The Crises of Migration, Demography, and Caregiving in Cuba

Cuban society is struggling today with complexities in its governance. The country is going through multiple crises that have heightened tensions to maximum levels—some of these crises are due to the pandemic, and others are the result of misguided economic policies that have been adopted from the so-called “Tarea Ordenamiento.” The situation is aggravated by the intensified economic sanctions of the United States, misgivings brought forth after the July 11 protests, and the government’s apparent inability to generate a winning strategy that controls, or at least minimizes, the impact of the present situation.

In a less visible way, the crisis in caregiving[1] has continued to worsen in Cuba with the rise in the demand for care. This is due to a sustained increase in the elderly population, decrease in public social service providers, crisis in the healthcare system that include cuts to social welfare, and rising cost of living, as well as the burden on families–especially women–with growing needs in the face of greater economic instability and social vulnerability. The structural and systemic aspects that link these crises have set off a new wave of migration from the island that started on November 15, 2021, the date that the Cuban government reopened its borders.

This analysis seeks to crystalize the close relationship between migration, an aging demographic, and the crisis of caregiving in Cuba based on the structural crisis that the society as a whole is experiencing. To do this, we analyze population dynamics based on two features of international migration for Cubans that impact an aging population. Second, we will explore how the feminization of Cuban migration affects the increase in the burden of care in old age, to the extent that migration has become a complementary strategy to resolve the crisis in caregiving.

The Growth of Cuban International Migration and its Relationship to an Aging Demographic

Cuban migration has increased in recent years, leaving a stable, negative migratory balance from the 1980s to the present (Mesa-Lago, 2020). As of 2017, the Cuban population began to decrease in absolute terms (Díaz-Briquets, 2020). Since the beginning of the century, growth rates were very low, or almost static, with a turning point in 2006, when the decline in the total population began (−0.4%), a trend that continues today (Aja and Hernández, 2019).

Albizu-Campos Espineira (2021) indicates that Cuba already completed its first demographic transition—a decrease in mortality and fertility levels—between 1989 and 1993. In this scenario, emigration, which was increasingly female, plays an important role. Alfonso and Albizu-Campos Espineira (2000) argue that while certain time frames of migratory patterns were circumstantial, as of 2006 they became structural. With a particular emphasis after the 1990s, various authors argue that leaving Cuba became both a familial and personal strategy for solving a range of economic problems, as well as being able to achieve life plans, including professional careers (Domínguez, Machado & González, 2016; Martín, 2005).

At the same time, and as a result of long-standing policies, Cuba is leading the aging process in Latin America and the Caribbean (ECLAC-CELADE, 2009). The National Survey on Aging (ENEP) (ONEI, 2019) and the National Migration Survey (ONEI, 2018) recognize that aging is the great sociodemographic challenge facing Cuban society today. An aging demographic is nothing more than a change in the age structure of a population as a consequence of reduced fertility over time and its stabilization at levels below the rate of replacement.

However, in the face of alarmist discourse regarding aging in Cuba, policy prescriptions should be exercised with caution as they try to break away from past failures. Some demographers maintain that Cuba has never experienced a very favorable demographic situation, and the key is that the population has lived through what in theory is known as the Reproductive Revolution.[2] The real issue is that while the Cuban population has completed this “reproductive revolution,” the economic and social model has not adjusted to the needs derived from that process. There has been no “productive revolution” to go along with it (Albizu-Campos, 2021).

In this sense, Mesa-Lago (2020) states that, although aging is beneficial in that it can be an indicator of a longer life expectancy, at the same time, it can have an adverse impact on social protections by generating higher costs in pensions, health, and social assistance. The underlying problem is not an increase in the population over 60, but the absence or unsustainability of social and economic policies, as well as insufficient resources to provide adequate care and social protections in response to the change in age demographics.

Greater Presence of Young People in International Migratory Flows from Cuba

In a scenario with systematic emigration of the population, there are two relevant issues that affect social welfare and protection policies, in addition to the economic development of the country. The first is the increase in young people migrating; the other is the growing number of women migrating (Hernández & Foladori, 2012). Research in Cuba shows that Cuban emigration is largely represented by the young adult population (Aja, 2007 and 2019 and Aja, Casañas, Martín and Martín, 2003). The primary age range of Cuban migrants is between 20 and 40 years old. A high percentage (76.7%) is found in the productive cohort, especially in qualified activities. The most recent survey on migration (ONEI, 2018) confirms this detail.

