Aging before prosperity: Vietnam's challenge

It is expected to become an aged society by 2036 with the proportion of elderly people (aged 60 and above) reaching 18%, and a super-aged society by 2050 with 25% of its population classified as elderly.

While Japan took 24 years to progress from an aging to an aged society, Vietnam is set to achieve this transformation in just 21 years, ranking it among the 10 fastest aging countries globally, according to the United Nations Population Fund.

Despite a significant increase in life expectancy, the quality of care for seniors generally remains moderate in Vietnam.

According to the National Committee on Aging, 70% of elderly people in Vietnam lack a stable income and 30% do not have health insurance.

Statistics from the Ministry of Health show that, on average, elderly people spend 14 years living in poor health and typically suffer from nearly three chronic illnesses.

Beyond common geriatric conditions, recent studies point to rising rates of chronic diseases and mental health issues among seniors.

These concerning statistics underscore Vietnam's challenge of "not rich but old."

When Japan transitioned into an aged society in 1994, its GDP per capita was US$40,000.

In comparison, Vietnam's GDP per capita targets for 2030 and 2035 are $7,000 and $10,000, meaning it will not match Japan's economic status when it enters this critical demographic era.

Meanwhile, medical costs for elderly people in Vietnam are estimated to be seven to eight times the average costs younger people pay.

Two elderly people sit in their house in Hoi An City in 2019. Photo by VnExpress/Dang Le

In Vietnam, rooted in East Asian tradition, children often shoulder the responsibility of caring for their aging parents.

While this custom offers clear benefits for the mental health of elderly family members, the rapid increase in the population aged 80 and above has resulted in a generational challenge: children who once cared for their parents are themselves becoming elderly and in need of care.

For families, this creates an unsustainable burden, as caregivers often experience a significant loss in income due to reduced or lost working capacity while dedicating time to care responsibilities.

Japan has shared its knowledge and experience in caring for elderly people with Vietnam through the Asia Health and Wellbeing Initiative.

Since 2000 Japan’s Long-Term Care Insurance (LTCI) system has demonstrated the effectiveness of a demand-driven, personalized care model over an authority-controlled approach.

The LTCI system covers long-term medical care, home nursing, outpatient rehabilitation, and the rental of assistive devices and small group homes for people with dementia.

A key innovation of Japan's LTCI system is its comprehensive coverage, extending support not only to the elderly but also to caregivers – a critical aspect that Vietnam must consider.

The program provides vital services such as bathing assistance, meal preparation and housekeeping while also offering financial support and specialized training for caregivers. This approach reduces stress for caregivers and ensures higher quality of care for the elderly.

This policy was informed by research showing that most Japanese citizens over 40 eventually become caregivers for their parents, underlining the urgent need for societal support.

For Vietnam, the time to act is now.

A similar model must be explored to address the compounding pressures of an aging population and labor shortages, particularly in geriatric care.

Due to deep-rooted cultural and social norms, nursing homes are yet to be developed and unlikely to gain widespread acceptance.

Thus, a comprehensive early care insurance scheme that addresses the needs of both the elderly and their caregivers would be the most practical and culturally appropriate solution for Vietnam.

Elderly care in Vietnam relies on three pillars: family, community and the state.

At the national level, the quality of economic growth will determine the government’s capacity to expand social welfare policies.

Within communities, there is an urgent need to develop and broaden access to retirement clubs, social activity groups, and elderly care centers.

At the family level, individuals must recognize and prepare for the natural life cycle – aging, illness, and mortality. By embracing this awareness, families can proactively plan for a dignified old age, contributing to society's overall well-being.

To build a resilient aging society, Vietnam must act decisively: a comprehensive care insurance system supporting the elderly and caregivers will be a vital foundation.

Such a policy will ensure that every elderly person can age with dignity while alleviating the burden on families and society.

Ultimately, a healthier and happier elderly population will contribute to the stability and prosperity of Vietnam’s future.

*Cam Ha is a public policy and communication consultant.