what factor is most likely to lead to higher income in old age:

The population of the Usa is growing older, a phenomenon widely noted and described, with significant implications for the nation'due south wellness, social, and economic institutions. It is necessary to empathize the past demographic and socioeconomic trends to better estimate the time to come size and characteristics of the older population as well as to forecast their demand for services and the extent to which those demands can be met. Assay of the demographic and socioeconomic trends of the elderly population will also help identify data needed to brand informed policy decisions related to the wellness of the future elderly population.

The Irresolute Demographic Structure of the Population

The distribution of the population in the United states of america has shifted rapidly in both the number and proportion of the population age 65 and over. This subgroup has grown faster than the rest of the population in recent decades, will continue to grow at a more rapid rate for the remainder of the twentieth century, and is expected to continue to increase well into the next century. Betwixt 1950 and 1980 the population historic period 65 and older more than doubled, from 12.3 million in 1950 to 25.v one thousand thousand in 1980 (Taeuber, 1983). During this 30-year period, the percentage increase in the number of elderly was 74 per centum larger than for the population nether historic period 65–108 per centum compared with 62 per centum. For the oldest-old, age 85 and over, the rise was the largest, a 281 pct increase from 577,000 in 1950 to 2.two million in 1980.

Population Forecasts

The size of the elderly population today and in the near future is relatively simple to estimate: it depends on the births in the early years of this century and the deaths in the nativity cohort in subsequent years. (A small portion of the total elderly population is deemed for by cyberspace migration, which is non as accurately counted equally births and deaths.) The elderly population in the next century depends on the births kickoff in the 1930s and the estimated deaths in each year's nativity accomplice. These estimates are subject to increasing dubiousness as we move further into the hereafter.

Birth rates were relatively high in the early part of this century, low in 1920–1940, high in the postwar years 1946–1964, lower again in 1965–1973, and slightly higher in more recent years. Throughout, at that place take been important variations by historic period of mother, birth order, and race. Death rates, meanwhile, take declined or remained level throughout the twentieth century, although at rates that varied by age, race, and sex. Declines in bloodshed rates have been consistently greater for women than for men and, since 1968, near as big for the oldest-sometime every bit for young-old (ages 65–74) females. Current indications are that the declines in mortality rates are continuing (National Eye for Health Statistics, 1986a). The future population has been estimated by the Bureau of the Census on the basis of a completed cohort fertility of 1.9 births per woman and a continued reject in mortality rates. The most probable forecasts are identified as the Bureau's "middle series," which are the basis for the assay in this study. Should there be great advances in medical care or unpredictable epidemics, the estimated size of the elderly population might exist considerably different.

Tabular array 2.1 shows the actual and projected growth of the older population. The middle serial estimates a steady ascension in the elderly (age 65 and over), from 25.five million in 1980 (11.iii percent of the total population) to a projected 64.three meg (21.1 percent) in 2030—more than doubling over the fifty-yr flow. The number of oldest-old volition continue to grow chop-chop in the next 50 years, from 2.2 million in 1980, to eight.eight meg in 2030, and to xvi.1 one thousand thousand in 2050. The progression of the postwar babe-boom accomplice, those born from 1946 to 1964 (Siegel and Davidson, 1984) may be seen in the height for the 65–74 age group in 2030, for the 75–84 historic period group in 2040, and those age 85 and over in 2050. The oldest-old population group was 1 percent of the full population and 9 per centum of the elderly in 1980; past 2050, this group is projected to increase to 5 percent of the total population and 24 percent of the elderly.

Tabular array 2.one

Actual and Projected Growth of the Older Population, 1980–2050 (numbers in millions).

The accelerated growth within the elderly population of those age 85 and over has shifted attention to this subgroup and its unique set of needs. The oldest-onetime are at risk for chronic affliction, tend to be functionally dependent, and have greater needs for medical, social, and back up services.

