Chile

An economic leader and high-income powerhouse within Latin America, Chile’s commitment to social service programs and robust health care are increasing longevity and hastening the country’s transition toward becoming a super-aged society in which over one in five people is age 65 or older. Recognizing this rapid shift and the potential implications for the economy and society, the national government is increasingly focused on policy change and is providing funding to municipalities and local stakeholder groups on the front lines designing and implementing age-related programs tailored to local needs. The geographical heterogeneity and physical separation of communities further fosters the development of local programs and services from the bottom up.

The family represents the primary means of social connection, caregiving, and introduction to new technologies. Despite a long history and tradition of family cohesion, older Chilean adults are becoming increasingly independent, self-sufficient and empowered. Associations of older adults are a formidable force in Chile, and are increasing in their reach, impact, and degree of political influence.

As in other countries, Chile’s increase in life expectancy is straining the country’s pension system, which is funded through individual savings accounts. The government’s traditionally narrow focus on pensions is beginning to broaden and take a more holistic view on aging and supporting older adults to remain productively engaged. A global leader in information and communications technology (ICT) connectivity, Chile is well-positioned to leverage this infrastructure to improve the social connectedness, productive engagement and health of its older population. But efforts to reduce its substantial digital divide are still nascent. While Chile’s age-related policies are largely in their infancy, the country’s commitment to health care and wellness has laid a solid foundation and remain critical to older adults’ overall welfare.

Those age 65 and older represented 6.2 percent of the population in 1990, which had jumped to 11.1 percent in 2017. This share is projected to grow steadily, and will hit 21 percent by the year 2041.

Source: United Nations, Department of Economic and Social Affairs, Population Division

Percentage of Population Age 65 and Over

(Source: United Nations, Department of Economic and Social Affairs, Population Division)

Ecosystem for Policy and Social Innovation

Chile’s long history of neoliberalism focused on free markets, trade, privatization, and global engagement have helped inform the country’s still-evolving approach to aging policy. The central government sets high-level policy, programs, and funding, for age-related initiatives. The country’s high degree of decentralization, grassroots organizations, and challenging topography, afford incredible power and autonomy to the municipalities to develop and implement programs within their communities. With a history of experimentation and commitment to evidence-based policymaking, local pilot projects and university research are driving social innovation in this relatively nascent field and continuing to inform Chile’s evolving policy on aging.

“We always seek to create networks, it’s our main way of working. And if there is not a network, we try to create one and raise interest in the topic of aging.”

– Consuelo Moreno, Fundación Oportunidad Mayor

“Older adults represent the country’s most organized age group.”

– Tania Mora, Director of the Judicial and Human Rights Unit of SENAMA

Driving Forces of Innovation and Cross-Sector Collaboration

Community Social Infrastructure

Recognizing the growing importance of this booming demographic, the national government, along with many proactive local governments, are steadily advancing policies and programs aimed at the social inclusion and empowerment of older adults. Local governments, in particular, have taken steps to establish a range of programs to enhance autonomy, minimize risks of isolation, foster social inclusion, and boost overall welfare through active aging. While the country is making advances, more can be done, especially to enhance mobility and accessibility. The decentralization of Chile’s government puts much of the impetus for designing and implementing age-related initiatives into the hands of municipalities and local organizations, with some notable leaders paving the way and advancing innovative models for others to follow.

While intergenerational households are predominant, older adults are increasingly living independently due to a shift toward smaller families and an increasing sense of individualism and autonomy. However, despite family structure and living arrangement changes, older people maintain relatively close social connections with their families and their communities.

Groups Maintaining Social Connections of Chile’s Older Population

“Gerópolis”

Gerópolis, a project of the University of Valparaíso’s faculties of medicine, architecture, and engineering and the Ministry of Education, was recognized by the WHO as one of the community-based social innovations of the year in 2018. The initiative started in 2006 as part of research within the University of Valparaíso and evolved into a research center “to develop an integral and replicable model to reveal, understand and address the reality of older adults as a social construction, through the implementation of integrated strategies in education, health and territory in terms of community space.” Valparaiso was an ideal testing ground for the project as it is home to the highest number of older adults in Chile with 20.6 percent of the population age 65 and older.

Gerópolis promotes aging in place and seeks to offer solutions that increase the opportunities for autonomy and independence for older adults. The program has created an Interdisciplinary Center for Integral Development of Older Adults, integrating internal and external stakeholders within the city. Their aging in place model trains Health Multiplication Agents (AMS or Agentes Multiplicadores de Salud); has developed a mobile health platform for older adults; and also runs the Urban Appropriation Program which co-designs spaces and devices for older adults.

Productive Opportunity

Chile was the first country in the world to privatize its national pension system and today has a consolidated system with one of the highest coverage rates in the region. Still, pension payments are in many cases unable to provide for a comfortable retirement for a population that is living longer, and older adults seeking to remain in or to re-enter the workforce, face ongoing challenges. Ageism is an issue for older adults seeking to remain in the workforce, and in order to address it, some business and civil society organizations have mobilized themselves to raise awareness of the benefits of older, experienced employees and view work as a way to enable older adults to remain active. This continued productive engagement is especially important in Chile, a society that strongly values work as a tool to dignify the individual. The National Service of Training and Employment (Servicio Nacional de Capacitación y Empleo) or SENCE, a government organization, seeks to improve the country’s productivity by improving the employability of the population through orientation, skills training for work, and labor intermediation between employer and employee. While nascent government efforts are growing, NGOs and business have helped to fill the gap to capitalize on the productive opportunity of seniors.

