Our Nation’s Elders: The Facts Chapter 1 McGraw-Hill/Irwin © 2013 McGraw-Hill Companies. All Rights Reserved.

1-2 Ageism The assumption that personal traits of older individuals and their situations are due to age, not other factors. “By ignoring an oppressed minority, which we are inevitably going to join, we do not realize that we are slashing our own tires.” – Alex Comfort

1-3 Who are Our Nation’s Elders? Elders are defined as 65 and over. In a survey by the National Council on Aging: Most saw themselves as “young or middle-aged” 90% agreed that, “As I look back on my life I am fairly well satisfied” 70% agreed that, “As I grow older things seem better that I thought they would be” Half agreed that “These are the best years of my life”

1-4 Who are Our Nation’s Elders? Demographics of elders is very heterogeneous. Demography is the study of the size, geographical distribution and vital statistics of a particular group. Information largely gathered via surveys

1-5 Number and Growth of the Older Population Older population is growing rapidly and will continue to grow – 1 in 8 people were 65 and over 2030 – 1 in 5 people may be 65 and over Why? Baby Boomers are “coming of age” More people survive, birth rate is constant

1-6 Life Expectancy Life expectancy in the U.S. continues to increase – 77.6 years 2009 – 78.2 years Many factors influence life expectancy: Gender Ethnicity Race Reduced death of infants and children through control of infectious disease

1-7 Housing and Geographic Distribution In 2009, 4 of 5 elders owned their own homes 3 of 4 elders live in metropolitan areas States with the highest elder population California (4.1 million) Florida (3.2 million) New York (2.6 million)

1-8 Marital Status and Living Arrangements Because of life expectancies: 8.9 million women are widows 2.1 million men are widowers Marriage is beneficial to elders: Companionship, help with daily activities, higher household income Elders who divorce is increasing 2/3 of elders live in a “family setting” Only a small proportion of elders reside in nursing homes

1-9 Education Older people have completed fewer years of formal education than younger adults. Baby Boomers are the most educated cohorts in history. Educational attainment differs by race and ethnic origin. Elders are lifelong learners

1-10 Income Medicare and Social Security make elders less financially vulnerable. Elders living in a family setting are less financially vulnerable. Disparity of income level with race and ethnicity. Elder men have higher income levels than elder women.

1-11 Health Status and Health Care Most elders have at least one chronic condition which: Limits activities Lengthens hospital stays Results in more physician visits Results in more medications prescribed Raises out-of-pocket expenses

1-12 Foreign-Born Population More likely than natives to: live with families to be poor to be uneducated Most have lived in the country for more than 30 years

1-13 Racial and Ethnic Diversity In general, minority elders are more likely to: Have lower education levels Live in substandard housing Have less money Have worse health Racial discrimination during working years leads to less financial security. The four largest groups of minority elders are:

1-14 African American/Black Elders Women outnumber men Most men are married, most women are widowed 20% were living in poverty (2009) More apt to suffer from chronic health problems than white elders Health Care Concerns: Low income can postpone seeking help Tuskegee experiment Racism/Alienation Professionals should: Treat them with respect Establish rapport Put them at ease

1-15 Hispanic American/Latino Elders Fastest growing minority in US Subgroups are highly diverse Many do not speak English 45% live in poverty Many live with their families Health Care Concerns: Respectful of health care workers Less likely to use social services Personalismo Professionals should: Exchange pleasantries Address patients by last name

1-16 Native American Elders Diversity: 560 tribes Higher death rates Shorter life expectancy Poorest minority Most live on reservations or rural areas Low education levels Strong family network Health Care Concerns: Lack of access Difficult to communicate Different views of disease and healing Professionals should: Understand cultural values Give personal space Not touch without permission

1-17 Asian and Pacific Islander American Elders Diverse subgroups including Chinese, Japanese and Filipino Uniting influence of Confucianism Most live in Metropolitan areas in the West Many worked as seasonal workers and will not have Social Security benefits Health Care Concerns: Similar health status as white elders. Higher incidence of suicide than their white counterparts Professionals should: Respect filial piety and treat elders with respect Recognize the subgroups and not generalize

1-18 Working with Minority Elders: Obstacles and Opportunities 1 out of 4 elders will be a minority by 2030 Must have culturally competent health service Consider some obstacles: Economic and educational Cultural Geographical Institutional Facilitating minority elder access to needed services How can you turn these into opportunities?

Our Nation’s Elders: The Facts Chapter 1