Old Age in Cuba

Fernando Ravsberg*

The population has aged to such a degree that many elderly people must now care for their centenarian parents, like Raul, who looks after his mother Margot. Photo: Raquel Perez

HAVANA TIMES — Nearly 20 percent of Cubans are over 60 years old and, in the very near future, a third of the island’s inhabitants will be senior citizens. The last population census has laid one of Cuba’s most complex problems on the table.

“Society has to prepare for old age,” Vice-President Marino Murillo told deputies this past December, adding that this trend “is unavoidable. It’s going to happen and we can’t do anything to change it in the short term.”

The situation has reached such an extreme that, today, there are more elderly people than children and teenagers in the country. This trend is owed to a reduced birthrate, an increase in life expectancy and, to a lesser extent, the emigration of young people.

One of the more complex challenges that such an aged society faces is the care of the elderly. The extension of life expectancy has created situations where you find elderly people having to care for their parents, who are nearly a hundred years old.

In economic terms, this means that the number of retired persons increases every year and the number of working-age citizens drops. The government is refurbishing retirement and old people’s homes but, ultimately, capacities are well beneath even current needs.

The Parents of the Elderly

Now 97 years old, Margarita Roca has some trouble walking but keeps a very clear head. Freshly-bathed, she is sitting on an armchair, having her lunch under the attentive gaze of her younger son, Raul Arias, a 71-year-old man who looks after her.

Hundreds of elderly people have enrolled in the University for Senior Citizens, where, among other things, they learn how to make the most of old age. Photo: Raquel Perez

Such a scenario will become more and more common as life expectancy, today estimated at around 78 for men and 80 for women, continues to rise. Different factors contribute to this trend, but the country’s wide health coverage is key.

Margot – as she asks us to call her – laughs and tells us that the main difficulty at home is that she’s “very silly”. She adds that she’s now behaving, that she eats at supper time and has her baths without grumbling about it. Shoe does argue with her son, but only so the he will let her do things around the house.

Raul faces far greater difficulties than that, however. “We live on two pensions that aren’t enough. I’ve had to quit work to be able to take care of her and all prices are sky-high. I barely have enough to buy her milk, for example.”

“We each have a 200-peso (US $ 8.00) pension each,” Raul tells us, saying that isn’t enough to make ends meet. “We spend it all paying for electricity, the gas cylinder, water, the newspaper and phone bill. Luckily, my kids help me get through the month.”

Services for the Elderly: Good but Too Few

Cuba has a number of interesting projects for the elderly, such as the University for Senior Citizens, where pensioners can study, Tai Chi exercise sessions and the Casas del Abuelo (“Grandparent Homes”), where the elderly can spend the day while their sons and daughters work.

The country’s retirement homes have a mere 9,000 beds at their disposal, for a population of more than 2 million elderly people. Photo: Raquel Perez

These centers are aimed at aiding families. There, senior citizens can meet people their age, do exercises, eat and play games. Though these services are free of charge, there only 230 such homes, whose capacity does not even cover a third of society’s needs.

Old people’s homes also offer free services, but there are a mere 127 such homes in the whole country, with a total of 9,000 beds. The government plans on building 13 new homes and 140 new Casas del Abuelo before 2015, but that still isn’t enough for a country with over 2 million senior citizens.

Elizardo Sanpedro, an employee at the Santovenia home, an institution managed by the Catholic Church and Cuban Ministry of Public Health, tells BBC World that they care for 450 residents, feed an additional 150 elderly people and have an immense waiting list.

“Many elderly people want to come here” because “this is the best home. The rest are in a deplorable state,” Sanpedro tell us, adding there isn’t much corruption at the home. “The nuns give the residents everything that’s sent to them, they keep nothing.”

Sub-Replacement Fertility

Alberto Fernandez, head of the Senior Citizen Services Department of the Ministry of Public Health, explained that Cuba is the only country in Latin America where people over 60 (18.3 % of the population) are more numerous than those belonging to the 0-14 age group (17.3 %). This leaves Cuba without a generational replacement.

Tai Chi exercises, practiced in nearly every park around the country, are among the most popular physical activities among the elderly. Photo: Raquel Perez

In addition to increased life expectancy, low natality indices (Cuban women have an average of 1.69 children) have a say in this. The reasons for this are varied, but economic difficulties, the integration of women into the workforce and, most particularly, housing shortages are among the most significant.

The large numbers of young people currently leaving the country may have a say in this also. The migratory privileges Cubans enjoy in the United States, however, also prompt many elderly to emigrate. According to Colonel Lamberto Fraga, in 2013, the greatest number of travelers were between the ages of 40 and 60.

Cuba is still not ready to care for such an aged population. In most cities, architectural barriers abound, pensions are insufficient, public transportation is inadequate, nursing homes are few and far between and other institutions for the elderly have very reduced capacities. Addressing this reality in one of the country’s greatest challenges.
(*) An HT translation of the original published (in Spanish) by BBC Mundo.

12 thoughts on “Old Age in Cuba

  • Simply not true. More propaganda. The TRUTH is that Cuba has developed cheap and inexpensive versions of first-world vaccines and there are US profiteers who are anxious to benefit from the shortcuts and low quality/low cost procedures that the Castros have taken to bring a handful of pharmaceutical products to fruition.

  • Cuba lacks materials because of the embargo. Cuba has many vaccines the americans want to get their hands on.

