Aging – Part I: The Status of Aging in America March 2018

Suggested Citation: Garko, M. G. (2018, March).  Aging – Part I: The Status of Aging in America. Health and Wellness Monthly. Retrieved (insert month, day, year), from www.letstalknutrition.com.

Aging – Part I: The Status of Aging in America

Michael Garko, Ph.D.
Syndicated Host & Producer – Let’s Talk Nutrition

 Introduction

 “The aging of the U.S. population is one of the major public health challenges we face in the 21st century” (Centers for Disease Control and Prevention and The Merck Company Foundation, p. 2007). Since 1900, while the population in the United States tripled, the number of older adults (i.e., people 65 or older) has increased at a faster pace from 11-fold from 3.1 million in 1900 to 35 million in back in 2000 (see Centers for Disease Control and Prevention and The Merck Company Foundation, 2004) to 46 million currently (Mather, et. al., 2015).

The fast paced growth of the elderly population will continue as baby boomers (i.e., people born between 1946 and 1964) turn 65. Between 2020 and 2030, the number of older persons is projected to increase by almost 18 million as the last of the large baby boom cohort reaches age 65, with one in five Americans being 65 or older by 2030. According to Mather et al. (2015),  this dramatic demographic shift involving Americans 65 and older is projected to more than double from 46 million to better than 98 million by 2060, with the 65-and-older age group’s share of the total population increasing to nearly 24% from 15%. While smaller in total size, the number of people ages 85 and older is projected to more than triple from 6 million today to nearly 20 million by 2060.

In the Population Reference Bureau’s report, Aging in the United States, Mather et al. (2015) contend that the current growth of the baby boomer population is among the most significant demographic trends in the history of the United States but caution that while “U.S. policymakers and others have had many decades to plan for the inevitable aging of the baby boom cohort, it is not clear that sufficient preparations have been made to meet baby boomers’ anticipated needs in old age” (p. 2).

The March, 2018, issue of Health & Wellness Monthly is the first installment in a series on aging, with a particular focus this month on life expectancy, healthy life expectancy, differences in life expectancy between women and men and reasons why people are living longer in America.

Life Expectancy in the United States

Life expectancy is a statistical measure/metric used to provide an understanding of the overall health or overall mortality of a given population. It serves as a summary of the mortality pattern cutting across age groups (i.e., children, adolescents, adults and the elderly). Life expectancy at birth is the average number of years a group of newborns would be expected to live if the group were to experience age-specific death rates in the year they were born (see National Center for Health Statistics, 2017; World Health Organization, 2006).

Remarkably, life expectancy has increased dramatically in the United States. People who were born in the year 1900 could expect on average to live only 47 years. Children born in 2005 can expect to live nearly 78 years (77.9) (Centers for Disease Control and Prevention, 2007). This is the good news. The bad news is that compared to other countries the United States does not rank well in life expectancy when compared with other countries. For example, the World Health Organization (2015) ranks the United States 31st. The United Nations World (2015) ranks the United States 43rd. The Central Intelligence Agency ranks the United States 43rd in life expectancy. Finally, the Organization for Economic Co-Operation and Development (2018) ranks the United States 26th.

It is important to remember that life expectancy is different from the concept of life span. Life span represents the upper limit of human life which could be reached by a person. The oldest authenticated female life span recorded to date was for J. Calment of France. She died at age 122 years and 164 days, while the oldest authenticated male life span recorded to date was for C. Mortensen (a Danish immigrant to the U.S.). He died at age 115 years, 252 days (see Max Planck Institute for Demographic Research 2010). 

Healthy Life Expectancy

As it was pointed out above, although the statistic on life expectancy in the United States has steadily improved over the past hundred years, the statistic on healthy life expectancy (i.e., the number years living in a healthy state after age 65) seems to have stalled, remaining at 12 years since 1990 (Merck Institute of Aging & Health and The Gerontological Society of America, 2000). Thus, Americans are living longer but there is concern that they are not necessarily living longer in good health and quality of life.

Although they are living longer, people in the United States are not living necessarily in better health during the latter part of their lifespan. Since 1990, the statistics on healthy life expectancy (i.e., the number years living in a healthy state after age 65) has stayed at 12 years (Merck Institute of Aging & Health and The Gerontological Society of America, 2004). To make aging matters even more challenging, experts project that health care spending in the United States will increase by 25% because of the ever rapidly growing elderly population.   

Differences in Life Expectancy Between Men and Women

The most recent statistics related to the average life expectancy at birth show that for women it is 80.4 years and for men it is 75.2 years (Centers for Disease Control and Prevention, 2007).  As they age, the gap in life expectancy for women and men decreases. For example, according to the Centers for Disease Control and Prevention (CDC) (2007), the difference in life expectancy between women and men is 2.9 years at age 65 (20.0 years and 17.1 years, respectively). At age 85 the gap between women and men narrows to just a little more than one year (7.2 years and 6.1 years, respectively). It is interesting to note that since 1979 the gap in average life expectancy at birth between women and men has decreased from 7.8 years to 5.2 years (see Centers for Disease Control and Prevention, 2007).

