Table Of ContentGROWING OLD
IN AMERICA
TABLE OF CONTENTS
PREFACE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii
the educational attainment of today’s older adults and
CH AP TE R 1 examines trends toward lifetime learning and growing
Older Americans—A Diverse and Growing Population. 1 computer literacy. Also explored is the political clout of the
Thischapterintroducesthereadertotoday’solderAmericans.It older population: their voting conduct and party affiliation;
defines terms used when discussing aging and older adults, and their force as a political bloc; and their participation in grass-
itexplainswhyAmerica’spopulationisgrowingolder.Inaddition roots politics, such as Silver-Haired Legislatures and town
todemographicdata,thischapterdescribesattitudesaboutaging councils.
andolderadults.
CHA P TE R 6
CH AP TE R 2
On the Road—Older Adult Drivers. . . . . . . . . . . . . 79
The Economics of Growing Old in America . . . . . . . 17
The ability to drive often determines whether an older adult is
Chapter 2 begins with a discussion of some measures used to able to live independently. Chapter 6 discusses driving safety
determine economic security, such as net worth and median issues, strategies to make driving easier for older adults, and
income. It details income sources for older adults and considers alternative transportation for older Americans who cannot, or
pensionfunds.ConsumerspendingtrendsamongolderAmericans choosenotto,drive.
are documented, and the chapter also contains an in-depth
description of the Social Security program and threats to its
continuedviability. CHA P TE R 7
The Health and Medical Problems of Older Adults . . 95
CH AP TE R 3 This chapter considers the epidemiology of aging—the distri-
Living Arrangements of the Older Population. . . . . . 41 bution and determinants of health and illness among older
adults. It describes trends in aging and the health of aging
This chapter details the varied housing arrangements of older
Americans; distinctions between healthy aging, disease, and
Americans, including living with family members; residing in
disability; health promotion and prevention as applied to
boardandcarefacilitiesornursinghomes;ordwellinginassisted
older persons; and selected diseases and conditions common
living,sharedhousing,publichousing,orretirementcommunities.
in old age.
Thechallengesofgrandparentsraisinggrandchildren,retrofitting
homestoaccommodatedisabledolderadults,andtheprevalence
ofhomelessnessintheolderpopulationarealsodescribed.
CHA P TE R 8
Mental Health and Mental Illness. . . . . . . . . . . . . .125
CH AP TE R 4
Changesinmentalcapabilitiesareamongthemostfearedaspects
Working and Retirement: New Options for Older of aging. Mental health problems that impair functioning are
Adults . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 among the most common age-related changes. This chapter
OlderAmericansmakegreatcontributionstosocietyinbothpaid detailshowthenumberofpersonswithmentalimpairmentssuch
and unpaid roles. Discussed in this chapter are changes in life- asdementiaisanticipatedtoincreaseasthepopulationages;why
styles (from linear to cyclic life paths) and the economy (from olderadultswithmentalimpairmentareatriskforinstitutionali-
agricultural to industrial to service-oriented) that make these zation; and how the financial costs to individuals and to society
contributions possible. Laborparticipationandvolunteerism are areexpectedtoescalate.
discussed,aswellascommonstereotypesaboutolderworkersand
agediscrimination.Alsodescribedarewaysinwhicholderadults
CHA P TE R 9
aredefiningandredefiningretirement.
Caring for Older Adults—Caregivers. . . . . . . . . . . .139
In the United States most long-term care of older adults con-
CH AP TE R 5
tinues to beprovided by families as opposed to nursing homes,
Education, Political Behavior, and Voting . . . . . . . . 69
assistedlivingfacilities,socialservice agencies,andgovernment
Greater numbers of older Americans are pursuing continuing programs. This chapter explores the continuing commitment to
education and are active in politics. This chapter outlines family care of older adults in view of relatively recent changes
GrowingOldinAmerica v
in the fabric of American society. It also includes descriptions CHA P TE R 1 1
of programs aimed at supporting caregivers. Crime and Abuse of Older Adults. . . . . . . . . . . . . .171
Chapter11enumeratestheratesandtypesofcrimeagainstolder
CHA P TE R 1 0 Americans,includingcharacteristicsofoldercrimevictims.Italso
Health-Care Use, Expenditures, and Financing . . . . .151 describes domestic abuse, mistreatment, institutional abuse, and
fraudsperpetratedagainsttheolderpopulation.
