The Graying of America:
65+ Population 1950–2030
70
Number in Millions
60
50
40
30
65 years+
20
10
0
1950
85 years+
1960
1970
1980
1990
Year
Source:Health, United States, 1999, U.S. Bureau of the Census
2000
2010
2020
2030
Population Statistics
70
Number in Millions
60
50
40
• According to the US Census the 65+
population numbered 35 million in 2000
• 20% of the US population will be 65+
by 2030, up from 12% in 2000
30
20
10
• Between 2000-10 the 65+ population
65 years+
is expected to continue to grow at a
rate twice that of the general population
0
1950
85 years+
1960
1970
1980
1990
Year
2000
2010
2020
2030
Our Frail Elders
70
Number in Millions
60
• The most rapid growth between 2000-15
50is expected to occur among the oldest &
frailest population groups (85+ up 28.2%,
40
Impaired up 16.6%)
30
• Between 2000 and 2040 the 85+
65population
years+
20
will grow from 4.3 million to 19.4 million
10
0
1950
85 years+
1960
1970
1980
1990
Year
2000
2010
2020
2030
NYS - Projected Population Growth
30.0%
28.2%
25.0%
20.0%
20.2%
15.0%
10.0%
5.0%
0.0%
2000
1.2%
6.6%
7.0%
Impaired
2.4%
2005
+
5
6
d
e
Ag16.6%
Aged 85+
8.9%
19.3%
2010
2015
The Graying of America:
65+ Population 1950–2030
70
Number in Millions
60
50
40
30
65 years+
20
10
0
1950
85 years+
1960
1970
1980
1990
Year
Source:Health, United States, 1999, U.S. Bureau of the Census
2000
2010
2020
2030
Median Income By Age
$30,000
$25,873
$25,000
$20,291
$20,000
$17,282
$16,714
$15,000
$12,964
$10,000
$5,000
$0
65-69
70-74
75-79
80-84
85+
The Number of Minority Elderly in NYS Will Grow By Over 384,400
(50.8%) Between 2000 & 2015
(Base Year 2000)
60.0%
50.8%
1,141,023
50.0%
40.0%
28.7%
973,630
30.0%
20.0%
10.0%
9.7%
830,095
0.0%
2005
2010
2015
Minority Growth By Category
2000-2025
250.0%
208.2%
200.0%
150.1%
150.0%
100.0%
53.3%
50.0%
0.0%
Black
Hispanic
Asian/PI
Minority Elderly Characteristics
• Higher rates of IADLs and ADLs at earlier
ages than non-minority elderly
• Highest poverty rates of any population,
with 24.3% in poverty versus 8.5% for
non-minority elderly
• Very high risk of converting to Medicaid
Draw on Resources
Lay of the Land
The ratio of aged 65+ to
homecare worker will
increase from 7:1 to 24:1
between 2000 and 2050
The ratio of workers
to those aged 65+
will decrease by
approximately 33%
between 2000 and
2050
Family Members
The ratio of elderly to the general population will
continue to change dramatically
• The population support ratio (aged 18-64
vs. aged 65+) will decrease by approx.
40% (6.5:1 to 3.5:1) between 2000 and
2050
• The dependency care ratio (85+ vs. 4564) will increase by over 70% between
2000 and 2050
Aging: A Family Issue
• Has Been
• Is Now
• Will Be
Caregiver Statistics
• About one in ten New York State households
(approx. 734,000) includes a caregiver for an
individual 60+; as many as 25% have
some caregiving responsibility for an elder
• Caregivers spend an average of 22.1 hours
per week on caregiving activities; about
30% spend more than 40 hours per week
• Caregivers for the elderly save the New York
State health care system approx. $11.18
billion annually
Value of Home Care, Nursing Home Care
and Informal Care - NYS
$11.2
$12.0
$10.0
$8.0
$5.5
$6.0
$4.0
$2.4
$2.0
$0.0
Home Care
Nursing Home
Informal Caregiving
Prevalence of Disabilities & IADL/ADL
Impairments for 65+ at Home in NYS
With ADLs
174,358
557,945
With IADLs
With Disabilities
0.0%
7.5%
24.0%
894,261
5.0%
38.5%
10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0% 45.0%
Estimated Per Capita Health
Expenditures
18,000
16,000
by Age and Sex, 1995
Do llars
14,000
Women
12,000
10,000
8,000
6,000
4,000
2,000
59
10
-1
4
15
-1
9
20
-2
4
25
-2
9
30
-3
4
35
-3
9
40
-4
4
45
-4
9
50
-5
4
55
-5
9
60
-6
4
65
-6
9
70
-7
4
75
-7
9
>8
0
0
04
Men
Age in
Years
Source: From Baby Boom to Elder Boom: Providing Health Care for an Aging Population
Copyright 1996, Watson Wyatt Worldwide.
