# 6.5: Problems Facing Older Americans

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Learning Objectives

1. Present a brief sociodemographic profile of the US elderly.
2. Discuss the several problems experienced by the US elderly.
3. Describe how the social attitudes of older Americans generally differ from those of younger Americans.

We now turn our attention to older people in the United States. We first sketch a demographic profile of our elderly and then examine some of the problems they face because of their age and because of ageism.

• ## Who Are the Elderly?

Table 6.2 “Demographic Composition of the Elderly, 2010” presents the demographic composition of Americans aged 65 or older. Slightly more than half the elderly are 65–74 years of age, and about 57 percent are female, reflecting males’ shorter life spans as discussed earlier. About 80 percent of the elderly are non-Latino whites, compared to about 66 percent in the population as a whole; 8.6 percent are African American, compared to about 13 percent of the population; and 7.0 percent are Latino, compared to 15 percent of the population. The greater proportion of whites among the elderly and lower proportions of African Americans and Latinos reflects these groups’ life expectancy differences discussed earlier and also their differences in birth rates.

Table 6.2 Demographic Composition of the Elderly, 2010

 * 2009 data Age 65–74 years 52.3% 75–84 years 33.4% 85 years and over 14.3% Gender Female 56.9% Male 43.1% Race and/or ethnicity* White, non-Latino 80.1% African American 8.6% Latino 7.0% Asian/Pacific Islander 3.5% Amer. Ind., Esk., Aleut. 0.6% Two or more races 0.7% Living in poverty 9.0% Marital status Married 57.6% Widowed 28.1% Divorced 10.0% Never married 4.3% Years of school completed 0–8 years 10.2% 1–3 years of high school 10.3% High school graduate 36.4% 1–3 years of college 20.6% College graduate 22.5% Labor force participation Employed 16.2% Unemployed 1.2% Not in labor force 82.6% Household income* Under $15,000 18.8%$15,000–$24,999 20.7%$25,000–$34,999 15.4%$35,000–49,999 15.1% $50,000–$74,999 14.2% $75,000–$99,999 6.5% $100,000 and over 9.4% Source: Data from US Census Bureau. (2012). Statistical abstract of the United States: 2012. Washington, DC: US Government Printing Office. Retrieved from www.census.gov/compendia/statab. The lower proportions of African Americans and Latinos among the elderly partly reflect these groups’ lower life expectancies. Evgeni Zotov – Grandparents – CC BY-NC-ND 2.0. The percentage of elders living in poverty is 9.0, compared to 15.1 percent of the entire population. Although most elders have fixed incomes, the fact that their family size is usually one or two means that they are less likely than younger people to live in poverty. In fact, today’s elderly are financially much better off than their grandparents were, thanks to Social Security, Medicare (the federal health insurance program for older Americans), pensions, and their own assets. We will revisit the health and financial security of elders a little later. Turning to education, about 22 percent of the elderly are college graduates, compared to about 29 percent of the population as a whole. This difference reflects the fact that few people went to college when today’s elderly were in their late teens and early twenties. However, it is still true that today’s elders are better educated than any previous generation of elders. Future generations of the elderly will be even better educated than those now. While most elders are retired and no longer in the labor force, about 16 percent do continue to work (see Table 6.2 “Demographic Composition of the Elderly, 2010”). These seniors tend to be in good health and to find their jobs psychologically satisfying. Compared to younger workers, they miss fewer days of work for health or other reasons and are less likely to quit their jobs for other opportunities (Sears, 2009). Although we emphasized earlier that many older Americans do not fit the negative image with which they are portrayed, it is still true that they face special problems because of their age and life circumstances and because of ageism. We discuss some of these here. • ## Physical and Mental Health Perhaps the problem that comes most readily to mind is health, or, to be more precise, poor health. It is true that many older people remain in good health and are fully able to function mentally and physically (Rowe et al., 2010). Still, the biological and psychological effects of aging do lead to greater physical and mental health problems among the elderly than in younger age groups, as we briefly discussed earlier. These problems are reflected in responses to the General Social Survey (GSS) question, “Would you say your own health, in general, is excellent, good, fair, or poor?” Figure 6.6 “Age and Self-Reported Health” shows that the elderly are more likely than the nonelderly to report that their health is only fair or poor. Figure 6.6 Age and Self-Reported Health Source: Data from General Social Survey. (2010). Retrieved from http://sda.berkeley.edu/cgi-bin/hsda?harcsda+gss10. The elderly’s perception of their own health is supported by government estimates of chronic health conditions for older Americans. Of all people aged 65 or older not living in a nursing home or other institution, almost 50 percent have arthritis, 56 percent have high blood pressure, 32 percent have heart disease, 35 percent have hearing loss, 18 percent have vision problems, and 19 percent have diabetes (these numbers add up to more than 100 percent as people may have several health conditions) (Federal Interagency Forum on Aging-Related Statistics, 2010). These rates are much higher than those for younger age groups. The elderly also suffer from dementia, including Alzheimer’s disease, which affects almost 13 percent of people 65 or older (Alzheimer’s Association, 2009). Another mental health problem is depression, which affects almost 15 percent of people 65 or older. Because of mental or physical disability, about two-thirds of all people 65 or older need help with at least one “daily living” activity, such as preparing a meal (Federal Interagency Forum on Aging-Related Statistics, 2010). Older people visit the doctor and hospital more often than younger people. Partly for this reason, adequate health care for the elderly is of major importance. Ted Van Pelt – The Coopers – CC BY 2.0. If the elderly have more health problems, then adequate care for them is of major importance. They visit the doctor and hospital more often than their middle-aged counterparts. Medicare covers about one-half of their health-care costs; this is a substantial amount of coverage but still forces many seniors to pay thousands of dollars annually themselves. Some physicians and other health-care providers do not accept Medicare “assignment,” meaning that the patient must pay an even higher amount. Moreover, Medicare pays little or nothing for long-term care in nursing homes and other institutions and for mental health services. All these factors mean that older Americans can still face high medical expenses or at least pay high premiums for private health insurance. In addition, Medicare costs have risen rapidly along with other health-care costs. Medicare expenditures soared from about$37 billion in 1980 to more than \$500 billion today (see Figure 6.7 “Medicare Expenditures, 1980–2010”). As the population continues to age and as health-care costs continue to rise, Medicare expenses will continue to rise as well, making it increasingly difficult to find the money to finance Medicare.

Figure 6.7 Medicare Expenditures, 1980–2010

Source: Data from Centers for Medicare and Medicaid Services. (n.d.). National health expenditure data. Retrieved from http://www.hhs.gov.

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