Older adults account for about 12% of the U.S. population, but
theyareresponsiblefordisproportionatehealth-careexpenditures.
Thischapterdescribestrendsinhealth-careuse,expenditures,and IMPORTANT NAMES AND ADDRESSES. . . . . . .187
financing,anditprovidesin-depthcoverageofgovernmententitle-
mentprograms—MedicareandMedicaid.Thechallengesoflong- RESOURCES. . . . . . . . . . . . . . . . . . . . . . . . . . .191
term care are discussed along with in-home services that enable
olderadultstoremaininthecommunity—‘‘aginginplace.’’ INDEX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .195
vi TableofContents GrowingOldinAmerica
PREFACE
Growing Old in America is part of the Information content.Eachbookalsopresentsthewidelyheldpositions
PlusReferenceSeries.Thepurposeofeachvolumeofthe and important ideas that shape how the book’s subject is
series is to present the latest facts on a topic of pressing discussed in the United States. These positions are
concern in modern American life. These topics include explained in detail and, where possible, in the words of
today’smostcontroversialandmoststudiedsocialissues: their proponents. Some of the other material to be found
abortion, capital punishment, care for the elderly, crime, in these books includes: historical background; descrip-
the environment, health care, immigration, minorities, tions of major events related to the subject; relevant laws
nationalsecurity,socialwelfare,women,youth,andmany and court cases; and examples of how these issues play
more.Althoughwrittenespeciallyforthehighschooland out in American life. Some books also feature primary
undergraduate student, this series is an excellent resource documents or have pro and con debate sections giving
for anyone in need of factual information on current the words and opinions of prominent Americans on both
affairs. sides of a controversial topic. All material is presented
in an even-handed and unbiased manner; the reader will
By presenting the facts, it is Thomson Gale’s inten-
never be encouraged to accept one view of an issue over
tion to provide its readers with everything they need to
another.
reach an informed opinion on current issues. To that end,
there is a particular emphasis in this series on the pre-
sentation of scientific studies, surveys, and statistics. HOW TO USE THIS BOOK
These data are generally presented in the form of tables, The percentage of Americans over the age of sixty-
charts, and other graphics placed within the text of each five has increased over the past century and will continue
book. Every graphic is directly referred to and carefully to increase as the children born during the mid–twentieth
explained in the text. The source of each graphic is pre- century baby boom age. This book explores the current
sented within the graphic itself. The data used in these condition of growing old in the United States. Included is
graphics are drawn from the most reputable and reliable a general overview on growing old in America; the eco-
sources, in particular from the various branches of the nomicstatusofolderpeople;theSocialSecurityprogram;
U.S. government and from major independent polling Medicare and Medicaid; the living arrangements of the
organizations. Every effort has been made to secure the elderly;workingandretirement;andtheeducationlevels,
mostrecentinformationavailable.Thereadershouldbear voting trends, and political behavior of the elderly. Phy-
in mind that many major studies take years to conduct, sical and mental health and health problems; drug and
and that additional years often pass before the data from alcohol abuse; care for the elderly; and crime are also
these studies are made available to the public. Therefore, covered.
in many cases the most recent information available in
2006 dated from 2003 or 2004. Older statistics are some- Growing Old in America consists of eleven chapters
times presented as well if they are of particular interest andthreeappendices.Eachofthechaptersisdevotedtoa
and no more recent information exists. particular aspect of growing old. For a summary of the
information covered in each chapter, please see the
Although statistics are a major focus of the Informa- synopses provided in the Table of Contents at the front
tion Plus Reference Series, they are by no means its only of the book. Chapters generally begin with an overview
GrowingOldinAmerica vii
ofthebasicfactsandbackgroundinformationonthechap- Appendices
ter’s topic, then proceed to examine subtopics of particu- In addition to the main body text and images, Grow-
lar interest. For example, Chapter 7: The Health and ing Old in America has three appendices. The first is the
Medical Problems of Older Adults begins with a discus- Important Names and Addresses directory. Here the
sionofthegeneralhealthofolderAmericans.Itthengoes reader will find contact information for a number of
on to detail the chronic physical problems of the elderly, government and private organizations that can provide
among them arthritis, diabetes, malnutrition, and hearing further information on growing old. The second appendix
and vision loss. This is followed by discussion of the is the Resources section, which can also assist the reader
threat that influenza and pneumonia pose to the elderly. in conducting his or her own research. In this section
Many older Americans are disabled by these and other the author and editors of Growing Old in America
conditions; the meaning of ‘‘disabled,’’ its prevalence, describe some of the sources that were most useful
anditsimpactareexamined.Druguseamongtheelderly, during the compilation of this book. The final appendix
health maintenance, sexuality in aging, causes of death is the detailed Index, which facilitates reader access to
among the elderly, and the state of geriatric medicine are specific topics in this book.
