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Ageing in the Mediterranean$

Joseph Troisi and Hans-Joachim von Kondratowitz

Print publication date: 2013

Print ISBN-13: 9781447301066

Published to Policy Press Scholarship Online: May 2014

DOI: 10.1332/policypress/9781447301066.001.0001

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Ageing in Turkey: the Peter Pan syndrome?

Ageing in Turkey: the Peter Pan syndrome?

Chapter:
(p.297) Fourteen Ageing in Turkey: the Peter Pan syndrome?
Source:
Ageing in the Mediterranean
Author(s):

Özgür Arun

Publisher:
Policy Press
DOI:10.1332/policypress/9781447301066.003.0014

Abstract and Keywords

This paper investigates the following issues relating to population ageing in Turkey. What is the course of ageing in its barest form and basic meaning in Turkey? What are the conditions of older adults based on sociological factors such as daily life, gender, marital status, urbanization, education, work and income, health, religion and ethnicity? What is the perspective of the state in Turkey towards ageing in the realm of social policy? This paper compares social change processes in Turkey with those in Europe by way of utilising eight sub-themes determined as urbanization, gender, marital status, education, work and income, health, religion and ethnicity. The position of the Turkish state will be discussed in the context of those services which should be developed and implemented by a modern welfare state such as social security, retirement rights and health policies. In conclusion, a range of objectives and expectations regarding Turkey’s future gerontological agenda is discussed in light of the issues and challenges identified as a consequence of population ageing.

Keywords:   Ageing, Social policy, Gender, Religion and ethnicity, Health, Turkey

Introduction

The story of the legendary character Peter Pan living in Neverland begins with such words, ‘All children, except one, grow up’ (Barrie, 1911, p 3). J.M. Barrie’s character Peter Pan is a child who will never grow up. This legendary story promulgated the myth that, while it was the fate of all children to grow old, this was not the case with Peter Pan. In reality, the children of Turkey today will be part of the future demographic trend towards rapid population ageing. Turkey is neither a Neverland nor are its young people endowed with the eternal youth of Peter Pan. While Turkey, at the present time, has a predominantly young and dynamic population, this will change in the near future due to declining fertility rates combined with increasing numbers of people living into old age. Turkey must accept that it, too, is becoming part of the worldwide trend towards population ageing.

In the light of the demographic revolution in the age composition of world populations, it seems reasonable and timely, therefore, for Turkey to investigate the following research questions: what is the course of ageing in its barest form and basic meaning in Turkey? What are the conditions of older adults based on sociological factors such as daily life, gender, marital status, education, work and income, health, and religion and ethnicity? What is the perspective of the state in Turkey towards ageing in the realm of social policy?

Drawing on the preceding information and questions, the issues of older people and ageing in Turkey are discussed in this chapter in terms of four main themes. First, the chapter begins with a discussion of the current dynamics relating to the demographics of population change in Turkey, and likely emerging challenges and future trends. Attention is thereby focused on comparing social change processes in Turkey with those in Europe by way of using seven sub-themes, namely: urbanisation, gender, marital status, education, work and income, health, religion and ethnicity. It is also the aim to highlight the emerging image of older people in Turkish society, and how the ageing process is being perceived within the wider societal context.

In order to foster a meaningful discussion on the preceding issues it was decided to source and analyse raw data from a number of relevant research projects. The (p.298) main sources of raw data emanated from a selection of several large-scale surveys in Turkey conducted over the last decade, and represented the final stage of the analytic process for this chapter, namely, a more in-depth analysis of the Household Budget Survey (HBS) (Turkish Statistical Institute, 2009a), Income and Living Conditions Survey (ILCS) (Turkish Statistical Institute, 2009b), Life Satisfaction Survey (LSS) (Turkish Statistical Institute, 2010a) and Consumption and Income Survey, 2001 (CIS) (Özcan et al, 2003) were conducted. Additionally, the most recent and updated census results of the Turkish Statistical Institute (TurkStat) were evaluated as a secondary source of data. As a result, it is held that the following analyses of the preceding datasets represents an innovative framework offering a more balanced and realistic assessment of trends and issues that warrant urgent discussion and attention by local, regional and central authorities.

Population trends in Turkey: a demographic transition?

According to TurkStat, in 2011 the population of Turkey amounted to 74,724,269. It is noteworthy that the population, which amounted to 14 million when the Turkish Republic was founded, is now over 70 million. It therefore seems reasonable to expect that Turkey, for reasons of future planning, must consider the likely implications and related challenges associated with population and individual ageing.

During the first years of the Republic, during the 1920s, the life expectancy rate at birth was approximately 35. It has now increased to around 74. Moreover, 90 years ago, the number of people reaching 60+ represented approximately 3.5 per cent of the total population, while today the same segment of older Turkish citizens represents close to 11 per cent of the total population. When the change in the composition of the Turkish population is examined over the period 1960 through to 2011, it is observed that while the overall population increased almost three-fold, the population of older adults (65+) increased almost six-fold.

Figure 14.1 illustrates the transformation in the demographic structure of the population regarding the three age groups 0–14, 15–64 and 65+ over the period 1935–2023 according to the categorisations of the economically active and inactive groups. A study of Figure 14.1 also shows that, over the same time period, the 0–14 group has been declining, while the 15–64 and 65+ groups have been increasing in relation to the overall population. ‘It was estimated that the number of those aged 65 and over in 2000 stood at around 3.6 million. This same age group is projected to reach an estimated 17 million in 2050. In about 25 years from now Turkey will no longer have a “young” population’ (Behar, 2006, p 23).

The official estimate for 2011 indicates that those aged 65+ will constitute 7.4 per cent of the total population, while those aged 60+ are expected to account for 10.8 per cent of the total population. Table 14.1 highlights the respective proportion to the total population based on the 2011 estimates of seven age groups, starting with those aged 60–64 through to those aged 90+. (p.299)

Ageing in Turkey: the Peter Pan syndrome?

Figure 14.1: transformation of the population according to age groups in Turkey, 1935–2023

Source: TurkStat (1937, 1944, 1949, 1954, 1961, 1964, 1969, 1973, 1982, 1984, 1989, 1993, 2003, 2010c, 2010d), cited by Koç et al (2010, p 11)

Table 14.1: distribution of the older populations in Turkey

Age

A Count

B % (in 60+ group)

C % (in total population)

60+ total population

60–64

2,566,487

31.9

3.4

65–69

1,868,175

23.2

2.5

70–74

1,451,368

18.0

1.9

75–79

1,118,310

13.9

1.5

80–84

688,840

8.5

0.9

85–89

284,594

3.5

0.4

90+

79,428

1.0

0.1

Total

8,057,202

100.0

10.8

(p.300) The same 2011 population estimates for the listed age categories 60–64 through to 90+ shows that the 60–64 age group constituted 31.9 per cent of those aged 60+ while those aged 90+ constituted only 1.0 per cent of the population aged 60+ (see Table 14.1, column B). When considering the entire population based on the 2011 estimates, it is clear (see Table 14.1, column C) that the age group 60–64 amounted to only 3.4 per cent of the total population while only 0.1 per cent belonged to the 90+ age group.

