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May
2006 is Older Americans Month |
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The United States is on the brink of a
longevity revolution.1
In 2004, there were 36.3 million
Americans ages 65 and over, making up 12% of the population. By
2050, the U.S. Census Bureau projects that number will have more
than doubled to 86.7 million, making up 21% of the population at
that time.2
The composition of America’s older population is also shifting.
In 2003, 82.5% of Americans aged 65 and over were non-Hispanic white; by
2050 non-Hispanic whites are projected to make up about 61.3% of the
population. The older Hispanic/Latino population is growing at
the fastest rate: in 2003 only 5.7% of older adults were of Hispanic
origin and by 2050 they will account for 17.5% of the older adult
population.3 |
United
States Population Ages 65+
by Race and Hispanic Origin,
2003 (estimated) & 2050 (projected) |
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Non-Hispanic White |
African American |
Hispanic/Latino |
Asian American |
Other |
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It used to be accepted wisdom that
disability and ill-health were just part of getting older. No
longer. As America ages, we’ve learned that people can stay active
and healthy well into older years – and the more active they stay,
the healthier they will be. Many chronic diseases can be prevented
or postponed through healthy lifestyles, physical activity, getting
recommended screenings and appropriate follow-up, and meaningful
social engagement.4 |
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EXAMPLES OF IMPORTANT HEALTH DISPARITIES |
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Chronic Conditions |
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In 2003, 25.5% of adults aged 65 and older
reported their health as “fair or poor,”
compared to only 5.6% of adults aged 18-44.5
Older adults also report more activity limitations due to chronic
diseases than adults aged 18-44 (34.6% vs. 6.0%.6 |
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In 2001-2002, among people aged 65 years
and older, non-Hispanic blacks reported higher levels of hypertension than non-Hispanic whites (66% compared with 49%
for hypertension).3 |
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In 2002, 8.6 million Americans aged 60
years and older had diabetes (18.3%),
2.1 times more prevalent than among Americans aged 20 years and over
(18.2 million, or 6.3%).7
In 2001-2002, among people aged 65 years
and over, non-Hispanic blacks reported higher levels of diabetes
than non-Hispanic whites (23% compared with 14%). Hispanics
also reported higher levels of diabetes than non-Hispanic whites
(24% compared with 14%).3 |
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In 2003, 52% of adults 75 years and over
reported a doctor's diagnosis of arthritis, compared to 7.8% of
adults aged 18-44, 28.8% aged 45-64, and 46.2% aged 65-74.8 |
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Older women report more depressive
symptoms than older men. In 2002, 18% of women aged 65 years
and older reported depressive symptoms compared with 11% of men.3 |
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In 2000, approximately 4.5 million
Americans had Alzheimer's disease. By 2050 the number of
individuals with Alzheimer's could range from 11.3 million to 16
million.9
In 2002, Alzheimer’s disease accounted
for 2.6% of deaths from white Americans, making it the 8th leading
cause for this group. It is not among the top ten causes of death
for any other racial or ethnic group.16 |
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In 2002, 46% of people aged 65 years and
over with family income below the poverty line reported having no natural
teeth, compared with 27% of people above the poverty threshold.3 |
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Cancer and Early
Detection |
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In 2003, Adults aged 75+ were 2.7 times
more likely to have any type of cancer (21.6%) than persons aged
45-64. Adults aged 65-74 were 2.3
times more likely to have any type of cancer (18.0%) than those aged
45-64 (7.9%).10 |
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In 2000, 55% of women aged 65 years and
older living below the poverty level reported having had a mammogram
compared with 70% of older women living above the poverty level.
