Mexico: Not Ageing Gracefully无法优雅老去的墨西哥

As Mexico ages， public services are not keeping up.

墨西哥人口老龄化加剧，但该国的公共服务却跟不上社会需求。

In a sunlit room in Mexico City a group of old people sit round a whiteboard. Some are asleep; others are playing a game. They shout out words， starting with the syllable that the previous one ends with： “Taco！” “Comal！” A bubbly1 young worker leads them along.

在墨西哥城一个洒满阳光的房间里，一群老年人围坐在一块白板周围，有的在打瞌睡，有的在玩游戏。他们轮流大声说出词语，下一人说的词的首音节要跟上一人说的尾音节相同：“玉米卷饼！（taco）”“饼铛！（comal）”。一位活力四射的年轻工作人员引导着他们。

It is a rare sight in Mexico， where facilities for old people are sparse. Emma Tapia founded the home， Casa Alicia， in 2017. It has space for 20 female residents; the day centre is open to men as well. “Demand is growing very quickly，” she says.

这样的场景在墨西哥并不常见，因为该国的养老设施稀缺。埃玛·塔皮亚于2017年创建了这家名为“卡萨·阿莉西亚”的养老院。养老院可以容纳20位老年女性居住;日间护理中心也对男性开放。埃玛·塔皮亚表示：“对养老院的需求增长得非常快。”

Mexico is ageing fast. The proportion of its people who are under 20 peaked in 2010. The birth rate has been falling. In 1960 the average Mexican woman could expect to have seven children; now the figure is two. Life expectancy has soared from 57 to 75 over the same period， putting Mexico on a par with2 China or Lithuania. Today 12% of Mexicans are over 60， up from 9% in 2010; by 2050 they will be around a quarter of the population. “Mexico’s population pyramid is no longer so clearly a pyramid，” says Baruch Sanginés， a demographer. Covid-19， which， according to The Economist’s calculations， has resulted in over half a million excess deaths in Mexico， may have slowed down this trend， but only slightly.

墨西哥正在快速步入老龄化社会。20岁以下人口的比例在2010年达到了峰值。墨西哥的生育率一直在下降。1960年，其妇女平均生育7个孩子;而现在，她们平均生育两个孩子。同期，墨西哥人的预期寿命从57岁飙升至75岁，与中国或立陶宛相当。如今，12%的墨西哥人超过了60岁，与2010年的9%相比有所上升;到2050年，超过60岁的人口将占到总人口的1/4左右。人口统计学家巴鲁奇·桑希内斯表示：“墨西哥的人口金字塔已经不再那么像金字塔了。”根据《经济学人》的计算，新冠肺炎已导致墨西哥的超量死亡人数超过了50万。虽然这可能减缓了老龄化趋势，但也只是稍稍减缓。

Most countries that are grey are also rich， and so can afford good public services for the elderly. For not-yet-rich countries like Mexico， rapid ageing presents trickier problems. Mexican policy-makers are starting to take note of the situation and grapple with3 it， but too slowly， says Luis Miguel Gutiérrez Robledo of the National Institute of Geriatrics， a government research body.

大多数人口老龄化的国家很富裕，因此有能力为老年人提供良好的公共服务。对墨西哥这样尚不富裕的国家来说，快速老龄化带来了更加棘手的问题。在政府研究机构——国家老年病学研究所工作的路易斯·米格尔·古铁雷斯·罗夫莱多称，墨西哥的决策者开始关注这一情况，并着手尽力解决，但进展太慢。

Mexico’s old people， unfortunately， are not in good shape. Nearly a third of those over the age of 50 are obese， compared with one-fifth in 1995， according to the national statistical agency. Not surprisingly， diabetes and heart disease are widespread. As people live longer， dementia is becoming more common， too.

不幸的是，墨西哥老年人的身体状况较差。根据国家统计机构的数据，在50岁以上的人口中，接近1/3的人过度肥胖，而在1995年，这一比例为1/5。不足为奇的是，糖尿病和心脏病很普遍。随着人们寿命的延长，痴呆症也变得越来越常见。

On top of this， Mexico’s public health-care system is fragmented. A survey from 2018 found that 12% of old people lacked access to any medical service， whether in private or public clinics. There are 700 geriatric specialists in the country， serving a population of 126 m. In the United States there are ten times as many （for a population nearly three times the size）.

除此之外，墨西哥的公共医疗卫生体系支离破碎。2018年的一项调查显示，12%的老年人无法获得任何医疗服务，无论是在私人诊所还是公立诊所。墨西哥只有700位老年病专科医生，却要服务于1.26亿人口，而美国的老年病专科医生是墨西哥的10倍之多（而其人口差不多仅是墨西哥的3倍）。

For many Mexicans care homes have “negative connotations”， says Ms Tapia. As in many other Latin countries， most think the elderly should be cared for at home， surrounded by their relatives and loved ones. But this creates a burden that many middle-aged Mexicans find hard to shoulder. More women work outside the home， so have less time and perhaps less inclination to take on the traditional role of caregiver. In 1990 34% of women were in the workforce; 46% are now.

塔皮亚女士称，对许多墨西哥人来说，养老院具有“负面含义”。和许多其他拉美国家一样，大多数墨西哥人认为老人应该在家里养老，身边陪伴着亲人。但这给墨西哥的许多中年人带来了难以承受的负担。越来越多的女性外出工作，因此她们没有太多时间，或许也没有太强意愿来承担传统的照料者角色。1990年，有34%的女性在职场;而现在则有46%。

In a sunny patio filled with cactuses， Ramón Jordan explains that his mother， 100-year-old Amalia Rocha Hernández， moved in with him after being passed between his siblings， each of whom grew tired of looking after her. Mr Jordan is 66. “Híjole， he’s old too！” says Ms Rocha， looking up from her sewing. Mr Jordan says his mother is no burden， but then lists a litany4 of difficulties he faces， from her wanting to talk too much to her knocking on his door at night.

在阳光充足、养满仙人掌的露台上，拉蒙·霍尔丹解释道，他的母亲阿马利娅·罗查·埃尔南德斯已年满百岁，现在搬到他家常住了，之前老人是在几个子女家轮换着住，但霍尔丹的那些兄弟姐妹对照顾老母渐生厌倦。霍尔丹先生66岁了。罗查女士从正在做的针线活儿上抬起头来，感叹道：“唉，他也老了！”霍尔丹先生说，他的母亲并不是负担，但随后又列举出了一连串他所面对的困难，比如母亲话太多，夜里敲他的门之类的事。

Help is hard to come by. There is no comprehensive public system of carers and private ones cost a lot. Mr Jordan relies on his son and daughter-in-law to help. The National Institute of Geriatrics reckons there are only 1，490 care homes， offering 40，000 places， in the whole of Mexico. Almost all are private and costly. Casa Alicia charges 16，000 pesos （$793） a month for residents， and 9，500 pesos for those who use the day centre.

家庭养老很难得到帮助。墨西哥没有全面的公共看护体系，请私人护理的费用又很高，霍尔丹先生只有依靠自己的儿子和儿媳帮忙。据国家老年病学研究所估算，全墨西哥只有1490家养老院，共提供4万个床位。几乎所有的养老院都是私立的，并且收费高昂。卡萨·阿莉西亚养老院每月向入住老人收取1.6万比索（合793美元），对需要日间护理服务的老人每月收取9500比索。