Journal of Cross-Cuhural Gerontology 11: 269-286, 1996.
~) 1996Kluwer Academic Publishers. Printed in the Netherlands.
AGING TRENDS
Aging in Singapore
PEGGY TEO
Department of Geography, National University of Singapore
Abstract. This paper outlines the aging trends in Singapore and takes stock of socioeconomic
differencesbetweenMalayand Chinese elderlypersons. It draws attention to the idea that policy
response to the graying of Singapore has largelybeen confinedto dealing with the consequences
of population aging for the economy on the one hand and to creating social and community
support for caregiving for elderly persons on the other. These policies cover employment,
healthcare, housing, and social and recreational needs. Although fairly comprehensive, it is
the position of this paper that further attention on supplementary programs that will address
the particularities of specific ethnic groups will be required in order that the minority ethnic
groups may also age gracefully.
Key words: Singapore, Ethnic differences, Policy formulation.
Introduction
Within Asia where the population aged 55 years and over averaged 10% of
the total population, Singapore ranked third only after Hong Kong and China
(Kinsella 1988) (Figure 1). In Southeast Asia, because of the country's past
fertility experience, Singapore has the highest proportion of aged persons
(Table 1). In this article, the 1990 census of Singapore is used to outline the
rapid aging process occurring in the country. While ethnic socioeconomic
differences have been documented for the entire population (Chiew 1991;
Teo & Ooi 1996), little has been written about elderly persons. Class and/or
economic differences can place significant constraints on the ability of older
people to fulfill basic needs or to enjoy a fruitful Third Age (Markides &
Mindel 1987; Mutchler & Burr 1991; Angel, Angel & Himes 1992). Thus,
a discussion of such differences is raised with the aid of secondary sources
of information. The paper will integrate the information together in order
to evaluate the coverage of Singapore's policies for elderly persons. It is
asserted that these policies were designed with the idea of managing the
overall aging phenomenon, particularly in the areas of Singapore's future
economic growth and in the provision of social and community support
for the care of elderly persons. However, the policies fail to address ethnic
270
P. TEO
Asia
Hong Kong
1 17.0
China
5.~
~ 12.2
Singapore
Korea Rep. of
I
'
~
I 10.4
4.5
Turkey
4.3
, i : I 9.7
Tha,and
India
90
8.6
'~"=*'=-===" 3.4
Indonesia
7.8
Philippines
7.5
Bangladesh
7. 2
55 and over
•
65 and over
Figure 1. Proportion of older population: 1988. Source: Kinsella (1988: 2).
Table 1. Some demographic indices for Southeast Asia: 1990
Country
Singapore
Malaysia
Thailand
Indonesia
Philippines
Population
(million)
Total
fertility
rate
Population
< 15/65+
Life
expectancy
% 55+
(1988)
2.8
18.3
58.8
181.4
62.3
2.0
3.6
2.6
3.3
4.3
23/6
38/4
35/4
38/3
39/3
73
68
66
59
64
11.9
5.0"
9.0
7.8
7.5
*Population aged 65 and above.
Source: PopulationReferenceBureau (1990); Phillips (1992).
disparities in the economic and social arenas. This is necessary in order that
the specific needs of the economically disadvantaged will also be met to give
them a more comfortable later life.
The graying of Singapore and its implications
While in 1970, the proportion of people aged 60 and above was only 5.7%,
this statistic grew steadily to 7.5% in 1980, peaking at 11.8% in 1988 before
steadying at 9.1% in 1990. At an average annual growth rate of 3.8% over
AGING
271
IN SINGAPORE
AGE GROUP
RESIDENT
POPULATION
I
[
80+
75-79
70 - 74
65- 69
6O-64
J 55-59
1990
J so-5,,
[
J 45- 49
J 40-44
I
J"
I 35-39
3O-34
25-29
20- 24
~s-Io
] ~o- 14 [ :
L,~
5 -o
I
,5o
16o
THOUSAND
:
,¢o
PERSONS ( MALE )
o
I
j
-4
I
o
I
o
5b
THOUSAND
ido
PERSONS (FEMALE)
,5o
Figure 2. Age pyramid of resident population: 1990. Source: DOS, Singaporecensus of
population: Demographiccharacteristics(1990).