In 2000, 58% of women aged 65 years and older without a high school
diploma reported having had a mammogram in the preceding 2 years
compared with 72% of women who had a high school diploma and 74% of
women who had some college education.3 |
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In 2003, Asian American women were least
likely to have had a mammogram in the past two years (58.8%)
compared with non-Hispanic whites, African Americans (both 70.4%),
Hispanics/Latinas (66.1%), and American Indian/Alaska Natives
(68.6%).11 |
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Preventive
Measures |
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In 2001-2002, men aged 65 years and over
were more likely than women in the same age group to report engaging
in regular leisure time physical activity (26% and 18%,
respectively). Older non-Hispanic white adults report higher
levels of physical activity than non-Hispanic black adults or Hispanics
(23% compared with 14% for Hispanics and 13% for non-Hispanic
blacks).3 |
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In 2002, 66% of people aged 65 years and
older reported receiving a flu shot in the past 12 months; 69% of
non-Hispanic whites reported receiving a flu shot compared with 50%
of non-Hispanic blacks and 49% of Hispanics. Despite recent
increases in pneumonia vaccination rates for all groups,
non-Hispanic whites were more likely to have received a pneumonia
vaccination (60%) compared with non-Hispanic blacks (37%) or
Hispanics (27%).3 |
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PROMISING INTERVENTION STRATEGIES |
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Research has shown that poor mental and physical health and loss of independence are not inevitable consequences
of aging. The following strategies have proven effective in
improving the health of older adults: |
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Healthy lifestyles. Research has shown
that healthy lifestyle behaviors, such as being physically active,
eating a healthy diet, and not smoking, are more influential than genetic factors in
helping older people avoid the deterioration traditionally
associated with aging. |
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Early detection of diseases. Screening to
detect chronic diseases early in their course, when they are most
treatable, can save many lives; however, many older adults have not
had all of the recommended screenings covered by Medicare. |
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Immunizations.
About 36,000 people aged 65 or older die each year of influenza and
invasive Pneumococcal disease. Immunizations can reduce a
person’s risk for hospitalization and death from these diseases. |
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Injury prevention.
Falls are the most common cause of injuries to older adults. More
than one-third of adults aged 65 or older fall each year, and of
those who fall, 20% - 30% suffer moderate to severe injuries that
decrease mobility and independence. |
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Self-management techniques. Programs to
teach older adults self-management techniques can reduce both the
pain and costs of chronic disease. For example, people with
arthritis can learn practical skills such as how to manage their
pain, how to deal with fatigue and stress, and how to develop a
personal exercise program.12 |
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However, these preventive measures are
not reaching many individuals belonging to a racial or ethnic
minority group. While much is known about how to prevent disease and
preserve function among older adults, significant disparities exist
both in the incidence and prevalence of diseases and conditions, and
the extent to which effective preventive measures reach these
individuals.13 |
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Older Adult Health - Programs
and Accomplishments
Centers for Disease Control and Prevention (CDC) |
| The dramatic aging of the
U.S. population, coupled with the growing proportion of racial and
ethnic minority groups, compels an enhanced emphasis on addressing
the health-related needs of older adults, with tailored strategies
for individuals within these groups. The Centers for Disease
Control and Prevention (CDC), together with its sister federal
agencies (e.g., Administration on Aging, National Institute on
Aging), are working to ensure that proven prevention strategies to
promote health and preserve independence in older people are more
broadly applied.13
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| CDC’s scientific and
programmatic expertise is readily applied to target major health
issues among older Americans. CDC supports programs in states
targeting cardiovascular disease, diabetes, cancer, arthritis,
injuries, and influenza and Pneumococcal disease. Within these and
other CDC programs, efforts are focused on promoting healthy
lifestyles, adult immunization, chronic disease self-management, and
injury prevention.13
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| In addition to
targeting disease prevention and health promotion efforts, CDC
provides public health leadership and coordinates with the aging
services network and national health and aging organizations to
promote health and independence among older adults. Examples of
current efforts include: |
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Providing grants to states through CDC’s SENIOR Grant Program for
health promotion efforts targeted to older adults. |
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Supporting the translation and dissemination of evidence-based
practices to communities through the Health Aging Research Network
of CDC’s Prevention Research Centers program. |
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Monitoring the health trends of older adults through The State
of Aging and Health in America report series, with a special
emphasis in the 2006 edition on health disparities. |
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Developing and building on recently-established public health
priorities for addressing end-of-life issues. |
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Collaborating with the Alzheimer’s Association on a multi-faceted
approach to protect and promote brain health that includes the
development of a public health action plan and community
demonstration projects.13 |
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CDC’s
Racial and Ethnic Approaches to Community Health (REACH) 2010
REACH 2010 is one of the
cornerstones of CDC’s efforts to eliminate racial and ethnic
disparities in health. Launched in 1999, REACH 2010 is designed to
eliminate disparities in the following six priority areas:
cardiovascular disease, immunizations, breast and cervical cancer
screening and management, diabetes, HIV/AIDS, and infant mortality.
