A surprisingly high number of young adults in Thailand I speak with tell me one of their parents has cancer. If you talk to people in their twenties and thirties, this seems to keep coming up. This week alone, I have spoken with three young adults whose parents have been hospitalized from cancer. It’s a major stress for them, disrupting their lives, saying nothing of the distress their parents must be going through.
It’s sad to see such suffering, and I have been trying to figure out why. This piece is not an in-depth sociological analysis, but it is an initial reflection. I am not an expert in this topic, but I have been trying to observe and read in-between the lines to understand what is happening and how this has been impacting families in Thailand.
First, in 2023, Thailand officially became an “aged society” (aka one with a disproportionate number of older people, generally considered to be 14-19% of the population, see https://pmc.ncbi.nlm.nih.gov/articles/PMC13111867/). Japan and South Korea are well-known for their high proportion of older people, with many Western countries in the same boat. Southeast Asians have also been aging fast and could quickly cross the threshold of an “aged” society, with Thailand the furthest along.
Having such a high proportion of older people can produce a lot of strain on a society as it must find a way to provide resources older people tend to need, such as more medical care, generally with a lower base of younger people to help. Most “aged societies” to date tend to be wealthier (European countries, Japan, South Korea, the United States, etc.), and they still struggle to provide the resources necessary to support their aging populations.
Thailand has much less wealth per person than any of them. It seems to be the first country with a low per capita income to become an aged country. On an individual level, many older people do not have retirement savings to support them nor does the society have as much economic resources it can devote to developing the infrastructure that older people tend to need (see https://www.economist.com/asia/2023/10/12/poor-asian-countries-face-an-ageing-crisis).
So, how will older people in Thailand find the resources to support themselves as they get older? The most common answers that Thai people give when I ask is “their children.” As in common culturally in Southeast Asia (and frankly much of the world), families tend to approach this problem as a unit, with the expectation that the children will financially provide for and care for their elderly parents both in general and especially when they become sick. It is pretty normal that a significant proportion of a working adult’s paycheck will go to their parents, sometimes to the detriment of them being able to save or even get by. They are also expected to take care of many of the physical needs of their elderly parents as their bodies deteriorate.
This seems to place a huge burden on many young adults. Some feel forced to work harder or tolerate abuse at their jobs out of fear that they cannot support their parents if they lose their jobs. Young adults are often sandwiched by expectations that they must pay for their own kids and their own parents, sometimes being called the “sandwich generation”, although the number of children in Thailand is also declining (see https://www.bangkokpost.com/thailand/general/3196723/thailand-pushes-to-arrest-plunging-birth-rate). Maybe part of why is that supporting a new generation seems even more expensive when one must already support yourself and the generation above you.
I do not have an easy answer to this. For example, a common approach in the West is to send older people to “old folks home” where they can get the care they need. This certainly has its own cons. Across Southeast Asia, many people would consider the idea of sending their parents away instead of supporting them “offensive,” and these homes certainly can be dehumanizing, isolating places. That tradeoff may not work.
Instead, I am merely reflecting on a problem. I think in Thailand’s case, social safety nets seem some of the worst. The country can be very isolating. It does not have the societal infrastructure to support people who become isolated nor do many families have the wealth built up to support themselves. The family becomes the major way support occurs, but that too has its problems. All this often seems to leave some families on their own without much support, and the people in that family expected to provide with a burden to take care of everyone. If better solutions are not found, much of that burden will fall on young adults, potentially preventing them from building the life they need to themselves.