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A Profile of Older Americans: 2002

Health, Health Care, and Disability

In 2000, 27.0% of older persons assessed their heath as fair or poor (compared to 9.0% for all persons). There was little difference between the sexes on this measure, but older African-Americans (41.6%) and older Hispanics (35.1%) were much more likely to rate their health as fair or poor than were older Whites (26%).****

Limitations on activities because of chronic conditions increase with age. In 2000, among those 65-74 years old, 26.1 percent reported a limitation caused by a chronic condition. In contrast, almost half (45.1%) of those 75 years and over reported they were limited by chronic conditions.

In 1997, more than half of the older population (54.5%) reported having at least one disability of some type (physical or nonphysical). Over a third (37.7%) reported at least one severe disability. Over 4.5 million (14.2%) had difficulty in carrying out activities of daily living (ADLs) and 6.9 million (21.6%) reported difficulties with instrumental activities of daily living (IADLs). This is in sharp contrast to the much lower levels in the 25-64 populations of ADL difficulties (2.8%) and IADL difficulties (4%). [ADLs include bathing, dressing, eating, and getting around the house. IADLs include preparing meals, shopping, managing money, using the telephone, doing housework, and taking medication].

The percentages with disabilities increase sharply with age (Figure 8). Disability takes a much heavier toll on the very old. Almost three-fourths (73.6%) of those aged 80+ report at least one disability. Over half (57.6%) of those aged 80+ had one or more severe disabilities and 34.9% of the 80+ population reported needing assistance as a result of disability. There is a strong relationship between disability status and reported health status. Among those 65+ with a severe disability, 68.0% reported their health as fair or poor. Among the 65+ persons who reported no disability, only 10.5% reported their health as fair or poor. Presence of a severe disability is also associated with lower income levels and educational attainment.

Figure 8: Percent With Disabilities, By Age: 1997

Figure 8: Percent with Disabilities, by Age.  The percent with any disabilities from age 65 to 69 is 44.9, age 70 to 74 is 46.6, age 75 to 79 is 57.7, and over 80 is 73.6.  The percent with severe disabilities from age 65 to 69 is 30.7, age 70 to 74 is 28.3, age 75 to 79 is 38, and over 80 is 57.6.  The percent that need assistance from age 65 to 69 is 8.1, age 70 to 74 is 10.5, age 75 to 79 is 16.9, and over 80 is 34.9.

Most older persons have at least one chronic condition and many have multiple conditions. The most frequently occurring conditions per 100 elderly in 1996 were: arthritis (49), hypertension (36), hearing impairments (30), heart disease (27), cataracts (17), orthopedic impairments (18), sinusitis (12), and diabetes (10).

Older people had about four times the number of days of hospitalization (1.8 days) as did the under 65 aged population (0.4 days) in 2000. The average length of a hospital stay was 6.4 days for older people, compared to only 4.6 days for all people. The average length of stay for older people has decreased 6 days since 1964. Older persons averaged more contacts with doctors in 2000 than did persons of all ages (7.0 contacts vs. 3.7 contacts).

In 2000, older consumers averaged $3,493 in out-of-pocket health care expenditures, an increase of more than half since 1990. In contrast, the total population spent considerably less, averaging $2,182 in out-of-pocket costs. Older Americans spent 12.6%of their total expenditures on health, more than twice the proportion spent by all consumers (5.5%). Health costs incurred on average by older consumers in 2000 consisted of $1,775 (51%) for insurance, $884 (25%) for drugs, $693 (20%) for medical services, and $142 (4%) for medical supplies.

(Sources: Health United States: 2002; Current Population Reports, "Americans with Disabilities, 1997" P70-73, February 2001 and related Internet data; Internet releases of the Census Bureau, the National Center on Health Statistics; and the Bureau of Labor Statistics)

****1996 figure

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