When compared to the ageing of Europe’s respective populations, the course of ageing in Turkey can be perceived more clearly. According to 2009 data, the proportion of those aged between 60–74 was 17.1 per cent in Germany and 14.9 per cent in the UK (Walker and Naegele, 2009, p 3). When comparing the statistics from Germany and the UK, the result for Turkey was only 7.29 per cent. In other words, when comparing the number of people aged between 60–74 as part of the total respective populations for Germany, the UK and Turkey, the resulting outcome shows that in Turkey older people in this age group registered a percentage that was half that registered in the UK and less than half of that registered in Germany. Following a similar pattern of comparison for older people aged 75+ for all the three countries shows the respective scores to be 8.5 per cent in Germany and 7.6 per cent in the UK (Walker and Naegele, 2009, p 3), whereas for Turkey the score is considerably lower, at only 2.74 per cent. This means that the percentage of individuals aged 75+ in Turkey is less than one third of that in Germany and half of that in the UK.

The preceding comparisons appear to indicate that Turkey is in a more advantageous position in terms of having an overall smaller percentage of older people than is the case for both Germany and the UK. However, when future demographic trends for Turkey are taken into account, the preceding assumed advantage changes quite considerably, in so far that demographic estimates point to a faster growth in the numbers of older people over a shorter period of time than that projected to occur in both Germany and the UK. For example, in the UK it took 45 years for the population of older people aged 65+ to increase from 7 to 14 per cent (National Research Council, 2001, p 38). For a similar growth for Turkey it is estimated that on present trends the time period would be between 15 to 20 years. Projections for the period between 2010 and 2050 indicate that, in the case of Germany, the percentage of older people aged 60+ will increase from 25.6 to 37.2 per cent (Walker and Naegele, 2009, p 3). Over the same period, it is estimated that for Turkey the percentage of older people will increase from 10.8 to 24.5 per cent (Timonen, 2008, p 21). In other words, over the next 40 years it is expected that the percentage of older people in Germany will increase by approximately 11.6 per cent, while in Turkey this percentage is projected to increase by around 14.5 per cent. What is quite clear is that, in less than 40 years, Turkey will experience a demographic transition, from a relatively young nation to a rapidly ageing society.

Turkey can no longer claim to be an exception to this trend towards global ageing. This steady, sustained growth of an older population will create a myriad (p.301) of challenges, including the need to anticipate both the dynamics and diversity surrounding the increasing numbers of older people. Unlike in many southern and southeastern shore Mediterranean countries, there is no substantial literature on the situations of older people in Turkey. While Gilleard and Gurkan (1987) initiated ageing studies in Turkey, additional research is needed to further our understanding of the issues of ageing and older people in Turkish society. There now exists an urgent need for Turkey to fully appreciate the dynamics of its ageing population which will require, among other things, an accurate description of the respective older cohorts and the likely future impact of the changing interrelationships between demographic, economic, social, cultural and health factors.

An important question is, when the current and future demographic transformation of Turkey is taken into account, what might be the prime areas of focus for a socioeconomic-cultural research agenda? In other words, how can personal conditions such as gender, educational background, health, marital status, religion and ethnicity, work and income as well as increasing urbanisation affect the lifestyles and quality of life of older Turkish citizens? The following sections attempt to address these questions as well as other important issues and concerns.

Images and representations of older people in turkish society

Urbanisation

Up until 2013, there has been a steady and progressive migration from rural to urban areas (see Figure 14.2). This migration process transformed the Turkish population to an urban population. While 8 out of 10 people were living in rural areas in the 1920s, this rate has been reversed. The rate of migration from rural to urban did not allow sufficient time for adequate infrastructure and housing development, resulting in the creation of many slum-type environments, the consequence of irregular urbanisation. During the early 1970s, the population living in rural areas had already dropped to around 60 per cent. By 2008, however, the population living in urban areas throughout Turkey accounted for approximately 75 per cent of the total population (Koç et al, 2010, p 19).

Table 14.2 highlights the 2009 distribution of the Turkish population between urban and rural according to the age categories 0-14, 15-64 and 65+.

According to the results of HBS 2009 (TurkStat, 2009a), presently in Turkey, the majority of people aged 65+ reside in rural areas (chi-square = 766,617.07; p = 0.0001). On the other hand, the migration of people looking for improved education and work opportunities has seen an increasing exodus of the younger and middle-aged people into urban areas, resulting in a predominantly larger and growing Turkish labour force residing in and around urban environments. As a consequence, the socioeconomic profile of the Turkish workforce will need constant monitoring as the shift from largely agricultural pursuits to industrial, post-industrial and service-type employment will undoubtedly create the potential for different and possibly unequal levels of opportunity for men, (p.302)

Ageing in Turkey: the Peter Pan syndrome?

Figure 14.2: Transformation in the rural and urban population in Turkey, 1927–2008

Source: TurkStat (2010e, 2010f), cited by Koç et al (2010, p 19)

women and particularly for older people. Urbanisation affects all age groups, with particular implications for changing family dynamics because, with its respective opportunities in education and varied work-related opportunities, it is resulting in a youthful migration from rural areas to the larger cities. Urbanisation influences the age distribution in rural areas which are losing younger members of their

Table 14.2: Distribution of the population according to residential area in Turkey

Age categories

Urban

Rural

Total

0–14

12,608,099

6,240,428

18,848,527

25.9%

28.6%

26.7%

15–64

33,529,902

13,260,193

46,790,095

68.7%

60.8%

66.3%

65+

2,608,915

2,294,223

4,903,138

5.4%

10.6%

7.0%

Total

48,746,916

21,794,844

70,541,760

100.0%

100.0%

100.0%

Source: Estimates were computed from HBS 2009 (TurkStat, 2009a)

(p.303) communities, while the urban areas, in contrast, are receiving a diverse and steady inflow of people seeking new ways of working and living.

