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The Social and Built Environment in an Older Society (1988)

Chapter: THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS

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Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
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Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
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Page 43
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 44
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 45
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 46
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 47
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 48
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 49
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 50
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 51
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 52
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 53
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 54
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 55
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 56
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 57
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 58
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 59
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 60
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 61
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 62
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 63
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 64
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 65
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 66
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 67
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 68
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 69
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 70
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 71
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 72
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 73
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 74
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 75
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 76
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 77
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 78
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 79
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 80
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 81
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 82
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 83
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 84
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 85
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 86
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 87
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
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Page 88
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
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Page 89
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 90
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 91
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 92
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 93
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 94
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 95
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 96
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 97
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 98
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 99
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 100
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
×
Page 101
Suggested Citation:"THE DEMOGRAPHY OF CURRENT AND FUTURE AGING COHORTS." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
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Page 102

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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

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 .

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

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

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

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.

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

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.

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

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

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.

DEMOGRAPHY OF CURRENT AND FUTURE COHORTS 53 the size of the cohorts tends to offset the "aging effect" of de- creases in death rates when the averages are calculated. If we Took at the age distributions of the elderly over the period, a different picture of change emerges. In 1940, 54 percent of the population aged 55 and older was under the age of 65; a full 30 percent was under the age of 60. As late as 1960 the correspond- ing figures were just over 50 percent and nearly 29 percent, but by 1980 the percentage of the population that was 55 and older but still under 65 had declined to 46 percent; less than 25 per- cent of the 55-and-older population was under the age of 60. Although the decrease in the relative numbers of the elderly was heavily concentrated in the two youngest age groups, the increase in relative numbers was heavily concentrated in the age groups over 75. The age group 75-79 increased its share of the elderly population from 7.7 percent to over 10 percent; the age group 80-84 increased its share from just under 4 percent to over 6 percent. Persons aged 85 and older, who made up less than 2 percent of the population aged 55 and older in 1940, were 4.7 percent of that population by 1980. This shift in the age composition of the elderly population can also be highlighted by noting that the ratio of persons 55-59 to those 85 and older declined from 16:1 in 1940 to just over 5:1 by 1980. We can observe similar compositional shifts for the population aged 65 and older in the sense that the share of the population in the two youngest age groups declines whereas that in the age groups over 75 increases. In addition, the largest proportional increase occurs in the population aged 85 and older, which saw its share of the 65-and-older population increase from 4 percent in 1940 to S.7 percent in 1980. Sex Composition At the same time the elderly population has been increasing and undergoing a substantial shift in its age composition, its sex composition has also been changing dramatically, a trend that is highlighted in Table 4 by comparing the upper left cell of the first four rows with the Tower right cell. This comparison shows that in 1980 the proportion of the 55-and-older population that was female was nearly the same as the proportion of the 85-and-older population that was female in 1940. In 1940 the proportion of females in both the population aged 55 and older

~4 WILLIAM J. SEROW AND DAVID F. SLY TABLE 4 Sex Differentials in the Elderly Population, 1940-1980 Differential 1980 1970 1960 1950 1940 Percentage of women In population by age group 55 + 56.7 55.5 51.4 51.3 49.9 65 + 59.7 58.1 54.7 52.8 51.1 75 + 64.4 61.0 57.1 55.1 53.1 85 + 69.6 64.1 61.0 59.4 57.1 Percentage of change from previous decade Men 55+ 18.9 14.4 20.5 27.1 Women 55+ 24.9 25.5 30.1 34.3 Men 65+ 22.4 12.2 29.5 31.4 Women 65+ 30.8 28.6 39.5 40.7 Age composition by group Men 65-69 37.9 37.1 39.0 42.0 43.0 70-74 27.7 27.5 29.1 28.2 28.8 75-79 17.9 18.5 18.1 17.1 16.4 80-84 9.9 10.4 8.9 8.6 8.1 85-89 4.6 4.3 3.4 3.1 2.8 90 + 2.0 2.1 1.4 1.0 0.8 Women 65-69 32.0 33.2 36.7 40.0 41.4 70-74 25.9 26.9 28.2 27.5 28.1 75-79 19.3 19.5 18.7 17.8 16.9 80-84 12.6 12.1 10.1 9.6 9.0 85-89 6.8 5.6 4.3 3.9 3.4 90+ Average age of 65 + population Men 73.6 73.6 73.1 72.8 72.5 Women 74.8 74.4 73.6 73.4 72.8 SOURCE: Derived from Table 1. and the population aged 65 and older was not substantially different from one-half, but at each census after this date fe- males made up a larger share of each of these age groups. In fact, by 1970 they were nearly 57 percent of the 55-and-older population and 60 percent of the 65-and-older population. Table 5 contains a more detailed account of the sex differen- tial. The ratios in this table show the number of women to men at each census by 5-year age groups. The data clearly demon- strate the effects of differential survival by age and its cumula- tive effects as well as the difference in the relative improve- ments in survival for men and women. That is, at each point in time the excess of women in the population increases with age, and at each age the excess of women increases over time. In

DEMOGRAPHY OF CURRENT AND FUTURE COHORTS TABLE 5 Ratios of Women to Men in the Population Aged 65 and Older by Age Group, 1940-1980 55 Age Group 1980 1970 1960 1950 1940 55-59 1.12 1.09 1.04 0.99 0.94 60-64 1.16 1.14 1.09 0.99 0.97 65-69 1.25 1.24 1.13 1.06 1.01 70-74 1.38 1.35 1.17 1.09 1.02 75-79 1.59 1.46 1.25 1.17 1.08 80-84 1.88 1.61 1.37 1.25 1.16 85-89 2.19 1.81 1.54 1.42 1.28 90 + 2.52 1.73 1.63 1.61 1.51 SOURCE: Derived from Table 1. 1940 the age differential in the sex ratio increased from .94 at age 55-59 to 1.51 by age 90 and older; or one could say the range in this ratio was just 0.57. By 1950 and 1960 this range varied slightly at around 0.60 before increasing by 1970. By 1980 it had increased to 1.40 as the sex ratio at age 55-59 had increased to 1.12 and at age 90 and over reached 2.52. Indeed, by 1980 women outnumbered men by more than 2:1 in both age groups above 85 and by more than 1.5:1 at ages 75-79 and 80-84. Thus, the increase in the range was more the result of changes at the upper end of the age distribution or among the oldest of the old than the result of changes among the younger old. Finally, going back to Table 4, we can see Has the sex ratios would suggest) that the older female population is older than the older mate population. In 1940 nearly 72 percent of the mate population aged 65 and older and more than 69 percent of the female population aged 65 and older was under the age of 75. Although by 1980 both sexes had experienced age compositional changes that were generally similar, the magnitude and timing of the changes were quite different. For example, over the five censuses the total shift up from the two combined age groups 65-74 for men was 6.2 percent; for females, it was nearly double at 11.6 percent. The percentage of the male population at these ages decreased at each census from 1940 through 1970 but ac- tually increased from 1970 to 1980; the percentage of the female population at these ages decreased continuously from 1940 to 1980. The general shift from these younger old ages was, of course, a concomitant of a general shift toward the older old ages for both sexes with the majority of the gain occurring for

