Unmet Challenges for an Aging America

Negative images of aging and entitlements fights obscure the growing need for major societal shifts.

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If you look at the major public issues and stories of our times, the only two likely to involve older Americans are the intractable battles over Social Security, Medicare, and other senior benefits, and the general awareness that a lot of us are getting older and approaching a period of life typified by chronic illness, frailty, and Alzheimer's. The most prevalent stereotype of aging: It sucks to be old, dude.

[See Attractive and Functional Design Solutions for Aging Homeowners.]

Within that portion of the communications, research, and policy-making landscape that focuses on aging, however, the story has long been much different. The image of older Americans here is of an increasingly vibrant group of longer-lived people. They are setting off on an expanded journey that can bring them tremendously rich experiences, new careers, and an extremely high quality of life well into their 80s and even 90s. They will be living in age-friendly communities with great mass transit and universal-design homes tailored for older occupants.

To date, however, these visions of the future have yet to make a meaningful impact on broader political, business, and social leaders. Yet anyone north of 50 should hope that aging becomes as much the talk of the day as economic growth, the environment, repairing the nation's infrastructure, immigration, and other significant issues.

One place where aging has been front and center is the U.S. Senate Special Committee on Aging, which is celebrating its 50th anniversary. On a regular basis, senior issues have been the subject of hearings overseen by committee chair Herb Kohl, a Democrat from Wisconsin who is not running for re-election. Often, there are few, if any, other committee members at these hearings, and Kohl listens to testimony, asks questions, and builds a public record.

The National Academy on an Aging Society sponsored a series of papers commemorating the committee's anniversary. The broadest views on aging were provided by John W. Rowe, the former head of insurance giant Aetna. Rowe is also a medical doctor and has focused on aging issues in recent years, as a professor at Columbia University and as the director of the MacArthur Foundation Research Network on an Aging Society.

Rowe's paper bemoaned the focus on negative elements of aging. He also shot down three common perceptions of aging issues he said were just flat wrong:

[See Talking Turkey About Aging and Retirement.]

1. It is all about the baby boom. "Some believe that once the baby boomers pass through the age structure, population aging will be over," Rowe said. "To the contrary, the demographic changes experienced in the last century are permanent."

2. An aging society is all about elders. This view reinforces "the inaccurate view of older people as individuals who do nothing but take resources from younger generations." Aging needs to be seen as affecting all age groups.

3. It is all about Social Security and Medicare. "This commonly held view," Rowe maintains, "tends to drown out all other considerations."

"More important," he adds, "almost no acknowledgment of the substantial positive aspects and potential of an aging society is occurring. This hyper-focus on entitlements to the neglect of the positive aspects of an aging landscape, combined with a related paralysis in policy developments, seems especially acute in the United States compared with other nations."

Society would enjoy a substantial "longevity dividend" if it can better harness longer-lived citizens as contributing members of the workforce and as a growing source of experienced volunteers and problem solvers at all levels of civic life.

[See Looking at Aging with Fresh Eyes.]

One place to start making such shifts, Rowe said, is to develop new sets of economic and social indicators that are responsive to the needs and required changes of an aging society. Regularly measuring and publicizing key aspects of an aging society would raise awareness and help bring aging issues into broader public discussions.

Well before people reach traditional retirement ages, Rowe added, "a reorientation to a life-course preventive health model is needed to strengthen education regarding healthy lifestyles and to implement interventions in at-risk groups" to produce healthier seniors and reduce future healthcare costs.

Already, there are disturbing signs that aging Americans could develop into less-healthy seniors than their parents. Physical impairments in middle age are rising. And while major gains in treating chronic diseases are prolonging life spans, the quality of life in those added years could decline.

Solving Social Security and Medicare won't address the underlying pressures for age-centric workplace, community, and family shifts. "What will failure look like?" Rowe asks. "Rather than a cohesive, equitable, and productive society, what will be left is one rife with intergenerational tensions, characterized by enormous gaps between the haves and the have nots (an increasingly less educated cohort) in quality of life and opportunity, and unable to provide needed goods and services for any of its members—especially a progressively older and more dependent population."

Twitter: @PhilMoeller