New portrait of older adults emerges from federal report

Liz Seegert

About Liz Seegert

Liz Seegert (@lseegert), is AHCJ’s topic editor on aging. Her work has appeared in NextAvenue.com, Journal of Active Aging, Cancer Today, Kaiser Health News, the Connecticut Health I-Team and other outlets. She is a senior fellow at the Center for Health Policy and Media Engagement at George Washington University and co-produces the HealthCetera podcast.

Photo: thinkpanama via Flickr

Today’s older population is mostly better off than prior generations when it comes to health and poverty, and they’re also living longer. But incidence of chronic conditions is up, and older adults today spend proportionally more of their income on health care.

These are some of the latest findings from the 2016 edition of Older Americans: Key Indicators of Well Being, from the Federal Interagency Forum on Aging-Related Statistics.  The report takes a close look at older adults in the United States as they live longer and face new economic, health care, and residential living challenges. Forty-one key indicators encompassing population, economics, health status, health risks and behaviors, health care, and environment are detailed. There also is a special feature this year on informal caregiving. The following are some highlights.

The Older Population Is Growing

There were 46 million people age 65 and older, about 15 percent of the population, living in the U.S. in 2014. By 2030, that will jump to 74 million people, or about 21 percent of the population. Older women now comprise 56 percent of those 65 and older, and 66 percent of those 85 and older. Women also were more likely to live alone.

The “oldest-old” population will increase rapidly, as more baby boomers reach age 85. The U.S. Census Bureau predicts that the 85-plus population could grow from 6 million in 2014 to 20 million by 2060.

About 1.2 million people age 65 and older were residents of nursing homes in 2014. In the same year, nearly 780,000 of those age 65 and older lived in residential care communities such as assisted living facilities. People age 85 and older were the largest share, by age group, of residents in both settings.

Economic Gains For Some

Older Americans are generally in better economic shape now than they were four decades ago. In 1974, the proportion of older people with income below the poverty threshold was 15 percent; in 2014, it fell to 10 percent. Women were more likely than men to be poor.

Between 1983 and 2013, the median net worth, (including retirement investment accounts), of households headed by people age 65 and older rose from $116,500 to $210,500 (2013 dollars). But the median net worth of white elders was almost five times that of blacks ($225,000 vs. $56,700).

Rising Health Costs, Declining Death Rates

Many Americans enjoy longer lives with some functional limitations. Twenty-two percent of the population age 65 and older report at least one limitation related to vision, hearing, mobility, communication, cognition or self-care.

Diet is a concern for the older population. Overall diet quality, as measured by the Total Healthy Eating Index-2010 score was 68 out of 100 for people age 65 and older. As with other age groups, obesity remains a challenge. In the 2011–2014 perod, about 35 percent of people age 65 and older were obese, compared with 22 percent in 1988–1994.

Life expectancy is increasing. An adult who survives to age 65 can expect to live an average of 19.3 more years. At age 85, women are expected live an average of 7 more years, and men approximately 5.9 more years.

People are living longer with chronic diseases. Between 1999 and 2014, the age-adjusted death rates for all causes of death among older adults dropped by 20 percent. Death rates from heart disease, cancer, chronic lower respiratory disease, diabetes, stroke and influenza and pneumonia declined. Instances of Alzheimer’s disease and unintentional injuries increased over the same period, however. Men under age 75 were more likely to have dementia than women, but after age 85, women were more likely to have the disease.

Management of multiple chronic conditions – which affects the majority of older adults – impacts frailty and disability. Men reported higher levels of heart disease, cancer, and diabetes than did women. Women had higher levels of asthma and arthritis.

Health care spending as a share of total expenditures, increased dramatically with age. In 2014, those 75 and older spent more than twice that of those age 45-54. (16 percent to 7 percent). Inflation-adjusted costs were substantially higher for those age 85 and over compared with the “young-old.” Outpatient hospital and physician services were the largest components of health care costs, accounting for 35 percent in 2012.

Prescription Drug Costs

The cost of prescription drugs factors heavily into wellness. Average prescription drug costs for non-institutionalized older adults increased rapidly for many years but were relatively stable from 2005 to 2012. On average, seniors spent $3,201per person in 2012, but those with five or more chronic conditions spent $8,263.

Family Caregiving

This year’s report includes a special section addressing the issues and challenges of family caregiving. The report cites 2011 statistics of 18 million informal caregivers providing 1.3 billion monthly care hours. Newer figures from RAND tallies the cost at $43.5 billion/month for 2.5 million hours and AARP found that approximately 34.2 million Americans have provided unpaid care to an adult age 50 or older in the prior 12 months.

While many informal caregivers cite the positive aspects of their role, almost half said they’re overwhelmed and cannot handle certain aspects or don’t have enough time for themselves. Almost half of caregivers were adult children and about 21 percent were spouses. Women were more likely than men to provide medical and self-care. Men tended to assist with mobility.

The report is loaded with many more facts and figures, painting a vivid portrait of our increasingly older population.  If you want to explore the data further, downloadable Excel files are available for each main category.

Journalists: How does your state, city, or community compare to the national data?

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