Published online by Cambridge University Press: 21 October 2015
Over the last decade, the growing size of Vietnam's older population has prompted the government to pay more attention to the well-being of this group (Bui et al. 2000; Nguyen 1998; VCPFC 2002). The proportion of Vietnamese adults age 60 and above is projected to rise substantially from 8 per cent in 2000 to 13 per cent in 2025 and over 25 per cent by the mid twenty-first century (United Nations 2007a). Female old-age vulnerability has been placed in the forefront of government-funded social programmes to improve the living standards of the old (HelpAge 2007; Mitchell and Khuat 2000; United Nations 2002, 2007b). Influenced by the dominant policy discourse on gender and ageing, Vietnamese policymakers are concerned that older women would be more susceptible than men to various forms of hardship because they tend to experience socioeconomic disadvantage in early life and to be widowed in older years (Giang and Pfau 2007a; Ofstedal et al. 2003).
Recently the disproportionate policy focus on older women's vulnerability has been increasingly criticized for its lack of consistent evidence and for its dismissal of men's potential disadvantages (Knodel and Ofstedal 2003). For example, while women might be inferior to men in the labour market, they are not necessarily more vulnerable in later life since female elders tend to be more protected socially by family and kin network support. These criticisms also extend to the prevailing perspective on gender and health equity which posits that women are more likely than men to have poor health at older ages. The issue is particularly relevant to Vietnam's recent efforts to address the healthcare needs of its older population. While healthcare provision for the elderly, especially for female elders who are less likely to receive pension and health insurance, has been discussed widely in the public sphere, little is known about the extent to which health status in older years varies by gender and what mechanisms lie behind male-female differences (Thanh Nien News 2009; Vietnam News 2008).