New report details growth shifting ethnic, racial makeup of older adults

Liz Seegert


Row of older men sitting on a bench
Photo: Carlos Ebert via Flickr

One in seven Americans is now 65 or older, comprising an increasing share of the U.S. population, according to the latest Profile of Older Americans. The annual summary of vital statistics from the Administration on Community Living (ACL) illustrates the shifting demographics of community-dwelling elders, including income, living arrangements, education, health, and caregiving. The summary also includes special sections on COVID-19 and mental health.

The report is based primarily on data from the U.S. Census Bureau, the National Center for Health Statistics and the Bureau of Labor Statistics. They found:

  • 54.1 million people (30 million women and 24.1 million men) were 65 or older in 2019 — about 16% of the population
  • The older cohort increased 14.4 million (36%) since 2009
  • In comparison, the under-65 population increased by 3%
  • By 2040, the share of the older population is expected to climb to 21.6% (80.8 million) of all Americans

The racial and ethnic makeup of the population is changing, too:

  • One in four elders identified as a member of a racial or ethnic minority group.
  • Between 2019 and 2040, the white (non-Hispanic) population 65 and older is projected to increase by 29%.
  • In comparison, racial and ethnic minority populations are expected to increase 115%
  • Hispanic by 161%
  • African American (non-Hispanic) by 80%
  • American Indian and Alaska Native (non-Hispanic) by 67)
  • Asian American (not Hispanic) by 102%

And, the age of the older population itself is increasing. Compared to the population in 1900, the population in 2019:

  • was more than 14 times larger (31.5 million vs. 2.196 million) in the 65–74 age group
  • was 20 times larger (16 million vs. 771,000) among 75–84 year-olds
  • was more than 53 times larger (6.6 million vs. 122,000) in the 85+ group

The number of centenarians is also increasing. More than 100,000 people were over 100 in compared with about 32,000 in 1980.

Most elders live in just a handful of states. However, in 2019, just over half (51%) of those 65 and older lived in nine states:

  • California (5.8 million)
  • Florida (4.5 million)
  • Texas (3.7 million)
  • New York (3.3 million)
  • Pennsylvania (2.4 million)
  • Ohio (2 million), Illinois (2 million)
  • Michigan (1.8 million)
  • North Carolina (1.8 million)

The most significant proportion of older residents per total population live in Maine (21%), Florida (21%), West Virginia (20%) and Vermont (20%).

Health care costs continue to climb. Consumers in this age group averaged out-of-pocket health care expenditures of $6,833 in 2019, up 41% from 2009. In 2019, 22.3% of the population aged 65 to 74 assessed their health as fair or poor compared to 29.3% of the population age 75+. Leading chronic conditions among adults age 65 and older in 2019 include:

  • arthritis (48%)
  • coronary heart disease (14%)
  • myocardial infarction (9%)
  • angina (4%)
  • any cancer (25%)
  • COPD, emphysema, or chronic bronchitis (10%)
  • stroke (9% in 2017- 2018)
  • physician-diagnosed and undiagnosed diabetes (29% in 2015-2018)

Physical issues were of concern as well. In 2019, 19% of adults 65 and older said they could not function at all or had a lot of difficulty with at least one of six domains: vision, hearing, mobility, communication, cognition or self-care. The good news is that nearly all (96%) people said they had a usual place to go for medical care, and only 3% said that they failed to obtain needed medical care during the previous 12 months due to cost.

Income remains low. From 2018 to 2019, the real median income (after adjusting for inflation) of all households headed by older people increased by 6.5%, which was statistically significant. Yet median income remained low, at $27,398 ($36,921 for men and $21,815 for women). Older homeowners fared slightly better, with a median income of $36,200 in 2019.

The poverty rate declined among older adults between 2018 and 2019 (from 9.7% to 8.9%); however, nearly 1 in 10 older people (4.9 million) live below the poverty level. Another 2.6 million were considered “near-poor.” Poverty rates were highest for older adults living in:

  • New Mexico (13.5%)
  • District of Columbia (13.3%)
  • Louisiana (13.2%)
  • Mississippi (13.2%)
  • New York (12%)
  • Kentucky (11.6%)
  • Florida (10.7%)
  • Texas (10.6%)
  • Alabama (10.5%)
  • Arkansas (10.5%)
  • California (10.5%)
  • Georgia (10.4%)
  • South Carolina (10.1%)

Perhaps not surprisingly, a higher proportion of African American, Asian American, and Hispanic elders were poor than their white counterparts. In addition, more older women than men and more people who lived alone than with family were also poor.

Many older adults still work — by choice or by necessity. In 2020, 9.8 million Americans age 65+ were in the labor force (working or actively seeking work). This is a decrease from the 10.7 million (20.2%) older adults in the labor force in 2019. However, the report also noted that at the start of COVID-19 — between March and April 2020 — the unemployment rate for adults age 65+ more than quadrupled.

This increase in unemployment rates for older adults reverses years of increasing numbers of older adults remaining in or returning to the labor force, according to the report. As of April 2021, the unemployment rate for the 65+ group was 5.5%, down from 15.3% at the same time in 2020.

Mental health among older people remains a concern. In 2019, 13% of people age 65 and older reported taking prescription medicine for feelings of worry, nervousness, or anxiety and 12% reported taking prescription medicine for depression. COVID-19 has taken a toll on mental health as well, with older adults reporting an increase in symptoms of anxiety or depression. Among those age 80 and older, this increase occurred most dramatically between late 2020 and early 2021. However, compared with younger age groups, a smaller percentage of older adults 60 and older reported symptoms of anxiety or depression.

The mental effects of the pandemic continue. Recent surveys show:

  • 21% of Medicare beneficiaries reported feeling more lonely or sad (25% women, 14% men)
  • 15% of Medicare beneficiaries reported feeling less financially secure (16% women, 13% men)
  • 38% of Medicare beneficiaries reported feeling less socially connected to family and friends (42% women, 33% men)

There’s a wealth of story ideas in the report for journalists. For example, you can compare your state to others in terms of population, poverty rates or health costs. What programs are in place to help older people find jobs? How is your state addressing poverty among older people in times of tightening budgets? And, what are they doing to help older people cope with the serious issues of anxiety, depression, loneliness and social isolation?

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Liz Seegert

Liz Seegert

Liz Seegert is AHCJ’s health beat leader for aging. She’s an award-winning, independent health journalist based in New York’s Hudson Valley, who writes about caregiving, dementia, access to care, nursing homes and policy. As AHCJ’s health beat leader for aging,