1980 to 1990, this segment of the population is projected to reach 26% by
the year 2030 (Department of Statistics (DOS) 1983; Chen & Cheung 1988).
The median age of the population has similarly risen. It was only 18.8 years
in 1957, rising to 24.4 in 1980 and further to 29.8 in 1990 (DOS 1992a). It is
expected to be 47 by the year 2030 (Chen& Cheung 1988). At the same time,
the life expectancy of Singaporeans rose to 72 for males and 76 for females
in 1990 (Saw 1990).
The full impact of the aging process in Singapore cannot be understood
apart from the fertility experience of the island. Singapore was very successful
in its anti-natal policy from 1965-1987. As a result of the'Stop at Two' policy,
the Total Fertility Rate (TFR) fell from 3.08 in 1970 to 2.08 in 1975. By 1980,
it had gone below the net replacement rate when the statistic was documented
as 1.73 (DOS 1983; Yap 1989). Five years after an official reversal to a pronatal policy which was announced in 1987, the TFR was only 1.76, a small
rise considering the many incentives offered (see for fuller details of this
policy and its effects on the population, Drakakis-Smith, Graham, "leo & Ooi
1993). How Singapore's fertility trend has influenced the aging process is
most evident by the population pyramid (Figure 2). It mimics the constrictive
model in which the middle portion of the pyramid has begun to bulge while
the bottom is shrinking.
A closer examination of the various age groups within the broad category of
'older persons' indicates that Singapore's aged population is in fact relatively
272
P."rEo
'young'. The young-old (60-69 years) comprised more than half (57%) of the
247,000 old people in 1990. The old-old (70-79) made up a third (31.3%),
and the very old (80 and above) 11%. Age-specific sex ratios for the youngold to very old were as expected, with more females outliving males as they
get older (97 males per 100 females for the young-old; 80 per 100 for old-old
and 60.2 per 100 for the very old category) (Shantakumar 1994).
While still 'young' in chronological age, in terms of economic contribution,
persons aged 60 and above are perceived by the state to be a burden to
Singaporeans (Ministry of Social Affairs 1983; National Productivity Board
(NPB) 1989; 1992):
If we do nothing to address this issue [of an aging population], the longterm trends would have serious repercussions on our economic competitiveness (Labor Minister Lee Boon Yang cited in The Straits Times, 21
March 1996).
The 'burden' is defined as the draining of resources as well as a decline in
output. According to Prime Minister Goh Chok Tong, 'older workers need
constant retraining if they are not to stagnate, or worse, become redundant'
(NPB 1989: i).
In terms of Singapore's long-term economic plans, the country has moved
away from a manufacturing-based economy to become a service economy.
For the last 10 years, there has been a concentration on high-end services such
as Research and Development in knowledge-based industries, in telecommunications, in port and sea services, and in investment banking and corporate
finance. To keep Singapore competitive in the global economy, the state has
made it explicitly clear that Singapore needs a highly skilled and stable workforce (Singapore Economic Committee 1986; Report of Fiscal and Financial
Policy Subcommittee 1986). With an almost zero population growth, there
may not be enough manpower to ensure the desired growth. The implications of declining fertility coupled with an aging population therefore weigh
heavily on the Singapore government. The demographic reality is an older
workforce, as well as a higher dependency rate.
The Old Dependency Ratio (persons aged 60 and above as a percentage of
persons aged 15-59) was only 7.5% in 1957 but by 1990, it had doubled to
13.5%. In addition, in 1992, the age-specific labor force participation rate for
those over 60 years averaged 16.8% compared to 19.3% in 1980 and 20.2%
in 1970 (DOS 1983, 1992b). In the developed world, despite the higher
retirement ages, there has been a decline in the work participation rates of
older persons. Most of the decline has been due to the availability of social
security benefits, an increased inclination towards leisure, and health reasons.
In Singapore, there is little in the way of research to explain the declining
AGING IN SINGAPORE
273
work participation rates. Shantakumar (1994) suggests mandatory retirement
agreements, the availability of social security funds, high home equity and
increased demand for leisure as probable reasons. There is also the possibility
that employers are unwilling to keep employees. He cites the armed forces
as a case in point where workers have been prematurely retired even before
the age of 55. To curb this trend, changes must be made to keep Singapore
afloat in a highly competitive labor market. It has been projected that the
overall dependency ratio will rise to 1.35 (a rise of 145%) by 2030 if the
retirement age stays at 55 (NPB 1989). This problem is compounded by rapid
technological changes. To enable future growth, the state continually urges
older people to update their skills or to acquire new ones (The Straits Times
21 March 1996; 30 April 1996). More details on the employment policy of
the government will be discussed in the section on policy response to the
aging population.