Currently, REACH 2010 efforts are focused on reaching African
Americans, American Indians, Alaska Natives, Asian Americans,
Hispanics, and Pacific Islanders. Among the community-based
projects funded by REACH 2010 are efforts specifically focusing on
addressing health disparities among racial and ethnic minority
populations.13,14 |
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What Individuals & Communities Can
Do to Promote Healthy Aging |
| Much of the illness,
disability, and death associated with chronic disease is avoidable
through known prevention measures. Key measures include practicing a
healthy lifestyle (e.g., regular physical activity, healthy eating,
and avoiding tobacco use) and the use of early detection practices
(e.g., screening for breast, cervical, and colorectal cancers,
diabetes and its complications, and depression).1 |
| Broader use of clinical
preventive services is one of the keys to preserving and extending
the health of older Americans. Because research has shown that
older adults are motivated by health care providers’ recommendations
for screening and immunization, better educating seniors on
recommended preventive measures is essential. Community
organizations can promote and facilitate access to preventive
measures by hosting health fairs and “Immunization Days” where older
people live and congregate and by widely publicizing the benefits
and local availability of immunization and screening services.15
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| The current gap between
life expectancy and healthy years of life can be narrowed. Research
shows that simple behavioral changes can improve the health
conditions of older adults. These improvements in health can be
achieved through a combination of practicing healthful behaviors,
effectively identifying disease, modifying health risks, and
managing chronic conditions. An important way to promote health
behaviors among older adults is to improve patient-provider
communication and to provide time for counseling and referral
regarding lifestyle modifications, so that older adults can adopt
and maintain these behaviors.15
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FOR MORE
INFORMATION |
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United States Department of Health and Human Services (HHS) |
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HHS’ Office of Minority Health Resource Center (OMHRC) |
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Health Information for Older Americans |
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Centers for Disease Control and Prevention (CDC) |
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National Center for Chronic Disease Prevention and Health Promotion
(NCCDPHP) |
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Healthy Aging |
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The State of Aging and Health in America 2004 |
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National Center for Health Statistics (NCHS) |
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Older Persons’ Health |
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Administration on Aging (AoA) |
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Agency for Healthcare Quality and Research (AHRQ) |
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Improving the Health and Health Care of Older Americans: A Report of the
AHRQ Task Force on Aging |
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Centers for Medicare and Medicaid Services (CMS) |
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Medicare |
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New Medicare Prescription Drug Coverage |
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Medicaid |
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Environmental Protection Agency (EPA) |
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Aging Initiatives |
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Federal Interagency Forum on Aging-Related Statistics |
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Older Americans 2004: Key Indicators of Well-Being |
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Food and Drug Administration (FDA) |
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Growing Older, Eating Better |
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Medicines and You: A Guide for Older Adults |
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Health Resources and Services Administration (HRSA) |
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United States Department of Agriculture (USDA) |
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Food and Nutrition Information Center (FNIC) |
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Aging |
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U.S. Census Bureau |
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Older (55+) Population |
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Elderly (65+) Population |
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