Written by Joseph Troisi and Hans-Joachim von Kondratowitz - two productive and internationally recognised scholars in the field of gerontology - Ageing in the Mediterranean provides the reader with an extensive (text numbers 384 pages), and well-organised, comprehensive look at ageing trends and issues in Mediterranean countries. Without doubt, Ageing in the Mediterranean is an important and timely publication, filling in a key void in international literature on ageing societies. In times of extreme globalisation a regional handbook that highlights the overlapping and idiosyncrasies of ageing issues in one particular territory is more than welcome. Ageing in the Mediterranean comprises useful information for professionals and stakeholders involved directly or indirectly with older persons.
This publication into three main parts, each containing four to five chapters. The first part includes four chapters: ‘Squaring the circle: Demographic outlook and social development’, ‘Demographic outlook of ageing in the Mediterranean, 1950-2050’, ‘An ageing population: Institutional context and family values in Southern Europe’, and ‘Becoming conscious of the ‘whole Mediterranean’: Old cleavages and recent developments’. These chapters provide informed and critical analyses of numerous concepts related to the concept of the phenomenon of population ageing in the Mediterranean by confronting competing approaches to defining the region, describing demographic developments longitudinally, and comparing the historical family regimes in central/northern European countries with the northern parts of the Mediterranean. Therefore, ‘the first part of the book aims to deliver a detailed overview about the whole social fabric of what is described and implied when “the Mediterranean is” has been defined as a unit of analysis’ (p. xi).
The second part brings the focus on to a more detailed account of existing diversities of ‘the ageing experience in the Mediterranean region’ (p. xi). Chapters highlight and discuss ageing and employment, present and future health status of older people, the risks of dependency in old age and (missed) employment opportunities, migration and transnationalism, as well as projected demographic trends. Interestingly, in Chapter nine, ‘The future of demographic regimes in the Southern Mediterranean’, Youssef Courbage highlights how despite the fact that the image of ‘population explosion’ has always been attached to the Arab world in the Southern Mediterranean, he concludes that this image is false since fertility decline is clearly under way. Indeed, total fertility rates in this region are rapidly converging with the low levels reaching in the Northern parts of the Mediterranean with sometimes, to my surprise, remarkable inversions. For example, the present total fertility rates in Lebanon and Tunisia are now lower than or close to those in France.
The third part tackled the area of care policies for an ageing population in a situation of an increase in old-age care needs. This part highlights new approaches in the management of social policy for old age in Portugal, migrant care work for older households in Italy, caring for frail older persons in Israel, and ageing-in-place in the Maltese Islands. Here, one learns that the dynamic of the Italian model pushes for a systematic approach - that is, ‘the urgency in helping to establish a more equitable and internationally oriented perspective to solve staff shortages in elder care’. Of course, the potential lack of social and health workers in the immediate future traverses all chapters, with Giovanni Lamura - who penned the chapter on the Italian situation - advocating countries to ‘place solidarity at the centre of the public interest, by promoting more substantial investments in long-term care, in order to improve its quality and attractiveness for domestic staff…thus reducing the need to solve current care labour shortages through migration’ (p. 251).
The book’s final part shifts attention to the emerging welfare societies of the southern shore of the Mediterranean, by focusing on the ageing situation in Turkey, Lebanon, and Tunisia. Whilst Turkey has presently a predominantly young population, this will change in the near future due to declining fertility rates combined with increasing number of people living longer, with Özgür Arun providing data on the conditions of adult and older people based on sociological factors such as daily life, gender, marital status, education, work and income, health, religion, and ethnicity. One also reads that in Lebanon, despite the decreasing fertility and increasing life expectancy rates, research activities and funding resources continue to be heavily geared towards the health of children and young people. As regards Tunisia, this country has one of the highest percentages of persons aged 65-plus in Arab countries, and is distinctive by the fact that ‘it is one of the few countries in the world that has incorporated the word ‘elderly’ into the name of its Ministry entrusted with ageing’ (p. xiv).
Personally, I found this book extremely interesting. It gives a concentrated solid base for understanding ageing population in the Mediterranean region, whilst also declaring the rich variety of older persons’ needs in countries which, despite being positioned in one geographic region, are characterised by diverse cultural norms and political structures. There is no doubt that this volume brings together a distinguished set of international scholars who provide rich information about the social, economic, political, and historical factors responsible for shaping ageing policy in the Mediterranean region. It also presents a range of key issues and concerns including migration, care-giving, employment, and health care amongst others, whilst providing rich data from various countries such as Portugal, Turkey, Lebanon, Tunisia, and Israel. In general, the book is rich with information, clearly expressing core ideas for which the authors stand, the content is problem-oriented and stimulates fresh thinking, it is interdisciplinary, and at the same time holistic. Ageing in the Mediterranean will warmly welcomed by researchers in social and public policy, gerontology and geriatrics, welfare economics, and health care. It will also be of interest to policy makers and NGOs involved in welfare and social care services.
Dr Marvin Formosa is from the European Centre for Gerontology at the University of Malta