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Aging
in Cuba: Realities and
challenges
By Alberta Durán Gondar and Ernesto Chávez Negrín
TEMAS,
April-June 1998
Demographic
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
2. The velocity and intensity of Cuba's demographic aging process is
far greater than that 3. The process of population aging in Cuba is not occurring in optimal
international conditions, 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:
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:
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:
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 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 1. Alvarez Suárez, M. et
al (1996): La familia cubana. Cambios, actualidad y retos.
CIPS. CITMA, La Habana. 2. Bazo Ma. Teresa (1996):
"Aportaciones de las personas mayores a la sociedad: análisis sociológico"
Revista REIS Magazine, #3, CIS, Madrid, Jan-March. 3. ___________ (1990): "La sociedad anciana" Col. Monografías
#113. Edit. CIS and Siglo XXI, Madrid, Spain. 4. Camdessus, Brigitte, M. Bonjean and R. Spector (1995): Crisis
familiares y ancianidad. Edit. PAIDOS, Barcelona. 5. Centro Iberoamericano de la Tercera Edad (1996): Boletín demográfico.
Año XXX, No. 59. Santiago
de Chile. 6. CNN en Español (5 de
julio de 1999). "Las bajas tasas de natalidad frenarán el
desarrollo económico de Europa", Economía y Finanzas. 7. Coale, Ansley J. (s.f.):
El efecto de los descensos de la mortalidad en la distribución por
edad. Centro Latinoamericano de Demografía, Chile.
8. Chávez Negrin, Ernesto
(1998): "Transformaciones demográficas, cambios en la familia y
niveles de salud en Cuba". Revista CIDE Magazine, Vol.
3, No. 1, Edición Especial. Centro de Investigaciones Demográficas,
Universidad de Puerto Rico, San Juan. 9. Duran Gondar, Alberta y
Ernesto Chávez Negrín (1998): "Una sociedad que envejece: retos y
perspectivas. In: Temas Magazine, No. 14, April-June,
1998. La Habana.
10.
________________________________________ (1997): La tercera edad en
Cuba. Un acercamiento sociodemográfico y socio psicológico. (Informe
de investigación) Centro de Investigaciones psicológicas y Sociológicas,
La Habana.
11. Kalish, Richard A.
(1996): La vejez. Perspectiva sobre el desarrollo humano. Edit.
Pirámide, S.A. Madrid. 12. Ministerio de Salud Pública (n.d.): Anuario estadístico
1997. Ministerio de
Salud Pública, La Habana. 13. Naciones Unidas,
Departamento de Asuntos Económicos y Sociales (1978): Factores
determinantes y consecuencias de las tendencias demográficas. Vol.
1. New York. 14. Oficina Nacional de
Estadísticas (1999 "a"): Anuario demográfico de Cuba1998.
Oficina Nacional de Estadísticas, La Habana.
15.
__________________________ (1999 "b"): El envejecimiento de
la población en Cuba y sus territorios. Oficina Nacional de
Estadísticas, La Habana.
16.
__________________________ (1999 "c"): Panorama económico y
social. Cuba 1998. Oficina Nacional de Estadísticas, La
Habana.
17. Sainz de Robles, F.C.
(1979): Diccionario español de sinónimos y antónimos. Edit.
Científico Técnica. La
Habana.
18. Sánchez, Carmen D.
(1994): Ancianos como recurso de la familia. (Ponencia presentada en la
1ra Conf. Interamericana de Gerontología. oct. 1994, Viña
del Mar, Chile). Photocopy.
19. ________________
(1990): Nuevos patrones, nuevas situaciones que afectan las relaciones de
la familia actual. (Ponencia al Foro Interdisciplinario del 6º congreso
Interamericano sobre Derecho de Familia. Univ. Interamericana de P.
Rico, oct. 1990) Photocopy. 20. Valentei, Dimitri
(1978): Teoría de la población. Editorial
Progreso, Moscú. 21. Walker, Alan (1996): "Actitudes europeas ante el
envejecimiento y las personas mayores". In: Rev. REIS
Magazine #73. CIS, Madrid, Jan-March.
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