Highlights

Older Americans 2008: Key Indicators of Well-Being is one in a series of periodic reports to the Nation on the condition of older adults in the United States. The indicators assembled in this chartbook show the results of decades of progress.  Older Americans are living longer and enjoying greater prosperity than any previous generation.  Despite these advances, inequalities between the sexes, and among income groups, and racial and ethnic groups continue to exist.  As the Baby Boomers continue to age and America’s older population grows larger and more diverse, community leaders, policymakers, and researchers will have an even greater need to monitor the health and economic well-being of older Americans.  In this report, 38 indicators (and one special feature) depict the well-being of older Americans in the areas of demographic characteristics, economic circumstances, overall health status, trends in health risks and behaviors, and cost and use of health care services.  Selected highlights from each section of the report follow.

Population

The demographics of aging continue to change dramatically. The older population is growing rapidly, and the aging of the “baby boomers,” born between 1946 and 1964 (and who begin turning age 65 in 2011), will accelerate this growth. This larger population of older Americans will be more racially diverse and better educated than previous generations. Another significant trend is the increase in the proportion of men age 85 and over who are veterans.

• In 2006, there were an estimated 37 million people age 65 and over in the United States, accounting for just over 12 percent of the total population. The older population in 2030 is expected to be twice as large as in 2000, growing from 35 million to 71.5 million and representing nearly 20 percent of the total U.S. population. (See “Indicator
  1: Number of Older Americans.”)     
• In 1965, 24 percent of the older population had graduated from high school, and only 5 percent had at least a bachelor’s degree. By 2007, 76 percent were high school graduates, and 19 percent had a bachelor’s degree or more. (See “Indicator 4: Educational Attainment.”)
• The number of men age 85 and over who are veterans has more than doubled between 1990 and 2000 from 150,000 to 400,000 and is projected to reach almost 1.2 million by 2010. The proportion of men age 85 and over who are veterans is projected to increase from 33 percent in 2000 to 60 percent in 2010. (See “Indicator 6: Older Veterans.”

Economics

Overall, most older people are enjoying more prosperity than any previous generation. There has been an increase in the proportion of older people in the high-income group and a decrease in the proportion of older people living in poverty, as well as a decrease in the proportion in the low-income group. Among older Americans, the share of aggregate income coming from earnings has increased since the mid–1980s, partly because more older people, especially women, continue to work past age 55. Finally, on average, net worth has increased almost 80 percent for older Americans over the past 20 years.  Yet major inequalities continue to exist with older blacks and people without high school diplomas reporting smaller economic gains and fewer financial resources overall.

• Between 1974 and 2006, there was a decrease in the proportion of older people with income below poverty from 15 percent to 10 percent and with low income from 35 percent to 26 percent; and an increase in the proportion of people with high income from 18 percent to       29 percent. (See “Indicator 8: Income.”)
• In 2005, the median net worth of households headed by white people age 65 and over ($226,900) was 6 times that of older black households ($37,800).  This difference is less than it was in 2003 when the median net worth of households headed by older white people was 8 times higher than that of households headed by older black people. (See “Indicator
  10: Net Worth.”)
• Labor force participation rates have risen among all women age 55 and over during the past four decades with a majority of the increase occurring after 1985. Labor force participation rates among men age 55 and over have gradually begun to increase after a steady decline from the early 1960s to the mid–1990s. (See “Indicator 11: Participation in the Labor Force.”)

Health Status

Americans are living longer than ever before, yet their life expectancies lag behind those  of other developed nations. Older age is often accompanied by increased risk of certain diseases and disorders. Large proportions of older Americans report a variety of chronic health conditions such as hypertension and arthritis. Despite these and other conditions, the rate of functional limitations among older people has declined in recent years.

Life expectancy at age 65 in the United States is lower than that of many other industrialized nations. In 2003 women age 65 in Japan could expect to live on average 3.2 years longer than women in the United States. Among men, the difference was 1.2 years. (See “Indicator 14: Life Expectancy.”)

The prevalence of certain chronic conditions differs by sex. Women report higher levels of arthritis (54 percent versus 43 percent) than men. Men report higher levels of heart disease (37 percent versus 26 percent) and cancer (24 percent versus 19 percent). (See “Indicator 16:      Chronic Health Conditions.”) Between 1992 and 2005, the age adjusted proportion of people age 65 and over with a functional limitation declined from 49 percent to 42 percent. (See “Indicator 20: Functional Limitations.”)

Health Risks and Behaviors

Social and lifestyle factors can affect the health and well-being of older Americans.  These factors include preventive behaviors such as cancer screenings and vaccinations along with diet, physical activity, obesity, and cigarette smoking.  Health and well-being is also affected by the quality of the air where people live and by the time they spend socializing and communicating with others. Many of these health risks and behaviors have shown long-term improvements, even though recent estimates indicate no significant changes.

• The proportion of leisure time that older Americans spent socializing and communicating—such as visiting friends or attending or hosting social events—declined with age. For Americans age 55–64, 13 percent of leisure time was spent socializing and communicating compared with 10 percent for those age 75 and over. (See “Indicator 28: Use of Time.”)
• There was no significant change in the percentage of people age 65 and over reporting physical activity between 1997 and 2006. (See “Indicator 24: Physical Activity.”)
• As with other age groups, the percentage of people age 65 and over who are obese has increased between 1988–1994 and 2005–2006, from 22 percent to 31 percent. However, over the past several years, the trend has leveled off, with no statistically significant change in obesity for older men or women between 1999–2000 and 2005–2006. (See “Indicator 25: Obesity.”)
• The percentage of people age 65 and over living in counties that experienced poor air quality for any air pollutant decreased from 55 percent in 2000 to 34 percent in 2006. (See “Indicator 27: Air Quality.”)

Health Care

Overall, health care costs have risen dramatically for older Americans.  In addition, between 1992 and 2004, the percentage of health care costs going to prescription drugs almost doubled from 8 percent to 15 percent, with prescription drugs accounting for a large percentage of out-of-pocket health care spending. To help ease the burden of prescription drug costs, Medicare Part D prescription drug coverage began in January 2006.

• After adjustment for inflation, health care costs increased significantly among older Americans from $8,644 in 1992 to $13,052 in 2004. (See “Indicator 30: Health Care Expenditures.”)
• In 2004, as in the 4 previous years, over one-half of out-of-pocket health care spending (excluding health insurance premiums) by community dwelling people age 65 and over was used to purchase prescription drugs (from 54 percent in 2000 to 61 percent in 2004). (See “Indicator 33: Out-of-Pocket Health Care Expenditures.”)
• The number of Medicare beneficiaries enrolled in Part D prescription drug plans increased from 18.2 million in June 2006 to 19.7 million in September 2007. In September 2007, two-thirds of enrollees were in stand-alone plans and one-third were in Medicare Advantage plans. In addition, approximately 6.5 million beneficiaries were covered by the Retiree Drug Subsidy in both years (See “Indicator 31: Prescription Drugs.”)

Special Feature: Literacy and Health Literacy

Many older Americans have difficulty navigating the health care system because of their low rates of health literacy.

• Older Americans are proportionately more likely to have below basic health literacy than any other age group.  Almost two-fifths (39 percent) of people age 75 and over have a health literacy level of below basic compared with 23 percent of people age 65–74, and 13 percent of people age 50–64. (See “Special Feature: Literacy and Health Literacy.”)

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