The CDC (2007) recognizes that average life expectancy at birth for women and men has improved over the last 100 years but suggests that there is considerable room for improvement compared to other countries in their following statistical analysis:

 Although life expectancy for both women and men has increased dramatically over the past century, the United States lags behind many other developed countries. For example, in 2002, Japan, Hong Kong, and Spain (ranked 1, 2, and 3) reported life expectancy at birth for women to be 85.2, 84.5, and 83.5 years, respectively, and for men to be 78.3, 78.6, and 75.8 years (ranked 2, 1, and 15), respectively. In 2002, for women the United States ranked 26th in life expectancy at birth and 18th in life expectancy at age 65 years; for men the United States ranked 26th in life expectancy at birth and 13th in life expectancy at age 65 years among 37 selected countries ranked in Health, United States, 2006 (Centers for Disease Control and Prevention, 2007, p. 3).

 Reasons Why More People Are Living Longer

One would like to believe that the longevity revolution in the United States was due primarily to a majority of the population living an exemplary healthy lifestyle. However, the remarkable increase in average life expectancy at birth over the past 100 years or more was due to (1) an improvement in sanitation, (2) an increase in use of preventative health services, (3) public health efforts and (4) to some lesser extent healthier lifestyles for a small percentage of the population (see Centers for Disease Control and Prevention and The Merck Company Foundation, 2007; Centers for Disease Control and Prevention and The Merck Company Foundation, 2004). 

Conclusion

The portrait of aging in America is a paradoxical one. On the one hand, Americans are living longer than ever before in the history of our country, the proportion of people age 65 and older is increasing and average life expectancy at birth is at an all-time high. On the other hand, all of these factors are contributing to an unprecedented increase in our aging/elderly population, for whom healthcare must be provided.

The fundamental challenge facing the country will center on how to provide that healthcare to ever growing elderly population, so as to keep them healthy longer, ensure quality of life and wellbeing and to care for them when they become ill with chronic diseases, all of which begs the question of how will the country pay for the projected commensurate rise  in healthcare costs. Furthermore, while more people are living longer, they are not necessarily living healthier lives, increasing the likelihood of a rise in chronic diseases and healthcare costs. In fact, living a healthier life style is on a decline in the United States, reflected in the reality that two-thirds of the population is overweight or obese and an alarming percentage of the people are living sedentary lives.

In addition to providing and paying for healthcare for the increasing elderly population, there are various political, philosophical, ethical and societal issues which enter into the conversation on the status of aging in America, which will be discussed at various points along the way in the series on aging. 

References

Centers for Disease Control and Prevention (2007). Trends in health and aging: Trends in health status and health care use among older women (2007). Retrieved from http://www.cdc.gov/nchs/data/ahcd/agingtrends/07olderwomen.pdf

Centers for Disease Control and Prevention and The Merck Company Foundation (2007). The state of aging and health in America 2007. Retrieved from http://www.cdc.gov/aging/pdf/saha_2007.pdf

Centers for Disease Control and Prevention and The Merck Company Foundation (2004). The state of aging and health in America 2004. Retrieved from http://www.agingsociety.org/agingsociety/pdf/SAHA_2004.pdf

Central Intelligence Agency (2017). The world fact book: Country comparison – Life expectancy at birth. Retrieved from https://www.cia.gov/library/publications/the-world-factbook/fields/2119.html

Mark Mather, M., Jacobsen, L. A. & Pollard, K.M. (2015) Aging in the

United States, population bulletin 70, no. 2. Retrieved from http://www.prb.org/pdf16/aging-us-population-bulletin.pdf

Merck Institute Of Aging & Health and The Gerontological Society (2004). The state of aging and health in America. Retrieved from http://www.agingsociety.org/agingsociety/pdf/state_of_aging_report.pdf

Max Planck Institute for Demographic Research (2010).  Supercentenarians. Retrieved from http://www.supercentenarians.org/

National Center for Health Statistics (2017). Health, United States, 2016: With chartbook on long-term trends in health. Hyattsville, MD. 2017. Retrieved from https://www.cdc.gov/nchs/data/hus/hus16.pdf#glance

Organization for Economic Co-Operation and Development (2018). Life expectancy at birth (indicator). Retrieved from https://data.oecd.org/healthstat/life-expectancy-at-birth.htm

United Nations World (2015). Population prospects: 2015 revision. Retrieved from https://esa.un.org/unpd/wpp/Publications/Files/WPP2015_Volume-I_Comprehensive-Tables.pdf

World Health Organization (2016). World health statistics 2016: Monitoring health for the SDGs annex B: tables of health statistics by country, WHO region and globally. Retrieved from  http://www.who.int/gho/publications/world_health_statistics/2016/EN_WHS2016_AnnexB.pdf?ua=1

Suggested Citation: Garko, M. G. (2018, March).  Aging – Part I: The Status of Aging in America. Health and Wellness Monthly. Retrieved (insert month, day, year), from www.letstalknutrition.com.