The shakedown [By? Jiao Haiyang/China.org.cn]

The highly public suicide in early April of Greek pensioner Dimitris Christoulas prompted a wave of sympathy in the country, where many of the elderly are struggling amid the deep recession.

He became a symbol of the pain inflicted by the country's austerity measures, implemented in response to its sovereign debt crisis, when he shot himself in the head outside parliament."I see no other solution than this dignified end to my life, so I don't find myself fishing through garbage cans for my sustenance," he wrote in his suicide note.

Pensioners like Christoulas have been hard hit by Greece's worst economic crisis since World War II, with cuts of 25 percent in old-age benefits on average over the past two years, as well as health spending cuts.

But even without the added hardships imposed by the global downturn, elderly people have a higher risk of suicide than any other age group worldwide, including China. Suicide rates among the elderly are the highest in any demographic group.

Though no exact statistics are available, Michael Phillips, a professor at the Shanghai Mental Health Center and a mental health consultant with the World Health Organization, has projected that China and India both have high rates of suicide. A study published in 2003 that he participated in suggested that one third of the people that take their lives in China are old people.

Though the total number of suicides is declining, suicides among aged people are on the increase, especially in rural areas. Working in towns and cities, their children leave them behind in their empty nests. This should sound an alarm to policymakers and stir them into action because China's population is graying fast.

China already has the largest elderly population in the world. According to the 2010 national census, there were 119 million people aged 65 and over, about 8.87 per cent of China's overall population. Over the coming generation, this group is set to rise to 280 million - growing by almost 3.8 percent every year. By 2035, nearly one in five Chinese residents will be 65 or older, constituting a staggering 280 million senior citizens.

This gray tsunami is challenging the country's care system for senior citizens. Two Chinese taxpayers may have to look after one retiree by 2039.

At the Health Aging Symposium in Beijing on April 7, Rao Keqin, a leader of the Chinese Medical Association, admitted that China has become an aging society without realizing modernization nor a developed economy.

According to a survey conducted by the China Research Center on Aging in 2011, two thirds of the seniors above 60 are living with an illness, with 33 million seniors partially disabled or totally disabled. The aging process presents the country with enormous challenges, as the country's care system is not yet up to the task. The resources available for the elderly, particularly those in rural areas, are inadequate. Traditionally they rely on their children and grandchildren to take care of their needs. Suicide is more common in rural areas, because doctors and counseling services are few and far between.

And the suicides of elderly people receive relatively little attention, with public health measures, medical research, and media attention focusing on younger age groups. The neglect of the frail and vulnerable in hospitals and care homes, and the inadequate number of care facilities for the elderly, need addressing by policymakers. China's care system for old people requires a radical overhaul. At present, it is underfunded, understaffed and poorly regulated.

Targeted approaches for reducing suicides in older people should include optimizing the management of pain and disability and reducing social isolation.

The 12th Five-Year Development Plan on Ageing (2011-15) includes developing a nationwide system of older people's homes with 3.42 million more beds for the elderly, encouraging all grassroots medical institutions to provide health services for seniors and monitoring the health conditions of people aged 65 years and over, and developing an ageing industry to respond to the health care needs of the elderly.

It is essential that these goals are realized as we need to improve the support systems for the elderly, build up and improve the healthcare delivery system for older people, and develop a social environment that embraces senior citizens.

The author is a senior writer of China Daily. E-mail: caihong@chinadaily.com.cn