Ikaria: The Greek island of Long Life

Have you ever heard of the Greek Island of Ikaria? Well they might just hold the secrets to living longer. One third of Ikaria’s population lives past the age of 90 years old. Ikaria is one of five places that is considered a blue zone. A blue zone is a term referring to regions of the world where people live much longer than the average. Besides living longer, Ikarians have much lower rates of cancer and heart disease as well as significantly less depression and dementia. This Greek island looks like many of the other Greek islands, so what makes this Island so unique? Their diet mainly consists of fresh herbs and other vegetables, beans, wine and very little meat and dairy. They drink varied herbal teas and have types of honey you won’t see anywhere else in the world. No one on the island is in a hurry or consumed with the concept of time. Afternoon naps are a part of the daily life. You are lucky if you find a properly working clock there. Due to the challenging geography, the island has had to learn how to become self-sufficient over time. Ikarians remain closely connected to their family and neighbors. The older adults play a large role in the community, whether they help raise grandchildren or run businesses. They get up every day with a sense of purpose. The island’s diet, social structure, sense of connection and purpose play a large role in longevity. But the Ikarian formula to long life remains a bit of an enigma. I personally think we should, at the very least, institute daily afternoon naps.

Let us now take a look at more areas of the world and learn about how other cultures view older adults, their roles in society and some of the challenges that they face.

Asian Culture

Japan has a higher percentage of older adults than any other country. Japan has some of the highest life expectancy rates in the world. Japan has a national holiday called Respect for the Aged Day. There are close to 30,000 Japanese who celebrate their 100th birthday each year. The Japanese culture is accommodating the large aging population in some unique ways, such as having escalators designed for people in wheelchairs or providing a variety of prescription strength eye glasses for people to use at the post office, bank or hotel. China and other Eastern cultures adhere to the Confucian tradition of Filial Piety which stresses the importance of the family unit and values elders with the utmost respect. In China, there is an “Elderly Rights Law” mandating that adult children visit their aging parents often, regardless of how far away they live. Companies in China are required to allow time off to visit parents. A couple things that may contribute to older adults living longer in Japan, besides their healthier diet, is their attitude towards death and their devotion to cultivating “ikigai.” The word “ikigai” is one’s sense of daily purpose or reason for being. Death is not something that is feared by the older adults in Japan. Japan has what is called “Fureai Kippu” which translates to, “ticket for a caring relationship.” It is a system that provides care for older adults through the exchange of time credits. People will donate their time by helping an older adult and then they are issued a ticket as payment. Anyone can earn these tickets, whether it is an older adult helping another older adult or a young person helping someone older in the community. The tickets can be used for yourself or transferred to someone of choice, typically a parent or another family member. The ticket can then be used for a variety of things like help around the house or a ride to a medical appointment or grocery store.

Middle Eastern Culture

The majority of this region as a whole is still young. However, the aging population is advancing much more quickly due to lower fertility rates and mortality rates as well as longer life expectancy. It is projected that by 2050 the older adult population will have increased by 19%. Older adults in the Middle-Eastern cultures are viewed as sources of spiritual blessing, religious faith, wisdom and love. Islamic teachings emphasize the duty to care and respect older adults by providing them comfort, protection and security. For instance, if aging parents are in need of money, it is considered an obligation that the children give them access to their own wealth. Long term care for older adults is primarily family-based. It is mainly due to the deeply-rooted religious and cultural norms that emphasize the duties of the younger generations taking care of the older generations. There are very few formal long term care options, since there is a social stigma attached to the idea of having aging family members placed in facilities. Conversely, these dynamics are being threatened by factors such as modernization and urbanization. It is threatening the traditional forms of long term care with the typical intergenerational family unit. According to the Economic and Social Commission, it is estimated that social security coverage extends to less than 25% of the aging population. Some governments are beginning to recognize the need to address the future challenges of the increase in the aging population.

