Persons age 65 and over numbered more than 35 million in 2002, an increase of more than 10% over the previous decade. About 1 in every 8 Americans is in this age group; and by the year 2030, the elderly population is projected to more than double to 71.5 million.
Older women outnumber older men by nearly a third. Members of minority groups are projected to represent over one-quarter of the elderly in 2030, up from about 16% in 2000. About 3.6 million elderly lived below the poverty level in 2002, corresponding to a poverty rate of over 10%. Another 2.2 million, or more than 6% of the elderly, were classified as near poor, with incomes between the poverty level and 125% of this level.82
On average, 65-year-olds can expect to live an additional 18.1 years. In 2003, 38.6% of noninstitutionalized older persons assessed their health as excellent or very good compared with two-thirds of persons ages18-64. Older Blacks and Hispanics were less likely to rate their health as excellent or good than older Whites. Most older persons have at least one chronic condition. In 1997, more than half of the elderly reported a disability and over a third reported a severe disability.82
The Medicare program provides core health insurance to nearly all elderly Americans and reduces many financial barriers to acute and postacute care services. The Medicare Prescription Drug Improvement and Modernization Act of 2003 adds new prescription drug and preventive benefits to Medicare and provides extra financial help to persons with low incomes. Consequently, differences in access to and quality of health care tend to be smaller among Medicare beneficiaries than among younger populations. However, racial, ethnic, and socioeconomic differences are still observed.
Surveys of the general population often do not include enough elderly to examine racial, ethnic, or socioeconomic differences in health care. Consequently, the NHDR relies upon data from the Medicare Current Beneficiary Survey to examine disparities in access to and quality of care. Findings presented here highlight three quality measures and two access measures of particular importance to the elderly:
| Component of health care need: | Measure: |
|---|---|
| Prevention | Fecal occult blood test, dental care |
| Timeliness | Waiting 30 minutes or more to see a doctor |
| Access to care | Usual source of care, problems getting to the doctor |