~6 WILLIAM J. SEROW AND DAVID F. SLY the ages 80-89; but again, in both of the age groups in this range, the gain for women was about double that for men. Ethnic or Racial Composition Although it is generally believed that there are some major differences in population aging among ethnic or racial subgroups, these differences are difficult to track with confi- dence over time. For example, there are problems of coverage and age misreporting of varying degrees in nearly all of the censuses for blacks and some ethnic groups. These problems are compounded by differences in procedures for collecting and cod- ing data in the different censuses. In censuses prior to 1960, race was determined by the interviewer, but with the introduc- tion of self-enumeration in 1960, race came to be determined by the respondent. In 1980 coding and allocation procedures were altered in such a way that many Hispanics who were formerly classified as white were classified as nonwhite. Thus, data com- paring whites and nonwhites are more useful for intercensal periods prior to 1970-1980; data for blacks are probably more useful for periods after 1960. With these qualifications in mind, let us examine the data in Table 6. From 1940 to 1980 the nonwhite population increased its share of the total elderly from about 7 percent to over 10 percent. Even given the problems of comparing 1980 white/non- white data with white/nonwhite data for earlier periods, there is strong evidence in the table for an increasingly important role for the growth of the nonwhite elderly population in helping to shape the growth of the total elderly population. In the two decades 1940-1950 and 1950-1960, the nonwhite population con- tributed just over ~ percent to the total increase in the popula- tion aged 65 and older, but in the ensuing decade this figure increased to nearly 13 percent. What these figures suggest is that the growth in the number of nonwhite elderly has been greater than the growth in the white elderly. Although this is true, it is also true that the nonwhite elderly population relative to the total nonwhite pop- ulation has not grown at the same pace as the elderly population in general has grown relative to the country's total population. In the country as a whole the population aged 55 and older increased its share of the total population from 14.9 percent in

DEMOGRAPHY OF CURRENT AND FUTURE COHORTS TABLE 6 Ethnic or Racial Differentials in the Elderly Population, 1940-1980 57 Differential 1980 1970 1960 1950 1940 Percentage of total 55 + nonwhite population 10.7 9.1 8.4 7.3 7.0 Percentage of total 65 + nonwhite population 10.2 8.6 7.7 7.4 7.1 Percentage of total nonwhite population 55 + 13.4 13.8 13.1 11.5 10.2 65 + 6.8 6.8 6.1 5.6 4.8 Percentage change from previous decade Nonwhite 55 + 44.9 31.3 44.7 35.0 65 + 49.9 39.0 38.2 41.2 White 55 + 20.0 20.1 24.1 29.4 65 + 26.8 22.3 32.0 35.5 Composition by age group Nonwhite 65-69 37.3 39.9 41.5 46.9 48.0 70-74 27.0 26.6 27.9 25.5 26.4 75-79 18.6 16.3 17.4 15.1 13.4 80-84 9.6 9.5 7.8 7.5 6.6 85-89 4.6 4.5 3.6 3.4 3.3 90 + 2.9 3.2 1.8 1.6 2.3 White 65-69 34.0 34.4 37.8 40.3 41.8 70-74 26.6 27.2 28.8 28.0 28.6 75-79 18.8 19.4 18.4 17.7 16.9 80-84 11.7 11.6 9.5 9.3 8.7 85-89 6.1 5.1 4.0 3.5 3.1 90 + 2.8 2.3 1.5 1.2 0.9 Average age Nonwhite 73.8 73.8 73.0 72.3 72.4 White 74.4 74.1 73.4 73.0 72.7 SOURCES: U.S. Bureau of the Census, 1943 (Table 1), 1953 (Table 94), 1964 (Table 156), 1972 (Table 50), and 1983 (Table 40). 1940 to 20.9 percent in 1980; the population aged 65 and older increased its share from 6.8 percent in 1940 to 11.3 percent in 1980. For the nonwhite population the comparable figures were 10.2 percent to 13.4 percent for the population aged 55 and older and 4.8 percent to 6.8 percent for the population 65 and older. The nonwhite population is aging more slowly than the total

58 WILLIAM J. SEROW AND DAVID F. SLY population largely because its younger age groups are growing at a more rapid rate than are the younger age groups in the total population. Whites aged 65 and older have had a higher mean age at each census than nonwhites, but nonwhites have had a higher propor- tion reporting age 90 and older at each census. This difference fluctuates considerably over the five censuses, however, and the variation is largely the result of variations in the nonwhite population. There can be no doubt that some of this fluctuation is the result of the reporting problems discussed earlier, but there is evidence to suggest that a mortality crossover effect does occur. That is, studies have shown that, although the chances of whites outliving nonwhites are better throughout most of the life span, at advanced ages the probabilities "cross over" and the chances of nonwhites living longer are better than those of whites. Nevertheless, the general trend for both whites and nonwhites is for their age compositions to be shifting toward the upper ages to those age groups 80 and older. The data in Table 7 are for the black population. In 1940 blacks made up just under 10 percent of the total population. During each decade from 1940 to 1980, blacks increased their representation in the total population, but these increases were marginal at best. Thus, as late as 1980, blacks still made up less than 12 percent of the total population. If we Took only at older Americans, the picture of change is not radically different, but black representation is considerably less, making up just less than 7 percent of all persons aged 55 and older and 65 and older in 1940 and rising to S.5 percent and 8.2 percent, respectively, by 1980. In short, blacks are a significant minority within the population generally and among the elderly specifically. It is evident from the increasing percentage of the black pop- ulation in the older ages that this subpopulation is aging in the same general manner as the total population. In 1940 slightly more than 10 percent of the black population was over the age of 55 compared with nearly 15 percent of the total population. By 1980 just over 15 percent of the black population was over the age of 55 compared with nearly 21 percent of the total population. Thus, aging within the black population has been occurring in the same general manner as in the total population, but it has occurred more slowly in the former as the gap between the percentage of the elderly in the two increased from 2 per

DEMOGRAPHY OF CURRENT AND FUTURE COHORTS TABLE 7 Characteristics of the Elderly Black Population, 1940-1980 59 Characteristic 1980 1970 1960 1950 1940 Percentage of total population that is black Percentage of population 55 + that is black 8.5 8.2 7.7 6.9 6.7 11.7 11.1 10.5 10.0 9.8 Percentage of population 65 + that is black 8.2 7.8 7.0 7.1 6.8 Percentage of black population 55 + 15.1 14.0 13.1 11.8 10.2 65 + 7.9 6.9 6.2 5.8 4.8 Percentage change from previous decade 55+ Population 26.2 27.9 65+ Population 33.9 33.5 40.1 35.0 34.8 40.7 Composition by age group Total 65-69 37.2 40.2 41.7 47.0 48.2 70-74 27.0 26.8 27.8 25.5 26.5 75-79 18.6 16.3 17.4 15.1 ~ 80-84 9.6 9.2 7.7 7.5 ~25.3 85 + 7.6 7.5 5.4 5.0 J Sex ratios (F:M) 65-69 1.34 1.26 1.13 1.13 0.95 70-74 1.40 1.26 1.15 1.01 0.94 75-79 1.54 1.31 1.16 1.01 80-84 1.67 1.46 1.27 1.12 1.14 85 + 2.00 1.55 1.38 1.56 SOURCES: U.S. Bureau of the Census, 1943 (Table 1), 1953 (Table 94), 1964 (Table 156), 1972 (Table 50), and 1983 (Table 40). centage points in 1940 to 3.4 percentage points in 1980. The difference in aging within these two populations is the product of a combination of higher birth rates and Tower rates of survi- vorship among blacks of most ages. Data showing the age composition and sex ratios for the black population are also shown in Table 7. In general, these data reveal the same general trends as were discussed earlier for the total and nonwhite populations. The age composition of the older black population (as well as the changes in it) is approximately the same as for the nonwhite population. As was the case in comparing the nonwhite and white older age structure, the black