Another concern of population aging is the provision of shelter. Older
persons may live in their own homes, with their children, or in a variety of
living arrangements. In Singapore, the success of the public housing program
is well known. In 1990, 87% of the population lived in public housing and
home ownership was 87.5% (DOS 1992c). Since the census only documents
if aged persons live in owner-occupied homes as opposed to tenanted homes
or institutions and those provided by an employer, it is not always possible
to conclude whether the aged persons actually own the home. Instead, the
provision of shelter is taken as the primary concern. In this respect, families
in Singapore do not seem to be shirking their responsibility. In 1990, 85%
of elderly persons lived in premises that were owner occupied. Only 1.6% of
aged persons lived in institutions (DOS 1992c).
In terms of kin support, it was found that aged persons in Singapore were
also not lacking. In the 1990 census, 67.8% of aged persons lived in onenucleus households with two (e.g. aged persons with unmarried children/aged
married head of household living with parents etc.) or three generations in the
household (aged persons with married children and grandchildren/married
couple with unmarried children and parents etc.). If multigenerations were
included, the proportion went up to 86.6% (Shantakumar 1994). The National
Survey on Senior Citizens (Ministry of Social Affairs 1983) comprising 5538
respondents showed that only 5.4% of elderly persons surveyed lived alone.
A total of 81.9% of the respondents lived with children and/or grandchildren.
In terms of caregiving, the predominance of the family was also very clear.
Whether adult children lived together or apart from their elderly parents, the
Survey on the Aged Living in the Community (Ministry of Health 1986) on
1013 persons revealed that 72.3 % of the care providers of elderly persons were
family members. In the 1990 census, as much as 63 % of elderly persons lived
274
P.TEO
Table 2. Resident elderly persons by household size and
gender: 1990 (%)
Household size (persons) Total Males Females
1-2
3-4
5-6
7 & above
Total
Source:
17.1
31.4
31.6
19.9
13.2
31.9
31.2
23.7
18.6
30.9
32.1
18.4
100.0
100.0
100.0
Shantakumar(1994).
in households with at least 3 and up to 6 persons (Table 2). Given Singapore's
Asian context where filial piety is often encouraged, such a large proportion
augurs well for the family as an institution because it means that more hands
are available to offer caregiving assistance. For both males and females, only
4% of elderly persons lived in 1-person households. These households are
often getting public assistance from the government.
Lewis & Meredith (1988) and Goldscheider (1990) suggest that where
shelter is provided and kin caregivers are available, it cannot necessarily be
assumed that elderly persons are well cared for or happy. Conflicts within
households have been known to arise between older people and their caregivers especially where responsibilities shift or where conditions/situations
change. However, Mehta, Osman & Lee (1995) provide counter evidence for
Singapore in which they discovered that co-residence with family members
was preferred by all their respondents and that this was still the predominant living arrangement for many older people, regardless of ethnic grouping.
Strategies involving mediation or negotiation help families to tide over bad
times (see also Blake 1992). The study also confirmed that financial contributions are still forthcoming from children, even where non co-residence was
concerned, affirming a trend established by Wee (1983) and Cheung, Ngiam,
Vasoo & Chan (1991).
The extent to which elderly persons can support themselves independently
is in some ways related to their educational level which in turn affects their
income levels. It was found in the 1990 census that the majority of elderly
persons had no formal education or did not complete primary school (Table 3).