alsoincluded.Readerscanfindtheirwaythroughachap-
ter by looking for the section and subsection headings,
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viii Preface GrowingOldinAmerica
CHAPTER 1
OLDER AMERICANS—A DIVERSE
AND GROWING POPULATION
Old age is the most unexpected of all the things that on every aspect of society—challenging policymakers,
happen toa man. health-care providers, employers, families, and others to
—Leon Trotsky, Russian Communist revolutionary and Soviet meet the needs of older Americans.
politician(1879–1940)
Manyofthe findingsandstatisticscitedinthischap-
ter, as well as a number of the tables and charts pre-
THE UNITED STATES GROWS OLDER
sented, were drawn from Older Americans 2004: Key
The United States is aging. During the twentieth Indicators of Well-Being (http://www.agingstats.gov/
century the country’s older population—adults age chartbook2004/default.htm), a report prepared in 2004
sixty-five and over—increased significantly. According by the Federal Interagency Forum on Aging-Related Sta-
to the U.S. Census Bureau, the number of older adults tistics. The group is a consortium of thirteen federal
grew from 3.1 million in 1900 to 35.9 million in 2003 entities—Administration on Aging; Agency for Health-
(the most recent year for which data, as opposed to care Research and Quality; Bureau of Labor Statistics;
estimates or projections, are available). Of an estimated Census Bureau; Centers for Medicare & Medicaid Ser-
U.S. population of 296.2 million people in 2005, about vices; Department of Veterans Affairs; Environmental
12%, or slightly more than thirty-six million, were over Protection Agency; National Center for Health Statistics;
theageofsixty-five.Between2000and2050thepercen- National Institute on Aging; Office of the Assistant
tage increase of adults age sixty-five and over is pro- Secretary for Planning and Evaluation, U.S. Department
jectedtobe147%,comparedtojusta49%increaseinthe ofHealthandHumanServices;OfficeofManagementand
population as a whole. Budget; Social Security Administration; and Substance
By 2030 there will be about 71.5 million people age Abuse and Mental Health Services Administration—
sixty-fiveandolder,morethantwicethenumberin2000, dedicated to encouraging cooperation and collaboration
and by 2050 the ranks of older adults will increase to among federal agencies to improve the quality and utility
nearly eighty-seven million. (See Figure 1.1.) In 2050, of data on the aging population.
21%—one in five Americans—will be age sixty-five and
To understand the aging of America it is not only
over. Even as the percentage of older adults approaches
important to consider the current population of older
13%, however, the United States is relatively young
adults but also to look at how the older population will
among developed countries. In 2003 older adults com-
fare over time. In order to anticipate the needs of this
prised at least 15% of the population of almost twenty
growing segment of society, policymakers, planners,
such countries, including nearly 19% in both Italy and
and researchers rely on projections and population esti-
Japan. (See Table 1.1.)
mates. Population estimates and projections are made at
Fewer children per family and longer life spans have different times and based on different assumptions. As a
shifted the proportion of older adults in the population. result it is not surprising to find considerable variation
The growth in the population segment of older adults in in the statistics cited by different agencies and investi-
theUnitedStates,oftentermed‘‘thegrayingofAmerica,’’ gators. This chapter contains estimates and projections
is considered one of the most significant issues facing the of demographic changes from several different sources,
country in the twenty-first century. The swelling popula- and as such there is some variability in the data
tion of persons age sixty-five and over has an impact presented.
GrowingOldinAmerica 1
FIGURE1.1
Number of people age 65 and over, by age group, selected years 1900–2000 and projected 2010–2050
[In millions]
65 and over 85 and over
100
90
80
70
60
50
40
30
20
10
0
1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010 2020 2030 2040 2050
Projected
Note: Data for 2010–2050 are projections of the population.
Reference population: These data refer to the resident population.
