Middle Eastern Countries

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The southern part of Asia, known as the Middle East, covers an area about the size of the United States and Mexico. The Middle Eastern countries are Bahrain, Iran, Iraq, Israel, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, Syria, Turkey, the United Arab Emirates (UAE), the West Bank and Gaza Strip, and Yemen. Although often discussed collectively, they are different in as many ways as they are similar. For example, all Middle Eastern countries are Arab except Iran, Israel, and Turkey (which account for 59 percent of the region's population). In 1981 the Congressional Quarterly defined the so-called Arab countries as "those in which Arabic is the primary language and who share a common culture."

Most residents of these countries are Sunni Muslim. Exceptions are the Israelis, 90 percent of the Iranians, and two-thirds of the Iraqis, who are Shi'a Muslim. The Middle Eastern countries also differ in historical development, social and ethnic composition, economic history, natural resources, size, population, and forms of government.

This entry reviews the demographic, economic, political, cultural, and social support structures that influence aging and the older people of the Middle Eastern countries. The North African countries of Algeria, Egypt, Libya, Morocco, and Tunisia, which share a culture and religious beliefs with the Arab population of the Middle East, are included in Table 1 along with the Middle Eastern countries. Although Israel is mentioned for comparison, that country is not discussed at length here.

Economic conditions, population, and aging

The Middle Eastern countries possess different resources and are at different stages of economic development. Some, such as Saudi Arabia, Oman, Qatar, Kuwait, and the UAE, have vast oil reserves and oil-dependent economies; others, such as Iran, Iraq, and Syria, are partially oil-dependent. Still others, such as Israel, Jordan, Lebanon, Turkey, and Yemen, have no oil reserves; their economies rely on agriculture and young industries. Oil in the Middle East is a national property. Most of the oil-dependent countries, such as Saudi Arabia and Kuwait, are rich in capital, have labor shortages, and employ guest workers. Turkey and Yemen are low on capital but have a large supply of labor, which they export to the oil-producing countries. The generous old-age benefit programs in some of these countries, which also cover migrant workers, allow the workers to return to their homelands and collect a pension.

Iran and Turkey, each with an estimated population of about 65 million in 2000, account for 56.4 percent of the 232.5 million inhabitants of the Middle East. Turkey has enjoyed a relatively stable government during the last quarter of the twentieth century (except for Kurdish independence movements). Six percent of Turkey's population was estimated to be sixty-five and older in 2000; this figure is projected to increase to 10.8 percent in 2025 (see Table 1). Perhaps more than women elsewhere in the Middle East, women in the Turkish Republic enjoy equality with men in employment opportunities and social freedom. Except for Israel, Turkey has the region's most extensive old-age benefit program: it covers all residents and the benefits are adjusted periodically for changes in the cost of living. Employees and employers finance the system jointly with no government supplement. The amount of benefits is related to past earnings and allows for disability and survivors' benefits.

Iran's experience in the late twentieth century was very different. The country underwent an Islamic revolution, a change in the system of government, an eight-year war with Iraq, and an economic blockade by the United States. In addition, the new regime pursued an isolationist policy in the years following the 1978 revolution. These changes created a difficult economic situation with little or no growth, double-digit inflation for several years, and a reduction in oilproduction capacity. The sharp increase in the population due to strict adherence to Islamic laws, which prohibits family planning and birth control, led to a population explosion after the revolution. Although the policy has been reversed, Iran has a very young population. In 2000, fewer than 5 percent of Iranians were sixty-five or older; this proportion is expected to reach 7.3 percent by 2025.

The old-age benefits cover nearly all workers with some employment history. Self-employed persons can join by paying the employer's and employee's portion of the contribution. The health care system is almost universal, covering the employees and their dependents, especially in nonagricultural areas

Another one-third of the region's population lives in the next four largest countriesIraq, Saudi Arabia, Syria, and Yemenwith a total population of 78.5 million. Saudi Arabia has been able to maintain stability and allow its oil industry to expand. This country, more than any other Islamic nation, follows strict Islamic laws. Men are permitted to have up to four wives at a time; family planning and birth control are not practiced. With an estimated fertility rate of 6.3 children per woman in 2000, Saudi Arabia has one of the fastest-growing populations in the world. The population is expected to more than double by 2025 (see Table 1). The proportion of the population age sixty-five or older will also double during that period. Because of generous old-age pension and health care benefits, which are subsidized by the government and cover nearly everyone except agricultural workers and seamen, life expectancy is projected to increase by seven years between 2000 and 2025.

Iraq faced other challenges during the 1980s and 1990s. It fought an eight-year war against Iran, in which both countries suffered heavy casualties, and then turned its attention to another neighbor, Kuwait. The international community, concerned about the flow of oil to the West and Iraq's weapon buildup as a threat to its neighbors, collectively punished Iraq in what is known as the Persian Gulf War. The country's infrastructure and armed forces were destroyed, and Iraq was subjected to severe economic sanctions and isolation. These conditions resulted in major health problems and malnutrition, with high rates of infant mortality and childhood diseases. The full impact of these events on the population's age distribution will become clear in the future. In 2000, only 3.1 percent of the Iraqi population was estimated to be sixty-five and older; by 2025, the proportion age sixty-five and older is projected to increase to 4.3 percent (see Table 1). These figures represent one of lowest life expectancies in the Middle East, second only to Yemen, which has suffered similar circumstances. Iraq has an old-age pension system that is designed to cover all employees except agricultural and temporary workers. It is not clear whether the system has been able to pay for health care and fulfill its obligations to retired and disabled persons since the Persian Gulf War.

