Changing demographics and impact on health care

U.S. Population Aging and Implications for Health Spending

POPULATION REFERENCE BUREAU | www.prb.org

Mark Mather, Associate Vice President, U.S. Programs, PRB

June 2015

© 2015 Population Reference Bureau. All rights reserved. www.prb.org


In the U.S., the Number of People Ages 65 and Older Will Nearly Double By 2050.


The Age Profile of the U.S. Population Has Shifted, from the 1970s

Source: U.S. Census Bureau.


Through the Present (2014)



And Into the Future (2030)



By 2030, More Than One in Five Americans Will Be Ages 65 and Older.

NOTE: Percentages for subcategories may not sum to category totals due to roundingSOURCE: Population Reference Bureau, analysis of data from U.S. Census Bureau.

Percent


The Census Bureau Projects a 10-Fold Increase in the Number of Centenarians


By 2030, There Will Only Be Three Working-Age Adults For Every Person Age 65 or Older.

SOURCE: PRB analysis of data from the U.S. Census Bureau.

Elderly Support Ratio: Number of persons ages 18-64 per person ages 65+


SOURCE: PRB analysis of data from U.S. Census Bureau, Vintage 2012 Population Estimates.

Older Americans Make Up At Least 20 Percent of the Population of One-Fifth of U.S. Counties.


IMPLICATIONS FOR HEALTH AND HEALTH CARE


Social Security and Medicare Expenditures Are Projected to Reach 12% of GDP by 2050.


More People Are Living with Chronic Diseases. Longer life expectancies

Severe disabilities declining with advances in health care

But many older adults at risk of chronic diseases and premature death Often linked to smoking, obesity, alcohol use

Socioeconomic status


Obesity Rates Continue to Increase Among Older Americans.

Percent obese


Poor Diet, Lack of Exercise Impede Progress on Reducing Premature Deaths.

Percent of Early Deaths (Before Age 80) by Cause


More People Living With Dementia.

Affects 1-in-4 people over age 80 1-in-3 unpaid caregivers in U.S. helping

someone with dementia. Providing 6 billion hours of unpaid care each

year Dementia is the most costly U.S. health

condition ($215 billion per year). These costs could more than double by

2040.


Changes in Family Patterns May Result in Fewer Family Caregivers.

High rates of divorce

Increasing cohabitation and nonmarital childbearing

Lower fertility

Blended families


Households Have Changed Significantly Since the 1940s.

NOTE: Percentages for subcategories may not sum to category totals due to rounding.SOURCE: U.S. Census bureau, Decennial Censuses and American Community Survey.

Percent


Among Those Ages 85+, Over Half of Women and Nearly a Third of Men Live Alone.

SOURCE: U.S. Census Bureau, Current Population Survey.

Percent


Will Population Aging Affect Health Care Spending?

Yes… For federal government and many states, local

areas Current law hard to sustain for entitlement

programs Rise in number of people with chronic conditions Growing number of people with dementia Potential shortage of caregivers and shrinking

social networks


HOWEVER


The U.S. Population is Relatively Young Compared with Many Other Developed Countries.


Compare the U.S. with Japan (in 2030).


United States Japan


SOURCE: PRB analysis of data from U.S. Census Bureau.

Nearly Half of the U.S. Population will be Racial/Ethnic Minorities by 2030.Percent of U.S. Population by Race/Ethnicity: 1980-2030


Source: PRB analysis of data from U.S. Census Bureau.

But Children are Expected to Pass the “Majority-Minority” Threshold Sooner.Percent of U.S. Population Under age 18 by Race/Ethnicity: 1980-2030


The Non-Hispanic White Population is Aging Rapidly as Baby Boomers Reach Retirement Age.

Population by Age and Sex, U.S. White Alone, not Hispanic: 2014

SOURCE: U.S. Census Bureau.


The Latino Population has a Younger Age Structure Because of Higher Fertility and Past Immigration.

SOURCE: U.S. Census Bureau.

Population by Age and Sex, U.S. Hispanic or Latino: 2014


Both Older Men and Older Women are Working More.


More Adults Ages 55+ Have Completed College.

Source: U.S. Census Bureau, Current Population Survey.


More Men Are Surviving to Old Age.Number of men per 100 women


More Options for Older Adults to Maintain Their Independence Residential options

Nursing facilities Assisted Living Home health care Adult day care

Adaptations to help maintain independence Assistive devices Home modifications


Does U.S. Population Aging Really Matter?

No… U.S. is young, relative to Europe Population aging is selective, affecting some

groups more than others Baby boomers can cope better than previous

generations Better educated, working longer Men’s life expectancy improving relative to women

More options to remain independent


Major Demographic Changes are Underway Aging baby boomers

Changes in family structure

More racial/ethnic minorities

Juxtaposition of older boomers (mostly white) and children/young adults who are increasingly Latino, Asian, multiracial


Demographic Opportunities

Future elderly will be better educated

Labor force participation among those 65+ has increased and could help to offset declining elderly support ratio

Increasing the future productive capacity of today’s youth can help to offset costs of an aging society


Thank You!

Mark [email protected]

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Changing demographics and impact on health care