||Well-Being Improves For Most Older People
But Not For All
Older Americans are living longer and living better than
ever before. But many of those age 65 and older face
disability, chronic health conditions, or economic stress,
according to a new federal indicators report that describes
the status of the nation's older population. This is the
first in a continuing series planned by the Federal
Interagency Forum on Aging-Related Statistics, a consortium
of U.S. government agencies working together to improve the
quality and usefulness of data on older Americans.
The global population is aging at a rate unprecedented in
history. In the U.S., the population age 65 and older is
expected to double by 2030. The Forum developed the report,
"Older Americans 2000: Key Indicators of Well-Being," to
regularly track trends as society and individuals look for
ways to address the aging boom. Today's report, which brings
together information from more than a dozen national data
sources for the first time, will serve as a baseline for
"Americans age 65 and older are an important and growing
segment of our population. While many federal agencies
provide data on this diverse population, it is sometimes
difficult to understand how this group is faring. For the
first time, the federal statistical system has come together
to provide a unified picture of the overall health and well-
being of older Americans," says Katherine K. Wallman, Chief
Statistician, U.S. Office of Management and Budget.
The 128-page report covers 31 key indicators carefully
selected by the Forum to portray aspects of the lives of
older Americans and their families. The report is divided
into five subject areas: population, economics, health
status, health risks and behaviors, and health care.
- Population -- The Number And Proportion Of Older People In
The U.S. Population Have Grown And Generally Will Continue
To Grow At A Very Rapid Pace. Aging In The 21st Century Will
Be Characterized By A Steep Rise In The Population Age 85
And Older And Increased Racial And Ethnic Diversity.
- The number of older people in the U.S. has increased ten-
fold since 1900. Today, an estimated 35 million people, 13
percent of the population, are age 65 and older. By 2030,
20 percent of Americans, about 70 million, will have passed
their 65th birthday. The population age 85 and above is
currently the fastest growing segment of the older
population; its growth is particularly important for
anticipating health care and assistance needs, because these
individuals tend to be in poorer health and require more
services than people below age 85.
- The racial and ethnic makeup of the U.S. is changing, and
the older population is no exception. In 2000, an estimated
84 percent of the population age 65 and older is non-
Hispanic white, 8 percent non-Hispanic black, 6 percent
Hispanic, 2 percent non-Hispanic Asian and Pacific Islander,
and less than 1 percent non-Hispanic American Indian and
Alaska Native. By 2050, those proportions are projected to
be substantially different: 64 percent of the older
population is expected to be non-Hispanic white, 16 percent
Hispanic, 12 percent non-Hispanic black, and 7 percent non-
Hispanic Asian and Pacific Islander, with the non-Hispanic
American Indian and Alaska Native populations remaining at
less than 1 percent.
- Today's older Americans are better educated than their
counterparts 50 years ago, a factor that can positively
influence socioeconomic status and health. In 1998, a high
school diploma was held by some 67 percent of older
Americans, compared with just 18 percent in 1950. About 15
percent of older Americans had earned at least a bachelor's
degree in 1998, increasing from 4 percent in 1950.
- Economics -- The Economic Picture For Most Older Americans
Is Improving. But There Are Also Significant Disparities In
Income And Wealth. Poverty Has Dropped Dramatically, But
Rates Are Still Very High For Some Groups. Social Security
Benefits And Pensions Have Taken On Greater Importance.
Overall, The Net Worth Of Older Americans Also Has Increased
- In 1998, 11 percent of older Americans had incomes below
the poverty threshold, compared to 35 percent in 1959. The
proportions of the older population in poverty vary,
however, by age, gender, and race and ethnicity. For
example, the poverty rate is highest at older ages -- 14
percent for people age 85 and older, compared with 9 percent
for people ages 65 through 74. It is higher among older
women (13 percent) than older men (7 percent). And it is
higher for minorities than non-Hispanic whites; for example,
divorced black women ages 65 through 74 had a poverty rate
of 47 percent in 1998, among the highest for any subset of
older people. On the other end of the income spectrum,
almost two-thirds of the older population experienced medium
and high incomes in 1998, compared with about half in 1974.
- The importance of Social Security to the lowest-income
elderly cannot be overestimated. It accounts for some 80
percent of income for people in the lowest two-fifths of the
- Net worth (the value of real estate, stocks, bonds, and
other assets minus outstanding debts), an important measure
of economic security, has increased in recent years.
Estimates of the amount of the increase vary, but in one
survey, median net worth among households headed by older
people jumped 69 percent between 1984 and 1999. However,
there is a large disparity in net worth between older black
and white households.
- Health Status -- Older Americans Are Living Longer And
Feeling Better. An Overwhelming Majority Rate Their Health
As Good Or Excellent. Men And Women Report Comparable
Levels Of Well-Being. Disability Rates Are Declining As
Well. But Large Numbers Of Older People Find Their Health
Threatened By Memory Impairments, Depression, Chronic
Conditions, And Disability, Especially At Very Advanced
Ages, Which Can Substantially Diminish Quality Of Life.