Of those who worked, very few had secondary education (19.2% for males and
only 7.2% for females) or higher. Sources of income for elderly persons were
found to vary a great deal but generally for males who worked, 78.9% of their
income source came from wages/salaries, 30.6% from profit sources such as
dividends, interests and rentals, and 4.9% from any 'other' income source. For
275
AGING IN SINGAPORE
Table 3. Resident elderly persons by educational attainment, work status and
gender: 1990 (%)
Educational
attainment
No formal education
Primary
Secondary
Tertiary
Total
Working
Males Females
Non-working
Males Females
Total
32.9
45.5
19.2
2.4
74.0
17.8
7.2
1.0
46.2
35.6
16.9
1.3
78.1
14.9
6.6
0.4
81.8
5.4
11.8
1.0
100.0
100.0
100.0
100.0
100.0
Source: Shantakumar (1994).
females the proportions were 60.1% from wages/salaries, 36.4% from profits,
and 3.5% from 'other' sources (Shantakumar 1994). The higher proportion
of profits for women is significant because this becomes the main source
of income for them when they retire. There was probably under-reporting
of informal sources of income, especially intergenerational exchanges. Data
from the 1983 National Survey on Senior Citizens revealed that 84% of elderly
persons (working and non-working) received financial and material support
from their immediate family members and other relatives (Ministry of Social
Affairs 1983). These forms of support were more pronounced for those who
did not have a stable source of income.1
Considering that the majority of the aged (over 90%) are ambulant, when
combined with a real growth in wages and higher education for the younger
aged persons, it stands to reason that the elderly should continue to work.
It is posited that since Singapore has no natural resources, it has to bank on
its well educated and highly skilled workforce. Although this is a truism, the
argument tends to overlook nuances in the socioeconomic profile of older
Singaporeans. While it may be desired that the workforce should remain on
the job for as long as possible, socioeconomic disparities between the various
ethnic groups in Singapore may prevent certain groups from acquiring a better
and higher standard of living enjoyed by the majority of Singaporeans. It is
to this issue that the next section will address.
Ethnic economic and social characteristics
Ethnic differentials in population dynamics is pervasive and extends to fertility, mortality and socioeconomic indices. In 1990, the Chinese constituted
77.7% of the total population while the Malays comprised 14.1% and the
Indians 7.1%. The remaining 1% was made up of Eurasians, Europeans,
276
P. "lEO
Table 4. Age-specific sex ratio by ethnic group: 1990
Age
group
Age-specificsex ratio (malesper 100 females)
Malay
Indian
Chinese
60--64
65-69
70-74
75-79
80 & above
86.4
81.1
72.0
68.8
55.5
107.1
125.1
120.0
104.2
103.1
247.3
288.4
299.3
263.7
213.3
Total
75.6
113.6
266.3
Source: Shantakumar (1994).
Arabs and Japanese. While the TFR of the Chinese saw the greatest decline
from 3.03 in 1970 to 1.86 in 1990, Malay TFR declined more slowly from
3.5 to 2.71 in 1990. Indian fertility decline shadowed the Chinese, having
fallen from 3.19 to 1.95 in the same period. Despite this, the younger Malay
population needed to support the elderly Malay population had shrunk. Elderly proportions grew from 4.8 to 7.2% while the young population remained
at 64% between 1980 and 1990. In contrast, the young Chinese population
had increased 3.8% compared to the old Chinese population which had only
increased 1.4% (DOS 1992a). Expressed in terms of the old age dependency
ratio, the increase for the Chinese was from 12 to 14 per 100 persons aged
15-59 in 1980 and 1990 respectively while the Malays' went up from 7 to
11 per 100 in the same period. The greatest increase was experienced by the
Indians whose numbers went up from 9 to 15 per 100 (Shantakumar 1994).
The sex ratio by specific age groups reveals a significant demographic
pattern. As at the time of the 1990 census, Singapore's elderly population
still bore the imprint of an immigrant population. For example, the Indian
population had twice as many males to females in all the age categories
(Table 4). Indian immigrants had come since the island's founding in 1819 to
work as laborers in the construction industry, as clerks, or they were convicts
transferred from India. Many came without their families or as unmarried
persons. For those who were married, some managed to bring their families
over when their income permitted, but many settled for regular remittances
to be sent to India even after they became permanent residents. The influx
of Indian migrants only petered out after 1930 (Sandhu 1969). The legacy
of immigration was also apparent among the Chinese. Some of the old-old
Chinese had come to Singapore in search of fortune and bec~me businessmen.
The less enterprising were coolies who carded cargo from the ships to the
warehouses or were artisans. Initially, the migration flow comprised mainly
277
AGINGIN SINGAPORE
Table 5. Elderly population by educational attainment, ethnicity and
working status: 1990 (%)
Educational qualification
No formal education
Primary
Secondary
Upper secondary*
Tertiary
Total
Working persons aged 60 & above
Chinese
Malay
Indian
73.7
17.6
4.9
2.1
1.7
76.0
21.3
2.2
0.4
0.1
62.6
23.8
8.6
2.6
2.4
100.0
100.0
100.0
*Includes polytechnic.