Forecasts by Sex

At nascence, every cohort has a small excess of males but, owing to the higher death rates for the male population and the more than rapid comeback in mortality for women, there is a large backlog of women at older ages. In 1980 there were 10.2 million elderly men (age 65 and over) and 15.two elderly women, a ratio of 68 men to 100 women. The Census Bureau population projections show that the sexual activity ratio of the population age 65 and over volition continue to fall in the next few decades, but more slowly than in the past, reaching 64 males per 100 females in the yr 2000 (Siegel and Davidson, 1984). Subsequently, the tendency volition modify, so that by the twelvemonth 2020 the sexual practice ratio of the elderly population will be 69 men per 100 females.

The sexual activity ratio declines rapidly with increasing historic period: in 1980 there were lxxx males per 100 females for those historic period 65–69 and 44 males per 100 females for those age 85 and older. For the latter grouping, the ratio of men to women is projected to fall betwixt 1980 and 2020, from 44 men to 36 per 100 women. Since the vast majority of the oldest-quondam are female, many of the wellness, social, and economic problems of this group are those of women.

Forecasts past Race

In 1980, 12 percent of the white population was age 65 and older—a much larger proportion than the eight percent of the black population (Siegel and Davidson, 1984). The Census Bureau attributes the difference to higher fertility of the black population and secondarily to college mortality at ages below 65. The Census Bureau projects that the black population of the time to come will go on to be a younger population than the white, although improvements in mortality rates for elderly blacks are expected. Past 2020, 19 percentage of the full white population compared with 12 per centum of the black population is projected to be historic period 65 and over (U.S. Department of Health and Human Services, 1985b).

Geographic Distribution of the Elderly Population

Older persons tend to move far less often than younger persons, remaining in the state, county, or local area where they settled during their developed years. Between 1975 and 1979, their rate of interstate migration was three.6 per centum (Agency of the Census, 1984). Betwixt 1970 and 1980, the largest numerical increases in elderly people were in the states of Florida, California, and Texas. Growth of more fifty percentage in the number of elderly in that decade occurred in Arizona, Florida, Nevada, New United mexican states, Alaska, and Hawaii. In 1980, virtually half the elderly were living in 8 states: California, Florida, New York, Pennsylvania, Texas, Illinois, Ohio, and Michigan, merely these states besides deemed for 47.9 percent of the full population. In Florida, 17.3 pct of its 1980 population was elderly, the highest proportion of any land, although Florida had only 4.3 percent of the full population (Taeuber, 1983).

Short-term population projections to the twelvemonth 2000 by the Agency of the Census show significant differences in rates of change in the population of the four regions of the United states of america. The West and South will be the fastest-growing regions from 1980 to 2000, increasing 45 percent and 31 percentage, respectively. The North Central region is projected to lose population during the same period. The elderly population in all regions, however, is projected to rise, ranging from a 12 per centum increase in the Northeast to a 60 percentage increase in the Southward and Westward (Taeuber, 1983).

These geographic data imply differential utilise of medical care services by region. For instance, in the Northeast and North Central regions, the number of nursing home beds volition need to increase by 44 percentage. In the South and West, the number of nursing habitation beds will accept to more double to meet the needs of the projected elderly population (Rice, 1985).

Marital Status and Living Arrangements

Among the near of import social characteristics affecting the welfare of the elderly are those that pertain to their marital condition and living arrangements. Elderly men are nigh likely to be married; elderly women are almost probable to be widowed. In 1981, 79 percent of elderly men and 39 pct of elderly women were married. For elderly women, the proportion of widows increases speedily and remains at a high level: for the 65–74 age group, 40 percent are widowed; for the group historic period 75 and older, 68 percent are widowed.

Marital status has a straight bearing on the living arrangements of the elderly. Among elderly men, 82 percentage alive in a family unit setting and more than 74 percent are married and living with their wives. A very dissimilar state of affairs exists for elderly women; 55 percent alive in a family setting and but 36 pct are married and living with their husbands. In short, women age 65 and older are more likely to be widowed than married and living alone rather than with husbands. The number of elderly women living lone has doubled in the last xv years, and projections by the Census Bureau testify a substantial increase up to 1995 in the proportion of households with an elderly female living alone or with nonrelatives (Siegel and Davidson, 1984).