It is important to consider the situation of the older population residing in rural areas for a number of reasons. First, it is difficult for people living in rural areas to have the material resources that are more easily accessible in urban areas. Prior to the impact of rapid urbanisation in Turkey there were strong traditional practices that valued and supported social ties between older people, their families and their respective communities. However, this situation is changing rapidly. Today, the exodus of increasing numbers of younger people from the rural areas to the larger cities is raising the proportion of older residents in the majority of rural environments throughout Turkey. As a consequence, traditional family ties and allied support systems for older people, particularly frail older people, are declining. This means that younger family members residing in urban areas are not in a position to provide direct or regular personal care for relatives remaining in rural areas. While some family decisions result in the movement of older family members to urban areas, there are still many older people who remain living in their rural environments.

Those older frail residents living in rural areas who have little or no regular contact with their younger family members are particularly vulnerable due to a number of health-related problems (Tufan, 2009). Their problems can be further exacerbated by the lack of accessibility to healthcare support and rehabilitation services. Accordingly, while older people living in urban areas, and particularly those with family support, can generally access a degree of health, care and rehabilitation services, their counterparts in rural areas experience greater difficulty in accessing such services. The point has to be made that, at the present time, older rural residents are not a high priority in terms of receiving readily available public or private healthcare support or rehabilitation services. In essence, older rural residents are seriously disenfranchised in the sense that they have limited power to influence public officials to activate appropriate measures to improve the delivery and availability of essential healthcare support services. The ageing of rural communities in Turkey is taking place at a fast level, and as such, there is an urgent need to know more about the conditions of life in rural communities.

Gender

A common characteristic of populations around the world is the higher number of women in the older age categories. This gender imbalance at older ages has important implications for healthcare and the provision of community support networks. In terms of current and future planning, it seems appropriate, therefore, to investigate the gender representations of the respective cohorts aged 60 + in Turkey (see Table 14.3).

The population statistics indicate that as age advances, the number of women in each respective age group, 60–64 through to 90+, increases considerably. This higher representation of women in the older population of Turkey indicates a (p.304)

Table 14.3: Distribution of the older population according to gender in Turkey

Total

Number

% (in 60+ group, male)

% (in total male population)

60+ total male population

60–64

1,231,274

33.9

3.3

65–69

876,489

24.2

2.3

70–74

649,739

17.9

1.7

75–79

497,023

13.7

1.3

80–84

260,355

7.2

0.7

85–89

94,160

2.6

0.3

90+

20,159

0.6

0.1

Total

3,629,199

100.0

9.7

60+ total female population

60–64

1,335,213

30.2

3.6

65–69

991,686

22.4

2.7

70–74

801,629

18.1

2.2

75–79

621,287

14.0

1.7

80–84

428,485

9.7

1.2

85–89

190,434

4.3

0.5

90+

59,269

1.3

0.2

Total

4,428,003

100.0

11.9

higher female life expectancy than for men. In other words, Turkey is experiencing, and will continue to experience, a feminisation of ageing. The feminisation of the older Turkish population is particularly noticeable when examining the gender figures for the 75+ age groups. A consequence of lower female mortality rates is that increasing numbers of women will be widows, thus living without spousal or partner support. Therefore, many older women will be living alone and in danger of experiencing increased poverty, poor health and disability. It is crucial, therefore, for social scientists to conduct a range of research projects that examine the quality of life and health and disability-related issues for older people aged 75+.

Life expectancy at birth in Turkey has shown an upward trend in recent years (see Figure 14.3). In 2004, the average life expectancy at birth in Turkey was 72.5 years with that for men standing at 70.5 and for women at 74.6. Compared with the European life expectancy, that for men in Turkey is five years less and seven years less for women. It is projected that the life expectancy rates for men and women in Turkey will approximate those in Europe by around 2050.

The gender imbalance in the older population of Turkey needs to be recognised as an important challenge for social policy formulation. While women outnumber men in the older age groups, the health and social support needs of older men, although different in many aspects from those of older women, must also be given equal priority. Although women in Turkey live longer than men, they have a history of disadvantage as a collective in terms of access to education, employment and life chances compared to their male counterparts. If realistic and supportive policies and services are to be developed for older people in Turkey it must be (p.305)

Ageing in Turkey: the Peter Pan syndrome?

Figure 14.3: Life expectancy at birth in Turkey, 2004–25

Source: TurkStat (2011)

understood, from the outset, that the older population forms a heterogeneous rather than a homogeneous group. At the same time, any future social policies and support services must aim for a balanced measure of reciprocity between the genders, beginning in early life and continuing into very old age.

It is important that due recognition be given to the fact that the ageing experience for many women can be very positive. However, efforts by public officials in concert with social researchers need to be taken to identify structural and social factors that may act against positive life satisfaction for both older men and older women. In particular, older women may find themselves in what might be seen as a position of ‘triple jeopardy’ resulting from a combination of ill health or disability, low income and living without a spouse. Older men and women are not a homogeneous group, as in reality there is a lot of variation and differentiation in terms of their respective experiences of ageing, more so with women than with men. According to research by ünsal et al (2009), in rural areas, the quality of life was worse for dependent older women, particularly for widows, those who were illiterate, those who were bedridden and those with a disease. Additionally, while women were found to be more dependent with regard to housework, shopping, travelling and bathing, men were found to be more dependent with regard to issues such as meal preparation.

While traditional values relating to family relationships and friends remain strong and highly valued in Turkish society, this should not be seen as a reason for the welfare state to ignore the diminished capacity of increasing numbers of older people to access suitable health and social support services, often resulting in limited ability to participate in community life.

(p.306) Marital status

Marriage is a common trend in the majority of social systems, with Turkey being no exception. However, the possibility of staying married decreases with increasing age, and more so in the case of older women than older men. Table 14.4 shows the marital status of Turkish older people according to gender, with a clear and unequivocal trend for older women to experience a much higher incidence of widowhood than men. In relation to Table 14.4 the categories ‘never married’ and ‘divorced’ were excluded due to their low prevalence. The focus instead was on the two categories ‘married’ and ‘widowed’ in order to demonstrate the gender imbalance between men and women aged 60+. It is quite clear from an examination of the total older population aged 60+ through to the age of 90+ that the percentage of married men amounted to 87.3 per cent while the percentage for married women decreased to 53.8 per cent. The changes in marital status at older ages can affect financial security and social support networks and, for some older individuals, their level of vulnerability for being ‘at risk’ also increases quite sharply.

