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OCR for page 42
The Demography of Current
arid Future Aging Cohorts
William J. Serow and David F. Sly
For a number of years, demographers have been making peri-
odic forays into the realm of aging issues (HermaTin, 1966; Key-
fitz, 1968; Lopez and Hanada, 1982; Manton, 1982; Pearl, 1940)
and in fact much of their general subject matter deals either
directly or indirectly with population aging (Coale, 1964;
Cowgill, 1974; Myers, 1985a). Yet systematic efforts to define
and give legitimacy to "population aging" as a subfield of de-
mography are of relatively recent vintage (Myers, 1985b; Siegel,
19801. These excellent essays nonetheless accomplish their objec-
tive of providing clear, concise statements about the substantive
domain of the field and the approaches that demographers can
use to analyze and explain the causes and consequences of pop-
ulation aging. Moreover, some legitimacy has been given to the
field by the extent of agreement these researchers show concern-
ing the basic parameters that define it.
For example, demographers generally agree that they should
be primarily concerned with aging as an aggregate phenomenon
and that there are two aggregates of primary concern: (1) the
total population and (2) the population older than some specified
William Serow is professor of economics and associate director at the Center for
the Study of Population at Florida State University, Tallahassee. David Sly is profes-
sor of sociology and director of the Center for the Study of Population. Their research
for this paper was supported by National Institute of Aging research grant AG05395.
42
OCR for page 43
DEMOGRAPHY OF CURRENT AND FUTURE COHORTS
43
age. With respect to the former, demographers concern them-
seIves with how general population processes influence the age
composition of populations and the causes and consequences of
changes in that composition. In terms of the latter, demogra-
phers consider the older population as a subpopulation and study
the causes and consequences of changes in its size, composition,
and distribution. Although there is agreement that these two
aggregates are clearly distinguishable as different points of an-
alytical departure, there is also consensus that neither can be
viewed in total isolation from the other. That is, an understand-
ing of how aging evolves in a population is crucial to under-
standing changes in the older population and the causes and
consequences of such changes.
Just as these essays reflect a high level of agreement about
the general domain of the demography of aging, so too do they
reflect accord when it comes to general analytical strategies and
techniques of analysis. Clearly, then, the demography of aging
has gained legitimacy as a specialized subfield in an academic
sense, but a question essential to our undertaking here is
whether it can also be given legitimacy in a more practical
sense. More specifically, we need to ask how an awareness of the
knowledge provided by the demography of aging can help policy-
makers and others charged with the responsibility of planning
for the needs of this group as well as for the consequences of
changes in it.
It is not possible here to present a fully developed response to
this question, but it is possible to provide a broad overview of
some of the general ways in which knowledge of the demo-
graphic structure of the population as a whole and of the chang-
ing demographic structure of the elderly will assist policymak-
ers and planners. For example, the needs of this subpopulation
and its resulting demands are going to be strongly influenced
by its size. In this sense, it is important for us to know much
more about patterns of mortality and longevity and how these
are changing. This may sound simple, but the complexity of such
knowledge is evident when we consider that the size of this
population is influenced by historical patterns of fertility and
morality to the point at which persons enter o]Ld age, as well as
by patterns of mortality throughout the older years of life- to
say nothing about the patterns of immigration and emigration
over the whole course of life. Similarly, the structure of the
.
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44
WILLIAM J. SEROW AND DAVID F. SLY
processes that are responsible for growth in the elderly popula-
tion (fertility, mortality, and migration) and the changes that
are likely to occur in that structure will influence the demand
for "needs" and even influence what these needs are and will
be. For example, temporal patterns of childbearing (when com-
bined with increased longevity) across generations influence how
old children are when their parents reach old age and may have
profound influences on the physical, economic, and social ability
of children to care for their aging parents. Similarly, changing
patterns of mortality may not only influence the number of
people who reach old age but may also affect how many people
survive for longer periods after reaching old age. In addition,
changes in mortality may have an impact on the physical, eco-
nomic, and social abilities of this sub-population's members to
care for themselves.
In short, we must understand how trends in basic demo-
graphic processes have operated (and will operate) over time so
we can better estimate the size of this subpopulation and the
level of demand it will create for various needs. Similarly, vari-
ations over time in the levels and structures of basic demo-
graphic processes have important implications for both the types
of specific needs likely to arise and the types of options available
for meeting them.