New York State
Age-Specific Net Migration
5.0%
4.0%
3.0%
2.0%
1.0%
0.0%
-1.0%
-2.0%
-3.0%
-4.0%
-5.0%
-6.0%
Substantial
disposable
income
55-59
60-64
65-69
70-74
75-79
80-84
85+
Medicaid Expenditures for Aged 65+ in New York State
(D o lla r A m o unt in B illio ns )
$5.500
$5.250
$5.000
$4.750
$4.500
$4.250
$4.000
$3.750
$3.500
$3.250
$3.000
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
Projected Medicaid Expenditures Aged 65+
(Expenditures in Billons)
$11.0
$10.5
$10.0
$9.0
$8.0
$8.2
$7.0
$6.8
$6.0
$5.0
2000
2005
2010
2015
Summary
• Dramatic increases in 85+ (1990-2000) rate of growth
was 26% - same for only a few more years –
*Accelerating phenomenon*
- Frail
- Poor
• Dramatic decline in # of workers & caregivers per elder
• Dramatic increase in 65+ beginning in 7-8 years
• In-migration to NYS of frail, poor elders
• Dramatic increase in minority elders
- Lower Incomes
- Higher rates of frailty
• If we do nothing within 10 years the system as we
know it becomes unaffordable
Responding to the Challenge
Rebalance
• LTC
• Aging & Family Policy
- Retain
- Support & Partner
• Intervene Early
• Build Community/Neighborhood Capacity &
Responsibility
• Emphasize Independence / Not Dependence
….
Role of Aging Network
• Philosophy & Approach
- Relevant to meeting the Challenge
• Examine Customer Care
- MA to Aging demonstrates
the relevance
COMPARISON OF CLIENT
CHARACTORISTICS
Characteristic
Medicaid Client
EISEP Client
Women
81%
79%
Lives Alone
56%
68%
71 Years
80 years
38%
56%
Average Age
Aged 80+
COMPARISON OF SERVICE HOURS
SERVICES
Formal Services
MEDICAID
25 Hours
EISEP
10 Hours
Home Care
----
5.5
Case Management
----
0.5
Other Services
----
4.0
12 Hours
Informal Care
<1% of clients receive
ADL help
TOTAL
25 Hours
22 Hours
Cost Comparison Per Client
Service
Medicaid Network Services
Personal Care and
Home Delivered
Meals
$357
Weekly
$73
Weekly
Personal Care and
In-Home Services
$18,543
Annually
$3,704
Annually
Medicaid 65+ vs.
State & Local Aging Services Spending
SFY 2000-01 Expenditures
Medicaid
Aging
Services
STATE AGING SERVICES
ADJUSTED PER CAPITA EXPENDITURES
$16.50
$16.00
$15.50
$16.04
$15.00
$14.50
$14.00
$13.50
$13.46
$13.00
1990
2000
Medicaid vs. State Aging Services
Percent Change in Adjusted Expenditures
30.0%
Medicaid
State
25.0%
20.0%
15.0%
10.0%
5.0%
0.0%
-5.0%
-10.0%
-15.0%
-20.0%
199192
199394
199596
199798
200001
70
Responding to the Challenge
Rebalance
60
• LTC
50
• Aging & Family Policy
40
- Retain
- Support & Partner
30
• Intervene Early
20
• Build Community/Neighborhood Capacity &
10Responsibility
• 0Emphasize Independence / Not Dependence
1950
1960
1970
1980
1990
2000
2010
2020
2030
70
Responding to the Challenge
60
Reform
• Affect Rates of Disability
50
• Continue to Build/Strengthen Caregiver Based
40
Services
30
• Retain/Attract Young Elders
• Capitalize on Elders as a Resource
20
• Develop a System Approach/Strategy on Housing
10
•0 Reform & Strengthen APS
1950
1960
1970
1980
1990
2000
2010
2020
2030
70
60
Significance of Aging Services
1. LTC Reform
50 2. Early Intervention
40 3. Focus on Individual & Independence
30 4. Focus on Family
20
5. Non-Medical
6. Flexible
10
7. Effective & Efficient
0
1950
1960
1970
1980
1990
2000
2010
2020
2030