Chapter 2:

The Aging
Population
 Learning Objectives
• Identify trends in aging across the globe.
• Describe social and economic issues
related to aging in the United States.
• Discuss aging across different cultures.
• Consider challenges for aging in the
21st century.
 Key Terms

Aging in place Genomics

Baby boomers Health disparities
Centenarian Independent living
Chronic disease Indian Health Service
Cohorts Native-born
Elders Older adult
Foreign-born Oldest old
Genetics Senior citizen
 Developed and Developing
Dependency Ratios

Reproduced from United Nations. (2007). World economic and social survey 2007: Development in an ageing world. United Nations
publication, Sales No. E.07.II.C.1. Retrieved from http://www.un.org/en/development/desa/policy/wess/wess_archive/2007wess.pdf.
Reprinted with permission of the United Nations.ted Nations. (2007).
 Demographics

• The global share of older people (aged 60

years or over) increased from 9.2% in
1990 to 11.7% in 2013.
• The percentage of individuals at least 65
years old varies by country from 3.5/100
people in the least developed countries to
17.8/100 in the most developed countries
(United Nations, 2013).
 Centenarians
• The fastest growing segment of the population of
the United States is comprised of centenarians,
individuals who are over 100 years old.
• The U.S. Census Bureau (2011) estimated that
there were 71,991 centenarians in the United
States on December 1, 2010.
• The population of centenarians is
overwhelmingly female (84%), lower educated,
more impoverished, widowed, and more
disabled as compared to other older cohorts.
 Genetics and Genomics

• Genomics is the identification of gene

sequences in the DNA, while genetics is
the study of heredity and the transmission
of certain genes through generations.
• Research exploring genetics and
genomics in relation to aging include
identifying the genes that affect the aging
process.
 Gender and Older Age
• The older population is predominantly female.
• In 2013, globally, there were 85 men per 100
women in the age group 60 years or over and 61
men per 100 women in the age group 80 years
or over.
• For the age group 65–69 in the United States, it
is 112 women for every 100 men; for those 85+
the ratio is 206:100 (with more than two females
for every male).
 Race and Ethnicity and
Older Adults
• The growing aging population consists of a significantly
increased proportion of minorities.
• An understanding of cultural diversity and the unique
challenges it poses is needed to address health issues
and promote wellness for all older individuals.
• In 2010, 80% of U.S. older adults were non-Hispanic
Whites, 8.4% were Black, 6.9% Hispanic, and 3.4%
Asian. By 2050, the composition of the older population
will be 59.4% non-Hispanic White, 19.8% Hispanic, 11%
Black, 8.6% Asian, and 1% Native American and Native
Alaskan.
 Health Disparities
• Defined as “preventable differences in the burden of
disease, injury, violence, or in opportunities to achieve
optimal health experienced by socially disadvantaged
racial, ethnic, and other population groups and
communities.”
• Substantial health disparities among race, ethnicity, and
gender exist in many disease prevention and
management strategies such as vaccine administration,
colorectal cancer screening, coronary heart disease and
stroke, preventable hospitalizations, hypertension, and
hypertension control.
 Health Disparities (cont’d.)

• African American Older Adults

– The poverty rate for older African Americans was 20%
in 2008, compared to 9.7% for total older population.
– In 2007, net worth among older Black households
was estimated to be $46,000, compared to $280,000
among older White households.
– African Americans experience higher rates of
diabetes, hypertension, and chronic kidney disease
than other Americans.
 Health Disparities (cont’d.)
• Hispanic Older Adults
– The poverty rate in 2008 for Hispanic elders in
the United States was nearly twice that of the
total older population, 19.3% compared to
7.6%.
– Hispanics are less likely to obtain preventive
services such as flu and pneumonia vaccines
and mammograms as compared to Whites.
 Health Disparities (cont’d.)
• Asians and Pacific Islander Older Adults
– This ethnic group actually is composed of 40
different ethnic groups with varying economic,
educational, and health profiles.
– Census data from 1995 showed life
expectancy at birth of Asian Americans and
Pacific Islanders to be 79.3 years for males
and 84.9 years for females, as compared to
73.6 and 80.1 for non-Asian White males and
females, respectively.
 Health Disparities (cont’d.)
• Native American and Alaskan Native Older
Adults
– The census group Native American and Alaskan
Natives is comprised of 566 nations, tribes, bands,
and native villages in which 150 languages are used.
– This population has larger families, less health
insurance, and twice the level of poverty as other
American groups.
– This population also has higher rates of obesity,
substance abuse, and mental health problems.
 Health Disparities (cont’d.)

• The Older Foreign-Born Population

– The foreign-born are those people who are living in
the United States who were not U.S. citizens at birth.
– Approximately 13.1% of the total U.S. population is
foreign-born.
– Foreign-born persons comprised 12.4% of the over-
65 population at the time of the 2010 U.S. Census.
 Health Disparities (cont’d.)
• U.S. Veterans
– In 2015, one out of every two men over 65
years old were veterans.
– There are currently three cohorts of older
veterans: those who served in World War II,
those who served in the Korean War, and
those who served in Vietnam.
– PTSD.
– Changes in military healthcare systems.
 Health Disparities (cont’d.)
• The Disabled Older Population
– Advances in health care have increased the
life span of persons with disabilities including
individuals with acquired or congenital
disabilities.
– Twelve percent of persons with
developmental disabilities are now age 65 or
older; this translates to between 200,000 and
500,000 people.
 Health Disparities (cont’d.)
• Older Adult Prisoners
– As of 2010, there were 26,100 inmates over the age
of 65 in federal and state prisons, a 63% increase
from 2007.
– Due to the stressors related to incarceration, as well
as increased likelihood of an unhealthy lifestyle
preceding incarceration, prisoners aged 50–55
experience physical and mental changes normally
associated with free-world citizens at least 10 years
older.
 Mortality and Morbidity
• Chronic Diseases
– The incidence of chronic diseases increases with age.
• Causes of Death
– The leading cause of death for older adults in the
United States in 2013 was diseases of the heart.
• Healthy Aging
– Seventy-five percent of adults younger than 64 years
old report having three or fewer chronic conditions
such as high blood pressure or high cholesterol.
 Summary
• The challenge for successful aging will be
to reduce the incidence of chronic disease
across the lifespan, and to optimize the
additional years of life.