Population composition and distribution will also affect de-
mand. The socioeconomic status of the elderly subpopulation
will influence both the level of demand for needs and the types
of needs that will emerge. In this sense, it is important for us to
understand more clearly how the economic composition of the
elderly population is changing and the factors that are respon-
sible for this change. Different cohorts have quite different sav-
ings and labor force opportunity patterns, which can have quite
different consequences for the financial abilities of the popula-
tion during the early years of old age. In a similar fashion,
increased longevity among the aged will have important conse-
quences for how long savings and retirement income will have
to last, which in turn may have important consequences for how
the elderly dispose of income and savings throughout old age.
Levels of income and savings are also likely to have important
consequences for how much support will have to be provided
through the public sector; longevity will influence not only how
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DEMOGRAPHY OF CURRENT AND FUTURE COHORTS
45
many persons will have to be supported, but also when in old
age such support wit! begin and for how Tong it will be needed.
We can also expect the economic composition of the elderly
population to have important consequences for the private sec-
tor. Although we cannot explore the full range of such possibili-
ties here, it should be obvious from what has already been said
that everything from product development and retailing to fi-
nancial markets and the structure and availability of credit
could be significantly affected by changes in the economic com-
position of the elderly population.
The economic structure and circumstances of the elderly are
not the only compositional factors that will influence the social
and built environment. Other important elements include the
level of labor force participation and the structure of the elderly
labor force including the age of exit. In addition, we must take
into account changes in the marital status composition of the
elderly, which are affected by cohort patterns of divorce and
singleness as well as by changes in mortality differentials by
sex. All of these factors are likely to influence the demand for
and types of needs in such areas as housing, health care, recre-
ation and leisure, and living arrangements.
Population distribution will also be an important considera-
tion in determining the level and types of needs prevalent in the
elderly population. Redistribution of this population occurs es-
sentially as a result of areal differentials in mortality and mi-
gration. Where the elderly reside will obviously play a key role
in determining where services will have to be delivered and
what needs must be satisfied, but equally important is that, to
the extent these processes operate in a selective manner, we can
expect that areas with different redistribution experiences are
likely to have elderly populations with different needs. Unfor-
tunately, little is known about areal differentials in mortality
and migration and the factors that affect them, especially for
some very important types of areas such as metropolitan areas.
For our purposes here, however, and probably of greater impor-
tance is the fact that even less is known about the population
compositional differentials among areas that are being created
by redistribution.
To this point, we have focused almost exclusively on how a
knowledge of demographic trends can further our understand
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46
WILLIAM J. SEROW AND DAVID F. SLY
TABI~E 1 Size of the Older Population by Age and Sex, 1940-1980
1980 1970 1960
Totals Totals
Age Group Male Female by Age Male Female by Age Male
45~9 5,388,249 5,701,506 11,089,755 5,851,334 6,264,605 12,115,939 5,357,925
50-54 5,620,670 6,089,362 11,710,032 5,347,916 5,756,102 11,104,018 4,734,829
55-59 5,481,863 6,133,391 11,615,254 4,765,821 5,207,207 9,973,028 4,127,245
60-64 4,669,892 5,417,729 10,087,621 4,026,972 4,589,812 8,616,784 3,409,319
65-69 3,902,955 4,879,526 8,782,481 3,122,084 3,869,541 6,991,625 2,931,088
70-74 2,85S,547 3,944,577 6,798,124 2,315,000 3,128,831 5,443,831 2,185,216
75-79 1,847,661 2,946,061 4,793,722 1,560,661 2,274,173 3,834,834 1,359,424
80-84 1,019,227 1,915,806 2,935,033 875,584 1,408,727 2,284,311 665,093
85-89 477,185 1,043,107 1,520,202 362,063 656,084 1,018,147 255,776
90+ 204,340 515,525 719,865 180,316 312,438 492,754 106,500
Total of all
age groups 110,053,161 116,492,644 226,545,805 98,912,192 104,299,734 203,211,926 88,331,494
Total persons
aged 55 + 20,456,670 26,795,632 47,252,302 17,208,501 21,446,813 38,655,314 15,039,661
Total persons
aged 65 + 10,304,915 15,244,512 25,549,427 8,415,708 11,649,794 20,065,502 7,503,097
Total persons
aged 75 + 3,548,413 6,420,409 9,968,822 2,978,624 4,651,422 7,630,046 2,386,793
Total persons
aged 85 + 681,525 1,558,542 2,240,067 542,379 968,522 1,510,901 362,276
Percentage of
total
population
55 + 20.9 19.0
65 + 11.3 9.9
75 + 4.4 3.7
85 + 1.0 0.7
Percentage Change
1970-1980 1960-1970 1950-1960 1940-1950
55 + 22.2 . 20.3 25.4 30.7
65 + 27.3 21.2 34.8 36.2
SOURCES: U.S. Bureau of the Census, 1943 (Table 1), 1953 (Table 94), 1964 (Table
156), 1972 (Table 50), and 1983 (Table 40).
