the individual subjectivity of the older people in our study.  The psychological peculiarities expressed in the way they represent their reality, their moods, the images they use to characterize their individuality, their expectations of the future and their real capabilities should at the same time temper the relations of each of these individual personalities with their environment.

Among the older people we studied, we found the following characteristic subjective features:

  • They do not feel useless, more unlucky than others, afraid of their reality, although they do feel bored, worried and very often they feel sad and on the verge of crying.  Half of these people consider their lives empty.  Over a third expressed states of mind typical of depression.
     
  • Only one fourth have positive images of themselves; poor self-esteem prevails among them and they underrate themselves due to their current personal losses of capabilities,health, happiness, physical beauty, activity and power.
     
  • As to future expectations, only two out of 12 older people showed real aspirations for their future-that is, incentives to act.  Most of them prioritize solving their health and wellbeing needs, followed by other needs such as: personal relations, material needs, new opportunities for social participation.  Due to the fact that these wishes lack objectivity, they do not serve as real incentives for action.
     
  • Six out of ten of these older people expressed wishes that had some relation, showing a certain degree of stability in the individual needs revealed by these wishes.  Moreover, seven out of ten of these individuals who say they have material or relational needs give priority to them in their lives, revealing the urgency with which they are felt.
     
  • Only one out of ten reflected the need for or motivation to further social activity, specifically returning to work or participating in recreational activities.
     
  • Consensus prevailed in observing that older people are useful and can carry out many activities, that they act as good mediators in the conflicts between their children and grandchildren, and that they enjoy talking with children.   
     
  • Half of the interviewees accept as true the belief that old people tend to be rigid and prefer isolation.  Yet, none of them considered themselves inflexible or loners.  Rather, they assign  these characteristics to others, which can be interpreted as a projective defense mechanism.
     
  • Most of these subjects expressed negative opinions of young people.  Almost eight out of ten considered young people disrespectful of older people and accused them of disregarding their needs.  Six out of ten say they don't get any help from young people.
     
  • The images evoked when evaluating their families-including both positive and negative aspects-were more commonly related to the climate of interpersonal relations among family members and fundamentally affectionate interchange.  When speaking of what they liked about their families, they said it was important for them to feel affection.

Without trying to impose our views on achieving an acceptable quality of life for older people, we must conclude that when most older people have poor opinions about themselves, poor self-esteem, lack of aspirations and numerous symptoms of depression, they must lack a sense of personal wellbeing.  Perhaps French thinker Blas Pascal was right when he said three centuries ago: "There is nothing so unbearable for man as complete rest, with no passion, occupation, distraction or care.  It is then that he perceives his insignificance, his isolation, his insufficiency, his hollowness."

Challenges of Population and Individual Aging in Cuba
for the 21st Century

In the context of a comprehensive, stable and sustainable strategy of development, it is  absolutely necessary to promote as soon as possible the establishment of a demographic policy aimed at achieving a balance between fertility rate and the rate of migration to other countries.  The possibility of changing current patterns will decrease over time, and leaving them unchanged will pose a serious risk for Cuba both in the medium and long term.  This demographic policy should be based on  absolute respect for the rights of families and individuals to decide their own future.  It also must take into consideration the need to maintain population and individual aging rates under constant surveillance through multidisciplinary research in the field, in order to predict possible consequences.

Attention to older people as a quantitatively important and qualitatively distinctive social group today-and moreso in coming years-requires the creation of a national coordinating body with certain powers under law to centralizes the work of the agencies charged with this responsibility.  Moreover, this also implies the need to create an institutional mechanism for older people to express their opinions and defend their personal interests as a population group with special needs and features.

Taking into consideration that many older people have scant economic resources in the face of higher costs of living in Cuba today, and that there is both a need and a wish to open new avenues for their productive activity--as a contribution both to society and to their personal fulfillment and self-esteem-it is important to think about establishing more flexible job regulations for retirees. This might include working half a day every day, or only twice or three times a week, flextime, self-employment, and other measures.

In order to improve so-called "formal support" to the elderly, more specialists in geriatrics and gerontology are needed, and Family Doctors should receive more preparation to guarantee preventive, customized and systematic attention to the elderly.  The existing Senior Citizens' Clubs should be revitalized by increasing the social and recreational options offered for the elderly.

It is important to involve the Committees for the Defense of the Revolution and the Federation of Cuban Women at the community level.  These organizations can become direct channels for the solution of older people's needs and for their incorporation into social activities.  Furthermore, it is also important to have the support of the neighborhood People's Councils for initiatives directed especially at improving the quality of life for older persons.

A very important aspect of the work in the community is the development of educational and recreational programs, sports and cultural events, in which older people can contribute their personal and professional experience to activities aimed at improving production and social services in the community, contributing to the education of new generations and solving their own problems.

For older people to become active and transforming members of the community, they and those approaching retirement need new opportunities for learning and developing new potential.  For them to become subjects-rather than the objects-of their own process of socialization is one of our society's main challenges.

Finally, we think it is important to address family education where older people live with other generations, in an effort to involve the elderly in the family's plans and seek new resources for better intergenerational communication and living.

Considering the family as a mainstay in social policies for "informal" attention to the elderly, and as the main protagonist in the socialization of older people goes beyond designating the family as "caregivers" of the elderly.  The dynamics of family relations can have a more positive or negative impact on older people's individual development, but reducing the family to mere helpers of the aging generalizes the image of older people as incapable, a description that the majority of them neither want nor deserve. Arriving at an older age is a privilege that our society offers to today's younger generations; therefore, our elders deserve to fully and creatively enjoy the life that many generations of Cubans have built for them.  Consequently, there is a growing need for scientific and social resources to help us understand, accept and transform old age into period of continued social  contribution corresponding with the humanistic ideals of Cuban society.

References

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*This is an original article for MR by two specialists at the Center for Psychological and Sociological Research.  For more on this theme by the same authors, see their piece in the magazine TEMAS, "Una sociedad que envejece:  retos y perspectivas", No. 14, April-June, 1998.Scroll up