A long-standing marriage offers the partnership a range of support benefits that include trust, intimacy, friendship and caregiving in times of difficulty, illness and disability. Indeed, support from a caring spouse during times of ill health or psychological, physical or emotional stress can be an important factor in living more positively (Mollenkopf and Walker, 2007, pp 56-7). While the provision of emotional support in marriage is important during times of need, it is more than likely that, with older age, the need for such support will increase in accordance with the incidence of ill health and level of dependency. There is, of course, a danger that when researchers introduce statistics relating to the demographics of ageing including sex ratios and marital status, that the human side of individual and population ageing can be poorly understood or simply neglected. Calasanti and Sleven (2001) remind us that the notion of inequality can be associated with gender, socioeconomic status, ‘race’, ethnicity and, in more recent times, sexual

Table 14.4: Marital status of older people according to gender in Turkey (%)

Male

Female

Age

Married

Widowed

Married

Widowed

60–64

95.9

1.8

74.3

21.0

65–69

91.4

6.1

62.2

35.2

70–74

89.9

9.5

43.7

52.8

75–79

77.6

20.0

39.8

57.5

80–84

67.2

31.4

23.5

74.8

85–89

46.3

48.9

13.3

84.3

90+

11.0

89.0

0

100.0

Total

87.3

10.7

53.8

42.9

Source: Estimates were computed from ILCS 2009 (TurkStat, 2009b)

(p.307) orientation. It is interesting to note that the marital or partnership status is not usually considered as a possible source of inequality. ‘Marital status is often used purely as a socio-demographic variable that differentiates older people and, like age, is used in research as a control variable, rather than a characteristic of analytic interest’ (Arber et al, 2003, p 2). From this point of view, the family structure in Turkey, including the marital status of older individuals, should be closely monitored for quality of life issues including the presence of gender-related inequalities.

This association between gender and marital status presents an interesting comparison between older widowers and older widows in the total population aged 60+. In the case of older men, the widowhood rate is 10.7 per cent. However, a very different case exists for older women with a widowhood rate of 42.9 per cent, as the preceding difference in male and female rates of widowhood illustrates that many more women than men will spend their later years without a husband. This means that most widowed older people in Turkey are women, resulting from the fact that the majority of wives are more likely to outlive their partner than predecease them. At the same time, the larger numbers of widowed women provides widowed men with an increased opportunity to remarry.

While the percentage of married men in the age cohort 60–64 is 95.9 per cent, the percentage of married women in the same age cohort is 74.3 per cent, representing 22 percentage points below that of their male counterparts. An analysis shows that for all the remaining age cohorts up to and including 90+, that women display a higher prevalence of widowhood than men. Table 14.4 clearly shows that with increasing age, the rate of widowhood increases for both men and women, but even more so for older women. As in the case of occupational retirement, widowhood represents a major social role in later life. Apart from the loss and grief associated with the death of a long-time partner, the widow or widower is no longer part of a couple and is left with the challenge of forming a new identity.

Figure 14.4 illustrates the average annual income earnings of Turkish older people according to their marital status. Note that with each age cohort, commencing with 60–64 through to 90+, widowed men in every instance have higher average annual incomes than widows. Married couples also show that they are generally better off in terms of average annual incomes across five of the seven age cohorts, although, as in the case of widowers and widows, the increase in age shows a trend towards lower average annual incomes.

It is sometimes assumed that widows in comparison to widowers are more independent and successful at maintaining their social networks, although there are some research findings that indicate that older widows see no real advantages associated with widowhood (Arber et al, 2003, p 2). It also appears that being married in Turkey at an older age generates a higher sense of wellbeing and happiness than is the case for those without a spouse. In Turkey, 23.7 per cent of older widowers and 33.8 per cent of older widows stated that they felt helpless about their own future (TurkStat, 2010a, estimated from LSS). An important (p.308)

Ageing in Turkey: the Peter Pan syndrome?

Figure 14.4: Average annual income of older people according to marital status in Turkey (US$)

Source: Estimates were computed from ILCS 2009 (TurkStat, 2009b)

reason for the pervading sense of helplessness among older widows and widowers is the question of who provides care and support if they are unable to fend for themselves. Of greater concern is the fact that 33.6 per cent of the older widowers and 28.9 per cent of the older widows in Turkey do not have access to a comprehensive pension and, as a consequence, they have to rely on the social security rights of their children for all their healthcare needs (TurkStat, 2009a, estimated from HBS). This situation creates an unfortunate dependency relation between an older widowed parent and his or her offspring.

Education

There is growing recognition in Turkey surrounding the value of cultural capital that, in essence, relates to the provision of educational opportunities for young people in order to prepare them in acquiring the necessary knowledge and skills to meet the personal and social challenges of the modern world. Today, more than ever, there is an increasing interest among the lower classes to admonish their offspring with the following saying, ‘Go to school and save yourself’. This advice is about encouraging younger people to value education in order to find new and different ways of working and living in a world vastly different from that of their grandparents and parents.

The educational level in Turkey helps to differentiate the social classes, including gender differences (Arun, 2010). Table 14.5 provides an analysis of ILCS 2009 that highlights the level of education for the general population as well as for (p.309)

Table 14.5: Educational levels of older and total populations in Turkey, according to gender (%)

Education level

Female (60+)

Female (population)

Male (60+)

Male (population)

Total (60+)

Total (population)

Illiterate

55.3

19.3

17.2

4.7

37.8

12.3

Literate without diploma

12.6

9.1

17.1

5.8

14.6

7.5

Primary

22.9

37.7

45.6

39.8

33.3

38.7

Junior high school

3.5

13.4

6.7

18.7

5.0

15.9

High school

3.8

14.3

6.4

20.7

5.0

17.4

University

1.8

6.2

7.0

10.4

4.2

8.2

Total

100.0

100.0

100.0

100.0

100.0

100.0

Source: Estimates were computed by from ILCS 2009 (TurkStat, 2009b)

the older population aged 60+. It shows a disturbing shortfall in the educational attainment of women compared to men, leaving women at a great disadvantage in accessing middle to higher level career pathways.

In 1935, Turkish literacy levels were very low, with only 10 per cent of women and 29 per cent of men being listed as literate. While literacy levels for both men and women have improved substantially since 1935, it is clear from Table 14.5 that women, from the foundation of the Turkish Republic up to the present time, have showed lower levels of participation in the education system beyond primary school.

In Turkey, 37.8 per cent of the older population were illiterate. The preceding illiteracy level for older people is more than three times that of the total population. Gender has been and continues to be a variable determining the educational level in Turkey. Although the schooling rates of girls today are inclined to be higher than those for boys, there remains a strong attachment to the patriarchal tradition that views education as more important for males rather than for females.