Demographers and economists have warned about the pressures that this continuous exodus of the productive cohort generates on the Cuban social security system, a scenario that will become more precarious when, towards 2030, the baby boom turns into the retirement boom (Díaz-Briquets, 2020). The most populous generations, which were a consequence of the unusual increase in the birth rate between 1957-1963, will all enter retirement from economic activity simultaneously (Albizu-Campos, 2021).

The increased emigration of working-age people has immediate effects on the economy. It causes a fall in the economically active population (EAP), which in the long-term results in labor shortages and, if productivity is not increased, causes a decrease in production and the supply of services, as well as gross domestic product (GDP) (Mesa-Lago, 2020). The decreases in employment and the productive cohort have a negative impact on the sustainability of the pension system, since financing the rising costs of social security becomes more difficult.

When faced with a growing elderly population and pension costs, it is necessary to expand social spending. However, spending has been cut back since the early 2000s to make it financially sustainable for the country.[3] While this measure is logical from a fiscal point of view, it has adverse consequences for social protections. In the years that followed, this is reflected in the deterioration of programs and services for the elderly and a hike in the poverty rate for that age group. Most older people consider that their income is not enough to cover basic necessities, with women being the most affected (40% of women and 37.3% of men), as well as those who only have retirement or a pension to cover their basic needs. An overwhelming majority (70%) consider that they are deprived or lacking (ONEI, 2019; Acosta and Angel, 2020).

The Feminization of Cuban Migration and Transnational Care Chains

The migration survey (ONEI, 2018) also confirms the trend of a greater number of women in recent migration, with a higher rate of temporary migration abroad. Hernández and Foladori (2012) point out that since the end of the 20th century, Cuban migration has followed global feminization patterns, and that since 1995, women’s participation has grown to more than 50%, maintaining an upward trend in the following years. Since then, the rise in number of women has occurred in all Cuban emigration categories, with the exception of “mission abandonment,” where men predominate (Aja, 2007).[4] Evidence indicates that, when legal emigration gained space after a relaxation in Cuban immigration policy, women increased their participation, their numbers reaching over 55 percent with the exception of a few years.

This migration selectivity is closely related to managing family care, since it is women who are left in charge of children and relatives while they can organize safer migration routes (Acosta, 2021). It has been shown that, in the periods in which departures have been carried out in an orderly fashion, with trip certainty, and in support of family reunification, women emigrated more than men.

The feminization process of international migration in the case of Cuba is also challenging from a qualitative point of view, an issue that is evidenced in both the motivations and roles of migrant women. Marrero (2011) relates the increase in female heads of household in Cuba with the acquisition of greater autonomy and decision-making power of Cuban women, an issue that would influence the decision to migrate as a way to improve their living conditions compared to what they can achieve on the Island.

Several investigations have coincided that, more and more, Cuban women decide to migrate alone as an alternative for survival in the face of economic and social crisis (Martín, 2007). However, the decision to emigrate by women of reproductive age inevitably affects population dynamics, causing a decline in fertility rates, which substantially affects the growth rate of young segments of the population (Núñez, 2007).

Migration as a Complementary Strategy and its Effects in Response to the Crisis in Caregiving

Cuban families perceive emigration as a survival strategy. Since the nineties, migration has been considered a way to cope with the crises in daily Cuban life; at the same time, it is seen as the most effective way to solve daily issues (Aja, Casaña, Martín and Martín, 2003). In this context, the Cuban family has appeared as a central actor in the development of transnational practices and in the construction of transnational communities.

However, this analysis has neglected the role that migration has had in solving social care needs on the one hand, as well as the impact of the deficit of family caregivers, particularly on the elderly, on the other. The increase in single-person households of elderly people is notable, from 12.6% in 2012, according to the Census, to 17.4% in the latest ENEP survey (ONEI, 2019). The latest survey on aging reveals that around 7% of people over 60 have all their children living outside of Cuba, and 3%, or 70,300 people aged 60 and over, have all their children and grandchildren residing outside the country (ONEI, 2019).

At the same time, social care is still highly familial in Cuba (Acosta et al, 2018). Cuban women are the main caregivers in the family, and those with work commitments experience the demands of both the home and the workplace (Fleitas, 2014). The distribution of time and the burden of care at home is very unequal on the Island. The National Survey on Gender Equality-2016 (ONEI, 2018b) confirmed that it is women who, on average, spend the greatest amount of time in domestic and caregiving tasks, with a difference of over 14 hours per week compared to time dedicated by men.