This trend has important implications for housing needs and the need for institutional care. With the decline in the proportion of the elderly living with relatives likely to continue, there volition probably exist a greater need for the provision of social support and health services past the community or other public sources.

Education

The level of educational attainment of the elderly population is currently less than that of the younger population. This educational gap by age group has narrowed since 1950 and is expected to nearly close in the next decade, due to increased compulsory secondary schoolhouse requirements, every bit well as educational opportunities made available past the Yard.I. bill later World State of war II. A lower proportion of foreign-born in the future elderly population due to changes in immigration volition also serve to increase the educational attainment of the elderly population. The greater instruction of the future elderly population implies a alter in demand for services: combined with rising income, they may seek and demand more than and amend health care and other programs for their needs (Rosenwaike, 1985).

Income

The income of the elderly has improved over fourth dimension. According to the Congressional Budget Office, "After bookkeeping for inflation, the average cash income of families with elderly members increased past nearly xviii percent during the 15-twelvemonth period from 1969 to 1984, the latest year for which detailed information are available—while the boilerplate income of unrelated elderly individuals rose past 34 percent" (Gordon, 1986:ii). The income of younger families besides rose in this period, but not as much as for the elderly. Average elderly family income was 68 percent of boilerplate nonelderly family income in 1969 and 78 percent in 1984. For unrelated individuals, the elderly-to-nonelderly income ratio was 50 percent in 1969 and threescore percent in 1984.

The poverty rate among the elderly too declined in 1969–1984, from 25 percent to 12 percent, but in 1984 an additional 9 percent of the elderly had incomes of not more 25 pct above the poverty level. In 1984 incomes were beneath the poverty level for 9 percent of elderly men, 15 percent of elderly women, and 36 percent of elderly black women.

Social Security benefits are the largest single source of money income for the elderly (nigh 40 percentage), followed by earnings, property income, and individual and public pensions. The most pregnant change in source of income for the elderly population since the 1960s has been a decline in the importance of earnings and an increased reliance on retirement income from Social Security, public and private pensions, and assets. Noncash benefits are estimated to be 10 percent of the income of the elderly, the most important ones being Medicare, Medicaid, food stamps, and publicly endemic or subsidized housing. Although asset ownership (including savings and dwelling buying) is fairly common at the fourth dimension of retirement, the value of assets endemic past the elderly is low.

Current expenditures by the elderly are highest for shelter, followed past nutrient, transportation, and health care, which, surprisingly, uses less of the budget than transportation. These expenditures must be considered forth with available economical resource in planning and developing public policies for the elderly.

Labor Force Participation

Sharp declines take occurred in the final few decades in the labor force participation of men historic period 65 and older: from a third in 1960, to a quarter in 1970, to 17.half dozen percent in 1981 (U.S. Congress, Senate, 1986a). This trend is associated with an increase in voluntary early retirement and a drop in self-employment. With the growth in retirement programs, more older workers take been financially able to retire earlier. Projections by the Bureau of Labor Statistics (BLS) bear witness a connected turn down in labor force participation of elderly men at to the lowest degree upwards to 2000 (Fullerton, 1980). The proportion of older women in the labor forcefulness has increased moderately since 1960, due to economic necessity, more education, changes in social roles, and increased divorce rates that event in more than women heading their ain households. BLS projections evidence a moderate reject in the labor force participation of women age 65 and older and a continued increase for women historic period 55–64 upward to 2000 (Siegel and Davidson, 1984).

