In 2020, 100 working-age residents in North Sulawesi supported 17 elderly people.

The elderly dependency ratio in North Sulawesi was recorded at 17.95 in 2020. This means that for every 100 people of working age in North Sulawesi, approximately 17 to 18 elderly people need to be supported.

Compared to urban areas, the working-age population in rural areas bears a greater burden of supporting the elderly. The elderly dependency ratio in rural areas is 19.17, while in urban areas it is 16.88.

Looking at cities/regencies, the Siau Tagulandang Biaro Islands Regency has the highest elderly dependency ratio in North Sulawesi, reaching 24.67 per 100 working-age population. This is followed by Minahasa Regency (24.23) and South Minahasa Regency (22.76).

Bitung City has the lowest elderly dependency ratio at 12.49. The next lowest elderly dependency ratios are in South Bolaang Mongondow Regency and Manado City, at 12.61 and 13.82 respectively.

An increase in the elderly dependency ratio is directly proportional to increased needs, including care, thus increasing the economic burden on the working-age population to support the elderly. Therefore, synergy is needed in implementing programs related to the elderly.