Source: Shantakumar (1994).
men but women also started coming and this helped to balance the sex ratio.
Some of the women who came did not marry and worked as samsui workers,
carrying heavy loads of sand on their backs at construction sites, or they were
domestic maids in expatriate and rich local households. The unmarried men
and women who are now in their old age have benefitted from the generous
support of clan associations to which they belong. Eventually this cohort
will pass over, but for now, they help to inflate the number of dependents
who need to be looked after by the state since many do not have families of
their own. The Malay sex ratio also showed more males than females. This
is also a statistical artefact in the sense that non-residents are not included
in the data. Non-residents who may affect the sex ratio include Malays who
are employment pass holders, long social visit pass holders and work permit
holders from Malaysia.
The proportion of elderly Indians and, to a lesser extent, the Malays who
worked was higher than the national distribution of aged persons who worked.
When cross-tabulated with education, more working elderly Indians had secondary to university education (13.6%) than the other two ethnic groups (2.7%
for Malays and 8.7% for Chinese) (Table 5). The Malays had the highest proportion with no formal education (76%) or only with primary school education
(21.3%). Using age 55 as the starting point for old age, the proportion of Indian elderly people who still worked in 1990 was the highest at 10.2% compared
to the Chinese statistic of 6.3% and the Malay statistic of only 5.9%. Although
many Indians still worked, the median income did not commensurate with
their higher level of education. The arithmetic average monthly income for
the Chinese ranged from S$ 1485-16102 depending on the age cohort but
for the Indians, its range was lower from S$ 1161-1368. For the Malays,
the range was only S$ 924--967. No data is available for employment sta-
278
P. TEO
Table 6. Economic activity by ethnicity: 1990 (%)
Economic activity
Total
Chinese
Malay
Indian
Economically active
Economically inactive
Total
66.0
34.0
100.0
65.1
34.9
100.0
62.9
37.1
100.0
70.4
29.6
100.0
Economically active only
Employers
3.0
Own account workers
6.8
Employees
89.2
Unpaid family workers
1.0
3.6
8.1
86.9
1.4
0.6
2.4
96.6
0.4
2.1
4.7
92.6
0.6
Source: DOS (1993).
ms or occupation of elderly persons by ethnicity. For the general population
however, more Chinese were employers or own account workers (Table 6),
making the probability of self-income higher. Efforts have been made by the
government to ensure the course of meritocracy and an equal chance for all,
regardless of ethnicity but the final outcome has remained the same for many
years with the income of the Malays and Indians lower than the Chinese (see
Teo & Ooi 1996). While the median monthly income for all educational levels
for the elderly Chinese and Indians was S$1000, the Malays ranged from
S$ 921-1000. Self-help groups such as Maflis Pendidikan Anak-anak Islam
Singapura (MENDAKI), Chinese Development Assistance Council (CDAC)
and Singapore Indian Development Association (SINDA) were formed mainly to address the needs of the lower income such as in bursaries, tuition grants
etc. There is also KEMAS (or Singapore Malay Economic Association) which
renders assistance to encourage Malay enterprise. The direct benefits to the
elderly are only in the form of social welfare assistance (monetary and in
kind) and in recreational or religious programs catering to elderly persons.
A very small proportion of elderly persons lived in institutions in 1990. Only
0.5% Malays lived in institutions compared to 1.5% Chinese and 1.8% Indians
(DOS 1992c). It has been documented that daughters in Malay households
are taught to care for their elderly parents. In addition, fit elderly persons play
a large role in childminding. There is therefore a reciprocal material as well
as non-material relationship in most Malay households. Much of the good
relations stem from religious training. According to the holy Quran (cited in
Blake 1992: 12):
Thy Lord hath decreed
That ye worship none but Him
And that ye be kind
AGINGIN SINGAPORE
279
To parents. Whether one
or both of them attain
Old age in thy life
Say not to them a word
Of contempt, nor repel them
But address them
In terms of honor. (S 17:23)
Children are reminded that it is their religious duty to look after their parents.
The Hadith (sayings and doings of Prophet Mohammed) support the Quran.
