We often imagine the overseas territories as young societies, faced with a dynamic demography. In reality, the situation is very different, and the aging of the population is even more sensitive than in mainland France. Published last week, a parliamentary report drafted by the deputies Stéphanie Atger (LREM) and her colleague formerly minister of Overseas Ericka Bereigts (PS) examines this subject and draws an alarming assessment.
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The age pyramid of the overseas territories, Guyana and Mayotte aside, has changed considerably in fifty years. These territories are now struck by a "very rapid aging of their population" , with a share of 65 years and over multiplied "by 1.5 in each of these departments between 1999 and 2014" , note the elected officials of the Palais Bourbon. An analysis which corroborates the INSEE figures: in 1990, 7.1% of the population of the overseas departments was over 65, compared with 13.9% for the inhabitants of the metropolis. Thirty years later, these proportions increased to 13.7% and 20.7% respectively.
This phenomenon of aging of the population was particularly rapid in the overseas departments, the transition having been accelerated compared to the mainland. It should continue and even grow, widening the gap with the rest of the country: "projections for 2030 suggest a very unbalanced age pyramid" , making Martinique the oldest department in France in 2050 , whereas it was only at 74th place seven years ago. Thus, "there will be 134 seniors for 100 young people in Guadeloupe in 2030 against 54 seniors for 100 young people in 2013" , cite the deputies as an example. Local disparities remain, however: Guyana can thus count on a population remaining young, as well as Mayotte, marked by a significant immigration as well as the most active birth rate in France.
This over-representation of people aged 60 and over in these territories is explained by the combination of several factors. First, a rapid demographic transition, with fewer children per woman. Then, the arrival of retired people, attracted by the living environment and the climate. Also, an "exodus of young workers" , and in particular the wealthy, leaving to look for work in Europe and elsewhere. "The return to the country, at retirement age, accentuates this phenomenon," adds Stéphanie Atger.
Poor living conditions for the elderly
The problem of aging is complicated, however, by the socio-economic situation of these territories, less wealthy and more fragile than the mainland. "The ultra-marine populations are in poorer health" and therefore become dependent more quickly than their fellows from other areas. Overweight, inferior and fewer health facilities, lack of staff, diabetes, cardiovascular problems and poor oral health… Many problems complicate the aging of inhabitants and limit life expectancy.
Result: "the share of seniors with loss of autonomy is higher in the overseas departments and communities than on the national average" . And this, while the infrastructures are clearly insufficient in these territories: the nursing homes are "deficient and aging" , with an offer "two to three times lower in the overseas territories than it was at the national level" , in 2015 and “dilapidated or even dilapidated” establishments . In addition, places in nursing homes are expensive, a cost accentuated by the insufficient supply, by imports of products and drugs. These sums must be observed in relation to the local standard of living, which is much lower than the national average. This large discrepancy may partly explain why only 1% of Guadeloupean seniors are in nursing homes, for example: "mainly for financial reasons" .
"Overseas will be the first and most rapidly affected by the aging of their population"
The report therefore advises the public authorities to take a closer look at this issue, in order to better support the populations, while taking advantage of the "reservoir of jobs" and the economic potential of old age. Several tracks are advanced. First, upstream, a prevention policy aimed at reducing the dependence of individuals, in particular by promoting a better lifestyle and keeping people active. Next, improved information for retirees on their rights and on Alzheimer's disease. Elected officials also suggest developing infrastructure, in particular by creating new “autonomy residences” overseas and by using new technologies, for example via telemedicine and monitoring the patient who remains at home. Caregivers must be supported at the same time, and jobs aimed at caring for dependent people must be made more attractive, the document said.
Presenting the report to the Assembly, Stéphanie Atger clarified that this document aimed to enrich the discussions within the framework of the future bill aiming to finance dependence. "Overseas will be the first and most quickly affected by the aging of their population, and must show the way to be followed to the other territories" , she justified herself. Her colleague called on the authorities to set up an "innovative approach" , adapted to each territory, to effectively face the "extremely important, complex and violent" challenge of old age. Time is running out, she added, citing the case of Réunion, where everything will be played out "in the next ten years" . In addition, these atypical territories will sometimes require "proposals that will not necessarily be heard by all at the national level , " warned the former minister, adding that they would need a "force of collective persuasion" to make these ideas accepted.