Labor Force Participation Among Adults Age 65 and Older

Labor market participation among those older than 65 has been rising rapidly, with the percentage of working older adults increasing twice as fast between 2010 and 2016 than between 2000 and 2009.

“ServiSenior”

ServiSenior is a university initiative established in Valparaíso in 2015 and based on a concept developed by two partners from Chile’s Social Lab for Social Innovation. The program offers support to adults 50 and older in identifying opportunities in the labor market. “The organization recognizes that continuing working at this age is not only an economic matter, but it benefits older adults’ motor skills and their psychology, allowing older adults to stay active,” said Ignacio Hinojosa, co-founder of ServiSenior. ServiSenior seeks to integrate older adults in the labor market through three different paths: motivating older adults to explore opportunities in service sectors such as driving for a ride-sharing service; identifying groups of tasks and services that can be performed by older adults, that are then packaged and marketed to companies; and accompanying older adults to visit companies considering hiring, and helping the companies to identify candidates and fill vacancies. While ServiSenior’s activities are based in Santiago, Valparaíso and Viña del Mar, its virtual platform enables its scope to be national. Still small in scale, the initiative is seeing rapid growth in demand for its services.

Technological Engagement

An early adopter and integrator of technology, Chile scores highest among Latin American countries on the World Economic Forum’s 2016 Networked Readiness Index, which measures a country’s propensity to exploit the opportunities offered by information and communications technology (ICT). It has the highest internet penetration rate in the region, with 85.7 percent of the population having access to internet, substantially higher than the 65.9 percent average in the Americas and 79.6 percent in Europe. This high degree of integration and connectivity carries a range of benefits for older adults, including strengthening social connections and enhancing access and mobility. But more can be done to strengthen ICT skills and leverage technology to enhance the well-being of Chile’s older generations.

The share of older adults with a smartphone had increased from 3.6 percent in 2013 to 20.1 percent in 2016. For those who use the internet, the Online Poll of Usage of Digital Platforms indicates that 71.1 percent use email, 57.3 percent use WhatsApp, and 53.7 percent use social media at least 30 minutes per day.

Source: Fourth National Poll of the Quality of Life in Old Age

eHomeseniors

The eHomeseniors project represents an exception and potential model, seeking to enhance older adults’ lives through technology. The project was launched in 2015 based on an idea from Carla Taramasco, an academic at the University of Valparaiso. Funded by the regional government of Valparaiso, she sought to incorporate the idea of using technology to create “smart spaces” that serve the needs of older adults. The project was developed with the support of the Servicio de Salud Viña del Mar Quillota (Health Service from Viña del Mar Quillota) and the geriatric hospitals from the region. Together they developed the project with the goal of, according to Taramasco, “taking care of the older adult inside their own home, improving their quality of life, increasing autonomy, and reducing health risks inside the home.” The eHomeseniors project developed three smart sensors to be placed within the home of older adults: one to detect nycturia— the need to urinate in the middle of the night - a second sensor to detect repetitive events as a means of identifying early symptoms of cognitive deterioration, and a third that recognizes falls and communicates with those who can assist older adult.

“If you ask me today if older adults are seen as consumers, [I would say] at this moment they are not a concern of industry. However, if there was an orientation demonstrating potential demand, undoubtedly the companies would respond.”

– Marco Zuniga, CEO of Chiletec

Health Care and Wellness

While municipalities are the primary actors in aging policy implementation and innovation in other areas, the central government has traditionally been the force behind health care and wellness programs in Chile. The country’s health care infrastructure is well-developed and access has long been a priority, with the central government adapting policies to better accommodate the aging population. The government has increasingly incorporated the needs of older adults into its health policies with a focus on preventive care. Program implementation is local and based on alliances between the national health services and municipalities, operating in primary care centers or within NGOs. However, as in most countries, long-term care and support to caregivers require attention to ensure both the well-being and economic security of older adults and their caregivers along with the competitiveness of the economy. With dementia prevalence growing and projected to double over the next 20 years, Chile is at the leading edge of dementia awareness in Latin America.

Chile's LE and HALE Far Exceed the Average Across Latin America and the Caribbean

Over the period from 1990 to 2016, life expectancy (LE) of adults ages 60 to 64 increased by 4.2 years, and healthy average life expectancy (HALE) increased by 3.3 years, a larger increase than any other country in the region.

(Source: Institute for Health Metrics and Evaluation)

Kintun and the National Plan for Dementia

With dementia prevalence projected to double over the next 20 years, the government has created a National Plan for Dementia. Designed in 2014 as part of a collaborative effort by the Ministry of Health, academia and civil society, including experts in neurology, psychiatry, geriatrics, gerontology and social services, the National Plan for Dementia seeks to develop a participatory process that integrates people with dementia, their families, academia and the broader society. The Plan was inspired by a program called Kintun that was launched in 2013 in the city of Santiago with funding from SENAMA. Kintun used an interdisciplinary team to promote better support for individuals with dementia and their caregivers, based on Chile’s model of community and family-supported health care. The program integrated multiple services to deliver more holistic care, including a comprehensive geriatric assessment, activity-based day care centers with guidance from psychologists, training and education of family caregivers, home visits and case management, and public awareness campaigns. Evaluation of the pilot found a decrease in falls, improvements in the behavioral and psychological symptoms of dementia sufferers, and improved perceptions of those with dementia. The Ministry of Health backed the integrated approach, and as of late 2017, at least 259 people with dementia and their families were enrolled in the program.

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