Highlights
The indicators assembled in this
chartbook show the results of decades of progress. At the beginning of a new
century, older Americans are living longer and enjoying greater prosperity than
any previous generation. Despite these advances, persistent inequalities between
the sexes, income classes, and racial and ethnic groups continue to exist. The
rapid growth of the older population over the next 50 years will intensify the
need for policymakers, researchers, and community leaders to better understand
the health and economic needs of older Americans.
Population
The demographics of aging continue to
change dramatically. The older population is growing rapidly, and the aging of
the "baby boomers," born between 1946 and 1964, will accelerate this
growth. Both the number and the proportion of older people relative to the rest
of the population are increasing. This increase in the size of the older
population is accompanied by rapid growth in the population age 85 and older, as
well as increasing racial and ethnic diversity among all older people.
In 2000, there are an estimated 35
million persons age 65 or older in the United States, accounting for almost
13 percent of the total population. The older population is expected to
double over the next 30 years to 70 million by the year 2030. Over the next
50 years, the population age 85 and older is expected to grow faster than
any other age group. (See Indicator 1.)
Women make up 58 percent of the
population age 65 and older, and 70 percent of the population age 85 and
older. Older women are less likely than older men to be currently married
and are more likely to live alone. In 1998, about 41 percent of older women
were living alone, compared with 17 percent of older men. (See Indicators 1,
3, and 5.)
The older population will become more
racially and ethnically diverse during the next 50 years. Non-Hispanic
whites make up 84 percent of the population age 65 and older in 2000, and
this is expected to decline to 64 percent by 2050. (See Indicator 2.)
The current generation of older
Americans is more highly educated than previous cohorts of older persons,
and this trend will continue. In 1998, about 11 percent of older women and
20 percent of older men were college graduates. (See Indicator 4.)
Economics
Generally, the economic status of older
people has improved markedly over the past few decades. Poverty rates have
declined and there has been a substantial increase in net worth for many older
Americans. Still, major disparities exist, with older blacks and older women
reporting fewer financial resources.
The percentage of older persons
living in poverty declined from about 35 percent in 1959 to 11 percent in
1998. (See Indicator 6.)
In 1998, Social Security provided
over 80 percent of income for older Americans with the lowest levels of
income. For those in the highest income category, Social Security accounted
for approximately 20 percent of total income. (See Indicator 8.)
Between 1984 and 1999, the median net
worth of households headed by older persons increased by about 70 percent.
But there are large disparities in net worth. Households headed by older
black persons had median net worth of about $13,000 in 1999, compared with
$181,000 among households headed by older white persons. (See Indicator 9.)
Between 1963 and 1999, labor force
participation rates for men ages 62 to 64 declined from 76 percent to 47
percent, but participation rates increased from 29 percent to 34 percent for
women in this age group. (See Indicator 10.)
The burden of housing costs relative
to all expenditures declines as income increases. In 1998, low-income
households headed by persons age 65 or older allocated an average of 36
percent of all expenditures to basic housing, compared with high-income
households, which spent an average of 26 percent. (See Indicator 11.)
Health Status
The increase in life expectancy during
the 20th century has been a remarkable achievement. Older age, however, is
accompanied by increased risk of certain diseases and disorders. Significant
proportions of older Americans suffer from a variety of chronic health
conditions such as arthritis or hypertension. Despite these and other
conditions, the rate of disability among older people has declined in recent
years.
Americans are living longer than ever
before. If mortality rates remain constant, persons age 65 in 2000 are
expected to live another 18 years, on average, compared with persons age 65
in 1900 who had a remaining life expectancy of 12 years. Life expectancy at
age 65 is almost 2 years greater for whites than for blacks. (See Indicator
12.)
The leading causes of death for older
Americans are heart disease, cancer, and stroke (respectively). Mortality
rates for heart disease and stroke have declined by about a third since
1980. The mortality rates for cancer have risen slightly over the same
period. (See Indicator 13.)
In 1995, about 58 percent of persons
age 70 or older reported having arthritis, 45 percent reported having
hypertension, and 21 percent reported having heart disease. (See Indicator
14.)
In 1998, the percentage of older
Americans with moderate or severe memory impairment ranged from about 4
percent among persons ages 65 to 69 to about 36 percent among persons age 85
or older. About 23 percent of persons age 85 or older reported severe
symptoms of depression. (See Indicators 15
and 16.)
The percentage of older Americans
with a chronic disability declined from 24 percent in 1982 to 21 percent in
1994. In 1994, about 25 percent of older women reported disabilities,
compared with 16 percent of older men. (See Indicator 18.)
Health Risks and Behaviors
The social and behavioral aspects of life
for older Americans can make a difference in health and well-being. Most older
people report being socially active, which may contribute to their emotional and
physical health. However, other measured aspects of social and health behaviors
may threaten health, including the failure of many older adults to engage in
physical activity, to have healthy diets, or to be vaccinated against influenza
and pneumoccocal disease.
The majority of persons age 70 or
older reported engaging in some form of social activity during a two-week
period. About two out of every three persons age 70 or older reported that
they were satisfied with their level of social activities. (See Indicator
19.)
In 1995, about one third of older
Americans reported a sedentary lifestyle (i.e., no leisure-time physical
activities in a two-week period). (See Indicator 20.)
From 1994 to 1996, a higher
proportion of the population age 65 and older (21 percent) had diets that
were rated "good" compared with persons ages 45 to 64 (13
percent). Even so, a majority of older persons reported diets that were poor
(13 percent) or needed improvement (67 percent). (See Indicator 23.)
Older persons are much less likely to
be victims of both violent and property crime than persons ages 12 to 64.
(See Indicator 24.)
Health Care
Health care expenditures and use of
services among older people are closely associated with age and disability
status. There are large differences, for example, in health expenditures and use
of services between persons ages 65 to 69 and persons age 85 or older. Older
persons of all ages are generally satisfied with their health care and report
few difficulties in obtaining health care services.
In 1996, the average annual
expenditure on health care (both out-of-pocket expenditures and expenditures
covered by insurance) was $5,864 among persons ages 65 to 69, compared with
$16,465 among persons age 85 or older. (See Indicator 25.)
Although dollar expenditures increase
with income, the relative burden of health care costs is much higher among
lower- and middle-income households compared with higher income households.
(See Indicator 27.)
Among Medicare beneficiaries not
enrolled in HMOs (82 percent of all beneficiaries in 1998), the rate of
hospital admissions during the year increased from 307 per 1,000 in 1990 to
365 per 1,000 in 1998. However, the average length of stay in a hospital
declined from 9 days to 6 days during the same time period. (See Indicator
29.)
In 1997, about 1.5 million older
persons (4 percent of the population age 65 or older) resided in nursing
homes. This represents a decline since the mid-1980s in the proportion of
older people living in nursing homes. Three-fourths of nursing home
residents were women in 1997. Though a smaller proportion of older people
were residents of nursing homes in 1997 compared with 1985, those who were
in nursing homes were more likely to have serious functional limitations,
such as incontinence, difficulty eating, or mobility limitation. (See
Indicator 30.)
The percentage of older Americans
living in the community and receiving home care for disabilities declined
from 18 percent in 1982 to 15 percent in 1994. Of those who received care in
1994, 64 percent relied exclusively on informal (unpaid) care, 8 percent
received only formal care, and 28 percent received a combination of informal
and formal care. (See Indicator 31.)