A Dozen Big Questions About Aging in America

Stanford Center on Longevity report summarizes aging and related demographic trends.

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The aging of America is well documented. Even the youngest Boomers have been alive for more than 45 years, so their arrival is hardly a recently revealed secret. However, the implications of an aging world are not so frequently discussed or even raised. Governments and institutions at all levels already are overwhelmed with today's firestorms. Asking them to take steps to avoid future problems may seem like wasted effort.

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However, the stakes of not asking the right questions about the future are enormous. The Stanford Center on Longevity has just published a review of major aging and demographic information and research findings. It's called New Realities for an Older America: Challenges, Changes and Questions. As someone who spends a lot of time poring over research studies, it is invaluable to have the major trends captured in a single report. Better still, its authors -- Adele M. Hayutin, Miranda Dietz, and Lillian Mitchell -- not only summarize what we know about these new realities but pose a lot of the big questions asking how we're going to deal with them.

The major headlines of the aging and demographic shift have also been repeated over and over again for years. Here are six headline highlights in Stanford's recap that will drive debate over how we deal with an aging society:

-- One in every five Americans will be at least 65 years old in 2030, up from 13 percent today and only 8 percent in 1950.

-- The U.S. will turn majority Hispanic in about 30 years, at which time Hispanics will equal nearly a third of the work force and dominate the youth market.

-- Older people are living much longer, and retirements are lasting 20 to 30 years instead of 10 or 15.

-- The worker to retiree ratio has fallen from 8 in 1950 to 5.2 today and will decline to 3 by 2050. If we raise the retirement age to 70, the ratio would still fall to 4.3 by 2050.

-- The numbers of households with older Americans has soared to about 22.5 million and nearly half of them represent older Americans living alone.

-- Healthcare costs are much higher for older persons, and the price tag for caregiving and housing medically dependent seniors will soar.

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Responding to these powerful realities, the Stanford report is peppered with questions for government and business policymakers as well as individuals. In this case, the report is an essential study guide to learning the right questions to ask. The researchers don't attempt to answer them, and at least today, neither will I. But they are all thought provoking and will be the focus of countless future articles and commentaries. For now, here are a dozen of the biggest aging elephants in the room:

1) How should we change our old-age support programs — Medicare, Medicaid and Social Security — and other age-related polices so that we, as a society and as individuals, can realize the benefits of increased longevity without being overwhelmed by the costs?

2) How will voting patterns and social spending priorities change as the racial and ethnic composition of the country changes?

3) What are the political ramifications of having an increasingly Hispanic work force pay taxes to fund Social Security and Medicare for the largely white non-Hispanic 65-plus population?

4) What challenges will people face as they “age in place” in the suburbs?

5) What incentives would lead individuals and communities to make realistic provisions for their long-term care needs and living arrangements, without adding to the already substantial budgetary pressures governments face because of aging populations?

6) What home-based services available in traditional communities would allow people to remain independent longer? How can communities and states insure that there will be sufficient institutional capacity?

7) What are the characteristics of age-friendly communities and what are the critical indicators of success?

8) Will rising levels of obesity cancel out or even reverse projected increases in life expectancy? What is the best way to tackle obesity, and how much would be saved by reversing the trend?

9) Will mortality rates for dementia continue to rise? What medical breakthroughs might reduce the prevalence, age of onset or speed of


progression? 10) How will rising health care spending threaten personal and national financial security as the population ages?

11) What incentive structures would encourage older people to work longer? What barriers and disincentives affect labor force participation rates among older people?

12) What are the most effective tools for helping people better anticipate the financial needs of longer lives? What are the financial skills and tools necessary for appropriate decision making and planning regarding savings, retirement benefit plans, retirement age, housing choices and health care expenditures in an age of rising costs and asset volatility?

[See 8 Realities of the New Retirement.]