Aging and Demographics

Age as a Number

• Age is just a number; people age differently.
• Factors influencing aging:
  • Body functioning
  • Mental acuity
  • Social involvement
  • Community engagement

Key Terms

• Demographic trends: Ways of characterizing a population.
• Population aging: Worldwide increase in life expectancies and aging baby boomers.
• Median age is climbing globally.
• Compression of morbidity:
  • Reduced time spent in decline before death due to modern interventions.
  • Example: Heart disease management has improved significantly since the 1980s.
  • Morbidity relates to disease consequences. The aim is to minimize the impact of disease on quality of life.
• Dependent Life Expectancy: Time people live relying on others for basic needs (daily living, transportation, etc.).
• Demographics: Characteristics of a population (age, gender, race, economics).

Baby Boomers

• Baby boom: A significant increase of births from 1946-1964.
• Born between 1946 and 1964, becoming senior citizens in the early 2000s.
• Rising numbers of older adults are not just in the US but also in other countries post-World War II.
• Life expectancy significantly increased since 1946.
  • In 1900, the life expectancy was 47 years.
  • Reason: Lack of antibiotics and childhood immunizations.
  • In 2018, life expectancy was 78 years (WHO data).
  • Improvements in diabetic and cardiac care, which has lead to dramatic increase.

Population Pyramids

• Population Pyramids display the population by age and gender. The shape has changed over time.
• The x-axis represents the number of people (in millions), separated by gender (male = blue, female = pink).
• The y-axis represents age, in approximately 5-year increments.
• The population pyramid is becoming an outdated term, because it's no longer a pyramid shape.
• United States Population Pyramid (2020):
  • Significant increase in the 20-34 age range, attributed to immigration.
  • A bulge around the 55-59 age range: the baby boomers.
  • 65+ is considered older adults according to the U.S. Census.
  • 75+: older-old.
  • 85+: oldest-old, with a noticeable difference in the proportion of females to males.
  • Women statistically live about five years longer than men.
  • Small bar represented for those who are 100+ indicating that they are represented but not in large numbers at this point in time.

Public Policy Implications

• Public policy implications:
  • Resources available
  • Targeted resource/health resource allocation to meet the community's needs.
• Families:
  • Composition of families.
  • Demands on families i.e. caring for aging parents.
• Communities: Influencing the complexion of our communities.

Life Expectancy

• 1900: Life expectancy was 47 years.
• 2018: Life expectancy was approximately 78 years.
• 2030: Projected to approach mid-80s.
• 2020: Dramatic change due to COVID-19, decreasing by 1.5 years in the U.S.
  • 74% of the decline attributed to COVID.
  • 33% of the decline attributed to drug overdoses, impacting overall averages.
  • Non-Hispanic Black people in the U.S. saw a 2.9-year decline, versus 1.2 years for non-Hispanic White people.

Factors Influencing Life Expectancy

• Monaco: Has the highest life expectancy at 89 years.
• Japan: Ranks highly, likely due to dietary practices.
• United States: Ranks 45th, indicating potential for improvement via healthier lifestyles.
• Gender: Women tend to live longer.
  • Women: 80 years.
  • Men: 75 years.
• Theories for women living longer:
  • Extra X chromosome providing physical robustness.
  • Health promotion and risk behaviors (tobacco, alcohol, reckless driving, etc.).
  • Emphasis on wellness activities.
  • Women more inclined toward more wellness-oriented services and check ups.

Disparities

• Disparities by:
  • Race
  • Income
  • Education
  • Chronic diseases
  • Access to quality healthcare.
• These factors significantly impact quality of life and life expectancy.

Racial Disparities

• Two thirds of people 85 and over are female.
• Life expectancy in 2017:
  • All races: 78.6 years.
  • Non-Hispanic White: 78.8 years.
  • Black/African American: 75.3 years.

Diversity Among Older Adults

• Increasing diversity due to immigration.
• Over 20% of older adults are persons of color.
• Increase in people not identifying as heterosexual LGBTI.
• Historically, research didn't ask about sexual orientation, assuming heterosexuality or no sexual activity.
• Need to understand risk behaviors for screenings (STIs, blood-borne pathogens, etc.).

Diversity & Economics

• Racial disparities in economics/education.
• Without a high school diploma, it is harder to get a well-paying job.
• Retirement income based on pre-retirement earnings, which is on the low scale.
• Social Security provides only 40% of pre-retirement compensation.

Education

• Education:
  • High school diploma (65+ group):
    • All persons: 89% (up from 28% in 1970).
    • White: 93%.
    • Asian: 83%.
    • African American: 81%.
    • Hispanic: 63%.
  • Bachelor's degree:
    • Asian population has the highest percentage.

Below Poverty Level

• Below poverty level (65+ group):
  • White non-Hispanic: 7%.
  • African American: 19.3%.
  • Asian: 10.8%.
  • Hispanic: 17%.

Support Dependency Ratio

• Working Age Group (18-64) vs Dependency Group (65+).
• Fewer employed people per retired person can cause funding issues.
• Forces many to work later in life out of financial necessity, affecting health and long-term care options.
• Medicare alone isn't enough; supplemental coverage is needed.
• Medicare doesn't cover long-term nursing home care for conditions like Alzheimer's.

Ageism

• Negative stereotypes and their impact and should be considered in health care.
• Over 50% of people surveyed have ageist attitudes.
• Negative messages in marketing for anti-aging products perpetuate stereotypes.
• Internalized ageism can affect physical and mental health.
• Implies that older adults are unable to make contributions to contribute to home/community.
• Self self-fulfilling prophecy.
• Thoughts of aging well vs. genetic related risk/considerations.

Minimizing Ageism:

• Addressing the influence to change the physical and mental wellness.

• Self-directed ageism connected to lower recovery rates from strokes or heart attacks.

• Those with self-directed ageism are less likely to recover from severe disability and more likely to participate in behaviors that put their health at risk.

• General massive stroke example and how determination matters.

Cognitive Decline

• Connected Ageist attitude with an earlier death.
• Mental health connected with lower life expectancy. There have been studies that connect the positive/negative aging mindset with with rate of cognitive ability to decline.
• Constant expression of thinking