SOURCE: “Number of People Age 65 and Over, by Age Group, Selected Years 1900–2000 and Projected 2010–2050,” in Older Americans 2004: Key
Indicators of Well-Being, Federal Interagency Forum on Aging Related Statistics, Washington, DC, U.S. Government Printing Office, November 2004,
http://www.agingstats.gov/chartbook2004/population.html (accessed August 11, 2005)
HOW DO POPULATIONS AGE? children prompted families to have fewer offspring. The
Unlike people, populations can not only age but birth of fewer babies resulted in fewer young people.
become younger. There are key indicators of the age
According to estimates presented in The World Fact-
structure of a given population. Populations age or grow
book(Washington,DC:CentralIntelligenceAgency,2005,
younger because of changes in fertility (birth rates
http://www.cia.gov/cia/publications/factbook/index.html),
expressed as the number of births per one thousand
theU.S.total fertility ratein2005was2.08childrenborn
population per year) and/or mortality (death rates
perwoman.Thisrate,whichhasnotchangedsignificantly
expressed as the number of deaths per one thousand
sincethemid-1980s,issharplylowerthanthefertilityrates
population per year) or in response to migration—people
duringthenearlytwodecadesfollowingtheendofWorld
entering or leaving the population.
WarII(1946–64).VictoriousAmericansoldiersreturning
home after the war were eager to start families, and
TheagingoftheUnitedStatesresultedfromchanges
this was facilitated by the relatively prosperous post–war
in fertility and mortality that occurred over the past
economy.
century. Such shifts in birth and death rates are termed
‘‘demographictransition.’’Generally,populationagingis During this period following the war, which came to
primarilyaresponsetolong-termdeclinesinfertility,and be known as the ‘‘baby boom,’’ U.S. fertility rates
declining fertility is the basic cause of the aging of the exploded, at one point approaching four children born
U.S. population. Reduced infant and child mortality, per woman, according to Census Bureau statistics. Chil-
chiefly as a result of public health measures, fueled the drenbornduringthe1946–64babyboombecameknown
decline in the fertility rate—the increased survival of as‘‘babyboomers,’’anditisthishugecohort(agroupof
2 OlderAmericans—ADiverseandGrowingPopulation GrowingOldinAmerica
TABLE1.1 The decline in death rates, especially at the older
ages, has also contributed to the increase in the number
Population of countries with at least 10 percent age 65 and over, of older adults. Death rates of older adults began to
2003
plummet during the late 1960s and continued to decline
through the early years of the twenty-first century.
Total 65 and over
Advances in medical care have produced declining death
Region or country Number Number Percent
rates for all three of the leading causes of death—heart
Italy 57,998,353 10,893,973 18.8
disease, malignancies (cancer), and cerebrovascular dis-
Japan 127,214,499 23,720,030 18.6
Greece 10,625,945 1,947,336 18.3 eases that cause strokes. (See Table 1.2.) According to
Germany 82,398,326 14,643,067 17.8
the Centers for Disease Control and Prevention (CDC)
Spain 40,217,413 7,075,743 17.6
Sweden 8,970,306 1,545,515 17.2 National Center for Health Statistics, the age-adjusted
Belgium 10,330,824 1,777,398 17.2
death rate in the United States reached an all-time low
Bulgaria 7,588,399 1,293,949 17.1
Portugal 10,479,955 1,749,225 16.7 in 2003 of 831.2 deaths per one hundred thousand popu-
France 60,180,529 9,801,524 16.3
lation. Table 1.3 shows that the death rate declined
Croatia 4,497,779 723,788 16.1
Estonia 1,350,722 217,199 16.1 between 2002 and 2003 among adults age sixty-five to
Austria 8,162,656 1,282,955 15.7
seventy-four, from 2,315 to 2,254; among adults age
United Kingdom 60,094,648 9,429,087 15.7
Finland 5,204,405 805,215 15.5 seventy-five to eighty-four the death rate dropped from
Latvia 2,322,943 358,400 15.4
5,557 to 5,460; and among the oldest old (eighty-five
Switzerland 7,408,319 1,131,164 15.3
Ukraine 48,055,439 7,212,722 15 yearsandover)thedeathrate fellfrom14,828to14,596.