ing and our ability to predict the demand for needs among the
elderly. It is equally important to realize that a knowledge of
demographic trends will also help us to better understand and
predict the extent to which we will be able to supply these needs
and the kinds of trade-offs that may be necessary in order to do
so. Some of the subpopulation factors mentioned in the preced-
ing paragraphs may influence supply-side considerations, but
the more important factors in this sense will emerge from con-
sidering the elderly in relation to the total population. For ex-
ample, fairly good evidence suggests that as federal monies for
the elderly have increased, dollars for the youngest segment of
the population have decreased. Similarly, the viability of the
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DEMOGRAPHY OF CURRENT AND FUTURE COHORTS
47
1950
1940
Totals Totals Totals
Female by Age Male Female by Age Male Female by Age
5,521,560 10,879,485 4,545,606 4,556,172
4,871,125 9,605,954 4,142,277 4,153,303
4,302,620 8,429,865 3,639,761 3,612,763
3,733,133 7,142,452 3,047,212 3,027,151
3,326,822 6,257,910 2,431,035 2,582,455
2,553,716 4,738,932 1,633,382 1,785,826
1,694,135 3,053,559 992,645 1,157,730
914,834 1,579,927 500,345 624,225
392,805 648,581 177,760 251,845
174,171 280,671 56,670 91,175
9,101,778 4,209,269
8,290,580 3,752,750
7,252,524 3,011,364
6,074,363 2,397,816
5,013,490 1,896,088
3,419,028 1,270,967
2,150,375 723,680
1,124,570 359,011
429,605 121,455
147,845 34,919
4,045,956 8,255,225
3,504,096 7,256,846
2,832,501 5,843,865
2,330,524 4,728,340
1,910,569 3,806,657
1,298,565 2,569,532
780,302 1,503,982
415,380 774,391
155,557 277,012
52,821 87,740
90,991,681 179,323,175 74,833,239 75,864,122 150,697,361 66,061,592 65,607,683 131,669,275
17,092,236 32,131,897
9,056,483 16,559,580
3,175,945 5,562,738
12,478,810 13,133,170
5,791,837 6,493,256
1,727,420 2,124,975
25,611,980 9,815,300
12,285,093 4,406,120
3,852,395 1,239,065
9,776,219 19,591,519
4,613,194 9,019,314
1,404,060 2,643,125
566,976 929,252 234,430 343,020 577,450 156,374 208,378 364,752
18.5 17.0 14.9
9.2 8.1 6.8
3.1 2.6 2.0
0.5 0.4 0.3
current Social Security program is directly tied to the availabi-
lity of workers and the ratio of workers to retirees.
This discussion, although general, should make it clear that
demographic trends play a key role in shaping the social and
built environment and can have an important influence on dem-
ographic trends. In the pages that follow, we will trace the evo-
lution of the elderly population in the United States, giving
particular attention to the emergence of the "oldest old" as a
significant subpopulation and the "new aged" as a group that
has emerged from different social and built environments. Both
of these groups will pose new and different challenges to policy-
makers responsible for guiding the emergence of a social and
built environment to meet their needs.
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48
WILLIAM J. SEROW AND DAVID F. SLY
THE EVOLUTION OF THE OLDER
U.S. POPULATION
By now, nearly everyone is aware, at least in a general way, of
the rapid growth that has occurred in the nation's older popula-
tion (Siegel and Davidson, 1984; Population Reference Bureau,
19751. The data in Table 1 allow us to detail some of the high-
lights of the recent changes in the size of this subpopulation.