60 WILLIAM J. SEROW AND DAVID F. SLY elderly population is younger than the total elderly population, which results more from a concentration of blacks at the young- est old ages than from differences in their proportions at the oldest old ages. Similarly, the sex ratio patterns are generally the same for blacks as for the total population in the sense that there is a general trend at each age for the imbalance to increase over time and at each date for it to increase with age. The two major exceptions to this pattern appear to be at ages 85 and older, for which problems of coverage and age misreporting were particu- larly acute during the earlier censuses examined here, and for 1950, for which the ratio is higher for those aged 65-69 than for the intermediate older ages. Nevertheless, for later census dates, there.is a tendency for the black sex ratios to exceed the sex ratios for the total population at the younger old ages and for the sex ratios of the total population to exceed those for the black population at age 75 and older. Regional Distribution of the Elderly Table ~ focuses on the regional distribution of the elderly and the age composition of the elderly in each of the regions; sepa- rate data are presented for the total and black elderly popula- tions. The first row of figures in this table shows the percentage of all persons in the United States who lived in each of the regions at each census. Basically, these data highlight the well- known regional shifts that have occurred to the West and South during the post-World War IT period: the West and the South have increased their share of the population from just under 11 percent and 32 percent to about 19 percent and 33 percent, respectively; the Northeast and North Central regions have seen their shares decline from just over 27 percent and 30 percent, respectively, to about 22 percent and 26 percent. In 1940, 1950, and 1960, the largest plurality of older Americans lived in the North Central region; the Northeast, on the other hand, had the second largest concentration of elderly through 1950 and a proportion nearly equal to that of the South in 1960. The regional redistribution of the elderly population, however, has followed the same general trend as the regional redistribu- tion of all persons and in fact has been even more salient. For example, in 1940 the Northeast and North Central regions

DEMOGRAPHY OF CURRENT AND FUTURE COHORTS 61 housed 57.S percent of the total and 63 percent of the elderly population. Yet these percentages declined at each consecutive census, and by 1980 these regions had 47.7 percent of the total population and 49.9 percent of the elderly population. That is, although their share of the total population declined by 10.1 percent, their share of the elderly decreased by 13.1 percent. The overall trend in these redistributional changes in each region can be easily followed by looking at the index of redistribution, which is merely the ratio of the percentage of the population elder than the specified age to the percentage of the total popu . ~ ~ ration in the region. A value greater than unity ~na~cares ~ larger share of elderly than the total population; a value less than unity indicates a lower share of the elderly than the re- gion's total population share. In 1940 only one region, the South, had a proportion of the elderly that was Tower than its propor- tion of the total population; by 1980, however, the South and the North Central regions had nearly equal proportions of the coun- try's total and elderly populations. The Northeast was the only region to have a greater proportion of the elderly than its share of the total population. The West, on the other hand, stood out as the only region to have a Tower proportion of the elderly population than its total population share. Measured in terms of the percentage of population aged 55 and older and the percentage of population aged 65 and older, each regional population has aged, but aping has occurred dif ferently within each or the regions. The percentage of the re- gional population aged 65 and older is shown in tabular form in Table S. . In 1940 each of the regions except the South had populations with between 7.2 percent and 7.6 percent aged 65 and older. The South, with only 5.5 percent of its population over 65, had the youngest regional population. Between 1940 and 1960 the rise in the percentage of population 65 and older was considerably more dramatic In the Northeast and the South than in the North Central region ancl tne west. 1nclee(l, by labs Ills ~ ~ al IJ11- east, which had a lower percentage of the elderly in 1940 than either the North Central region or the West, had passed both of these regions, and the overall differential among regions was reduced to just 1.7 percentage points. Between 1960 and 1970 the rise in the percentage of the pop- ulation aged 65 and older was sharper in the South than in any

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64 WILLIAM J. SEROW AND DAVID F. SLY of the other regions; by the end of this decade the percentage aged 65 and older in this region surpassed that in the West. During the 1970s the population aged 65 and older increased in all regions more dramatically than it had since the 1940s; how- ever, it increased more sharply in the Northeast and South than in the North Central region and West with the result that by 1980 the Northeast had a full 3 percent more of its population aged 65 and older than did the West and the South and the North Central region had nearly identical shares of their popu- lation aged 65 and older. The age composition of the elderly population in each of the regions has also changed significantly over time. For example, the 65-and-older population in each of the regions has aged as indicated by the fact that in no region was there less than an ~ percent decline in the proportion of this population between ages 65 and 74 from 1940 to 1980. Nevertheless, there was sub- stantial variation in the extent of aging; this decline was just over ~ percent in the West, but it was just under 14 percent in the Northeast. In the Northeast the decline occurred mainly in the decade from 1940 to 1950 and in the two decades from 1960 to 1980. In the West, it was largely concentrated in the two decades from 1950 to 1970. In the North Central region and the South the decline in the percentage of population aged 65 and older that is 65 to 74 is similar and intermediate to that in the other two regions. In both of these regions the major proportion of the decline occurred from 1940 to 1970; the largest decline occurred from 1960 to 1970. Urban-Rural Differences Table 9 shows the level of urbanization of the total population and the 65-and-older population for the nation and for each of its regions from 1950 to 1980. During this period the definition of urban and rural changed slightly with respect to the way in which unincorporated places were treated; consequently, al- though the distribution of population at each date reflects a difference at that point in time, changes over time are also influenced by definitional change. None of these changes was major, however, and we are of the opinion that the data do cap- ture the trend of distributional change. With these considerations in mind, the observer is immedi

DEMOGRAPHY OF CURRENT AND FUTURE COHORTS 65 ately struck by the extent to which the total population and the elderly population are equally urbanized and the extent to which there has been little difference in the level of urbanization over time. At midcentury, both the total and the elderly populations had about 64 percent of their numbers residing in urban areas; and the level of urbanization of both populations increased con- siderably during the 1950s and the 1960s but little during the 1970s. By 1980 the level of urbanization for both populations was approaching 75 percent, and at no point did the difference exceed 0.S percent. These national patterns, however, do mask some interesting and substantial differences that exist across and within regions. The level of urbanization has been consistently higher in the Northeast and the West than in the North Central region and the South for both the total and elderly populations. In 1950 the largest differences in level of urbanization between the total and elderly populations could be found in the West, where the el- derly population was more urbanized than the total population, and in the North Central region, where the total population was more urbanized than the elderly. By 1980 there was still a sub- stantial differential in level of urbanization for both populations across regions, but within regions the differential between the total and elderly populations had virtually disappeared in all of the regions except the Northeast, where the total population was actually slightly less urbanized than it had been in 1950 and the elderly population was nearly 4.5 percent more urban- ized than it had been in 1950. In other words, within all regions the urban elderly population has been increasing at a faster rate than either the rural elderly population or the total urban and rural population except in the West (this statement is not true for the total urban population there) and the Northeast (there, it is not true for the rural elderly during the 1970s). The age composition data for the urban and rural elderly pop- ulations both nationally and regionally show that, in general, the urban elderly were somewhat younger in 1960 than the rural elderly in all areas except the West. The magnitude of this differential varied across regions, but over time the dominant trend has been for the rural elderly populations to "become" younger at a faster rate than the urban elderly. Indeed, by 1980 the rural elderly of each region were younger than their urban counterparts. This trend has probably been influenced consid

