Highlights
Today's older Americans
are living longer, healthier lives and enjoying greater prosperity than any
previous generation. The indicators of well-being included in this
chartbook reflect this progress and, at the same time, point out the inequalities that continue to
exist between the sexes, income levels, and racial and ethnic groups. As the
Baby Boomers continue to age and America's older population grows larger
and more diverse, community leaders, policymakers, and researchers will have an
even greater need to monitor the health and economic well-being of older
Americans.
Population
· In 2003, nearly 36 million people age 65 and over
lived in the United States, accounting for just over 12 percent of the total population. During the
20th century, the older population grew from 3 million to 35 million and is projected to grow to almost 87
million by 2050.(See
Indicator 1.)
· Women make up 58 percent of the population age 65 and
over and 69 percent of the population age 85 and over. Older women are less likely than older men to be
currently married and are twice as likely to live alone. (See Indicators
1,
3, and
5.)
· A majority of older men are veterans. Between 1990 and 2000, the proportion of
men age 65 and over who were veterans increased from 54 percent to 65 percent.
Although the number of older veterans is projected to decline slightly from
2000 to 2010, the number of veterans age 65 and over is projected to increase
again after 2010 as the large Vietnam era cohort ages. (See
Indicator 6.)
Economics
· The trend in median household income of the older population has been positive.
Between 1974 and 2002, the median house-hold income for people age 65 and over
increased (in 2002 dollars) from $16,882 to $23,152. Correspondingly, fewer
older people are living below the poverty threshold. The percentage of older
people living in poverty declined from 35 percent in 1959 to 10 percent in
2002. (See
Indicators 7 and
8.)
· In 2002, aggregate income for the population age 65 and over came largely from
four sources: Social Security (39 percent), earnings (25 percent), pensions (19
percent), and asset income (14 percent). Among older Americans in the lowest
fifth of the income distribution, Social Security accounts for 83 percent of aggregate income. For those whose income is in the
highest income category, Social Security accounts for approximately 20 percent
of total income. (See
Indicator 9.)
· Between 1984 and 2001, the median net worth of households headed by people age
65 and over increased by 82 percent (after accounting for inflation).
Although the rate of growth of wealth between 1984 and 2001 has been
substantial for both older black and older white households, large differences
continue to exist--the median net worth of older white households
($205,000) is five times larger than that of
older black households ($41,000). (See
Indicator 10.)
· The proportion of housing costs relative to all expenditures declines as income
increases. In 2002, households headed by people age 65 and over in the lowest
fifth of the income distribution allocated an average
of 40 percent of all expenditures to basic housing, while households in the
highest income category spent an average of 28 percent. (See
Indicator 12.)
Health Status
· Americans are living longer than ever before. In 1900, life expectancy at age 65 was
almost 12 years, and at age 85 it was 4 years. By 2001, life expectancy at age
65 had increased to more than 19 years for women and about 16 years for men,
and at age 85 it was 7 years for women and 6 years for men. Life expectancy
varies by race, but the difference decreases with age. At age 65, white people
can expect to live an average of nearly 2 years longer than black people, but
at age 85, black people have a slightly higher life expectancy. (See
Indicator
13.)
· In 2002, close to one-half of older men and nearly one-third of older women
reported trouble hearing without a hearing aid. Vision trouble (even with
glasses or contact lenses) affects 18 percent of the older population, 16
percent of men and 19 percent of women. In 2002, the proportion of people with
moderate or severe memory impairment ranged from approximately 5 percent among
people age 65-69 to 32 percent among people age 85 and over. The proportion of
older people with clinically relevant depressive symptoms was 11 percent for
older men and 18 percent for older women. (See
Indicators 16,
17, and
18.)
· The age-adjusted proportion of older Americans with a chronic disability
declined from 25 percent in 1984 to 20 percent in 1999. This proportion
declined for both older men (19 percent to 15 percent) and older women (28
percent to 23 percent). Despite the decline in rates, the number of older
Americans with chronic disabilities increased from about 6.2 million in 1984 to
6.8 million in 1999 as the size of the older population grew at a rapid enough
pace to outweigh the decline in the disability rates. (See
Indicator 19.)
· During the period 2000 to 2002, 73 percent of people age 65 and over rated
their health as good or better. This pattern was true for the decade preceding
2002 as well; the majority of older people reported their health to be good to
excellent. (See
Indicator 20.)