Perhaps one of the most important points to be made from these
data is that both the size and the pace of change in size are
strongly influenced by the age criterion employed to define the
"older population." In the discussion that follows, we focus on
the ages 56 and older and 65 and older because for most pur-
poses these two ranges represent the lower and upper ages
within which most persons have defined the older population.
In 1940 there were just over 20 million persons who were 55
years of age or older; just over 9 million of these were 65 or
older. The number of persons above these ages has increased
steadily during each successive decade and roughly doubled dur-
ing each of the 30-year intervals within the 40-year period; that
is, there were nearly twice as many older persons in 1970 as in
1940, and there were twice as many in 1980 as at midcentury.
Indeed, by 1980 the number of persons aged 55 and older had
passed the 47.25 million mark, and the number of persons aged
65 and older exceeded 25.5 million. These recent figures repre-
sent a 141 percent increase in the number of persons 55 and
older during the 40-year period and a 183 percent increase in
the number of persons 65 and older. To put the magnitude of
these increases into proper perspective, we need only consider
by way of contrast that the nation's total population increased
by 72 percent (from around 132 million to 227 million) while the
population under the age of 15 increased by just 55 percent (from
about 33 million to 51 million persons).
Although the increase in the older population seems quite
substantial, particularly when compared with the increase in
the total population and its youngest dependent sector, the most
substantial increases have actually occurred within the oldest
age groups of the old. For example, the number of persons aged
75 and older was more than 275 percent higher in 1980 than in
1940. Yet even this increase seems small compared with the
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DEMOGRAPHY OF CURRENT AND FUTURE COHORTS
49
increase in the number of persons SS and older, which went from
0.36 million in 1940 to over 2.2 million in 1980 an increase of
nearly 515 percent and 10 times greater than the increase occur-
ring within the group of individuals under the age of 15.
Components of Change
The number of elderly in the population can change from one
decade to the next as a result of three basic processes. One of
these processes, the aging of younger cohorts, is similar to fer-
tility in the general population in the sense that it is the basic
mechanism through which people are added to the ranks of the
elderly. Mortality, on the other hand, is the basic mechanism by
which people leave the population. Migration can make either a
TABLE 2 Components of Change (in millions) for the Population
Aged 65 and Older, 1940-1980
Components
1970-1980 1960-1970 1950-1960 1940-1950
Population at end of
decade 25,549 20,066 16,560 12,285
Population at beginning
of decade 20,066 16,560 12,285 9,019
Net increase 5,483 3,506 4,275 3,266
Gains-persons reaching
65 17,455 14,242 12,396 9,776
Losses
Death to 65+ 12,265 11,027 8,623 6,713
Deaths to initial
population 10,096 9,007 6,921 5,167
Deaths to remaining
population 2,169 2,020 1,702 1,546
Gross change 29,720 25,269 20,619 16,489
Percentage of changes
Rate of gross gain 87.0 86.0 100.1 108.4
Rate of gross loss 61.1 66.6 70.2 74.4
Rate of net gain 25.9 19.4 29.9 34.0
Total death rate 32.7 35.7 34.9 35.7
MRIP 65+ 50.3 54.4 56.3 57.3
MRPR 65 12.4 14.1 13.7 15.8
NOTE: MRIP 65 + = Mortality rate for initial population 65 and over. MRPR 65 =
Mortality rate for persons reaching 65.
SOURCE: Adapted from Siegel and Davidson, 1984.
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50
WILLIAM J. SEROW AND DAVID F. SLY
positive or negative contribution to the growth of the elderly
population. In Table 2 we present data that show the changes
over decades in the number of persons aged 65 and older, along
with estimates of the contribution of the components of change.
In making these estimates, we have relied on basic census sur-
vival techniques, and we have made no effort to take account of
migration or of the varying degrees of coverage or accuracy of
reporting age between censuses. Although we want to empha-
size that these estimates do contain errors, we are also confident
that they are sufficient to capture the general trends in the
components.
Between 1940 and 1950 the number of persons 65 and older
increased by nearly 3.3 million from an initial population of just
over 9 million. Achieving this net gain required the addition of
nearly 10 percent more people to the 65-and-older group than
were already part of it at the beginning of the decade because
nearly 60 percent of the persons 65 and older in 1940 died during
the decade, as did about 16 percent of those persons who aged to
65 and older during the decade. In other words, nearly 75 deaths
occurred over the decade to persons who were 65 and older or
who aged into this group for each 100 persons who were already
this age at the beginning of the decade.