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70 WILLIAM J. SEROWAND DAVID F. SLY erably by elderly mobility patterns operating on both ends of the age distribution that is, by young elderly moving in greater numbers from urban to rural areas than from rural to urban areas and older elderly moving from rural to urban areas. Marital Composition and Living Arrangements Age and sex differences in mortality as well as rates and patterns of remarriage in the elderly population strongly sug- gest the value of examining patterns of marital composition separately by sex. The extent to which these factors operate is clearly revealed in Table 10 in which recent changes in the marital composition of the elderly can be traced. Among men aged 65 and older, nearly 64 percent were married in 1940, and this proportion increased steadily to just over 76 percent by 1980. Among women of the same age, only 34 percent were married in 1940, and although this proportion increased to 37 percent by 1960, it changed little after this time. By way of contrast, some 55 percent of women aged 65 and older were widowed in 1940, and this proportion decreased to only about 52 percent by 1980; for comparable men, however, the proportion of men 65 and older who were widowed decreased from 25 percent in 1940 to about 15 percent by 1980. There is an inverse relationship between age and the percent- age of the population who are married and a direct relationship between age and the percentage of the population who are wid- owed for each sex at each point in time. Among men, the propor- tion married varied from nearly 72 percent for those aged 65-69 to 33 percent for those 85 and older in 1940; for women the comparable figures were 46 percent and about 7 percent. Thus, the age differential for both men and women in 1940 was about 39 percent. Between 1940 and 1980 the proportion of men mar- ried at each specific age increased, but because it increased somewhat more rapidly at the upper ages than it did at the Tower, by 1980 the differential for men had decreased to about 35 percent. Among women the general pattern of improvement in the proportion of women married at each date for each age is also evident, with one minor exception. In the case of women, however, the levels of improvement are much smaller at each age than those for men, and they are relatively much smaller at the older than at the younger ages. In fact, by 1980 the differ

DEMOGRAPHY OF CURRENT AND FUTURE COHORTS 71 ential between those women aged 65-69 and those 85 and older actually increased to more than 46 percent. Knowing this, what happens to the age differential in the percentage of the population who are widowed is not surprising. For both men and women, the differential was about 42 percent in 1940; it decreased to about 37 percent for males in 1980. For women, the differential increased to 48 percent in 1980 largely because improvements in the proportion of those widowed at the oldest ages came much more slowly than improvements at the younger ages. Data on living arrangements are particularly useful for telling us something about the daily environment in which the elderly function. Yet putting together a historical series of data on liv- ing arrangements, even for the short period under observation here, is difficult because of changes in tabulation procedures and concepts (e.g., the transition from head of a household to a householder from one census to the next). Nevertheless, it is possible to identify how each person in a household relates to the head/householder in rather broad terms (Table 111. Again, for largely the same reasons, it is important to Took at changes in living arrangements separately for men and women. In 1940, 79 percent of the men living in households were heads, and another 11 percent were members of households headed by one of their children. The remaining men (10 percent) were either members of households headed by other relatives or mem- bers of households headed by nonrelatives. The percentage of men heading households increased at each census, reaching nearly 91 percent by 1970 (the last census before the change to the householder concept). Even after this change in 1980, 90 percent of the men aged 65 and older were identified as house- holders; at the same time, about 3 percent were identified as spouses of householders. The percentage of men living in house- holds in which the head/householder was a child decreased to just over 3 percent; those living in households in which the head/ householder was another relative or nonrelative decreased to less than 5 percent. Thus, the dominant trend among men has been for the per- centage of men who are headsA~ouseholders to increase at each successive census and for the percentage in each of the other relationship categories to decrease. Indeed, this trend is so sali- ent that it is not merely the relative numbers that have declined

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DEMOGRAPHY OF CURRENT AND FUTURE COHORTS 73 but also the absolute numbers: in each relationship category except that of child this number has so decreased that by 1980 there were fewer men in households headed by each type of individual than there were in 1940. A similar pattern can be observed for women aged 65 and older: the number of heads/householders increased steadily from 1.5 million in 1940 to 7.3 million in 1980, and their share of all women in households rose from 34 percent to 51 percent. The number of women identified as spouses increased from one cen- sus to the next, but the percentage of women in households who were identified as spouses stabilized at the 1960 level of 35 percent. The number of women aged 65 and older living in a household headed by one of their children or their spouse in- creased through 1960 but has declined since then; on the other hand, the percentage of women living under this arrangement has decreased steadily since 1940. The number of women living with other relatives and nonrelatives has been smaller, and the relative number living under these arrangements has decreased with each successive census. Thus, although the overall trend for both men and women living in households has been for an increasing proportion to live in households they are heading, there are also some impor- tant sex differentials. Continuously since 1940, women have been about twice as likely as men to live in a household headed by another relative. In 1940 nearly 30 percent of women aged 65 and older who were members of households were in house- holds headed by some relative; this same statement was only true of about 15 percent of the comparable men. By 1980 the comparable figures were just over 12 percent and 5 percent, respectively. There have also been markedly different patterns for men and women in the growth of the nonhousehold population. In 1940 and 1950 there were actually more men than women in the nonhousehold population, but by 1960 there were 1.19 women for each man, and this ratio has increased steadily since then, reaching 2.35 by 1980. To some degree, these ratios merely re- fIect the growth differential between older men and women, but they have undoubtedly also been influenced by the greater like- lihood that women will live in households with relatives as heads during the early part of the period and the greater avail- ability of nonhousehold facilities such as homes for veterans.

74 WILLIAM J. SEROWAND DAVID F. SLY The reversal of the ratio in later years probably reflects the differential by sex in increased longevity and the greater avail- ability to women of nonhousehold care. For example, in 1980, there were nearly 1.5 million persons aged 65 and older in non- household settings. Of this group, 1.2 million were in homes for the aged, and nearly 75 percent of those in such facilities were women. THE "OLD OLD" That segment of the elderly population about which the least is known is the "old old" or the oldest of the old. It is generally believed that in recent years this population segment has been growing more rapidly than any other, and we have presented data earlier in this paper that confirm this notion. We do not, however, know a great deal about how this growth has come about or about the composition and distribution of this popula. lion (Rosenwaike, 19851. Unfortunately, demographers have been unable to explore these issues in much depth because of tabula- tion constraints in the data published by the Census Bureau. As a general rule, compositional information has been aggregated for the population aged 65 and older and, in some instances, for that aged 75 and older. The availability of public-use data tapes makes it possible for the researcher to overcome many of these problems, and projects that use these data sources are currently under way at the University of Pennsylvania and Florida State University. Even- tually, these projects will provide detailed data and analyses of the emergence of this population and its changing composition, but until they are further along, we can examine only the basic information about this population with any kind of historical perspective. Earlier, we noted the rapid rate at which the population aged 85 and older has been increasing. The data in Table 12 show that this is not as recent a phenomenon as is frequently thought and that the rate of increase for the population aged 90 and older has actually been greater than that for the conventionally defined old old aged 85 and older. During each decade since 1940 the 85-and-older population has increased by about 60 percent, except for the last decade (1970-1980), during which the in- crease was nearly 50 percent. In the three decades from 1940