Georgia 4,710,921 706,380 15
Denmark 5,394,138 802,456 14.9 Projections of an increasing proportion of older
Norway 4,555,400 676,160 14.8
adults from 2010 to 2030 are based on three assump-
Hungary 10,057,745 1,492,216 14.8
Slovenia 2,011,604 298,344 14.8 tions—historic low fertility and the prospect of continu-
Serbia and Montenegro 10,823,280 1,592,794 14.7
ing low fertility until 2030; aging of the baby boom
Lithuania 3,620,094 530,425 14.7
Luxembourg 456,764 65,985 14.4 cohort; and continued declines in mortality at older ages
Belarus 10,322,151 1,478,835 14.3
and low mortality until 2030. Demographers (those who
Romania 22,380,273 3,169,849 14.2
Czech Republic 10,251,087 1,432,188 14 studypopulationstatistics)anticipatethatwhentheentire
Netherlands 16,223,248 2,241,317 13.8
baby boom group has attained age sixty-five in 2030, the
Russia 144,457,596 19,203,848 13.3
Malta 395,178 51,969 13.2 proportion of older people in the U.S. population will
Uruguay 3,381,606 442,733 13.1
stabilize.
Canada 32,207,113 4,167,291 12.9
Poland 38,622,660 4,924,081 12.7
Australia 19,731,984 2,502,665 12.7
United States 290,342,554 35,878,341 12.4 DEFINING OLD AGE
Hong Kong S.A.R 6,809,738 836,153 12.3
Puerto Rico 3,878,679 461,501 11.9 Fortyistheoldageofyouth,fiftytheyouthofoldage.
Iceland 291,064 34,055 11.7
—VictorHugo,Frenchpoet,dramatist,andnovelist(1802–85)
Slovakia 5,416,406 630,190 11.6
New Zealand 3,951,307 457,805 11.6 When does old age begin? The challenge of defining
Ireland 3,924,023 447,070 11.4
Cyprus 771,657 85,629 11.1 old age is reflected in the terminology used to describe
Macedonia 2,063,122 217,965 10.6 adults age fifty and older—for example, middle-aged,
Argentina 38,740,807 4,042,311 10.4
Martinique 425,966 43,818 10.3 elder, elderly, older, aged, mature, or senior. AARP (for-
Armenia 3,001,712 306,182 10.2 merly American Association of Retired Persons), the
Moldova 4,439,502 452,797 10.2
Bosnia and Herzegovina 3,989,018 401,929 10.1 nonprofit, nonpartisan, national advocacy organization
for older adults, invites members to join its ranks at age
SOURCE: “Population of Countries with at Least 10 Percent of Their
Population Age 65 and Over,2003,”in Older Americans 2004:Key fifty. Many retailers offer ‘‘senior discounts’’ to persons
Indicators of Well-Being,Federal Interagency Forum on Aging Related beginning at age fifty or fifty-five, and federal entitle-
Statistics,Washington,DC,U.S. Government Printing Office,November
ment programs such as Social Security and Medicare
2004,http://www.agingstats.gov/chartbook2004/tables-population.html
#Indicator%202 (accessed August 11,2005) extend benefits to persons at age sixty-two, sixty-five,
or sixty-seven. Despite the varying definitions of old age
andtheageatwhichoneassumes‘‘olderadultstatus,’’in
thistext,unlessotherwisespecified,thetermolderadults
individuals that share a common characteristic such as
is used to refer to persons age sixty-five and older.
birth years and is studied over time) that is responsible
for the tremendous increase projected in the number of Gerontology, the field of study that considers the
people age sixty-five and over, and especially age sixty- social, psychological, and biological aspects of aging,
five to seventy-four, after 2010. The older adult segment distinguishes between three groups of older adults: the
of the population is expected to swell between 2010 and young-old are considered to be those persons age sixty-
2030 as the baby boom cohort completes its transition five to seventy-four, the middle-old includes those age
from ‘‘middle age’’ to ‘‘old age.’’ seventy-fivetoeighty-four,andtheoldest-oldarepersons
GrowingOldinAmerica OlderAmericans—ADiverseandGrowingPopulation 3
TABLE1.2
Death rate statistics, 2002–03
[Data are based on a continuous file of records received from the states. Rates are per 100,000 population; age-adjusted rates per 100,000 U.S. standard population based on the year
2000 standard. Figures for 2003 are based on weighted data rounded to the nearest individual, so categories may not add to totals.]