By the next decade (1950-1960) the number of deaths had
declined to around 70 per 100 people at the beginning of the
decade. Most of the improvement in this figure resulted from a
decline in the deaths of persons reaching age 65 or older during
the decade rather than a decline in deaths to persons already 65
at the start of the decade. At the same time, there was a sub-
stantial increase (3.5 million) in the number of persons who
aged into the elderly group during this decade from the number
who had done so during the previous decade. Thus, the resulting
net increase in the number of persons aged 65 or older during
the period can be thought of as resulting primarily from persons
"aging in" and from a decline in the number of deaths in the
group.
Had the trends of the 1950s continued, the elderly population
would probably have begun to "young" eventually. That is, the
average age of the elderly would have begun to decrease. This
did not happen, however, and a number of changes in trends
were initiated during the 1960s that reversed the potential di
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DEMOGRAPHY OF CURRENT AND FUTURE COHORTS
~1
rection of the l950s. First, the death rate of persons reaching
age 65 and older stabilized and was at nearly the same level
during this decade as it had been during the previous decade.
Second, the death rate for persons 65 and older began to decline
rather substantially. Finally, this was the first decade during
which the number of persons aging into the elderly population
was considerably smaller than the number of elderly at the
beginning of the decade. In this sense, it is important to note
that the latter was not a function of a decline in the number of
persons aging into the elderly population; this figure actually
increased by nearly 2 million over the number aging in during
the previous decade. Rather, the smaller number was a function
of the increased chances of survival for those aging in during
earlier decades and the increasing size of the cohorts supplying
these individuals.
During the 1970s the trends that had emerged in the 1960s
continued, and the result was the largest interdecade net in-
crease in the number of elderly over the period being considered.
The cohorts aging in were some 2.2 million persons larger than
the cohorts that had aged in during the 1960s; they constituted
roughly the same proportion (87 percent) of the population aged
65 and older at the beginning of the decade as was true of those
aging in and those 65 and older during the 1960s. Whereas the
mortality rate for those persons aging in was nearly stable be-
tween the 1950s and the 1960s, there was once again a substan-
tial reduction between the 1960s and the 1970s. Even this reduc-
tion (1.7 deaths per 100 persons), however, was small compared
with the reduction of 4.1 deaths per 100 population that occurred
for persons who were 65 and older at the beginning of the decade.
Age Composition of the Elderly Population
Thus, over the whole period under consideration (1940-1950
to 1970-1980), the number of persons reaching age 65 and older
during the last decade was some 78 percent larger than during
the first, the mortality rate for persons 65 and older at the start
of each decade decreased by more than 12 percent, and the
mortality rate for those reaching age 65 and older during the
decade decreased by over 21 percent. The percentage of the total
population in this group increased steadily from just 6.S percent
OCR for page 52
52
WILLIAM J. SEROWAND DAVID F. SLY
in 1940 to 11.3 percent in 1980; the comparable change for the
population aged 55 and older was from 14.9 percent to 20.9
percent.
The data presented earlier documenting the growth of the
elderly population, and in particular those data dealing with
the components of change, strongly suggest that there have been
significant changes in the composition of this population. What
is interesting in this sense is that many of these changes are
not as dramatic as some people have believed whereas others
are more dramatic than is usually thought. A clear example of
the former can be seen in Table 3. Many people still believe that
the average age of the elderly population has increased dramat
. ~ ~
~ ~ . ~ ~ ~ 1 _ _ 1 ~ 1 Lie ~ ~ ~ ~ a_ ~ ~ ~ at +1-~ ~ ah ~
ically over the past tew clecactes, DUE Inese data snow ant Ills
mean age for persons 55 and older increased over the past five
decades by just 2 years to 67.7 in 1980. Over the same period,
the population aged 65 and older aged by 1.7 years to 74.4.
