Prevalence of chronic disease is on the rise, and the ability to afford nursing home care is declining among older adults, according to a new report from the U.S. Census Bureau commissioned by the National Institutes of Health.

The report,  65+ in the United States: 2010,  highlights several trends among America’s older population. There are more than 40 million people over age 65. That figure is expected to more than double by mid-century, to 83.7 million people and one-fifth of the U.S. population by 2050. The report presents population trends among older adults, as well as data on life expectancy,  how well they age, their financial and educational status, medical,  long-term care and housing costs, where they live and with whom, and other factors important for aging and health.

According to the NIA, a key aspect of the report is the effect that the aging of the baby boom generation will have on the U.S. population and on society in general. Baby boomers began to reach age 65 in 2011; between 2010 and 2020, the older generation is projected to grow more rapidly than in any other decade since 1900.

The report points out some critical health-related issues:

• Rates of smoking and excessive alcohol consumption have declined among those 65 and older, but the percentage of overweight and obese people has increased. Between 2003-2006, 72 percent of older men and 67 percent of older women were overweight or obese. Obesity is associated in increased rates of diabetes, arthritis, and impaired mobility, and in some cases with higher death rates.
• Research based on NIA’s Health and Retirement Study suggests that the prevalence of chronic diseases, such as high blood pressure, heart disease, chronic lung disease, and diabetes, increased among older people between 1998 and 2008. For example, in 2008, 41 percent of the older population had three or more chronic conditions, 51 percent had one or two, and only 8 percent had no chronic conditions.
• The cost of long-term care varies by care setting. The average cost of a private room in a nursing home was $229 per day or $83,585 per year in 2010. Less than one-fifth of older people have the personal financial resources to live in a nursing home for more than three years and almost two-thirds cannot afford even one year. Medicare provides coverage in a skilled nursing facility to older and disabled patients for short time periods following hospitalization. Medicaid covers long-term care in certified facilities for qualifying low-income seniors. In 2006, Medicaid paid for 43 percent of long-term care.

“Most of the long-term care provided to older people today comes from unpaid family members and friends,” Richard Suzman, director of the Division of Behavioral and Social Research at NIA said in a press release. “Baby boomers had far fewer children than their parents. Combined with higher divorce rates and disrupted family structures, this will result in fewer family members to provide long-term care in the future. This will become more serious as people live longer with conditions such as cancer, heart disease and Alzheimer’s.”

Other highlights include:

• The older population has become more racially and ethnically diverse, with those identifying their race as white alone comprising 84.8 percent in 2010, down from 86.9 percent in 2000.
• Over 38 percent of those aged 65 and over had one or more disabilities in 2010, with the most common difficulties being walking, climbing stairs and doing errands alone.
• The share of the older population residing in skilled nursing facilities declined from 4.5 percent in 2000 to 3.1 percent in 2010. The share in other long-term care facilities, such as assisted living, has been growing.
• Medicaid funds for long-term care have been shifting away from nursing homes with funding for home- and community-based services increasing from 13 percent of total funding in 1990 to 43 percent in 2007.
• Eleven states had more than 1 million people aged 65 and older in 2010.
• States with the highest proportions of older people in their populations in 2010 included Florida, West Virginia, Maine, and Pennsylvania (all above 15 percent).
• The West and South regions experienced the fastest growth in their 65-plus and 85-plus populations between 2000 and 2010.
• In 2010, more than 7 out of 10 older Hispanics lived in four states: California (26.9 percent), Texas (19.2 percent), Florida (15.7 percent), and New York (9.0 percent).