Part-time employment is now an increasingly important source of employment for the elderly: half of those age 65 and over who work do and so on a part-fourth dimension basis, upwardly from a tertiary in 1960. Age at retirement and labor force participation of the elderly have a directly effect on retirement programs and economic dependency. The historic period of eligibility for Social Security and other alimony benefits will affect the historic period of retirement for many elderly, which in turn affects their level of income and economical dependency. The projected turn down in labor force participation rates of older persons will lead to a continued rise in the ratio of older nonworkers to the working population and an associated increased dependency. The Social Security Act of 1983 advanced the age of retirement from 65 to 67 for payment of full benefits. The change is to exist phased in from age 65 in 1983, to 66 in 2006, to 67 in 2027. It is uncertain what outcome the police will take on bodily age at retirement.

Dependency Ratio

The social support systems now in place reverberate the current balance betwixt the size of the working population and the retired. The trends for people to live longer and for families to have fewer children are changing the shape of the elderly dependency ratio—the population age 65 and over divided past the population ages xviii–64, the working population. This ratio has risen steadily, from eleven per 100 in 1940 to 19 per 100 in 1980, and information technology is expected to reach 22 in 2010. The expected leveling off or slower increase in the next several decades will be followed by a sharp increment betwixt 2010 and 2030, when the babe-boom cohorts will reach old age; the ratio is expected to be 29 per 100 by 2020 and 37 per 100 past 2030 (Siegel and Davidson, 1984). At the same time, projected low fertility rates volition result in fewer immature persons and, thus, a failing young dependency ratio, defined every bit the population under age 18 divided by the working population, ages eighteen–64.

The total dependency ratio, the sum of the young and elderly ratios, is a crude index of the total burden on the working population of its support of both onetime and immature dependents. The total dependency ratio has declined since 1960, only it is expected to increment in the next century, and the increase in the elderly dependency ratio will be greater than the turn down in the young dependency ratio. The elderly are primarily supported by publicly funded programs while, except for public didactics, mostly private (i.e., family) funds back up the young. Since the elderly volition be the most rapidly growing historic period group and more plush, the change in the dependency ratios will exist a major policy result for both Social Security and the hospital insurance programs under Medicare that are financed by payroll taxes (Rice and Feldman, 1983).

In addition to the unknown effects of advancing the age of retirement to 67 for payment of total benefits, fully effective in 2027, other social and legislative changes in the adjacent 50 years may change the relationships between the working and the retired populations, significantly changing the elderly dependency ratio.

Morbidity Patterns

There is considerable conjecture and controversy regarding future morbidity patterns. One theory holds that the improvements in lifestyle will delay the onset of inability and will result in a reduction in the prevalence of morbidity from chronic disease and a compression of morbidity at older ages. This theory foresees a standing refuse in premature death and the emergence of a pattern of natural death at the finish of a natural life bridge (Chips, 1980). Some other theory argues that chronic disease prevalence and disability will increment equally life expectancy increases, leading to a pandemic of mental disorders and chronic diseases (Kramer, 1980). This theory projects that the extension of life is bringing an extension of disease and disability. The increases in the prevalence of chronic conditions due to medical technology have been called the failures of success (Gruenberg, 1977).

A recent review of the bear witness (Schneider and Brody, 1983) concludes that the number of very old people is increasing rapidly, the average flow of diminished vigor volition probably rise, chronic disease will probably occupy a larger proportion of people's life spans, and the needs for medical care in later life are probable to increment essentially. Models linking morbidity and mortality can be adult to predict how good for you or ill cohorts of the older population will exist in the time to come (Manton, 1982).

The Limitations of Available Information

Needs for information in several areas related to the demographic and socioeconomic trends described can be identified. The sources of currently available demographic and socioeconomic data on the aging population are the decennial census and sample surveys, including the Current Population Survey (CPS), the Survey of Income and Program Participation (SIPP), and the National Health Interview Survey (NHIS). These surveys have sample sizes that are besides small to provide detailed historic period breaks and characteristics of subgroups of the elderly population. Analytic studies of the oldest-old, for example, are severely hampered because the size of the sample age 85 and older in these surveys is not large enough to provide a socioeconomic profile of this growing segment of the elderly. Future planning to meet the needs of this age group, especially the demand for institutional intendance, will require more in-depth knowledge of the sex activity, race, marital composition, and living arrangements of the oldest-former, forth with a more detailed income and wealth profile than is currently available from survey statistics. A major requirement is to obtain a large-enough sample of the elderly to provide detailed age and subgroup characteristics.