For these reasons, among others, Cuban women in general are overrepresented among the poorest incomes (Espina, 2008), and in particular those who are over 60 years old tend to have a more disadvantageous income status (Fleitas, 2014, Acosta and Angel, 2020). The proliferation of survival strategies within the family and raising income appear as consequences of this inequality, and in turn, have been pointed out as key features to understanding social re-stratification in today’s Cuba (Espina, 2008).

The decrease in family size and the increase in female-headed households can be considered indirect strategies in addressing the caregiving crisis (Acosta, 2021). At present, the size of the Cuban family has decreased. It has consolidated itself as a small family with few children (Rodríguez & Albizu-Campos, 2015). In the last sixty years, Cuban households have seen the average number of their members reduce by 2 people per household as an absolute value and by 40.8% as a relative value (Benítez, 2015). Tending to the young and the elderly population and their care needs has become a concern since there are fewer people available to provide care.

However, several researchers are critical of the pronatalist policies announced by the Cuban government as part of the solution to this crisis. Díaz-Briquets (2020) points out that despite implementing policies in favor of a higher birth rate since the beginning of the century and later expanded between 2015-2020, these have not produced results. The global fertility rate (TFR, or estimated number of children that the average woman will have during her reproductive years), as well as the annual number of births, stabilized between 2009 and 2018, while the net emigration rate at the end of this period remained high, although not as high as in previous years. Albizu-Campos (2021), for his part, interprets these policies as a form of populationism, which go against the effective exercise of people’s human, sexual, and reproductive rights.

Final Thoughts

The composition and magnitude that has characterized international migration in Cuba in recent decades, as well as its impact on the family dynamics and life projects of Cuban women, refer to a structural problem rather than a temporary one. Migration has become a survival strategy in the absence of sustainable solutions to the multiple crises that Cuban society is going through. Undoubtedly, an increasingly younger and more feminized international emigration is causing an aging of the general population and a deepening of the caregiving crisis, which has a larger impact on the elderly.

This situation requires further research and a public debate on the present and future impacts of demographic dynamics such as migration and aging in its relationship with the social organization of caregiving on the Island. The Cuban government lacks an integrated and efficient policy to face demographic aging and its adverse impacts on social protections. The results achieved by policies in favor of a higher birth rate are clear evidence of this. The route to reconciling new demographic realities with the caregiving crisis includes, on the one hand, accelerating and deepening structural reforms so that migration stops being a strategy for daily survival. At the same time, it is necessary to obtain resources to implement appropriate and integrated social policies that tackle the current and future challenges of aging. On the other hand, it is important to move towards a democratic redistribution of care, considering the four central pillars that intervene, unevenly, in the law and which guarantee the care needs of individuals and groups: the State, the market, families, and the community. In sum, there is an urgent need for a broader discussion on the welfare regime, its forms of expansion, the reordering and rationalizing current healthcare policies, and the role of migration, as well as on the rights of people who require care and their caregivers.

Elaine Acosta González is Executive Director of CuidO60 – Observatory of Aging, Care and Rights and a visiting researcher at Cuban Research Institute, FIU.

Illustration by Maikel Martínez Pupo. You can find him @MaikelStudio @maikelmartinezpupo.

[1] The “crisis in caregiving,” in its broadest sense, alludes to the tension between women’s different roles in providing care and the changes in the content, protagonists, and circumstances in which care work is carried out in actuality. It is a crisis related to the unequal and devalued way in which care is organized and socially distributed between the State, the market, the community, and families.

[2] It consists of the fact that the children brought into the world today live almost three times as much as those born in 1900, when infant mortality, one of the driving forces par excellence of the increase in life expectancy at birth, was just under 225 deaths for every thousand, while today it is just over 4 for every thousand (Albizu-Campos, 2021).

[3] Between 2006 and 2018, budget spending allocated to social assistance decreased from 2.2% to 0.3%, while the number of beneficiaries as a proportion of the population decreased from 5.3% to 1.6% (Mesa-Lago, 2020). The latest statistical yearbook (ONEI, 2021) confirms the downward trend in social spending dedicated to health and social assistance. The volume of investment by class of economic activity places health and social assistance (considered under the same indicator) with the lowest levels of investment among the 18 classes of economic activities mentioned (Acosta and Angel, 2020).

[4] The highest participation of men is recorded during the so-called “rafter crisis” of 1994, though women also participated, which according to Hernández & Foladori (2012) corroborates the hypothesis of Alfonso and Albizu -Campos (2000) on the relationship of gender migration with the character and means of emigration.