DEMOGRAPHY OF CURRENT AND FUTURE COHORTS 75 through 1970, the population aged 90 and older increased by 68 percent, 90 percent, and 75 percent, respectively, before increas- ing by just 45 percent in the decade from 1970 to 1980. In this sense, it is important to realize that the attention given to the 85-and-older population in recent years is probably due more to its growth to a significant number than to its rate of growth per se. Indeed, what might be more important in the future is that, over this period, the population aged 90 and older increased its share of the old old population, growing from less than one in four individuals to nearly one in three. For both the population aged 85 and older and that aged 90 and older; women increased in numbers at a more rapid rate than men. Over time, the sex differential has tended to increase in both ages, but it was particularly salient in the decade from 1970 to 1980 during which the male population aged 85 and older increased by only 25 percent and the male population aged 90 and older increased by only 13 percent. The comparable fig- ures for women were 61 percent and 65 percent. These growth differentials have produced an increasingly unbalanced sex ra- tio. Among the population aged 85 and older, the sex ratio in- creased from 1.33 (women per man) in 1940 to 1.56 in 1960. By 1970 the ratio had reached 1.79, and by 1980 it had increased to 2.29. In other words, in the single decade from 1970 to 1980, the increase in the sex ratio was greater than it had been over the previous 30 years. Similarly, among the population aged 90 and older the sex ratio increased by 0.22 from 1940 to 1970; it in- creased 3~/~ times this during the 1970s. The growth of the old old population and its increasingly large sex ratio are the result of two basic trends. First, the cohorts that have reached the threshold ages to become eligible to move into the old old ages have been increasingly large. For example, it is members of the cohorts that are aged 75-84 at the begin- ning of each decade who become the "new old old" over the course of the decade. In 1940 there were 2.3 million such people, whereas by 1960 their number had doubled. By 1970 there were 2.7 persons in this cohort for each person in it in 1940. By 1980 the number of persons aged 75-84 increased to more than 7.7 million, which represents some 3.4 persons in this cohort for each person in it in 1940. A substantial amount of the increase in the size of the cohorts reaching these ages is the result of reduced risks of mortality at

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78 WILLIAM J. SEROW AND DAVID F. SLY TABLE 13 Life-Table Death Rates and Survivors to Each Age Group from Age 55-84 per 1,000 Persons Aged 55-59, 1940-1980 Death Rates Survivors to Each Age of 1,000 Persons Aged 55-59 Age Group 1980 1970 1960 1950 1940 1980 1960 1940 Total 55-59 .0530 .0660 .0683 .0783 .0908 947 932 909 60-64 .0794 .0956 .1041 .1150 .1299 872 835 791 65-69 .1165 .1386 .1531 .1664 .1904 770 707 640 70-74 .1694 .1976 .2267 .2519 .2894 640 547 455 75-79 .2427 .2885 .3437 .3829 .4445 485 359 253 80-84 .3554 .4035 .5485 .5708 .6609 313 162 88 Male 55-59 .0707 .0890 .0912 .0992 .1073 929 909 893 60-64 .1061 .1306 .1383 .1433 .1522 830 783 757 65-69 .1571 .1872 .2004 .2035 .2175 700 626 592 70-74 .2259 .2573 .2829 .2947 .3214 542 449 402 75-79 .3149 .3563 .4080 .4322 .4833 371 266 208 80-84 .4354 .4688 .6204 .6243 .7073 209 101 61 Female 55-59 .0369 .0444 .0462 .0573 .0733 963 954 927 60-64 .0558 .0639 .0726 .0864 .1078 909 885 827 65-69 .0828 .0974 .1110 .1206 .1632 834 787 692 70-74 .1261 .1506 .1781 .2125 .2581 729 647 513 75-79 .1937 .2382 .2917 .3395 .4082 588 458 304 80-84 .3088 .3596 .4955 .5270 .6204 406 231 115 SOURCES: Grove and Hetzel, 1968; National Center for Health Statistics, 1975, 1985. the younger old ages. These reductions can be followed in Table 13, which contains the life-table death rates of persons aged 55 and older by 5-year age groups for each decade from 1940 to 1980. We could discuss the reductions in these mortality rates in detail, but the easiest way to illustrate their consequences in this context is to assume their effect by asking the following question: If a cohort aged 55-59 had 1,000 people in it and was subject to each of these schedules, how many people would sur- vive to age 85 and older? By the 1940 mortality schedule, nearly 100 of the original 1,000 persons would have died before reaching age 60, and 360 would have died before age 70. From this point on, deaths would increase, and by the time the cohort reached age 85, only 88

DEMOGRAPHY OF CURRENT AND FUTURE COHORTS 79 persons would survive. By the 1960 mortality schedule, the number of survivors to age 85 nearly doubles to 162, but the sharpest contrast occurs when the effects of the 1940 schedule are compared to those of the 1980 schedule. By the 1980 sched- uTe, just 50 people would die before age 60, and 230 would die before age 70. By age 85, the 1980 mortality schedule produces 313 survivors or 3.6 survivors for each 1 survivor by the 1940 schedule. The lower panels of the table show the same data separately for men and women. The same general pattern of survivorship for the artificial cohorts operates for men and women as it did for the general population except that the rates of mortality are higher for men than for women and the improved risk of death at the middle old ages (65-79) is considerably better for women than for men. Thus, the increased number of survivors from 1940 to 1980 for men aged 65-69, 70-74, and 75-79 is IDS, 140, and 163, respectively; for females the comparable numbers are 142, 216, and 284. Put another way, the mortality saved by the 1980 schedule over the 1940 schedule is about the same for women at age 65-69 as it is for men at age 70-74. After these points, women continue to gain through age 80-84; men, on the other hand, peak at 163 at age 75-79 before dropping back to 148 at age 80-84. Nevertheless, it is obvious that both men and women reaching the young old ages have considerably better chances of reaching the old old ages in 1980 than they did in 1940. For each male who was age 55-59 in 1940 and lived to age 85, there were 3.4 comparable men in 1980 (the ratio for women was 3.51. Indeed, by the 1980 mortality schedule, more than 40 percent of the women reaching age 55-59 would survive to reach the old old ages, whereas this was true of only about 20 percent of the men. In 1940, only 6 percent of the men and 12 percent of the women aged 55-59 would survive to reach the old old ages. Clearly, mortality reductions in the old ages have significantly contrib- uted to the growth of the old old population. THE NEW AGED It is our contention that changes in the composition, behavior, and needs of future generations of the elderly can best be fore- seen by a consideration of how newly entering cohorts differ

80 WILLIAM J. SEROW AND DAVID F. SLY from their immediate predecessors. Thus, the purpose of this section is to explore the differences over time and across cohorts between that group of the older population considered in the preceding section the old old-and the group at the opposite end of the spectrum those who have just entered the ranks of the older population. We have already discussed the fact that in recent censuses the new aged constitute smaller proportions of the entire older population than had been true previously, pri- marily because of reductions in mortality among those already aged 65 and older. Consequently, in 1980 those aged 55-64 ac- counted for only 46 percent of the entire 55-and-older popula- tion, whereas in 1940 this age group represented 54 percent. Our purpose here will be first to explore how the most recent cohort of the new aged differs in important ways from the re- mainder of the elderly. In particular, we will argue that the group aged 55-64 in 1980 represents the cutting edge of critical differences in the composition and life-course experiences of the elderly of yesterday and the elderly of tomorrow. Table 14 illus- trates one aspect of such differences: median years of education completed by birth cohorts prior to 1865 through those born from 1955 to 1960. The data are arranged so that the reader can consider differences in educational attainment by age, cohort, and period, and this threefold consideration will set the mode! for the analytical approach we follow throughout this section. The table can be read three ways: 1. by row (horizontally) showing median educational attain- ment for a stated birth cohort; 2. by column (vertically) showing median educational attain- ment for successive cohorts in a given age group; and 3. diagonally, showing the age structure of educational attain- ment for a given period. The 1980 groups aged 55-59 and 60-64 show 12.3 and 12.1 median school years completed, respectively. These rates are, on the one hand, anywhere from 1.1 to 3.9 years greater than those attained by other members of the older population and, on the other hand, a maximum of 0.6 years less than those attained by any other cohort. In other words, the 1980 "new aged" have educational experiences that are generally similar in duration to those of all segments of the population younger than them- seIves but that are substantially greater than those of all seg