According to one Hadith, a man asked the Prophet who deserved to be treated
well by him and the answer was his mother, followed by his father. The Hadith
and the injunctions of the Quran clearly state the importance of caring for
parents.
The 1990 census registered 17% of Malay households with three or more
generations in the household as compared to less than 13% for the other two
ethnic groups. Although extended households were more common among
Malays, many of them lived in 3-room fiats (49.7%) (Table 7). There were
at least 16% more Malays living in 3-room flats than there were Chinese.
The proportion who can afford private houses was also small - 1.2% only
compared to the 7% among the other two ethnic groups. The same may be
said for private properties which are condominiums or flats. Since property
prices in Singapore are very much market driven, this discrepancy may be
interpreted to mean that the Malays are lagging behind in terms of social
mobility.
Table 7. Housingtype by ethnicity: 1990 (%)
Housing type
HDB/JTC Total
1 & 2 room
3-room
4 room and above
Others
Other public flats
Private houses
Condominiumsand private flats
Stophouses, attap and zinc roofed
houses & others
Total
Source: DOS (1992).
Total Chinese Malay Indian
84.6
8.1
35.4
40.4
0.7
1.6
7.0
4.1
83.2
8.0
33.7
40.8
0.7
1.7
7.7
4.6
96.6
7.1
49.7
39.7
0.1
0.6
1.2
0.4
83.7
12.6
31.5
38.6
1.0
2.0
7.4
3.2
2.7
2.8
1.2
3.7
100.0
100.0
100.0
100.0
280
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This was confirmed by a study on 122 elderly Malays (Blake 1992). In
this sample, 43% of the respondents lived in 3-room fiats and 14% in rented
1-2 room flats. In terms of their occupational status, many were in clerical
positions (35 %) while the remaining bulk of the respondents were housewives
(33%). As much as 48% of this sample had a household income of less than
S$1000 a month.
The information points to distinct socioeconomic disparities and sociocultural differences especially between the Malays and the Chinese. While
Singapore has been quite successful at playing down ethnic diversity so that
Singaporeans can associate more with a national identity than with a specific
ethnic group, the class distinctions are not healthy for the country. The implications for caring for elderly persons becomes an even more important issue.
Culturally, the Malays as a group fair extremely well in taking care of their
old, but economically they are less well disposed to give them more. Of all
the ethnic groups, Malays use public services for elderly persons (such as
senior citizens centers) least of all, preferring the company of their families
and their Malay community. Religion is cited as a reason for this lack of
usage (Chan 1994/1995). Besides the Quran and the Hadith, the Malays also
have the concept of saudara anglat (adopted relative) in which older Malays
without blood relatives or without relatives who can support them are adopted
by neighbors and friends in their community. The jawatankuasa blok (block
committee) is an informal organization which will serve the social needs of
Malays living in a block or within a few nearby blocks of fiats in a public
housing estate. The kampulan berzanzi (committee to train the recitation of
the Prophet's life history) looks after the religious requirements of the people,
young and old. In the event of weddings, the rewang ~a group of ladies in
charge of cooking) will perform the organizational tasks of the wedding and
provides a good source of support for women; the khairat kematian will be
sourced for finances in the event of death or illness. In many aspects, the
Malay community seems self-contained in meeting their own needs (Blake
1992).
Policy response
Singapore has explicit state policies with regard to the elderly population.
Having recognized early that the population will age has helped the state to
design policies to create structural and social conditions that are conducive
to the sharing of the costs of caring for elderly persons. The first issue is
in the area of employment. To ease the strain of financial care for elderly
persons, the working life of Singaporeans has been extended from 55 to 60
years since 1988. There has been a recommendation to push it further to 65 or
AGING IN SINGAPORE
281
67. It is mandatory for employees (and matched by employers) to contribute a
share (18.5 %) of their income into Singapore's social security fund called the
Central Provident Fund (CPF). The monies deposited can be withdrawn upon
retirement. There are, however, home-ownership schemes, state-approved
share purchase schemes and insurance schemes in which members may withdraw their money before the age of retirement. Since their implementation,
these schemes have been extremely popular with Singaporeans as gains can
be acquired without the need for cash on hand. To ease the burden of both
the employer and the employee, the state reduced the contribution of both
parties to 12.5% each for employees aged 55-59, 7.5% each for those aged
60-64, and 5% each for those aged 65 and over. In addition, to attract workers to remain in the workforce, part-time and flexi-time work was introduced.