Detailed data on income, wealth, and pension statistics for the elderly are essential for policy analysis. Better income measures—for example, the apply of income distributions rather than averages—are needed to more accurately appraise the economic status of the older population. Noncash benefits also need to be quantified in determining the fiscal well-existence of elderly persons. And since employment status has a direct bearing on economic resources, diverse measures of income should separate the older population into working versus retired categories. In addition to income and wealth data, there is a need for information on detailed pension programs and retirement income. A related consequence is the need to analyze retirement trends in terms of a measure out such equally the boilerplate age at retirement. Better income data and measures will provide a more accurate picture of the fiscal well-being and economic resources of the elderly and besides aid in planning public and private retirement, wellness, and social programs. Methods of forecasting income at the time of retirement besides need to exist developed with those planning efforts.

Limited data are now available on the alimony prospects of women. Due to women'southward increased labor force participation, the situation of women as they plow 65 in future years is likely to be quite different in terms of anticipated futurity income and pension coverage and benefits. In order to forecast the pensions of women, there is a need to monitor the alimony benefits being accrued by the more than recent cohorts of women.

The increased labor force participation of women implies greater financial prospects from pension benefits on one hand, and lesser availability to provide a caregiver role for age parents on the other. With the rapid growth of the oldest-old, there is a greater likelihood for the young-old to have extremely aged parents in need of care. Fewer women will be available to provide such support and greater reliance will shift to formal caregiver and support systems.

Forecasts of the older population are especially useful for long-range planning, and several types of demographic and socioeconomic data are needed for more accurate and useful projections of the elderly. Get-go, greater historic period particular at extreme ages (i.east., over 75 or 80 years) is needed, which would allow analysis of such factors as institutionalization (Myers, 1985). Second, forecasts of the living arrangements and future housing needs of the elderly are needed to aid in planning efforts in the areas of publicly subsidized housing and institutional facilities. Projections of both the noninstitutionalized and institutionalized long-term care populations are needed.

Data on ethnicity and the foreign-born population of the elderly have been largely ignored. Although the proportion of foreign-built-in elderly persons is expected to turn down in future years, the need to written report changes in the foreign-built-in limerick of the older population arises due in part to unlike needs of such subgroups.

Greater geographic detail in national projections is too needed, along with forecasts of migratory flows of the elderly (Myers, 1985). Better data are needed on migration and mobility of the elderly and the subsequent population redistribution, which is peculiarly valuable in projection work. The need to better forecast migratory flows for states and local areas coincides with the need to know nigh the concentration or distribution of the elderly population. The following questions become increasingly important for regional planning and the provision of health and social services: Will in that location be a residential turnover amongst the elderly, from central cities to suburban areas? What is the likelihood of certain suburbs' becoming essentially elderly communities? Information related to such questions can help regional planners decide where to put facilities such as nursing homes and board and care homes. Knowledge about interstate migration as well as residential mobility of the elderly is important for project purposes.

Short-term projections (to 2000) show a regional shift amid the elderly from the Northeast and N Primal regions to the South and West regions. In a detailed written report of migration patterns of the elderly based on decennial census information, Longino observed that even while migration into the sunbelt states continued, outmigrants from Florida to northern states were characterized by high proportions of persons age 75 and over returning to their state of birth (Longino et al., 1984). Report of migration streams by age tin contribute to more accurate projections, and thereby to ameliorate land and regional planning.

