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Well-Being Improves for Most Older People, But Not For All, New
Federal Report Says
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. The public may view copies of the report on the
web site www.agingstats.gov.
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 future
updates.
"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. Highlights include:
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 over time.
| 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 income spectrum. |
| 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 declined. |
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 facilities.
| 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 Federal Forum on Aging-Related Statistics was established in 1986 to
foster collaboration among federal agencies that produce or use data on the
older population. The Forum is made up of nine federal agencies -- the
Administration on Aging, the Bureau of Labor Statistics, the Census Bureau, the
Health Care Financing Administration, the National Center for Health Statistics
of the Centers for Disease Control and Prevention, the National Institute on
Aging at the National Institutes of Health, the Office of the Assistant
Secretary for Planning and Evaluation (Department of Health and Human Services),
the Office of Management and Budget, and the Social Security Administration.
Other agencies contributing to "Older Americans 2000" are the Bureau
of Justice Statistics (Department of Justice), the National Highway Safety
Traffic Administration (Department of Transportation), and the Center for
Nutrition Policy and Promotion (Department of Agriculture).
The public may view copies of the report on the web site www.agingstats.gov.
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 nchsquery@cdc.gov.
Anyone wishing multiple printed copies of the report should contact Forum Staff
Director Kristen Robinson at (301) 458-4460 or send an e-mail request to kgr4@cdc.gov.
News media may view the report prior to the embargo date on a special web
site sponsored by the Forum. Please call media contacts to obtain more
information about access to that website or to get a printed copy of the
embargoed report.
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