Evidence of historical inequalities in educational opportunity for women in comparison to men is illustrated in Table 14.5, where it can be seen that 55.3 per cent of older women were illiterate as compared to the 17.2 per cent rate for older men. In other words, approximately one out of every two older females was illiterate. Furthermore, only one out of every five older females had completed a primary school education. Again the rate of high school graduates among older females did not even reach 5 per cent. In comparison, older men showed higher levels of educational achievement at every level, from primary school through to university education.

The level of illiteracy among older males is 17.2 per cent, amounting to approximately one quarter of the level of illiteracy for older females. On the other hand, the level of older males having primary school education is twice that of older females. The percentage of older males who had graduated from university was 7.0 per cent and for older women this percentage was 1.8 per cent. These (p.310) findings not only indicate how the older generations had low levels of formal education, but also demonstrate the influence of the patriarchal tradition that placed little value on encouraging the majority of women to undertake formal education at the medium to high levels.

There is no doubt that those who were provided with access to higher levels of education have enhanced their life chances and opportunities for improved economic and social advancement, including a greater potential to share in the distribution of scarce resources. Education remains a major privilege for those holding a higher economic status compared to those with limited access to financial resources. The current and future challenge for Turkey will be how best to remove many of the social and economic barriers that prevent gender equity and lower class access to improved educational and employment opportunities.

Work and income

The employment status at the time of the ILCS 2009 is an important indicator of household lifestyle and performance in relation to the ability to purchase essential goods and services to support the household unit.

According to the results of ILCS 2009, 18.1 per cent of the older population were employed. Table 14.6 shows that 27.6 per cent of older males stated that they were engaged in gainful employment; in comparison, only 10.0 per cent of the older women were so gainfully employed.

Table 14.6: Gainful employment status of older people according to gender in Turkey

Status (%)

Gender

Age

Working

Not Working

Male

60-64

40.5

59.5

65-69

30.1

69.9

70-74

22.7

77.3

75-79

17.7

82.3

80-84

6.0

94.0

85-89

2.7

97.3

90+

0

100.0

Total

27.6

72.4

Female

60-64

16.1

83.9

65-69

14.1

85.9

70-74

6.2

93.8

75-79

3.2

96.8

80-84

2.0

98.0

85-89

0

100.0

90+

0

100.0

Total

10.0

90.0

Source: Estimates were computed from ILCS 2009 (TurkStat, 2009b)

(p.311) As can be seen from Table 14.6, the employment status differs across ages. With advance in age, the employment status of both males and females decreased (chi-square = 203,457.1; p = 0.0001/chi-square = 144,216.0; p = 0.0001, respectively).

The occupational sectors in which older Turkish people are finding either full-time or part-time work are important for understanding the influence of educational background on socioeconomic status. Employment options and overall opportunities for earning higher annual incomes favour the younger generations who have or are currently undertaking tertiary level qualifications.

It is no great surprise, therefore, to find that the analysis of data from ILCS 2009 (TurkStat, 2009b) revealed that 63.2 per cent of older males and 86.6 per cent of older females were employed in the agricultural sector, thus showing significant gender differences (chi-square = 116,699.6; p = 0.0001). In the light of the preceding findings, it might be assumed that the high employment level of older people in the agricultural sector equates with the sufficient annual income earnings to meet day-to-day living expenditure, including unexpected healthcare costs.

It has to be appreciated, however, that agricultural workers in Turkey are generally low paid, and it should not be assumed that they have sufficient financial resources without reliable research that should cover all the age cohorts, 60+. Still having a necessity to work in order to be paid in the case of older employees is an indicator illustrating the low income status and being divested of social security. Retirement and the social security system are discussed in more detail later in this chapter. Apart from the need to undertake a thorough investigation of the quality of life and overall living standards of the older population in Turkey, the fact remains that, based on 2009 data, 88 per cent of older employees were not registered with the state social security system. In other words, they were working and living without the protection and benefits available from the state social security system. The fact that many of the older agricultural workers were not registered with the social security system is most concerning when the physical nature of their work is taken into account, along with the increased likelihood that many will have to face varying degrees of disability and ill health with advancing years.

The annual income earnings of older people is of paramount importance in determining their level of risk in relation to living in poverty, with corresponding implications for decreased social engagement and availability of appropriate healthcare.

Table 14.7 provides the 2009 distribution of cumulative income for older males and females. In developing countries, it is known that 80 per cent of older people do not have a regular income, and that 100 million have to live on less than US$1 per day (Sowers and Rowe, 2007, p 4). In Turkey, based on analysis of 2009 data, 6.1 per cent of older males stated that they did not have a pecuniary income. The same analysis indicated that 48.1 per cent of older females in Turkey stated the same position. The higher prevalence of older females without a pecuniary income that is eight times the level of their male counterparts simply highlights their level of social and economic dependency. One of the main explanations for the high (p.312)

Table 14.7: Cumulative annual income (US$) of older populations in Turkey, according to gender

Parameter

Female

Male

With no income (%)

48.1

6.1

Mean

3,202.2

5,428.7

Median

3,251.6

4,645.2

Mode

645.2

4,645.2

Standard deviation

2,276.5

5,480.9

Minimum

64.5

38.1

Maximum

17,032.3

62,709.7

Source: Estimates were computed from ILCS 2009 (TurkStat, 2009b)

level of older female social and economic dependency is the traditional cultural custom of assigning the major female role to housewife duties and responsibilities.

Women in Turkey have been seen, and are still seen, as the main contributors to caregiving for family members and housekeeping, including responsibilities for the general maintenance of ‘home and hearth’. For many women, household duties can be full time without any pecuniary income, although they do derive some non-pecuniary benefits. More importantly, however, greater recognition should be given to the value-added contribution of women’s non-pecuniary work that creates beneficial outcomes for their partners and respective family members.

It is obvious that gender inequality exists, with older women compared to older men displaying a significantly lower annual average income, resulting in smaller numbers of older women in paid employment (t = 532.7; p = 0.0001).The average annual income of older males living in Turkey is US$5,428.7. For older females, their average annual income is almost half of that for older males (US$3,202.2).

The unequal distribution of income between older males and females makes older females particularly vulnerable in their advanced years as they have longer life expectancies than their partners and, for many, the probability of spending their remaining years in poverty becomes a stark reality. For those on low incomes, including the prevalence of unequal distribution of income earnings between men and women not only increases the likelihood of experiencing poverty in older age, but this is the more so for women. This is not just an issue for Turkey but also for many countries worldwide.

