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The United States is in the midst of a major demographic shift. In the coming decades, people aged 65 and over will make up an increasingly large percentage of the population: The ratio of people aged 65+ to people aged 20-64 will rise by 80%. This shift is happening for two reasons: people are living longer, and many couples are choosing to have fewer children and to have those children somewhat later in life. The resulting demographic shift will present the nation with economic challenges, both to absorb the costs and to leverage the benefits of an aging population. Aging and the Macroeconomy: Long-Term Implications of an Older Population presents the fundamental factors driving the aging of the U.S. population, as well as its societal implications and likely long-term macroeconomic effects in a global context. The report finds that, while population aging does not pose an insurmountable challenge to the nation, it is imperative that sensible policies are implemented soon to allow companies and households to respond. It offers four practical approaches for preparing resources to support the future consumption of households and for adapting to the new economic landscape.
The population of Asia is growing both larger and older. Demographically the most important continent on the world, Asia's population, currently estimated to be 4.2 billion, is expected to increase to about 5.9 billion by 2050. Rapid declines in fertility, together with rising life expectancy, are altering the age structure of the population so that in 2050, for the first time in history, there will be roughly as many people in Asia over the age of 65 as under the age of 15. It is against this backdrop that the Division of Behavioral and Social Research at the U.S. National Institute on Aging (NIA) asked the National Research Council (NRC), through the Committee on Population, to undertake a project on advancing behavioral and social research on aging in Asia. Aging in Asia: Findings from New and Emerging Data Initiatives is a peer-reviewed collection of papers from China, India, Indonesia, Japan, and Thailand that were presented at two conferences organized in conjunction with the Chinese Academy of Sciences, Indian National Science Academy, Indonesian Academy of Sciences, and Science Council of Japan; the first conference was hosted by the Chinese Academy of Social Sciences in Beijing, and the second conference was hosted by the Indian National Science Academy in New Delhi. The papers in the volume highlight the contributions from new and emerging data initiatives in the region and cover subject areas such as economic growth, labor markets, and consumption; family roles and responsibilities; and labor markets and consumption.
First published in 1998. This volume (the second of a twin set grouping articles based on papers presented at seminars in Sigtuna, Sweden, during 1994 – 1996) deals with the largest spending programs of the welfare state – old age pensions and medical care, and their place within debates about the desirability and affordability of modern social programs. The volume is divided into four parts. The first part deals with general welfare state issues, cross-cutting themes and characterizations of whole systems within such diverse disciplines as social law, sociology and economics. Part two deals with old age pension reform. The countries discussed have widely different geographical, cultural and historical backgrounds. Part three takes up a number of interesting topics under the heading of health care reform. Part four deals with a substantial issue located and the juncture of aging, affordability, pensions and especially health care: increased longevity (and population aging) and the associated disability and frailty. What effect will these have on the future of modern welfare states?
The U.S. population is aging. Social Security projections suggest that between 2013 and 2050, the population aged 65 and over will almost double, from 45 million to 86 million. One key driver of population aging is ongoing increases in life expectancy. Average U.S. life expectancy was 67 years for males and 73 years for females five decades ago; the averages are now 76 and 81, respectively. It has long been the case that better-educated, higher-income people enjoy longer life expectancies than less-educated, lower-income people. The causes include early life conditions, behavioral factors (such as nutrition, exercise, and smoking behaviors), stress, and access to health care services, all of which can vary across education and income. Our major entitlement programs - Medicare, Medicaid, Social Security, and Supplemental Security Income - have come to deliver disproportionately larger lifetime benefits to higher-income people because, on average, they are increasingly collecting those benefits over more years than others. This report studies the impact the growing gap in life expectancy has on the present value of lifetime benefits that people with higher or lower earnings will receive from major entitlement programs. The analysis presented in The Growing Gap in Life Expectancy by Income goes beyond an examination of the existing literature by providing the first comprehensive estimates of how lifetime benefits are affected by the changing distribution of life expectancy. The report also explores, from a lifetime benefit perspective, how the growing gap in longevity affects traditional policy analyses of reforms to the nation's leading entitlement programs. This in-depth analysis of the economic impacts of the longevity gap will inform debate and assist decision makers, economists, and researchers.
Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.
Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.
The socioeconomic, health, and public-policy aspects of aging in India are presented in this study that draws on empirical research to assess the country’s preparedness. This analysis argues that many of the fundamental issues that need to be addressed by a country with a large aging population are not fully understood by public agencies. A number of policy options for the welfare of the growing number of elderly, particularly women, are proposed.
A growing chorus of prominent voices in Congress and elsewhere are calling for the expansion of our Social Security system—people who know that Social Security will not “go broke” and does not add a penny to the national debt. Social Security Works! will amplify these voices and offer a powerful antidote to the three-decade-long, billionaire-funded campaign to make us believe that this vital institution is destined to collapse. It isn't. From the Silent Generation to Baby Boomers, from Generation X to Millennials and Generation Z, we all have a stake in understanding the real story about Social Security. Critical to addressing the looming retirement crisis that will affect two- thirds of today's workers, Social Security is a powerful program that can help stop the collapse of the middle class, lessen the pressure squeezing families from all directions, and help end the upward redistribution of wealth that has resulted in perilous levels of inequality. All Americans deserve to have dignified retirement years as well as an umbrella to protect them and their families in the event of disability or premature death. Sure to be a game-changer, Social Security Works! cogently presents the issues and sets forth both an agenda and a political strategy that will benefit us all. At stake are our values and the kind of country we want for ourselves and for those that follow.
Social Security expansion is back on the agenda, at a time when Americans need it more than ever—here’s what it should look like (and why it matters to everyday people all over the country) “Altman and Kingson cut through the fog of calculated confusion and outright lies about Social Security.”—David Cay Johnston, Pulitzer Prize–winning journalist and author The COVID-19 crisis has pulled the curtain back on America’s looming retirement income crisis, a fraying of the national community, and ever-worsening income inequality. Never before have so many people’s livelihoods and futures been thrown into flux. Now more than ever, expanding Social Security is essential to addressing these challenges. Social Security Works for Everyone!, an evolution of the argument Nancy J. Altman and Eric R. Kingson made in their acclaimed first book, Social Security Works!, presents the case for expanding Social Security, explaining why monthly benefits need to be increased; why Americans need national paid family leave, sick leave, and long term care protections; and how we can pay for it all. Don’t believe the nearly four-decade, billionaire-funded campaign to convince us that the program is destined to collapse. It isn’t. At a time when growing numbers of Americans are seeing beyond the false choice between financial security for working people and financial security for the federal government, this book eloquently makes the case that universal programs that benefit all Americans (yes, even the rich) make our country stronger and our lives more secure. Social Security works because it embodies the best of American values—the ones that will allow Americans to obtain financial security and weather the next crisis.
As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care workforce that is too small and woefully unprepared to meet their specific health needs. Retooling for an Aging America calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. The book also recommends that Medicare, Medicaid, and other health plans pay higher rates to boost recruitment and retention of geriatric specialists and care aides. Educators and health professional groups can use Retooling for an Aging America to institute or increase formal education and training in geriatrics. Consumer groups can use the book to advocate for improving the care for older adults. Health care professional and occupational groups can use it to improve the quality of health care jobs.