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82 WILLIAM J. SEROW AND DAVID F. SLY meets older than themselves. In 1970 the position of these age groups was intermediate between those younger and older (sec- ond diagonal), but in 1960, 1950, and 1940, there was very little difference in educational attainment within the older popula- tion. There were successively greater differences between the younger and older populations as a whole, however. Thus, those cohorts born after 1915 differ from those born before that year in terms of the length of their education. The current cohort of the new aged and all successive cohorts who will become part of the older population (at least through the year 2015) will have, at the midpoint, completed high school and will have some post- secondary education. Although we certainly do not wish to claim that education is a panacea for all social ills, there is little doubt that greater educational attainment will have subsequent ef- fects on individuals' tastes and expectations. It is certainly con- ceivable that this greater degree of "sophistication" will affect the nature and type of services that will be demanded by these cohorts. Higher levels of education might be expected to have addi- tional influences on the life-course experiences of the new aged within the older population. In general, there is a positive influ- ence of education on earning power, although the actual level of earnings will also depend on the overall rate of labor force par- ticipation. Tables 15 and 16 show median income by age for men and women relative to overall income levels for persons of the gender. (The data presented here pertain only to those individ- uals with income.) Once again, the data are presented in such a way as to permit full consideration of age, period, and cohort effects. Turning first to the experience of men (Table 15), the age effects are quite clear: men at either end of the age spectrum tend to earn relatively less than those in the middle. Generally, the income of persons aged 25 to 64 is higher than that for persons under 24 and over 65. At a given point in time, peak income comes somewhere in the middle of the 25-64 age span. For 1950, 1960, and 1970 (no data are available for 1940), the peak income age was 35-39 and/or 40-44; in 1980 it had moved to 45-49. From a cohort perspective, a similar phenomenon- that is, the peak income years coming slightly later in middle age also seems to be emerging. The limited data available suggest that cohorts born prior to

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DEMOGRAPHY OF CURRENT AND FUTURE COHORTS 85 1920 enjoyed their peak income years before age 45; those born more recently seem to be reaching the income peak in their late forties or early fifties. Finally, and perhaps most important for present purposes, let us consider the period effects. The 1980 data (first diagonal) show much higher relative income after age 35 than was true in previous years. For those out of the labor force, this trend may well be attributable to the significant increases in the real value of Social Security retirement benefits during the 1970s. Yet relative income, not only for the "new aged" of 1980 but also for those who will be the new aged in 1990 and 2000, was also greater than had been the case in prior census years-for both the 45-54 and 35-44 age groups, income was 50-60 percent above the overall average, in rather sharp contrast to the expe- rience of older cohorts as they passed through the same age range. The experience of the new aged is similar, with relative income for those aged 55-64 in 1980 being appreciably greater than for previous cohorts when they were aged 55-64. The pattern among women (Table 16), however, is much differ- ent; a pronounced downward shift toward higher relative income by age has occurred between 1970 and 1980. Prior to 1980 the age pattern among women had been similar to that of men: peak income came in the 40-44 and 45-49 age groups, and there was some increase in this age over time. Yet in 1980, peak income occurred at age 25-29, and the highest relative income groups were entirely under the age of 45. The reason for this change may be seen in the pronounced changes in female labor force participation rates, which are shown in Table 17. The remarkable increases in labor force participation among American women during the 1970s is well known. For all ages from 20-24 through 55-59, the level of participation by age was higher in 1980 than it had been at any time since 1940. The largest absolute and relative increases occurred among women aged 25-34 and 35-44; as a result, peak labor force participation among women, which had previously been found for women in their late forties and early fifties (after age 20-24), occurred throughout the early forties. For those women who entered the ranks of the older population between 1:970 and 1980, labor force participation had been relatively constant compared with ear- lier cohorts but was much Tower than their own experience in 1970. Among men (Table 18), labor force participation declined

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88 WILLIAM J. SEROW AND DAVID F. SLY at all ages in 1980 relative to 1970 (and earlier years), with the most pronounced reductions occurring at ages 55-69 and espe- cially at age 60-64. In short, the life-course pattern of participation in the labor force among coming cohorts of the new aged is likely to be much different than the experiences of current and previous cohorts. Among men, some combination of institutional factors (pushing for earlier retirement) and possibly higher earnings earlier in the life cycle (affording the possibility of more leisure rather than more work in the late middle years) may have the effect of creating cohorts of new aged who are in the labor force to a relatively small extent. Among women, future cohorts of the new aged are likely to enter this phase with considerable expe- rience in working for pay throughout their life. Although it is unlikely that their labor force participation at ages 55-64 would be higher than the current level, it is important to note that they will be entering their retirement years with their own pension and Social Security entitlements. This trend should have two effects: (1) it should increase the level of income among future generations of new aged married couples, and (2) it should also have quite favorable consequences for the economic status of future cohorts of older widows. Another issue related to the support, financial and otherwise, of future generations of older persons is the number of family members available to provide such support. Women who were aged 55-59 and 60-64 in 1980 had borne, on the average, 2.9 and 2.6 children, respectively, over the course of their reproduc- tive lifetimes (Table 191. These levels are greater than those of women aged 65-79 (2.3-2.4) but Tower than those of women older than 80 (3.0-3.11. For the younger women, there is, of course, a greater probability that their children are still living and that they would still be approaching their own peak income years. There are fewer children of the extreme aged still alive, and they themselves are or will soon be entering the older popula- tion. Those women who will be the next generation of the new aged will have even more surviving children because their life- time fertility has been 3.1 to 3.2 children ever born. For younger women (i.e., for women born after 1935), however, a sharp drop in the probable number of surviving children is likely. Although these women have not yet finished with childbearing, completed fertility to date for all women born prior to 1965 is lower for

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go WILLIAM J. SEROW AND DAVID F. SLY each successive age and for each successive cohort. Important changes in the timing of reproductive activity among American women are still under way, but it seems unlikely that the aver- age completed family size for any cohort born after 1945 will greatly exceed 2 children. In a real sense, it could be argued that smaller families are the other side of the increased labor force participation discussed earlier. In effect, future genera- tions of women will enter their later years with greater financial resources but fewer familial resources to provide necessary support. The potential implications of this sort of change are profound. With fewer familial resources available, the responsibility for the provision of Tong-term care is likely to continue shifting away from the family and toward society as a whole. Conversely, we might also expect that older individuals will have greater command over resources and will be able to meet a larger share of the pecuniary costs of this care. This mention of health-related issues brings the present dis- cussion back to the overall question of the health of the older population and, in particular, the extent to which the new aged will differ from the present population over the age of 65 in terms of health characteristics. In the introductory section of this paper, we noted the changing pattern of mortality by age in the older population. In the context of health, we can now con- sider the role that other variables, especially income, might play in affecting the relative health status of future generations of older Americans. We have already noted several reasons for expecting higher levels of income among future members of the older population; there will be higher relative income among men while working and the greater labor force participation of women will not only increase current income but also tend to build up assets for use in retirement. Income levels among the older population, regardless of age, tend to interact with various measures of health status in more or less predictable ways. Table 20 illustrates that, in general, for each age group (56-64, 65-74, and 75+) within the older population, as the level of income increases, the fewer the number of chronic conditions limiting activity; the Tower the percentage of people assessing their health as "poor" or "fair"; and the fewer the number of days spent on average per year in short-stay hospitals. Within income groups, it is often the case that the number of