The unequal income distribution among the population groups is closely associated with long-term structural neglect that has, in a very serious way, jeopardised the welfare of the older age cohorts, made worse by gender-related inequities (O’Rand, 2006, pp 157-8). The coup of 1980 in Turkey with the subsequent introduction of neoliberal policies aimed at positioning Turkey more favourably in the global economy has had a devastating impact on the social system, with less stability in the employment sector, including low wage earnings for many employees. The absence of job security for many employees and the failure to expand the social security and pensions system to protect many employees and (p.313) their families, including those made vulnerable by old age, has predetermined a pathway towards impoverishment for increasing numbers of Turkish citizens.

The challenge for Turkey is to recognise and resolve the social tensions and structural inequalities embedded in daily life while, at the same time, advancing the political agenda that is transforming Turkey into a modern society. In countries like the US, Australia, the UK and Canada, support for older people and those with a disability is considered a social welfare function provided through social security and public assistance programmes. Likewise, in a developing society such as Turkey, it will be both an essential and ethical part of its quest for modernisation that it accepts its obligations to create new instruments, policies and support programmes aimed at protecting individuals and groups made dependent on social aid as a consequence of ongoing demographic, social and economic changes.

Health

The Ministry of Health in Turkey, in a combined effort with other public entities, non-governmental organisations (NGOs), and the private sector, provides a diverse range of health-related services, although the overriding responsibility for the implementation of health services and allied health policies resides with the Ministry of Health. Today the Turkish Health System is undergoing a transformation process facilitated by the implementation of a government Health Transformation Programme (HTP) in 2003. The HTP has been implemented to improve all aspects of service provision by undertaking structural reform initiatives aimed at preventing fragmentation and duplication, including a strategic focus on health finance, overall service provision and public access to health insurance and related services (OECD, 2008, p 11).

In recent years, the conditions surrounding the provision of health services have been improving rapidly and, in some cases, they are close to the Organisation for Economic Co-operation and Development (OECD) averages. However, in Turkey, average life expectancy is lower than that of other OECD countries, while infant mortality rates remain at unacceptable levels. Although the HTP initiative has produced a range of improvements in the healthcare system, there is still much that needs to be done so that it will be accomplished when Turkey is compared to other upper to mid-income level countries (OECD, 2008, p 13).

The social security status of older males and females reveal significant differences (chi-square = 34,336.6; p = 0.0001). While the official statistics state that only 15 per cent of the total population is not covered by any social security protection (OECD, 2008, p 22), the percentage of the older population without any social security coverage is 6.6 per cent. The percentage of the older population covered by the General Health Insurance (GSS) is 77.6 per cent constituted by the Pension Fund, Bag-Kur and SSK. The percentage of Green Card users out of the total older population is 15.1 per cent, and these users are essentially the poor and deprived who cannot access support via GSS coverage. It should be noted that the Green Card, with its limited coverage, represents a type of poverty symbol in (p.314) Turkey since only a fraction of the medical and social services, otherwise provided by GSS, are accessible. On the other hand, the percentage of those covered by private insurance, a symbol of elite status, is extremely low, at around 8 per 1,000 among the older population (see Table 14.8).

It is interesting to note that, on a worldwide basis, older people having some form of social insurance coverage number around 20 per cent, while for Turkey, the rate is 77.6 per cent (van Ginneken, 2003). Having social security coverage, however, is no guarantee that the provision of healthcare and related support will be forthcoming in times of need. Access and availability are two important components of healthcare and often, in times of urgent need, one or both components may be missing.

The existence of dubious guarantees by the health insurance system, combined with an unequal distribution of healthcare services, especially in the eastern and southeastern regions of Turkey, illustrate a problematic situation for disadvantageous groups (Akar et al, 2008). Although the majority of the population is covered by some type of social security, including the Green Card service, there remain some major and serious questions surrounding these services.

One study that compared older Turkish people with social security coverage with older Turkish people without such coverage indicated that those with social security coverage were generally less happy than their counterparts who were not covered by any social security system (Arun and çakıroğlu, 2009). It appears that the level of unhappiness is explained by the frustration of having healthcare protection that was often not forthcoming due to problems associated with access or availability to such protective healthcare services when required. This illustrates that, even when older people have healthcare insurance, they often experience difficulties in accessing healthcare service and support. There are also inequalities in accessing healthcare services arising from regional disparities between rural and urban regions.

In rural areas, access to health services is much more difficult and expensive. The problem of access is of particular concern for people living in the eastern and southeastern regions of Turkey. This is more so due to the absence of appropriate infrastructure and specialist healthcare services (OECD, 2008, p 12). More work is needed in terms of health promotion, public health strategies and preventive medicine that can include diagnoses and screening tests tailored to an individual’s age and family history.

Table 14.8: Distribution of social security insurance among older populations in Turkey (%)

Gender

GSS (Pension Fund, Bag-kur, SSK)

Private health insurance

Green Card users

Without insurance

Total

Male

81.1

1.0

12.5

5.3

100.0

Female

74.8

0.7

17.0

7.3

100.0

Total

77.6

0.8

15.1

6.6

100.0

Source: Estimates were computed from HBS 2009 (TurkStat, 2009a)

(p.315) It is important to note that, for Turkey, the share of health expenditure in the GDP increased from 2.2 to 5.6 per cent between 1985 and 2006 (OECD, 2008, p 54). However, this increase is not sufficient in so far as Turkey still has the lowest per capita income (US$10,771) and healthcare costs per person (US$609) within the OECD region (OECD, 2008, p 55).

Religion and ethnicity

Society in Turkey is quite heterogeneous in terms of religion and ethnicity. The clause in the Constitution stating that the official religion of the state is Islam was deleted in 1928. Since 1937, Turkey has declared itself to be a secular state that still exists today by way of a legally binding statement in the Constitution. Although it is generally emphasised that the majority of the population in Turkey is Muslim, it is possible to see different sects and beliefs among those who define themselves as Muslim. In this regard, it is not entirely correct to assume that Turkey is totally homogeneous in terms of religion. The situation is much the same in terms of ethnicity.

In reality, the Turkish modern society comprises considerable religious, ethnic and cultural diversity creating, in some instances, tensions between traditional and contemporary ways of thinking and living. Important questions need to be asked surrounding the possible influence that ethnicity may have in generating different outcomes in relation to the socioeconomic status and health related to the quality of life for older people. The research literature on ethnicity suggests that it is a strong explanatory factor in the creation of inequality among population groups (Calasanti and Sleven,2001;Arber et al,2003). As a consequence, the following two questions seem reasonable starting points for beginning an inquiry into the impact of ethnicity on the quality of life outcomes of older Turkish citizens: is ethnicity a major component leading to inequality among the older population in Turkey? Does the social and economic experience of old age in daily Turkish life differ according to ethnicity?