- Americans born at the beginning of the 21st century are
expected to live almost 30 years longer than those born at
the turn of the 20th century. In 1997, a newborn baby girl
could expect to live 79 years and a boy 74 years, compared
to 51 years for a girl and 48 years for a boy born in 1900.
Life expectancy varies by race, however. The average life
expectancy for a white baby born in 1997 was 6 years higher
than for a black baby born in the same year.
- Chronic disease, memory impairment, and depressive
symptoms affect large numbers of older people, and the risk
of such problems often increases with age. In 1995, almost
60 percent of people age 70 and older report having
arthritis, up slightly from the proportion reporting
arthritis in 1984. The prevalence of arthritis and other
chronic diseases, such as hypertension, heart disease,
cancer, diabetes, and stroke are also reported, and vary by
race and ethnicity. Increases in memory impairment and
depressive symptoms occur with advancing age: one-third or
more of men and women age 85 and older have moderate or
severe memory impairment and 23 percent of this group
experience severe depressive symptoms.
- Despite the prevalence of illness or chronic conditions,
the proportion of Medicare beneficiaries age 65 and older
with a chronic disability was 21 percent in 1994, down from
24 percent in 1982. During this time period, the older
population grew significantly, and the number of older
people estimated to have functional limitations increased by
600,000. This was considerably fewer, however, than the 1.5
million increase projected had disability rates not
- Health Risks And Behaviors -- Social And Behavioral Aspects
Of Life Can Make A Difference In Health And Well-Being.
Most Older People Describe Themselves As Socially Active,
Which May Enhance Their Physical And Emotional Health. But
Others Report Choices And Behaviors, Such As The Failure To
Engage In Physical Activity Or To Keep Up With Vaccinations,
That Could Interfere With Health And Independence.
- A large majority of older people report social contacts
with friends, neighbors, and relatives or engaging in
activities, such as going out to restaurants. The
proportion of older Americans engaged in physical activity
is increasing: between 1985 and 1995 the percentage who
were sedentary decreased from 34 percent to 28 percent for
men and 44 percent to 39 percent for women.
- From 1989 through 1995, the proportion of older people who
were vaccinated against influenza and pneumonia increased,
but reached the 60 percent coverage target set by Healthy
People 2000 for only one group, non-Hispanic whites
vaccinated against influenza. An increasing trend also
holds true for older women getting mammograms; 55 percent of
older women in 1994 reported having had a mammogram in the
previous two years, compared with 23 percent in 1987.
- Health Care -- Older People Report Being Generally Satisfied
With Health Care Quality And Access. Average Costs Have Not
Risen Steeply During The 1990s. The Cost Of Health Care And
Use Of Services Is Closely Associated With Age And
Institutional Status, With Higher Expenditures Incurred By
The Oldest Americans And Those Living In Long-Term Care
- Between 1992 and 1996, there was a slight increase in
average inflation-adjusted annual health care expenditures
(both public and private) for older Americans. In 1996, the
average annual expenditure was $5,864 for people age 65
through 69, rising to $16,465 at age 85 and older. In 1996,
69 percent of noninstitutionalized Medicare beneficiaries
had some type of private or public coverage for prescription
drugs, while 31 percent did not. Out-of-pocket expenditures
for prescription drugs were 83 percent higher for those not
covered than for those with coverage.
- People age 85 and older are the most likely Americans to
live in nursing homes. In 1997, only 11 people per 1,000 age
65 through 74 lived in a nursing home, compared with 192
people per 1,000 among those age 85 and older. About three-
fourths of nursing home residents are women, roughly equal
to their representation in the population age 85 and older.
People in nursing homes today are more functionally impaired
than their counterparts in previous years. The percentage of
nursing home residents who were incontinent, who needed help
with eating, or who were dependent on others for mobility
increased slightly between 1985 and 1997.
- For those who receive home care, the nature of assistance
may be changing. Most home care is provided informally by
family, friends, and the community, as it has been for quite
some time. But since the 1980s, the use of informal support
as an exclusive means of help appears to be declining. The
percentage of older people receiving only informal care
dropped from 74 percent in 1982 to 64 percent in 1994, while
the use of combined formal and informal care increased from
21 percent to 28 percent during the same time period.
- Beyond the specific indicators, the Forum's report also
examines areas where research and data efforts need to be
improved. Among the recommendations are extending age
reporting categories to more specifically incorporate upper
age ranges in federal data collection efforts, improving the
way data are collected to measure income and wealth,
strengthening measures of disability, and gathering
information to understand the reasons for improvements in
life expectancy and function.
The public may download a copy of the report from today's Vidyya. Single printed copies of "Older Americans 2000: Key Indicators of Well-Being" are available from the National Center for Health Statistics, at (301) 458-4636 or by sending an e-mail request to email@example.com.
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Editor: Susan K. Boyer, RN
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