Disability and Demographic Change

There is a demographic dimension to disability, especially in those countries at an advanced stage of the demographic transition. In 2006, faced with a shrinking workforce and an ageing society, the European Council called for mining the potential of the millions of people who are excluded from the labour market and identified persons with disabilities as one of the most important groups. For ESCWA member countries, the demographic transition presents a new challenge to the management of disability. Demographic change affects the age structure as well as disease and mortality patterns of the population and, hence, different types of disability.[1]  In the ESCWA region, the ageing process is slow considering that the region is still dealing with a history of high fertility rates and experiencing a youth bulge. Nevertheless, when examining ageing in absolute terms, it appears that the number of persons aged 65 and over in the region doubled from 3.7 million in 1980 to 7 million in 2000, and is expected to reach 14.3 million by 2020.[2]  Consequently, it is expected that the number of older persons with disabilities will also increase. For health policymakers, this issue requires early attention and intervention in order to respond to the needs of the increasing number of elderly with disabilities in terms of home care, geriatric research and care, hospitalization and nursing homes.  Additionally, with evolving demographic transition, urbanization and industrialization, countries of the region will need to deal with higher levels of chronic diseases, traffic accidents and work-related injuries, in addition to prevailing communicable diseases and illnesses.

Another facet by which demographic change can affect persons with disability is the changing role of the family. While family remains the primary caregiver for a person with disability in the region, social changes brought about by modernization and migration are slowly transforming the extended family structure, thereby threatening to weaken the traditional system that provides support for persons with disabilities. These changes could lead to a “disability pension crisis” and call for sustainable forms of social support and social protection for those who will be affected.