However, discussing religion and ethnicity in Turkey causes some difficulties given the fact that both are two hot issues opening doors for political debate in Turkey. In the case of religion, it is thought that fundamentalism lies at one end of the spectrum, and different belief systems and sects, such as Alevism and Mevlevism, lie at the other end. In comparison, in the case of ethnicity, since it is a recent political issue, it provides material for discussions about another hot debate, referring directly to the Kurdish minority in Turkey. Both subjects form difficult discussion arenas in Turkish academia. Although TurkStat gathers data on almost every subject and publishes statistics on every topic, it does not do so regarding religion and ethnicity. It is therefore not possible to reach valid and reliable data gathered by official institutions on ethnicity and religion. This deficiency causes difficulties when studying certain issues such as the population of the Alevi and Kurdish citizens and their regional distribution in the country’s demographic structure. In this context, researchers are urged to collect their own (p.316) data. Therefore, assessments on ethnicity are based on CIS, conducted by a team from the Middle East Technical University, Department of Sociology, in 2001 (Özcan et al, 2003), which is eligible to represent the whole of Turkey.

In Turkey, because of the reasons mentioned above, the question related to religious identity and ethnicity cannot directly be asked of the respondents. Since 1967, this has been compiled through inquiries made regarding the mother tongue of such groups. This approach is seen as an effective means of defining and classifying ethnic groups and is the preferred methodology for a number of researchers (see, for example, Mutlu, 1996; Içduygu et al, 1999; Gündüz-HoşgÖr and Smits, 2002; çarkoğlu and Toprak, 2006).

According to analysis of CIS, the responses given by the majority of respondents aged 60+ to the mother tongue question are presented in Table 14.9. The non-response rate to the preceding question was 5.1 per cent. It appears that there may have been a degree of sensitivity, caution and even anxiety by a small number of participants in not responding to the mother tongue question. The overriding response by older participants to the question of ‘What is your mother tongue?’ resulted in 84 per cent of respondents giving their answer as ‘Turkish’. The percentage of those declaring their mother tongue as ‘Kurdish’ was 10.1 per cent, with ‘Arabic’ being selected by 1.9 per cent of respondents. The remaining ethnic groups were predominantly a mixture of Armenians, Greeks and Jews, including Circassians and Bosnians. These were placed under the category of ‘Other’, which showed a collective response of 3.9 per cent for all the remaining older people living in Turkey. When the results, as illustrated in Table 14.9, are compared with those of çarkoğlu and Toprak’s recent findings (2006) regarding the demographic features of the population in Turkey, the findings from each respective survey reveal similar results in relation to the ethnic distribution among the older population.

Although the ethnic background of the older Turkish population is not differentiated according to gender (chi-square = 6.1; p = 0.109), there is a statistically significant difference between ethnic groups according to the age groups (chi-square = 22.5; p = 0.004) (see Table 14.10). It is seen that as age advances, the percentage of respondents reporting their mother tongue as ‘Turkish’ decreases and the percentage of respondents reporting their mother tongue as

Table 14.9: Distribution of older populations according to ethnic background in Turkey (%)

CiS 2001

çarkoğlu and Toprak (2006)

Mother tongue

Elderly (60+)

All

Turkish

84.0

85.9

Kurdish

10.1

11.5

Arabic

1.9

0.4

Other

3.9

2.2

Total

100.0

100.0

Source: Estimates were computed from CIS 2001

(p.317)

Table 14.10: Distribution of older populations according to ethnic background in Turkey (%)

Age groups

Turkish

Kurdish

Other

Total

60-64

84.3

10.5

5.2

100.0

65-69

84.9

10.9

4.2

100.0

70-74

84.0

5.9

10.1

100.0

75-79

89.8

7.1

3.1

100.0

80+

68.9

20.7

10.3

100.0

Total

84.1

10.1

5.8

100.0

Source: Estimates were computed from CIS 2001

‘Kurdish’ or, the percentage of those choosing ‘Other’, increased almost two-fold. The percentage of those aged 60-64 among the ‘Turkish’ decreased from 84.3 to 69 per cent, while this percentage among those who declared that their mother tongue was ‘Kurdish’ increased from 10.5 to 20.7 per cent as age advanced towards 80+. A similar increase was manifested among other ethnic groups including those older people who spoke ‘Arabic’. While in the case of those aged 60–64 the percentage was 5.2, in the case of those aged 80+, the percentage increased to 10.3 in all other ethnic groups including those who spoke ‘Arabic’. In this context, the percentage of the Turkish population in advanced ages decreased in comparison with other ethnic groups.

Statistical analysis confirms that ethnicity is an influential factor on the level of education (chi-square = 32.2; p = 0.001). Figure 14.5 provides an overview of the percentage of educational attainment of the older Turkish population according to their ethnic background based on data taken and analysed from the CIS. While not considering the absolute numbers of older people in each respective ethnic group, it can be seen that for the Turkish respondents, approximately 59.5 per cent completed primary education. On the other hand, the Kurdish group recorded a response rate of 82.8 per cent for primary education completion, with the Arabic group showing a completion rate of 69.2 per cent, followed by ‘Other’ at 46.7 per cent. When considering the completion of secondary education, the highest group response rate was recorded by ‘Other’ at around 40.0 per cent, followed in order by Turkish at nearly 33.0 per cent, Arabic at approximately 32.0 per cent and finally Kurdish, at just under 14.0 per cent. In relation to university education at undergraduate level the Turkish ethnic group showed a completion rate of 7.7 per cent, with both the Kurdish and ‘Other’ groups each displaying around 3.0 per cent, the Arabic ethnic group registering no completion of undergraduate studies among its older respondents. Taking into consideration the absolute numbers of older people, the Turkish ethnic group had the highest number of older graduates across all levels of education. In terms of the data from the CIS, it is clear that older people in both the Kurdish and Arabic ethnic groups were the most disadvantaged in relation to educational attainment when examined across all levels of education.

(p.318)

Ageing in Turkey: the Peter Pan syndrome?

Figure 14.5: Educational attainment of older populations in Turkey according to ethnicity

Source: Estimates were computed from CIS 2001

While the ‘Other’ group is small in absolute numbers, it is quite interesting to find that 10.0 per cent of their older respondents indicated completion of postgraduate studies. The Kurdish and Arabic older respondents, however, returned a nil response for completion of postgraduate studies. The percentage of older Turkish respondents having a postgraduate degree was around 7 per 1,000. It is also interesting to note that, while older Turkish citizens who had Armenian, Greek and Jewish roots represent a collective of religious minorities, they nevertheless attached a relatively high priority to higher education achievement at postgraduate level. This was not the case with the older members of the Kurdish and Arabic ethnic groups.