The population ages 45–64 today will go the ''new aged" population in the side by side 20 years, and longitudinal data are needed to monitor this group. These cohorts crave special attention, every bit they represent cohorts very unlike from the current elderly population in terms of educational, marital, income, and perhaps health characteristics (Myers, 1985). Changes in composition, behavior, and needs of the future elderly can all-time be foreseen by analyzing the differences between newly entering cohorts of the elderly and their immediate predecessors (Serow and Sly, 1985). Serow contends that the group ages 55–64 in 1980 is critically different in limerick and life-course experiences, separating the elderly of yesterday from the elderly of the future. This leads to several implications for the later on years of life for the new aged. The time to come elderly are also expected to have relatively higher incomes and greater avails, along with better wellness. On the basis of the changes in the labor force experiences of women noted before, future generations of women tin can be expected to enter their retirement years with greater financial resources, from their own pension and Social Security entitlements, but with fewer familial resources to provide necessary support. Although tomorrow'southward elderly may have an improved fiscal position, the size of the future population volition increase the need for long-term home intendance and may require a greater supporting role past social club. As the elderly population ages, the number of nursing home residents is projected to increase past 60 percent by 2003.

Successive cohorts of the elderly are projected to have both increased educational attainment and higher incomes. As educational level has been shown to be associated with various measures of health condition likewise as demands for better wellness care, information technology becomes increasingly important to study the implications of a more highly educated older population. College income levels of tomorrow's elderly imply a greater power to pay for better health care for acute weather. Information on irresolute weather condition for future generations of the elderly besides need to contain the implications of housing and transportation bachelor to the elderly, equally these factors affect people'southward quality of life, which in plow affects measures of health and illness.

Related to data needs on the older population are several methodological issues. These areas include the evolution of appropriate health status measures for major socioeconomic surveys, the linkage of data bases, the need for longitudinal studies of socioeconomic and health characteristics of the elderly, and studies of the elderly on an age cohort basis.

Advisable wellness measures need to be adult and incorporated into the major socioeconomic surveys. We need new approaches to the development of measures of physical, cognitive, emotional, and social operation. Several measures are available and take been used in national surveys. These need to exist improved and broadened to take into account the positive or successful aspects as well equally the negative aspects of aging and to reflect ordinary behaviors and activities of older persons that indicate their quality of life and touch on their relationships with those close to them (National Research Council, 1986).

Longitudinal studies of socioeconomic and health characteristics of the elderly are especially relevant. Such data are essential for assessment of transitions over the life bike. Despite the physiologic losses and psychosocial stresses often associated with avant-garde age, many elderly individuals have the vitality and resilience to function effectively or to recover and function independently, once over again, post-obit a disabling condition. Information are needed that measure the extent to which older individuals remain in good health and the changes that occur as they motion from one state of health to another, whether this marks an improvement or progressive loss of office leading to disability, dependency and, ultimately, mortality. Measuring this requires repeated observations on the same people over time, i.due east., longitudinal data on both the well and the impaired in the population (National Research Quango, 1986).

Data for the elderly on an age cohort basis are needed in improver to those existence collected on an historic period catamenia footing. For example, the onset of a particular disease or condition could vary by nascence cohort. Analysis of data on a accomplice basis would thus reveal if a shift in the age of onset has occurred for successive cohorts. Such data would aid greatly in understanding tomorrow'due south elderly.

Data base linkage could exist invaluable to inquiry on the elderly. Dissever analyses take been conducted based on survey data, medical records, and administrative data. Past linking these sources, more detailed analyses volition be possible along with the testing of new relationships. For example, linking Medicare files with social survey data and medical records could provide information on Medicare use by the availability of a social network or by the severity of the medical condition. Such linkage could supply a more comprehensive wellness profile of the elderly.

Implications for the Written report

The social, economic, and demographic changes in successive cohorts of elderly people highlighted in this affiliate have implications for the topics discussed in each of the chapters in this report. Indeed, they helped determine the topics selected for word.

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Source: https://www.ncbi.nlm.nih.gov/books/NBK217734/

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