One of the central arguments in support of pro-immigration policies in Europe is that developed nations in the West need young workers to help pay for the pensions and healthcare of ageing populations. We can argue over the merits of that into the night, but what is often forgotten is the fate of the older people in the countries suffering large net emigration of the young and educated to the West.
Countries in Eastern Europe and Central Asia (EECA) have been particularly affected, and in several ways. Young relatives who might have cared for the elderly move away to find work; and they pay little or nothing into a formal social care system that provided only meagre support in the first place. Young people are also potential parents, so their leaving (and staying) reduces the size of new generations.
And there’s more. Many grandparents (who are often in need of care themselves) can end up caring for their grandchildren whose parents are working abroad. In the case of Moldova, Unicef data from 2000 indicate that some 75,000 children had at least one parent abroad, and 35,000 lived with neither parent. These figures have been rising since.
The EECA region includes countries such as Albania, Bosnia and Herzegovina, Kazakhstan, Turkey and Ukraine. Their situation was highlighted in a recent report I worked on for the United Nations Population Fund (UNFPA) as part of the 15-year review of the Madrid International Plan of Action on Ageing.
These countries are going through a demographic change which has no parallels elsewhere in the world. Life expectancy has started to increase for both men and women in the region, but this increase in longevity is not always accompanied by good health (especially for women). And between 2017 and 2050, several countries in the region are expected to see their populations decline according to the latest World Population Prospects, some by 10% or more: namely Albania, Belarus, Bosnia and Herzegovina, Moldova, Ukraine, and Georgia.
This rapid demographic change has coincided with political, economic and social transformations that have led to generational divides. The fall of communism affected younger people differently. They were able to reorganise themselves relatively easily (say, to move abroad for a better future). Older people found this far more difficult, as was memorably portrayed in the 2003 film Goodbye Lenin.
Countries in this region now talk about “demographic security”, while the debate in Western Europe is about coping with ageing populations. The trends have given succour to nationalist parties, who place a strong emphasis on nativism and pro-birth population policies. Many countries have started to provide better day care centres, parental leave allowance and child benefits (especially for the second and third child).
The most damaging part of this process, however, is that large-scale emigration takes away the benefits of the “demographic dividend”. This occurs when the proportion of working and productive people in the total population is high, and provides a corresponding boost to growth of the economy. When this flips around a country can lose the chance to generate a more rapid economic recovery and prepare better for the challenges of its own ageing population. Indeed, the economic miracle of East Asia from mid-1950 to the early 1990s, was built on the back of this demographic dividend; a generation and more of young and productive workers who stayed put.
It may well be that the damage has been inflicted for nothing. Western European policy makers hoped to import young workers to rake in taxes they could use to pay for their own ageing populations, but this assumption has turned out to be wrong. There simply haven’t been enough new workers arriving to balance out the effect of the growing number of older people. A German government report estimated that Germany alone would need a net immigration of half a million immigrants per year to have enough workers for continued economic growth – and even this enormous number would merely postpone the impact by 20 years rather than solve the problem.
According to the IMF, close to 20 million mostly young and skilled Eastern Europeans left their countries over the past 25 years to seek better opportunities abroad. More than enough have left EECA countries to create the problems we have discussed.
Challenges of social care
The recent UN International Day of Older Persons reminded us of the need for quality social care for the elderly wherever we live in the world. In EECA countries there are severe shortages. Provision is fragmented as there is lack of effective coordination between health care and social services and between the central and local governments.
Consequently, formal social care services are thin on the ground, and caring for the elderly becomes a primary responsibility of family members and relatives. Reliance on informal family care (including financial support) can also be partially ascribed to strong traditional norms, but according to the International Labour Organisation, it is largely because care needs are not adequately met by the existing institutions.
These countries need to invest more in formal institutional and home-based care. And while the public sector dominates provision, the private sector should also be incentivised to play a role, especially in areas such as food delivery and domestic help. There has been experimentation in mobilising local communities, NGOs and other business actors, but they remain on a small scale.
What is required is a coherent strategy for institutionalising and coordinating all types of providers of formal social care services. There is also a need for policies which help to balance work and family life, and which offer flexibility to families caring for the elderly and disabled people.
And of course, this is treating the symptoms rather than the cause of a social care crisis.
Incentives are needed to encourage younger people to stay in their home countries. Reversing migration trends presents an even greater challenge than policy tinkering around care provision, and it will require the creation of genuine economic and investment opportunities at home.