Abstract
Demographic aging represents a major social and economic challenge for Cuba. This chapter examines the responses and coping mechanisms developed in Cuba over the past decades with regards to aging within Fassin’s (Ann Hist Soc Sci 6(64):1237–1266, 2009) conceptual framework of moral economy. It demonstrates that the moral economies of social justice and homecare tend to conflict in a context of care deficit (Hochschild in Soc Polit 2(3):333–346, 1995). The chapter is based on several rounds of ethnographic fieldwork, participant observation, and interviews conducted between 2009 and 2016 in Havana and other parts of Cuba. It first analyzes the components of demographic aging, namely the increase of life expectancy, the decrease of fertility, and migration. It then delves into public policies aiming to respond to the health care needs of the elderly, to foster their community integration, and to mitigate their impoverishment. Finally, it highlights how households develop strategies to cope with the care needs of aging relatives, in a context where market provision and institutional long-term care supplies are still incipient. Although constructed as a public problem and widely documented in Cuba, the pressure aging exerts on care systems has received little attention from social scientists. In this regard, this chapter contributes to comparative knowledge on aging in post-Soviet, Latin American and Caribbean countries.
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Notes
- 1.
From 2010 to 2014, this research was funded by the international project Offre institutionnelle et logiques d’acteurs: femmes assistées dans six métropoles d’Amérique latine (LATINASSIST; ANR SUDS II).
- 2.
The Aging Index refers to the number of elderly individuals per 100 individuals younger than 15 years in a given population. This index increases as population ages (ECLAC 2017).
- 3.
Health and social assistance expenditures represent 10.4% of Cuban GDP in 2015 (ONEI 2016).
- 4.
The discrepancy between men’s and women’s official activity rates—about 20 percentage points—demonstrates, however, that this process has been inhibited by sturdy underlying patriarchal social structures (see Destremau 2017a).
- 5.
This is notwithstanding that investment in “marketable” health services and the development of clinics dedicated to “health tourism” has considerably expanded (Brotherton 2013).
- 6.
- 7.
Last data found.
- 8.
The Constitution of the Republic of Cuba and the country’s Family Code also establish the rights and duties of the family in a more formal way.
- 9.
In 2010–2011, 92.5% of Cuban elders declared having living children (ONEI 2011).
- 10.
The Health, Wellbeing and Aging 2001 Survey (Salud, Bienestar y Envejecimiento) conducted in Havana (where 20% of the country’s elderly population lived at the time) shows that: 6.6% of the elderly face limitations to accomplish 3 or more basic activities of daily life; 12.5% face limitations to accomplish 1 or 2 basic activities; 28.5% have a vision impairment; 24.9% have a hearing impairment; and 11.1% of the total number of elderly live alone. Another study conducted over dementia in Cuba shows that 10% of all elderly suffer some form of cognitive deterioration (Peláez and Palloni 2001).
- 11.
Studies underscore the fact that sexual division of domestic labor tends to be more unequal in low-income households where educational and income levels are lower, and more equal when couples have higher levels of education.
- 12.
According to a fertility study conducted in 2009 by the Cuban Statistical Office, men between the ages of 15 and 54 declare to be “single” one third times more often than women (1.064 million, or 31.4% of the total, versus 667,020, or 20.1%; ONEI 2009).
- 13.
“Back to the ‘stove front’: An oral history project about Cuban housewives” aims at documenting this trend (https://blog.oup.com/2015/09/cuba-oral-history-project/).
- 14.
- 15.
The recent liberalization of the housing market (2011) mainly benefits families receiving remittances and/or disposing of foreign funds. It is expected to have an evicting effect on poorer households living in coveted city centers.
- 16.
Last estimates found.
- 17.
According to my fieldwork findings.
- 18.
Social abuse includes situations such as obstacles to walking on sidewalks due to potholes and tree roots poking through the pavement, impediments to crossing streets because of poorly coordinated traffic lights, or the absence of adapted public transportation.
- 19.
The proportion of one-person households in the total number of households increased from 13.9% in 2002 to 18.7% in 2012, according to census results.
- 20.
Despite contradictions between various sources and the economic challenges during the worst years of the crisis, the number of beds has been relatively stable since the 1990s.
- 21.
The Basque Foundation Euskal Fondoa, in this case.
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Destremau, B. (2019). Population Aging in Cuba: Coping with Social Care Deficit. In: Vega, W., Angel, J., Gutiérrez Robledo, L., Markides, K. (eds) Contextualizing Health and Aging in the Americas. Springer, Cham. https://doi.org/10.1007/978-3-030-00584-9_15
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