Retraining programs aimed at the older worker and sponsored by the Skills
Development Fund were also set up by the state to upgrade the productivity
of older workers. As a further incentive, the state advocated adjustments in
the wage system, away from wages based on seniority. There have been recommendations to tie salary to the worth of a job, a shortening of salary scales,
one-off bonuses as rewards rather than wage increments and the withdrawal
of fringe benefits tied to seniority.
Closely tied to finances would be health costs. With increasing longevity,
there has been a great deal of concern over the state's recent restructuring and
corporatization of Singapore's public hospitals. The intent was to make the
hospitals in both the private and public sectors more cost- and productivityefficient by pitting them against each other. As a back-up to ensure that
the lower income are not deprived of health care, the state kept the heavily
subsidized Class C wards although it reduced the number of beds available.
It also revised the rates of each class of wards and made the increases most
at the more expensive wards, i.e. B1 and A1 wards. 3 Primary health care
is promoted in Singapore, including comprehensive immunization programs
as well as education programs for early detection and treatment of serious
illnesses. The Medisave Scheme was introduced in which a certain amount
of one's CPF is set aside for medical payments. Members may use medisave
to pay for his/her own hospital/medical bills as well as that of his/her family
members, including parents. In addition, there are public and private health
insurance schemes available.
While it is obvious that fairness is sought for employers to retain older
workers and for the latter to continue to work, this principle does not help to
decrease the socioeconomic disparities between the Malays and the Chinese.
As CPF can be used to acquire assets, the lowering of their rates means
that even fewer Malays will be able to own equity in property as the major
portion of the payments come from this source. If fringe benefits like medical
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assistance is removed, the loss in 'real income' for the poor Malays will
be even greater, especially in a scenario in which medical costs are rising.
Medisave serves its purpose well but it can very quickly be drained away.
The amount of Medisave is a function of a person's income; thus for many
Malays, it may not be possible for them to stretch their Medisave dollar very
far.
Apart from the family, the community is also viewed by the state to be
integral to the continued well-being of elderly persons. Here, there exist two
programs designed for those who are frail and for those who are ambulant.
Senior Citizens Clubs, Singapore Action Group of Elders (SAGE) and community centers offer recreational programs, health screening and education as
well as keep fit activities. At the moment, there are 80,000 registered members
(Ng 1992). For the frail elderly, there is Befriender's Service which provides
care surveillance for frail elderly, Meals on Wheels Service, Home Nursing
Service and Day Care Service. The last two provide nursing, physical therapy
and medical care. Although these services are available to all Singaporeans,
utilization is segregated along ethnic lines with the take-up rate being much
lower among the Malays. Services have a paternalistic 'take-it-or-leave-it'
ring to them. Both the Ministry of Community Development and Peoples'
Association (which runs the community centers' programs) maintain that
they try to avoid ethnic and religious criteria as far as possible so as not to be
accused of being separatist in a multiethnic society (Chan 1994/1995). Food
taboos, language difficulty, the need for a rigid time schedule for prayers are
some of the obstacles that prevent elderly Malay from using the services. A
Muslim religious organization even went to the extent of setting up its own
food delivery service for elderly persons (The Straits Times 10 May 1995) and
a mosque-based senior citizens' club (The Straits Times 15 January 1995).
Residential care in Singapore is run mainly by Voluntary Welfare Organizations (VWOs) or as commercial enterprises. To deal with the expected
increased demand in the future, the state has undertaken to share the capital
and recurrent costs of homes run by VWOs. Properties are given a 30 year
lease by the state. By and large, residential care is seen as a last resort, thus
very stringent criteria are imposed for admission into homes run by VWOs.
These homes only accept patients who have no family or are estranged from
their family. There are very few Malays in residential homes, the reasons
already elaborated in previous paragraphs. What is more important for the
Malays would be how to maintain and reinforce this pattern of community
support they already have (e.g. saudara angkat) so that institutionalization
never becomes a necessary option to consider.