DEMOGRAPHY OF CURRENT AND FUTURE COHORTS TABLE 20 Selected Indicators of Health Status by Age and Income, 1979-1980 Income Less than Age Total $2,999 Activity limitations per person 55-64 3.0 6.0 5.7 65-74 4.1 5.9 5.3 75 + 5.3 6.0 5.4 Percentage in fair or poor health 55-64 26 57 50 65-74 32 48 43 75 + 31 35 33 Physician visits per person 55-64 5.5 6.2 8.7 65-74 6.3 6.9 6.6 75 + 6.6 6.2 6.1 Short-stay hospital days, per person 55-65 1.8 3.3 2.4 3.1 65-74 2.4 3.1 3.2 2.7 75 + 3.6 4.0 3.1 3.5 55-64 5.5 65-74 6.3 4.5 4.7 5.1 44 38 32 SOURCE: Ries, 1985. 5.9 6.4 5.9 91 More $3,000- $5,000- $7,000- $10,000- $15,000- than 4,999 6,999 9,999 14,999 24,999 $25,000 - 3.8 4.4 5.4 37 33 31 5.5 6.2 6.1 2.6 2.2 3.1 3.1 3.7 5.1 29 25 30 5.6 6.3 7.2 2.0 2.2 4.3 2.3 3.2 5.3 18 21 27 5.1 6.1 8.3 1.4 1.9 3.7 1.8 2.9 5.5 13 18 27 5.4 6.6 7.2 1.1 2.2 4.0 limiting conditions and average hospital days increase with age, but this is not the case for self-assessed health status for which this relationship holds only for the two highest income catego- ries. In fact, for family income levels below $10,000, fair or poor health is reported less frequently among persons aged 75 and oilier than among persons aged 55-74. Perhaps it may be fairly said that persons in the oldest age group survive to that age precisely because they are comparatively healthy. The average _ number of physician visits per year generally bears no relation- ship to income but generally shows a pattern of increasing fre quency of visits as a function of age. In brief, the data shown here as well as the demographic trends operating within the older population suggest two counterbalancing tendencies: 1. increased income, especially among the new aged, which has been associated with Tower levels of chronic, activity-limit- ing conditions, lower levels of self-assessed poor health, and fewer days, per capita, of hospital usage; and 2. the continued aging of the older population, which has been

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

93 - o .= ._ C) o o C~ 1 a ¢ Q _` U2 C~ CQ o cd o a) 5- e~ - ~o CQ V a b~ Ct a) ~ ~ Ct a) ~ P~ V ._ ~ b~ ,~ ~ ~ ~ ~ o ~ Z ~ o ._ Ct - o o o c4 C~ a, b~ Cd 5- a) ~ V ._ a) ~ ~ o o ._ ~ o o o c4 C~ ~R o U) · U) ~ c9 ~ r~ c~ a: C~ ~ o o o o o o o o - ~ C9 ~ C~ Lf: ~ a: oo Co oo c~ co r~ U: C~ ~ oo CO C~ U: o o o o o o oo ~ ~ O ~ C~ CD CO r~ ~ ~ c~ ~ ~ co o o o o o o o o o c~ ~ ~ m ~ oo ~ c~ l c~ + ct ~ ~ u: o co ~ ~ E~ oo u] v o u:

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

95 a) V o do Cal o o Cal . ~ of ~c°~ ·_. a) o o o m ° O en ~ C] '1) ~ ¢ ¢ ~ . U: CD LO LO U) C~ ~ o u: o a, z ~ + CO 1 0O 00 0 CC O 4~ + CO U: U) C~ ~ o uo: O Q) ~ P~ CD U: U) C~ ~ o u: z ~ ¢ C~ O 0 00 CD C~ ~ ~ CD ~ ~ ~ C~ ~ 00 . . . . . . . . C~ ~ 00 ~ ~ CO CO ~ O ~ ~ C~ ~ d~ O C~ ~ CO ~ ~ ~ 00 CD C~ 00 CD 0 ~ co ~ oo u: c~ co ~ ~r~ ~ O ~ ~ CD . . . . . . c~ ~ ~ cr. c cO c~ ~ ~ oo . . . . . . . . u: ~ u: ~ ~ c~ u: co 00 ~ ~ ~ ~ C~ ~ CS LO ~ o ~ oo ~ u: c~ ~ 0 r~ co r~ u: ~ r~ ~ 00 CO ~ 00 CD t(:) CO^ C~^ oo ~ ~ ~ c~ 0 cs ~ ~ r~ . . . . . . CO ~ O di oo CD ~ ~ ~ ~ (D ~ C~ . . . . . . . . ~ ~ ~ c~ oo c~ ~ ~ ~ ~ O ~ CC ~ U: CO LO ~00 D 00 (53 ~ ~ N C~ 0 0 ~ C~ ~ O ~ C~ O O ~(D r~ co 0 ~ oo ~ ~ ~ ~oo CO ~ ~ C~ C~ CD ~ ~ ~ 00 CO . . . . . . U: ~ C~ C~ ~ C~ 00 ~ O C~ oO C~ ~ C~ . . . . . . . . O ~ ~ ~ ~ ~ C~ C~ ~ ~ ~ oo cs ~ 0 ~ r~ cs o ~ ~ ~ CO 00 ~ LO CD ~ O C~ O - O O C5) 00 C9 ~ C~ C~ ~:) C.D CO C~ ~ C~ a) + + + O ~ O L~ O U) O U: O ~ U: E~ u: CD CS ~ r~ oo oo ~ co c~ ~ ~ oo ~ 'o o ~=) C ~,~, N 00 CD C~ CO O ~ C~ C~ ~ ~i C~ (~) ~ ~) ~4 CM oo r~ ~ ~ cc ~ c~ ~ ~ ~ C'1 ~ . C~ ~C~ + + L~ ~ 00 00 + + + 1 1 ~ ~ U: ~ U) CD + 00 ~ Co ;- a' o Ct o U' 50 a U: ._ Cd o .,_ o ~Q C~ 0 00 a Ct CQ a) co C ~ ' - V a C) ~ a) 0 ·0 ~ 11 '= m. .. V E~ ~ ~ O