These averages, however, are strongly influenced not merely
by the decreases in death rates discussed earlier, but also by the
sharp increases that have occurred in the size of the cohorts
entering the elderly ages between each decade; in other words,
TABLE 3 Age Composition (percentage) of the Population Aged 55
and Older and of the Population Aged 65 and Older, 1940-1980
Age 1980 1970196019501940
Population groups aged 55 and older
55-59 24.7 25.8 28.7 28.3 30.0
60-64 21.3 22.3 21.5 23.7 24.1
65-69 18.6 18.1 18.8 19.6 19.4
70-74 14.4 14.1 14.3 13.3 13.1
75-79 10.1 9.9 9.2 8.4 7.7
80-84 6.2 5.9 4.8 4.4 3.9
85-89 3.2 2.6 1.9 1.7 1.4
90+ 1.5 1.3 .8 .6 .4
Mean 67.7 67.2 64.6 66.1 65.7
Population groups aged 65 and older
65-69 34.4 34.8 37.8 40.8 42.2
70-74 26.6 27.1 28.6 27.8 28.5
75-79 18.8 19.1 18.4 17.5 16.7
80-84 11.5 11.4 9.5 9.1 8.6
85-89 5.9 5.1 3.9 3.5 3.1
90+ 2.8 2.5 1.8 1.3 .9
Mean 74.4 74.1 73.4 73.0 72.7
SOURCE: Derived from Table 1.
OCR for page 92
92
WILLIAM J. SEROW AND DAVID F. SLY
associated with greater levels of chronic conditions and greater
use of health care facilities and providers.
As noted earlier, much of the underlying cause of the contin-
ued aging of the older population lies in declining mortality.
One of the critical issues that will arise in conjunction with this
aging and that is of particular relevance to the social and built
environment is the question of Tong-term care needs. Ries (1985)
recently prepared projections of total population and nursing
home residents, by age, for the year 2003 under conditions of
constant and declining mortality (Table 211. Even in the un-
likely event that there would be no changes in mortality be-
tween the years covered by this study (1978-2003), Ries projects
that the number of nursing home residents will increase by
nearly 60 percent, from 1.2 million to 1.9 million. If, however,
age- and sex-specific mortality continues to decrease, as it did
during the period from 1966 to 1976, then the number of nursing
home residents would rise by more than 100 percent to 2.6
million.
THE FUTURE OLDER POPULATION
In the first three sections of this paper, we examined (1) the
basic demographic structure of the older population and how
this structure has changed from 1940 to 1980; (2) the dramatic
effects that reductions in mortality at the older ages have had
on the growth of the elderly population and its changing age
and sex composition; and (3) the emergence of the new old,
illustrating how cohorts entering the other end of the elderly
age distribution (its new births) would influence its composition
and structure.
Now, we want to draw from each of the three previous sections
and consider what we can expect in the future. To some extent,
these issues have already been touched on. The mortality sched-
uTes discussed earlier portend that new cohorts entering the
older ages will live under considerably Tower risks of death until
much later in life. The data we presented on education, earn-
ings, labor force participation, and family size suggest the poten-
tial for a more heterogeneous life-style among the elderly in the
future. What is important to realize is that we can identify such
trends, but we cannot necessarily extrapolate them to the future
OCR for page 93
93
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94
WILLIAM J. SEROW AND DAVID F. SLY
and know what to expect. For example, future cohorts that enter
the older ages may be more healthy than past cohorts and more
able to provide for themselves, but if they live longer, their
savings and income may actually become less adequate than
those of many elderly today. Indeed, it is even possible that their
better physical condition and their expectations of a different
life-styTe may lead them to dispose of savings at a greater rate
at the very time that they are expected to live longer.
Nevertheless, an understanding of future trends in the growth
and structure of the elderly population is necessary if we are
even to assess the alternative futures. The projections most fre-
quently used for planning and policy purposes are the Series 14
middle-mortaTity/middle-fertility projections of the Bureau of the
Census. These projections, which roughly assume a continuation
of current fertility trends, forecast that life expectancy at birth
will increase to 76.7 years by the year 2000 and continue to
increase gradually to 81 years by 2080. The corresponding fig-
ures for men are 72.9 years in 2000 and 76.7 years in 2080; for
women, the expectancy is 80.5 years in 2000 and 85.2 years in
2080 (U.S. Bureau of the Census, 1984b).
The projections (Table 22) also indicate that the total popula-
tion of the country will increase to nearly 250 million in 1990
and 268 million by the turn of the century. By the year 2020,
there would be some 296 million people in the country. The
proportion of persons aged 55 and older will not change radically
from its 1980 level (21 percent) through the turn of the century,
even though the absolute number of persons 55 and older will
have increased from 47 million in 1980 to nearly 59 million in
the year 2000. Over the next 20 years, however, as the first of
the baby boom cohorts enters the 55-and-older age group, both
the proportion and number of older persons will rise sharply.