The combined effects of smaller family size and increased female labor
force participation (from 29.7 to 51.3% in 1992) means that the family can
AGING IN SINGAPORE
283
be quickly eroded as an important social institution for the care of elderly
persons. To make it easier for families to look after elderly persons, the state
introduced the Joint Selection Scheme for public housing. In this scheme,
parents and their married children may apply for separate apartments within
the same block of fiats or housing estate. The Multi-tier Family Housing
Scheme grants preferential treatment in terms of waiting time as well as
lower down payments for applicants who will have their parents staying in
the same fiat. The CPF Housing Grant gives a one-time S$ 30,000 grant to
the applicant's CPF account to be used as capital payment for the purchase of
a resale fiat in a mature housing estate where no further building is planned
due to a lack of space. This is granted only if the resale fiat is close to
the applicant's parents (Chan 1994/1995). The full impact of this policy on
housing for the minority ethnic groups is unfortunately not possible to evaluate
as public sources of data are scarce on this matter. However, there has been
an overall improvement in the proportion of home equity even among the
Malays; whether older Malays have benefitted from the generous schemes
available in public housing will need to be assessed.
Conclusion
Unlike many countries in Asia Pacific, the government of Singapore became
cognizant of the rapid aging of its population at a very early stage and made
a conscious effort to formulate policies to cope with changing conditions and
with the increasing number of elderly persons. Singapore stands in stark contrast to Hong Kong which does not have a publicly-supported, comprehensive
retirement pension scheme o r community care services. According to Bartlett
and Phillips (1995: 164), demand for residential care in the colony is twice
that of supply. China is another case in point. As the country struggles to strike
a delicate balance between the centrally planned sector and the free market
sector of the economy, it has yet been able to convince its people that retirement benefits are not only gainful for the immediate cohort of retirees (which
is by no means a small group of people) but also the young workers who come
from more profitable economic enterprises (Kwong & Cai 1992). Within the
rural areas, there are hardly any social security systems to speak of. With
the demise of the Peoples' Commune System around 1983-1985, barefoot
doctors have disappeared and healthcare for older people has become expensive. The areas covered in Singapore are indeed comprehensive. It includes
not only policies and programs to ensure financial independence in old age,
it also includes health care provision, housing, and social provisions.
Notwithstanding these merits, Singapore's ethnic differences, especially
the socioeconomic distinctions should not be ignored. Low rates of use of
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v. TEO
public services for Malay elderly persons indicate that they have cultural
mechanisms which help them to deal with aging as a process, some o f which
were elucidated above. Perhaps what is needed are supplemental programs
that particularize the needs o f a sub-group, e.g. the Malays. T h e y are economically less well off which m a y exacerbate the burden o f caregiving. As
families b e c o m e smaller in the future, the c o m m u n a l nature o f support found
among the Malays is likely to be eroded and caregiving will return to the
family or the state. This must be noted and programs designed to meet their
needs. Although the social and health services provided by the state are available to all Singaporeans, the lack o f fit for the Malays has prevented their
participation. Food taboos, language difficulties, and dissonance in respect
to time schedules (especially time set aside for five prayers a day) are some
reasons. As Singapore becomes more and more developed and more and
more affluent, it is imperative that society does not b e c o m e impersonal and
detached. Addressing the nuances in a multicultural society will stand Singapore in good stead and contribute to the better quality o f life it aspires for in
'the next lap'.
No~s
1. No published sources could be found to update the information on financial sources for
older persons.
2. At current rate of exchange, US$1 is equivalent to S$1.6.
3. The ward charges of hospitals in Singapore were revised (The Straits Times 24 May 1990):
Private rooms
Subsidized rooms
Single bedded (A 1)
4 bedded (B1)
10 bedded (B2)
C class
Old rate (in S$)
New rate (in S$)
165
95
35
15
200
110
35
17
The amount of subsidy given to Class C wards remained the same but as Singapore
becomes more affluent, people seem to be 'shunning' these wards so that hospitals reduced
the proportion of Class C beds (e.g. from 80 to 20% in Tan Tock Seng Hospital and from
40 to 15% of total beds in Kadang Kcrbau Hospital). Subsidies given to Class B2 wards
were capped at 70% and the amount for B1 and A classes were reduced (Low 1991).
AGING IN SINGAPORE
285
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Address for correspondence: Peggy Teo, Department of Geography, National University of
Singapore, Kent Ridge, Singapore 119260, Republic of Singapore
Phone: (65) 7726104; Fax: (65) 7773091; E-mail: [email protected]