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

97 ·_1 _' o . - C: - o - - C: - C~ a) o U) o - o Pa :^ - Ct o U] o ~ o V I a) 0 o Cot a) ¢ 5- to A_ A ED ~ ~ o ¢ ,= o C~ o C~ o o C~, o g C~ o + CO U: U) o U: . .- o ~ z ~ + U~ CO U: o u°: o (, z ~ CO U] c~o ~o U) o a) z ~ U: C9 LO L~ U) ~o o z~ ~ ~ ~ ~ L~ ~ . . . . . . o ~ CO ~ C~ oo ~ C~ ~ ~ CD O ~ ~ r~ ~ c~ O ~ ~ c~ ~ ~ es ~ ~ ~ C~ ~ CO ~ o C~ ~ ~eo CM <3) ~oo o C~ CM ~ o o o ~ ~ ~ ~ C ~ ~ oo ~ C~:} <~) CS C~ O O C~ CO ~ CD ~ ~CO ~00 O C~ C~ ~ ~ U: C~ ~ CO ~ C~ ~ C~ . . . . . . O0 ~ C~ ~ 0 00 ~ ~ ~/ ~ 00 C] ~ U: C~ ~ ~ CD . . . . . . . . C~ ~ C~ ~ C~ 00 ~ CD U: C~ c~ ~ ~ cs r~ ~ c~ r~ 0 c~ ~ oo 0 ~ c~ CO ~ C9 ~ 00 ~ ~ ~ C~ 00 C~ c~ r~ u: 0 ~ ~ ~ O ~ ~ CD CO CO CC) CO ~ C~ . . . . . . . . CM ~ ~ ~ C~ 00 ~ C~ C~ ~ ~ 00 U: C~ C~ C~ ~ CC, =4 CC~ C~ · CC ~ CD O) C~ (S C~ ~ O ~ C ~CD l ~C~ ~4 ~ ~ O O oO O C~ ~,, CM ~ ~ ~ o C~ ~ - CO O ~ =) ~ U: CO C~ a) CO CD ~ ~ C~ C~ ~ co r~ ~ ~ oo . . . . . . N CO CO C~ 00 00 C~ . . . . . . . . 0 00 ~ ~ ~ ~ C~ N CM CC) CD CO O CS ~ ~ ~ ~ ~ C~ ~ O ~ O O O ~ C9 0 0 CO ~I C~ CKl O O O O oO CO ~ C~ ~ ~1 C~ CO ~C~ 00 CD ~ d~ oO CO -4· C`3 O ~ CD O CO LO C~ + + U: ~ ~ ~ ~ ~ d. =) + + + ~ 00 Cd ~ ~ ~ ~ ~ ~ ~+ + ~ ~+ 00 ~ CD O ~ o ~ O ~ O U: O ~ ~o ~ o o ~o ~ ~00 ~ ~ o ,._ - o C~ ~5 o U) ; ct u: .~ e o . - 4 a) o oo b~ ~ ~u:^ c) ~ - l ~ c) c~ ~o o ~ 11 ~ m U) ~ .. V ~ ~; E~ z °

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

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

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. REFERENCES Coale, A. J. 1964. "How a Population Ages or Grows Younger." In R. Freedmen (ed.), Population: The Vital Revolution, New York: Doubleday & Company. Cowgill, D. O. 1974. "The Aging of Populations and Societies." Annals of the Ameri can Academy of Political and Social Science 415:1-18. Feldman, J. 1985. "Demography of Aging." Paper presented at the annual meeting of the Gerontological Society of America, New Orleans.

DEMOGRAPHY OF CURRENT AND FUTURE COHORTS 101 Fries, J. 1985. "Evidence for Compression of Morbidity." Paper presented at the annual meeting of the Gerontological Society of America, New Orleans. Grove, R., and A. Hetzel. 1968. Vital Statistics Rates in the United States, 1940- 1960. Hyattsville, Md.: National Center for Health Statistics, Table 48. Hermalin, A. 1966. The effect of changes in mortality rates on population growth and age distribution in the United States. Milbank Memorial Fund Quarterly 44: 451-69. Heuser, R. 1976. Fertility Tables for Birth Cohorts by Color: United States, 1917- 1973. Hyattsville, Md.: National Center for Health Statistics. Keyfitz, N. 1968. "Changing Vital Rates and Age Distribution." Population Studies 22:235-251. Lopez, A., and K. Hanada. 1982. "Mortality Patterns and Trends Among the Elderly in Developed Countries." World Health Statistics Quarterly 35:203-224. Manton, K. 1982. "Changing Concepts of Morbidity and Mortality in the Elderly Population." Milbank Memorial Fund Quarterly 60:183-244. Myers, G. C. 1985a. "Aging and Worldwide Population Change." In Handbook of Aging and the Social Sciences, R. Binstock and E. Shanus, eds., New York: Van Nostrand Reinhold. Myers, G. C. 1985b. "Demographic and Socio-Economic Aspects of Population Ag- ing." In Population Aging Paris: CICRED. National Center for Health Statistics (and predecessor agencies). 1940-1980. Vital Statistics of the United States National Center for Health Statistics. 1975. U.S. Decennial Life Tables for 1969- 1971. Hyattsville, Md.: National Center for Health Statistics. National Center for Health Statistics. 1985. U.S. Decennial Life Tables for 1979- 1981. Hyattsville, Md.: National Center for Health Statistics. Pearl, R. 1940. "The Aging of Populations." Journal of the American Statistical Association 209:277-297. Population Reference Bureau. 1975. "The Elderly in America." Population Bulletin 30(3) Ries, P. 1985. "Health Characteristics According to Family and Personal Income." Data from the National Health Survey, Series 10, No. 147. Hyattsville, Md.: Na- tional Center for Health Statistics. Rosenwaike, I. 1985. "Implications for Aging and Diseases of Aging." Paper pre- sented at the annual meeting of the Gerontological Society of America, New Orleans. Schneider, E. 1985. "Implications for Aging and Diseases of Aging." Paper presented at the annual meeting of the Gerontological Society of America, New Orleans. Siegel, J. S. 1980. "On the Demography of Aging." Demography 17:345-364. Siegel, J. S., and M. Davidson. 1984. "Demographic and Socioeconomic Aspects of Aging." Current Population Reports, Series P-23, No. 138. Washington, D.C.: U.S. Government Printing Office. U.S. Bureau of the Census. 1943. Sixteenth Census of the United States: Population. Volume IV: Characteristics by Age, Part 1, U.S. Summary. Washington, D.C.: U.S. Government Printing Office, Tables 1, 6, 10, 18, 24, 26. U.S. Bureau of the Census. 1953. Census of Population: 1950. Volume II: Character- istics of the Population. Part 1, U.S. Summary, Chapter C. Washington, D.C.: Government Printing Office, Tables 94, 102, 107, 116, 139, 145, 156. U.S. Bureau of the Census. 1964. Census of Population: 1960. Volume I: Character- istics of the Population. Part 1, U.S. Summary, Chapter D. Detailed Characteris

102 WILLIAM J. SEROWAND DAVID F. SLY tics. Washington, D.C.: U.S. Government Printing Office, Tables 156, 173, 176, 181, 194, 219, 232, 233. U.S. Bureau of the Census. 1972. Census of Population: 1970. Volume I: Character- istics of the Population. Part 1, U.S. Summary, Chapter B. General Population Characteristics. Washington, D.C.: U.S. Government Printing Office, Tables 50, 56, 57. U.S. Bureau of the Census. 1973. Census of Population: 1970. Volume I: Character- istics of the Population. Part 1, U.S. Summary, Chapter D. Detailed Characteris- tics. Washington, D.C.: U.S. Government Printing Office, Tables 199, 203, 204, 215, 245. U.S. Bureau of the Census. 1983. Census of Population: 1980. Volume I: Character- istics of the Population. Part 1, U.S. Summary, Chapter B. General Population Characteristics. Washington, D.C.: U.S. Government Printing Office, Tables 40, 50. U.S. Bureau of the Census. 1984a. Census of Population: 1980. Volume I: Character- istics of the Population. Part 1, U.S. Summary, Chapter D. Detailed Characteris- tics. Washington, D.C.: U.S. Government Printing Office, Tables 262, 264, 265, 272, 293. U.S. Bureau of the Census. 1984b. "Projections of the Population of the United States by Age, Sex and Race; 1983 to 2080." Current Population Reports, Series P- 25, no. 952. Washington, D.C.: U.S. Government Printing Office.

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Third in the series, this book addresses the social implications of architectural and interpersonal environments for older people. It suggests how society and its structures can enhance the productivity of, and preserve the quality of life for, older residents in a community. The study investigates new approaches to the problem, including new housing alternatives and new strategies for reflecting the needs of the elderly in housing construction.

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