The percentage of the total population that is 55 and older will
pass 26 percent by the year 2010, and it will approach 31 percent
by the year 2020 when the number of persons aged 55 and older
will be nearly 92 million. Of particular significance in this
growth is the increasing size of the cohorts entering these ages.
Note, for example, that between 1990 and 2020, the two cohorts
making up the ages 55-64 double in size.
The population aged 65 and older wit! follow roughly the same
path in the sense that its absolute numbers will continue to
increase but its proportion of the total population will increase
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OCR for page 96
96
WILLIAM J. SEROW AND DAVID F. SLY
only moderately. The larger increase in the proportion of the
population aged 65 and older will lag 10 years behind the larger
increases in the 55-and-older population; thus, they will not
begin to appear until the year 2020. Nevertheless, according to
the projections, the population aged 65 and older will increase
from its 1980 level of 26 million to 39 million in the year 2010;
it will grow to 51 million by 2020. In other words, nearly one-
half of the expected growth in the population aged 55 and older
between 1980 and 2020 will occur in the single decade from 2010
to 2020, during which the size of the 65-and-older population
will increase by some 12 million persons.
The projected reductions in mortality will ensure the contin-
ued growth of the old old (aged 85 and older) population. Its
numbers will increase from their 1980 level of 2.2 million to
nearly 7.1 million by the year 2020. By that time, they will
constitute nearly 2.5 percent of the total population.
Although the projections described in the preceding para-
graphs are those that are most frequently cited, this does not
mean that the picture they portray will materialize. In fact, it
is important to note that a major shortcoming of the Census
Bureau middle-range projections in the past has been their un-
derestimates of reductions in mortality. In the two sets of projec-
tions released prior to those discussed above, the mortality error
accounted for over 40 percent of the 6-year aggregate error, and
in the projections made since 1960, ~ percent too many deaths
were predicted by only the sixth year of the projection period.
Clearly then, previous Census Bureau projections have erred in
a manner that most strongly affects the older ages. What can
we expect if this type of error is similarly reflected in the cur-
rent middle-range projections?
To help answer this question, Table 23 presents data for an
alternative set of projections that assumes a life expectancy at
birth in the year 2000 that is 2 years greater than in the previ-
ously discussed set and a life expectancy that will rise to 85.9
years in the year 2080.
These assumptions result in total population increases (over
the middle-level projections) that range from nearly 360,000 in
1990 to more than 5.4 million by the year 2020. What is even
more important for our purposes, however, is that the majority
of these gains would occur in the population aged 55 and older.
For example, by the year 2000, about 1.3 million of the total
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OCR for page 98
98
WILLIAM J. SEROW AND DAVID F. SLY
increase of 1.6 million (or about 81 percent) occurs in the popu-
lation aged 55 and older. By the year 2020, nearly 4.7 million of
the total increase of 5.4 million (or about 86 percent) occurs in
the population aged 55 and older. If we make these comparisons
on the basis of the population aged 65 and older, we can see that
the majority of deaths saved would actually be concentrated in
this age range. That is, with the Tow-mortality projections, there
would be 1.1 million more persons aged 65 and older than there
would be for the middle-level projections by the year 2000, and
nearly 4 million more by the year 2020.
As the data imply, these alternative sets of projections produce
substantially different age compositions of the elderly over time.
The proportion of the 65-and-older population aged 65-74 (which
was 61 percent in 1980) will drop to about 57 percent in 1990 by
both sets of projections, and it will continue to decline over the
next two decades. According to the middle-level projections, it
will increase again to 58 percent by the year 2020; yet according
to the low-mortaTity projections, it will reach only 55 percent by
this time. The reasons for this pattern center around the differ-
ent sizes of the newly entering cohorts and the extent to which
their fluctuations in size will be offset by the enhanced survival
chances of those already in the older ages. These factors can be
highlighted by looking at the other end of the elderly age distri-
bution. The proportion of persons aged 85 and older will increase
with both sets of projections for each of the first three decades
of the projection period, reaching 17 percent for the middle-level
projections and 19 percent for the low-mortaTity-level projec-
tions. By the end of the projection period (the year 2020), the
respective shares of the 65-and-older population that will be
aged 85 and older are 14 percent and 16 percent, but it should
be noted that with the Tow-mortality projections, we are estimat-
ing an increase of nearly 2 million more persons aged 85 and
older than with the middIe-level projections.