  • Hi Moses,
    I’m a regular reader on this site and I’m no lover of the Castros, I’m also a regular vistor to Havana and I usually stay at the Paseo Hotel on 17. I always ask for a room which faces the I.C. Cardiovascular Hospital .I often stand by my little balcony looking across into the hospital (often with a can of Crystal in my hand!!) and watching life passing by. Its a quiet residential area.
    The whole building is airconditioned. There is one patient to a room. All the rooms have flat screen TVs. Food arrives at the times of day you would expect. It appears to be well staffed. The patients all appear to be Cubans.
    Having said that, about 12 years ago I wanted to visit a friend who was in the Hospital Hermanos de Ameijeiras. They wouldn’t even let me through the doors and the whole place looked a complete tip.
    Please don’t shout at me, just commenting on what I see.


  • I would encourage you to spend one night in a regular Cuban hospital (not the ones set aside for tourists) before you label Cuban health care “superb”. I should advise you to take along your own linens and towels. Also, be prepared to empty the blood-stained wastebasket in your room. That is to say the room you share with 9 other patients. Also bring disinfectant for the bathroom if hygiene is important to you. I would not advise trying to read or watch TV. The TV is likely broken or was long ago stolen and the lights that are still working are far to dim to read comfortably. Finally, be sure to bring extra CUC to “tip” the medical staff. It is not that they won’t attend to your needs without the tips, but the guy in the best next to you is a tipper since his son lives in Miami and you will always receive your care after him if you don’t tip. After you experience Cuban health care for yourself, and not after reading Castro propaganda, get back to us on the “superb health care” you enjoyed.

  • As has been pointed out several times already, the WHO statistics on Cuba’s healthcare come directly from the Cuban government. Independent organizations have never been allowed to collect their own data. As was the case with the former Soviet Union and the East Bloc, The statistics released by the Cuban government are pure propaganda.

    Your incoherent anecdote is pointless.

  • If the healthcare in Cuba is so “horrifically substandard,” as you assert, how is it that Cuba’s life expectancy has increased dramatically since the Revolution, and is now exactly the same as the U.S.’s for males, and only one year less for females? (W.H.O. stats, and compare Cuba with similar Third World countries in the Caribbean and Central America.) While Cuba may not (thanks the the U.S. embargo, plus its relative poverty) have the latest equipment it does have far better preventative programs available to everyone, not just those with the gold-plated health insurance, like here in the U.S. Thanks to the A.C.A., this situation might improve here. Unfortunately, since the A.C.A. is still controlled by the insurance companies, I’m not expecting much.
    Even if you question the W.H.O.’s stats (you’d have the question them for the U.S. and other countries as well), anecdotally, travelling from one end of Cuba to the other during seven visits, some extended, over 50+ years, I’ve observed many folks in their 70’s, 80’s and 90’s who are not only still above ground, but often vibrant, like my friend’s father who, at age 94, still opens his ponchero shop most mornings at 6:30 a.m., and stays open ’til mid-afternoon (and will often reopen to patch a kid’s bicycle tire for free!). A few years back driving home from Centro we spotted him walking a couple of km. from home, stopped, and offered him a ride (in my rental car). He said he’d rather walk. (He was returning from the home of a g.f.!) Probably his continued exercise, simple diet, and habitual routine have much to do with his longevity.

  • Sorry, but your prayers are too late. Have you been to Cuba in the last few years? There is more ‘naked capitalism’ on the streets of Havana than in Stockholm, Sweden or Copenhagen, Denmark. By the way, why call me a government official? Does that unfounded name-calling make the point you are trying to make stronger? Do you think you sound clever? C’mon, play nice.

  • Healthcare in Cuba is not superb. For most Cuban’s it’s horrifically substandard. Only the ruling elite get good healthcare. The Cuban government does not allow any independent organization to collect data on their healthcare system. The statistics are considered a state secret and revealing them without government permission is a serious crime. Dr. Oscar Elias Biscet was given a 25 year prison sentence for presenting data about the prevalence of late term abortions in Cuba.

    The one aspect of the Cuba healthcare system which has contributed to the falling population is the extremely high abortion rate. In 2009, there were 209,900 abortions in Cuba, for a rate of 77 per 100,000 women of childrearing age. That’s the 3rd highest rate in the world, after Vietnam and Romania.

  • Unless and until the Cuban government implements profound political and economic changes, the demographic trend will continue. Young Cuban people have to have a good reason to hope for a better future if they are to be convinced to stay in Cuba and have children.

    The alternative is the gradual extinction of the Cuban nation. Will that be the ultimate legacy of Castro’s Revolution?

  • Yes Moses I am surprised that being a government official in the USA that you are not aware of the reason for the demise of the once proud Navajo nation who failed to bend to the authority of the new America, lets pray that the spirit of the Cuban people will not be bullied into becoming a capitalist driven system.

  • Once again the Cuban people show their empathy for each other, obviously this is encouraged by the government, and it is now obvious that the superb health care in Cuba is a good example to all other countries in the neighbourhood to follow.

  • There are no valid historical examples of societies who have faced the same set of negative demographic markers. It is generally agreed, however, that when the ‘replacement generation’ is chronically smaller than the elderly generation, that society will ultimately disappear. Prior sociological examples which best fit the situation in Cuba are the Native American populations in the US. If you liken Cuba to a reservation, then what happened to the once expansive Navajo nation could be likened to what is happening in Cuba.

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