Sub-Saharan African Culture

Currently, older adults only constitute a small part of the sub-Saharan African region. Only 5% of the population is 60 years or older. However, this is changing. By 2050, it is projected that the 60 years and older population will increase to 10%. There are tremendous disparities regarding status and wellbeing among older adults in this region. While many older adults live in poverty throughout the region, there is a small fraction that enjoys abundant wealth and influence. For example, approximately two thirds of African Heads of State are 60 years and older. A large majority of older adults still engage in small-scale farming. In fact, the labor force participation of older adults in Africa is the highest in the world. This is primarily due to not having access to pension/social security programs. Therefore, they have to continue to work as long as they are physically able. There has been an increase of younger family members migrating to urban areas. Consequently, older adults in rural areas, end up playing a vital role as caregivers themselves to grandchildren left behind by parents seeking employment in cities. African tribal societies view their aging population as wise. Many older adults carry with them tribal stories and traditions that they can then pass on to younger generations. Unfortunately, many older adults are greatly discriminated against. Often, they are given very little information about the possible services that may be available to them, and therefore end up having to compete for resources with other age groups. There are a number of legal frameworks that have been adopted and developed to protect the rights of older adults in Africa, but oftentimes it is ignored.

European Culture

At 22% Europe has the highest proportion of people 60 years or older. According to Global Age Watch, Sweden, Norway and Germany are the best places in the world for older adults when it comes to healthcare, pensions and an environment allowing them to remain active. For example the life expectancy in Sweden is among the highest in the world, with it being 81 years old for men and 84 years old for women. Today in Europe, many older adults are more educated, tech savvy and active than their predecessors. Older adults in Spain have taken it upon themselves to design innovative living situations. Spain has become Europe’s center for senior living cooperatives, where older adults are creating and managing their own retirement communities. For many areas of Europe right now, the portion of working people who can provide care for older adults is shrinking, even as the need for care is growing. The European Union is attempting to implement new retirement policies intended to increase the number of older workers, while reducing the burden on pension programs. The policy of increasing the retirement age has been met with some push back. The Netherlands and Scandinavian countries have well developed systems of formal care for the elderly. There is a broad network of government and private sector care in the home and in facilities. Central and Eastern European countries view aging care as the responsibility of the family.

Latin American Culture

There are 71 million people over 60 years old in Latin America. The coverage of retirement systems is very low. Therefore, older adults must continue working longer or depend on their families. They are typically living in the home with their children, grandchildren and sometimes even great-grandchildren. According to the Economic Commission for Latin America, 1 out of 4 households have an older adult living with them. They place a high value on intergenerational bonds. Some cultural beliefs unique to Latinos and Hispanics are: respect for hierarchy, emphasis on the present, and a belief that good/evil spirits have an impact on wellbeing. Latino culture values kindness, friendliness, respect and modesty. Latinos rely heavily on traditional folk medicine to address their ailments, primarily because other healthcare is not readily available. Some of the major challenges facing older adults involve improving social security coverage, access to healthcare and inclusion in the workforce. Once Latino adults reach 60 years and older, they are usually excluded from job opportunities and other activities. Many societies are unaware that older adults have rights. To address many of these concerns, there is now what is called the Inter-American Convention on protecting the human rights of older adults.

This is by no means an exhaustive list of all the cultures that exist. If I attempted that, I would have lost you halfway through. I think it is also important to note that in our discussion of these cultures, there are generalizations. There are variations within each cultural group, and they are not reflective of all experiences and viewpoints of those specific cultures. All world regions are experiencing an increase in their aging population for two main reasons: more people are living longer and fertility rates have decreased.

There are some good takeaways when reflecting on all the various cultures. I think Ikaria might certainly be on to something, besides the afternoon naps, with truly enjoying life to the fullest, in the most purest and simplest of forms. It is also a great reminder of all the things that we can be grateful for here in the U.S., but to also look to other cultures to glean some wisdom. You may have noticed a recurring theme with many of these other cultures- a level of reverence and respect for older adults. Studying cultures can give way to acceptance, understanding and awareness. It can challenge our thought processes and expand our minds. Let us learn from one another on how to best care for older adults and to give them the respect that they deserve.