The Syrian government, which has strong ties to the military after some modernization, liberalization, and purging, has maintained stability since the early 1980s. Syria contains oil reserves and arable land, and other industries exist beside oil production and refining; yet the country's economic development has been slow. Syria's political and military involvement in Lebanon and its continued role as peacekeeper have proved very costly. It is estimated that in 2000, only 3.2 percent of Syria's population was sixty-five or older; by 2025 this proportion is expected to reach 4.9 percent, with a decrease in the fertility rate (see Table 1).

Syria has an old-age pension system that covers everyone except domestic and temporary workers. The system, which is fully financed by employees and employers, also pays for health care, disability, and survivor benefits.

Yemen has few natural resources, and agriculture has declined because of prolonged droughts; the result is very slow economic development. Because of the harsh economic conditions and severe climate, estimated life expectancy in Yemen was the lowest in the region (59.8 years) in 2000. A major improvement in life expectancy is expected by 2025 (see Table 1) with cessation of hostilities between north and south and with improved stability and economic conditions. In 2000, Yemen had the highest estimated fertility rate in the Middle East (7.1 per woman); by 2025 the fertility rate is projected to be lower, but still very high (4.7, second only to Saudi Arabia). The old age pension system in Yemen is new, established in 1987 and revised in 1995. Employees and employers fund the program with no government support. It covers everyone except agricultural workers, fishermen, and domestic and temporary workers. The benefits are paid in a lump sum and are less generous than in some of the wealthier nations in the region.

In Western industrialized nations, where health care is better and retirement income security is greater, women enjoy a higher life expectancy; therefore they make up a larger proportion of older persons in those nations. In the Middle East, Turkey and Iraq are the only sizable countries (excluding Israel) in which women account for a higher proportion of the older population. The old-age benefits and pension programs in all of the Middle Eastern countries are conscious of females' shorter life expectancy and have instituted lower retirement ages for women than for men.

In the larger Middle Eastern countries such as Iran, Turkey, Iraq, and Syria, many urban women have received Western-style higher education. Women's labor force participation in these countries is much lower than in the West, however. Among the countries with a sizable proportion of the female population in the labor forceIran, Iraq, Jordan, Bahrain, and Yementhe ages of eligibility for pension benefits are sixty for men and fifty-five for women when the qualifying conditions are met. In Turkey the eligibility ages are fifty-five for men and fifty for women; in Israel, sixty-five for men and sixty for women.

The population characteristics of the Middle Eastern nations and some North African countries are presented in Table 1. All of these countries have old-age benefits programs, which provide income security and health care to almost all citizens with some employment history. The improved life expectancy in all of these countries, also shown in Table 1, may be due to the expansion of the social and health care programs from an early age, which reduce infant and childhood mortality and provide income security in later life.

Role of Islam in policies and practices related to aging

Although they differ ideologically, almost all Middle Eastern countries except Israel have laws based, to some extent, on the holy book of the Qur'an. The influence of Islamic teachings and recommended practices is most notable in family law. Hammudah Abd al Ati, after reviewing definitions of family in an Islamic context, suggests the following: "The term family will be used to designate a special kind of structure whose principals are related to one another through blood ties and/or marital relationships, and whose relatedness is of such a nature as to entail 'mutual expectations' that are prescribed by religion, reinforced by law, and internalized by the individuals" (p. 19). In cultural and traditional norms as well as Islamic teachings and laws, the family is regarded as an inclusive and supportive unit whose success and well-being are connected to the well-being of other members of the unit. Islamic teachings emphasize honor and respect for parents and older members of the family, comparing respect for elders to the honor offered to God.

The old-age pension/benefits programs in Middle Eastern countries define family very broadly. Not only a pensioner's surviving spouse and children but also the parents and siblings are defined as survivors eligible to receive benefits. The benefits for daughters continue as long as they are not married, reflecting the conditions in nations where only a small percentage of females are employed. The eldest son in the household has the acknowledged responsibility of caring for his parents and sibling(s) if necessary. This most often begins with coresidency, when a newly widowed parent moves in with the son's family. In the beginning, while this relative is still in good health, she or he assists in household chores, introduces the children to traditional and cultural values, and often cares for the younger children, teaching them a skill or a trade. This cultivated relationship later is reversed, when older family members need assistance in caring for themselves. Yet the arrangement is always viewed as mutually beneficial; caring for a disabled grandparent, aunt, or uncle is not viewed as a burden but as a natural extension of family life.

This is not to say that Middle Eastern countries have no agencies or institutions that provide daily care to disabled older people. In Iran, Iraq, Syria, and Turkey, an increasing number of women in the urban areas seek employment outside the home, which limits their availability for caregiving. In addition, some elders have no family members and no financial means of their own to hire domestic workers. To serve these isolated cases, a few institutions, mostly in urban areas, are available in the larger countries. It is more common, however, to hire a domestic worker to help care for the older persons in the family.

Shahla Mehdizadeh

See also Israel; Population Aging; Sub-Saharan Africa.


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Middle Eastern Countries

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Middle Eastern Countries