Health Risks and Behaviors
· In 2001-2002, 21 percent of people age 65 and over reported engaging in regular leisure time physical activity. The
percentage of older people engaging in regular physical activity was lower at
older ages, ranging from 26 percent among people age 65-74 to 9 percent among
people age 85 and over. (See
Indicator 24.)
· The increase in the prevalence of over- weight and obesity among older adults has been
dramatic. In 1999-2002, 69 percent of Americans age 65 and over were over-weight, and 30 percent were obese. In the last 2 decades, the increases among
class=GramE>those age 65-74 have been especially striking. Between 1976-1980 and 19992002, the percentage of people age 65-74 who were overweight
rose from 57 percent to 73 percent; the percentage who were obese rose from 18 percent to 36 percent. (See
Indicator 25.)
· The percentage of older men who are current cigarette smokers declined from 29 percent in 1965 to 10 percent in 2002. The corresponding percentage for women
has remained relatively constant, declining slightly from 10 percent in 1965 to 9 percent in 2002.
(See
Indicator 26.)
· The air pollutants that have the greatest potential to affect the health of older adults are ozone and fine particulate matter
(PM 2.5). In 2002, 46 percent of people age 65 and over lived in a county where ozone concentrations reached levels that were above the EPA standards compared
with 26 percent in 2000. About 19 percent of people age 65 and over lived in a county where PM 2.5 concentrations reached levels that were at times above EPA
standards, compared with 27 percent in 2000. (See
Indicator 27.)
Health Care
· Health care costs increased
significantly between 1992 and 2001 among older
Americans enrolled in Medicare (after adjusting for inflation).
Average costs were substantially higher for people with lower incomes, for
people at older ages, and for people with multiple chronic conditions. The mix
of health care services (and their associated costs) varied with age. For
example, average costs for nursing home and long-term institutional services
were much higher among people age 85 and over than among those age 65-74. (See
Indicator 29.)
· Most older people enrolled in Medicare are generally satisfied with their health care and report few difficulties
in obtaining health care services. The percentage who reported they delayed getting care because of cost declined from 10 percent in 1992 to 5 percent in
1997 and remained relatively constant thereafter. (See
Indicator 29.)
· Average prescription drug costs for older Americans increased rapidly throughout the
1990s, especially after 1997. Average costs per noninstitutionalized
Medicare enrollee age 65 and over were $1,340 in 2000. The average number of filled prescriptions for this population also rose
substantially over time, averaging 18 prescriptions in 1992 and 30 in 2000.(See
Indicator 30.)
· Medicare pays for slightly more than one-half (54 percent) of the overall health care
costs for its enrollees age 65 and over. This population pays 21 percent of their health care costs out of pocket. Medicaid covers 10 percent of their
health care costs (including 46 percent of nursing home costs), and other
payers (primarily private insurers) cover another 15 percent. Lower-income
individuals pay a lower percentage of health care costs out of pocket but use
more services than individuals with higher incomes. (See
Indicator 33.) The
percentage of noninstitutionalized people age 65 and over with out-of-pocket spending for health care
services increased between 1977 and 2001--from 83 percent to 95 percent (See
Indicator 32.)
· An increasing number of older veterans are turning to the Veterans Health Administration
(VHA) for their health care needs despite their potential eligibility for other sources of health care.
In 2003, approximately 2.3 million veterans age 65 and over received health care from VHA, and an additional
1 million older veterans were enrolled to receive health care from VHA but did not use its services that
year. (See
Indicator 34.)
· The age-adjusted rate of nursing home residence among the older population declined
from 54 per 1,000 in 1985 to 43 per 1,000 in 1999. Despite this decline, the number of current nursing home
residents has increased--from 1.3 million in 1985 to 1.5 million in 1999--because of the growth of the older
population. (See
Indicator 35.)
· In 2002, 2 percent of the Medicare population age 65 and over resided in community
housing with at least one service available, such as meal preparation, housekeeping
services, laundry services, and help with medications. Approximately 5 percent
resided in long-term care facilities. Residents of community housing with
services had more limitations in activities of daily living than those in
traditional community housing but fewer than residents of long-term care
facilities. (See
Indicator 36.)