While ethnicity demonstrates differences in terms of educational attainment for older people across the respective ethnic groups, in Turkey it also shows variations when associated with selected quality of life indicators that have an impact on older people, as shown in Table 14.11. Although other quality of life indicators could have been chosen, Table 14.11 highlights the frequency of older people’s responses to the following four indicators involving place of habitation, health condition, type of social security protection and average monthly income according to ethnic background.

When considering the responses regarding the frequency distribution for the respective ethnic group across all of the four indicators as shown in Table 14.11, due recognition must be given to the overall dominance of the larger numbers of people in the overall older population speaking Turkish. Further analysis of the frequency distribution of the ethnic-based responses indicates that eight out of ten older people live in urban places, three out of ten suffer from health (p.319)

Table 14.11: Quality of life among the older populations according to ethnic background in Turkey (%)

Selected indicators

Turkish

Kurdish

Arabic

Other

Location (%)

Urban

81.6

50.0

80.0

87.5

Rural

18.4

50.0

20.0

12.5

Illness (%)

Yes

27.2

40.8

15.0

28.2

No

72.8

59.2

85.0

71.8

Social security (%)

GSS

75.6

51.5

75.0

65.0

Private

0.9

2.0

5.0

5.0

Green Card

2.8

16.2

0

0

None

20.7

30.3

20.0

30.0

Monthly income (?)

Mean

289.1

203.6

255.4

372.6

Standard deviation

281.2

128.5

192.6

277.2

Minimum

9.1

22.8

63.9

118.6

Maximum

4,560.6

638.5

729.7

1,368.2

Source: Estimates were computed from CIS 2001

problems, two out of ten have no social security protection and their average monthly household income is ?289.

One noteworthy point relates to the transition difficulties frequently experienced by older people from minority ethnic groups who migrate from rural to urban settings. For example,Aykan and Wolf (2000) highlight the fact that many of the older Kurdish people migrating from rural to urban environments experienced high levels of discrimination and social exclusion. These were due to a combination of factors including conservative cultural values, low educational background, health problems and absence of social security protection. Brockmann (2002) demonstrates that similar experiences of social exclusion and discrimination have occurred in the case of older Turkish people who migrated to Germany, where their religious beliefs and cultural practices were not readily understood or accepted by their German counterparts. This tendency for minority ethnic migrants to experience discrimination and social exclusion is not uncommon, and in Germany the term Ethnisierung is used to explain this phenomenon.

The above findings provide an interesting contrast between the Kurdish older population and their older counterparts from both the Turkish and the religious minorities. It is quite clear that the Kurdish-speaking older population are seen to be the most vulnerable in relation to the quality of life indicators. However, the older people in the other religious minorities, while small in absolute numbers, appear to be the most advantageous-aged stratum in the whole of Turkey. This ambivalent situation represents an important area for future sociological investigation.

Any future policy developments aimed at improving overall quality of life for older Turkish citizens will need to take into account the varying degrees of disadvantage and inequality across all of the respective ethnic groups.

(p.320) The Peter Pan syndrome: a reality check for the state?

Population ageing will be one of the most challenging issues confronting Turkey in the 21st century. Today, in Turkey, the scope of social policies is based on an unbalanced approach that is discriminatory in that the older population, being smaller in terms of the total population, tend to be seen as irrelevant and somewhat less in need of attention and support in relation to basic human needs.

The Turkish state should focus not only on the economically active population and their needs, but also recognise that it needs policies and strategies to support all ages in society. Turkey should be taking appropriate steps to redress the current unemployment rate among the educated and young population in order to take advantage of their skills and motivations to succeed. In the long term, serious planning efforts should be taken to provide meaningful employment opportunities for the increasing numbers of educated young men and women wishing to help Turkey towards modernisation and economic stability. In other words, the country should start planning to capitalise on the energies and talents of its young population to engage in new forms of service and production. At the same time, however, the demographic ageing of Turkish society warrants the introduction of relevant policies and support mechanisms to advance increased access to social security, social welfare, health and community participation for all older people, particularly those who are either close to or living in poverty. An important and true measure of a humane society is reflected in the level of support and care provided to its most vulnerable groups, particularly older people and those with a disability, regardless of their status, ethnic backgrounds, gender or location.

A major weakness in the policy process in Turkey is its short-sightedness and its failure to understand and act on the long-term economic, demographic, cultural and social trends and changes that are occurring at a rapid pace. For example, Mottram and Hortaçsu (2005) illustrate the diverse intergenerational value systems of older Turkish women and their daughters, experiencing evolving sociocultural contexts that have shaped who they are and the values they embrace.

Regarding the issues of ageing, old age and social justice, a good starting point for examining equity imbalances is to understand the disadvantages associated with gender, partnership status, migration, education, social class, health, religion and ethnicity. Holding on to the myth that Turkey has a considerable young population is no longer realistic or sustainable in the light of the impending rate of population ageing that will dramatically increase the proportion of people aged 65 years and over during the next 40 years.

The Peter Pan syndrome raises some serious questions surrounding the nature of citizenship in Turkey when consideration is given to both gender inequality and old age. The inequalities discussed above lend strong support to the opinion that citizenship rights are being violated in Turkey. The shortfall in social policies to support the needs of older people denotes a lack of genuine concern and outright discrimination against the older population. Citizenship implies, among other things, that older people, like all people in a society, are entitled to a range (p.321) of services that are relevant to their physical, social, economic, mental and spiritual needs, which collectively contribute to their general wellbeing and quality of life. Two important questions concerning the wellbeing of older people and their access to relevant services might be as follows: ‘Are older people in both urban and rural locations receiving the services that they require to maintain health and wellbeing?’ and ‘How convenient, flexible and appropriate are these services, and do they cater for individual differences and existing circumstances?’. In Turkey at the present time, one out of five older people does not have any comprehensive social security. In this regard, this lack of welfare assistance to a sizeable number of older people is not only an infringement of their human rights but also represents a serious lack of uniformity in policy. A recent announcement under the heading ‘Transformation in health’ predicts a range of new benefits for those aged 25 years and younger, regardless of whether they are employed or not, while no reference was made to what benefits might be forthcoming to older people.

Between 2000 and 2025, working Turkish adults will represent the largest population group in the history of the country (Gürlesel, 2004, p 49). This working-age segment of the population can be thought of as a ‘demographic gift’. Turkey must decide in what direction it needs to go, both politically and economically, by way of this opportunity window (Gürlesel, 2004). This should also include a focus on the meaning of citizenship and what this might mean in terms of equal access for all people across all the social strata to quality health, educational, social and cultural services.

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