Age-adjusted death rate
Death Percent
Rank* Cause of death Number rate 2003 2002 change
… All causes 2,443,930 840.4 831.2 845.3 –1.7
1 Diseases of heart 684,462 235.4 232.1 240.8 –3.6
2 Malignant neoplasms 554,643 190.7 189.3 193.5 –2.2
3 Cerebrovascular diseases 157,803 54.3 53.6 56.2 –4.6
4 Chronic lower respiratory diseases 126,128 43.4 43.2 43.5 –0.7
5 Accidents (unintentional injuries) 105,695 36.3 36.1 36.9 –2.2
6 Diabetes mellitus 73,965 25.4 25.2 25.4 –0.8
7 Influenza and pneumonia 64,847 22.3 21.9 22.6 –3.1
8 Alzheimer’s disease 63,343 21.8 21.4 20.2 5.9
9 Nephritis, nephrotic syndrome and nephrosis 42,536 14.6 14.5 14.2 2.1
10 Septicemia 34,243 11.8 11.7 11.7 —
11 Intentional self-harm (suicide) 30,642 10.5 10.5 10.9 –3.7
12 Chronic liver disease and cirrhosis 27,201 9.4 9.2 9.4 –2.1
13 Essential (primary) hypertension and
hypertensive renal disease 21,841 7.5 7.4 7.0 5.7
14 Parkinson’s disease 17,898 6.2 6.1 5.9 3.4
15 Pneumonitis due to solids and liquids 17,457 6.0 5.9 6.1 –3.3
… All other causes 421,226 144.8 … … …
— Quantity zero.
… Category not applicable.
*Rank based on number of deaths.
SOURCE: Donna L. Hoyert, Hsiang-Ching Kung, and Betty L. Smith, “Deaths and Death Rates for 2003 and Age-Adjusted Death Rates and Percent Changes in
Age-Adjusted Death Rates from 2002 to 2003 for the 15 Leading Causes of Death in 2003:United States,Final 2002 and Preliminary 2003,”in “Deaths:
Preliminary Data for 2003,”National Vital Statistics Report,vol. 53,no. 15,National Center for Health Statistics,Hyattsville,MD,February 28,2005,http://
www.cdc.gov/nchs/data/nvsr/nvsr53/nvsr53_15.pdf (accessed August 11,2005)
ageeighty-fiveandover.Figure1.1showsthattheoldest States in the 21st Century,’’ New England Journal of
segment of older adults, the oldest-old, grew from just Medicine, vol. 352, no. 11, March 17, 2005).
overonehundredthousandin1900to4.2millionin2000
The investigators based their projections on an ana-
and is projected to steadily increase from 2010 to 2050.
lysis of body mass index (BMI is a number that shows
body weight adjusted for height) and other factors that
LIFE EXPECTANCY could potentially affect the health and well-being of the
Lifeexpectancy(theanticipatedaveragelengthoflife) currentgenerationofchildrenandyoungadults,andthey
has increased dramatically since 1900, when the average determined that obesity currently reduces life expectancy
age of death for men and women combined was forty- by approximately four to nine months. The investigators
seven. Most projections see life expectancy continuing to assertthatunlessstepsaretakentocurbexcessiveweight
rise; according to the National Center for Health Statistics, gain,youngerAmericanswilllikelyfaceagreaterriskof
the life expectancy of a baby born in the United States in mortality throughout life than previous generations.
2005waseightyyearsforfemalesand74.5yearsformales.
Global Life Expectancy
Some researchers caution, however, that the historic
The moredevelopedregionsof theworld havelower
trend of increasing longevity has ended, with life expec-
death rates than the less developed regions and, as such,
tancy at birth beginning to decline by as much as five
have higher life expectancies. The World Health Organi-
years as a direct result of the obesity epidemic in the
zation (WHO) observes that life expectancy at birth has
United States. An analysis by S. Jay Olshansky, PhD, of
increased globally from 46.5 years in the early to mid-
the University of Illinois at Chicago; Leonard Hayflick,
1950s to 65.2 years in 2002. The exceptions to this trend
PhD, of the University of California, San Francisco;
are Africa and the former Soviet Union, both of which
Robert N. Butler, MD, of the International Longevity
experienced declines in life expectancy of 2.9 years and
Center in New York, and their colleagues suggests that
one year respectively between 1990 and 2000.
themethodsusedtoestablishlifeexpectancyprojections,
whichhavelongbeenbasedonhistorictrends,needtobe Although the gap in life expectancy is expected to
reassessedinview ofincreasingobesity-relatedmortality narrow during the first half of the twenty-first century,
(‘‘A Potential Decline in Life Expectancy in the United the developed worldwill stillbe far ahead.From2045 to
4 OlderAmericans—ADiverseandGrowingPopulation GrowingOldinAmerica