Although it is clearly impossible to state definitively that the
Tow-mortaTity projection ultimately will prove closer to. reality
than the middle-level alternative, the weight of recent experi-
ence certainly favors this conclusion. Such an outcome will
clearly have profound effects on the social and built environ-
ment, both as it relates to the needs of the older population and
as it tempers the overall quality of life for the entire population.
The limitations of both space and time preclude a detailed
OCR for page 99
DEMOGRAPHY OF CURRENT AND FUTURE COHORTS
99
elaboration of the entire realm of such effects. We prefer to
consider the issue we deem to be potentially of the greatest
import, namely, the need for Tong-term care. Probably the most
striking difference between the two sets of population projec-
tions shown in Tables 22 and 23 is the difference in the size of
the very old population that is, the population aged 85 or older.
We have already noted the much greater probability that this
segment of the population resides in a nursing home or similar
facility. At this writing, it is far from certain whether reductions
in mortality will increase or decrease the level of morbidity and
the presence of chronic, potentially disabling conditions among
the older population (Feldman, 1985; Fries, 1985; Schneider,
19851. Of course, the worst-case scenario would be that increases
in life expectancy at the older ages would result in additional
years of life characterized by affliction with such conditions.
Thus, we would argue that the demand for congregate living
facilities and Tong-term care facilities would rise as a result of a
diminution in mortality. Furthermore, we could extend the ar-
gument to note that considerably greater resources will be re-
quired to construct such facilities, to train more personnel to
staff them, and to pay the costs of their operation.
Given the present role of the public sector, through Medicaid,
of bearing a large proportion of these latter costs (in addition to
the costs of increased short-term hospitalization and medical
treatment through Medicare), we could easily arrive at some
rather sobering conclusions regarding the impact of reductions
in mortality on the social and built environment, not only for
aged individuals and their families but also for society at large.
Even if the age-specific proportions of older persons residing in
long-term care facilities do not increase, the number of persons
so residing must inexorably rise with the increase in the size of
the population at risk. Any increases in the size of the 85-and-
older population, such as that arising from reduced mortality,
will increase the number who will ultimately require such a
living arrangement. And any increases in the demand for such
care will lead to increases in the demand for the resources to
underwrite these costs.
Such resources presumably will continue to come from the
aged individuals themselves, from their families, and from soci-
ety as a whole, embodied in the public sector. As we have previ-
ously noted, there is some reason to believe that future genera
OCR for page 100
100
WILLIAM J. SEROW AND DAVID F. SLY
tions of the elderly, especially women, will command more
resources than is true of present generations. Yet these re-
sources cannot be regarded as infinite and, indeed, will have to
be stretched over a Tong life span. These individuals will have
fewer surviving children on whom to rely for financial and other
support, and, as life expectancy rises, the children of the oldest
old will more and more be counted among the youngest (and
even among the intermediate) old. The children of the oldest old
will themselves be concerned with providing for their own im-
pending care needs and may be unable to provide both financial
and personal support to their oldest old parents. One might
argue that it is the proper role of society to provide the neces-
sary resources, but the allocation of additional scarce resources
for these purposes means that fewer resources are available for
other needs, that additional resources will have to be transferred
from the private to the public sector, or that continued borrowing
by the public sector wi]Ll ensue. Thus, under this worst-case
scenario, the social and built environment would deteriorate for
all parties.
Few persons Took forward to spending their last years in an
institutionalized setting. Unless policies are altered to permit
societal funding for home-based care, however, this prospect be-
comes increasingly likely. The children of the potentially insti-
tutionalized will be fewer in number, relatively, and it is possible
that they will be unable to provide home-based care even if it
were affordable. If society as a whole chooses to underwrite the
resource costs of such care, it may have to face the choice of
doing without resources for other socially defined purposes, sub-
jecting itself to greater taxation (and, therefore, to less disposa-
ble income), or witnessing the continued growth of the nation's
budgetary deficit, which will ultimately destroy the health of
the nation's economy.
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DEMOGRAPHY OF CURRENT AND FUTURE COHORTS
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WILLIAM J. SEROWAND DAVID F. SLY
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Representative terms from entire chapter:
elderly population
