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Social Structures
Demographic Changes and the
Well-Being of Older Persons
K. Warner Schaie, PhD
Peter Uhlenberg, PhD
Editors
Societal Impact on Aging Series
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Societal Impact on Aging Series
Series Editor
K. Warner Schaie
Evan Pugh Professor of Human Development and Psychology
College of Health and Human Development
The Pennsylvania State University
University Park, PA
2007 Social Structures: Demographic Changes and the Well-Being
of Older Persons
K. Warner Schaie and Peter Uhlenberg, Editors
2006 Social Structures, Aging, and Self-Regulation in the Elderly
K. Warner Schaie and Laura L. Carstensen, Editors
2005 Historical Influences on Lives and Aging
K. Warner Schaie and Glen H. Elder, Jr., Editors
2004 Religious Influences on Health and Well-Being in the Elderly
K. Warner Schaie, Neal Krause, and Alan Booth, Editors
2003 Impact of Technology on Successful Aging
Neil Charness and K. Warner Schaie, Editors
2002 Personal Control in Social and Life Course Contexts
Steven H. Zarit, Leonard I. Pearlin, and K. Warner Schaie, Editors
2002 Effective Health Behavior in Older Adults
K. Warner Schaie, Howard Levental, and Sherry L. Willis, Editors
2000 The Evolution of the Aging Self: The Societal Impact on the Aging Process
K. Warner Schaie and Jon Hendricks, Editors
2000 Mobility and Transportation in the Elderly
K. Warner Schaie and Martin Pietrucha, Editors
1997 Impact of Work on Older Adults
K. Warner Schaie and Carmi Schooler, Editors
1997 Societal Mechanisms for Maintaining Competence in Old Age
Sherry L. Willis, K. Warner Schaie, and Mark Hayward, Editors
1996 Older Adults’ Decision-Making and the Law
Michael Smyer, K. Warner Schaie, and Marshall B. Kapp, Editors
1995 Adult Intergenerational Relations: Effects of Societal Change
Vern Bengtson, K. Warner Schaie, and Linda K. Burton, Editors
1993 Societal Impact on Aging: Historical Perspectives
K. Warner Schaie and W. Andrew Achenbaum, Editors
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K. Warner Schaie, PhD, is the Evan Pugh Professor of Human Devel-
opment and Psychology at the Pennsylvania State University. He also
holds an appointment as Affiliate Professor of Psychiatry and Behavioral
Science at the University of Washington. He received his PhD in psy-
chology from the University of Washington, an honorary DrPhil from
the Friedrich-Schiller University of Jena, Germany, and an honorary ScD
degree from West Virginia University. He received the Kleemeier Award
for Distinguished Research Contributions from the Gerontological Soci-
ety of America, the MENSA lifetime career award, and the Distinguished
Scientific Contributions award from the American Psychological Associ-
ation. He is author or editor of 54 books, including the textbook Adult
Development and Aging (5th edition, with S. L. Willis) and the Handbook
of the Psychology of Aging (6th edition, with J. E. Birren). He has directed
the Seattle Longitudinal Study of cognitive aging since 1956 and is the
author of more than 325 journal articles and chapters on the psychology
of aging. His current research interests are the life course of adult intel-
ligence, its antecedents and modifiability, the early detection of risk for
dementia, and methodological issues in the developmental sciences.
Peter Uhlenberg, PhD, is Professor of Sociology and Fellow of the
Carolina Population Center, University of North Carolina, Chapel Hill.
He received his PhD from the University of California, Berkeley, in 1971.
His current research focuses on issues related to age segregation, inter-
generational relationships, and population aging. In 2006, he received
the Matilda White Riley Distinguished Career Award from the Aging and
Life Course Section of the American Sociological Association.
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Copyright ⃝C 2007 Springer Publishing Company, LLC
All rights reserved.
No part of this publication may be reproduced, stored in a retrieval system, or transmitted
in any form or by any means, electronic, mechanical, photocopying, recording, or other-
wise, without the prior permission of Springer Publishing Company, LLC.
Springer Publishing Company, LLC
11 West 42nd Street
New York, NY 10036
www.springerpub.com
Acquisitions Editor: Sheri W. Sussman
Production Editor: Peggy M. Rote
Cover design: Joanne E. Honigman
Composition: Aptara, Inc.
07 08 09 10/5 4 3 2 1
ISBN: 978-0-8261-2407-4
Library of Congress Cataloging-in-Publication Data
Social structures : demographic changes and the well-being of older persons /
[edited by] K. Warner Schaie, Peter Uhlenberg.
p. cm. – (Societal impact on aging series)
Includes bibliographical references and index.
ISBN 0-8261-2407-0 (hardback)
1. Older people–United States. 2. Aging–Social aspects–United States.
3. Population aging–United States. 4. Baby boom generation–United
States. 5. United States–Population. 6. United States–Emigration and
immigration–Social aspects. I. Schaie, K. Warner (Klaus Warner), 1928-
II. Uhlenberg, Peter.
HQ1064.U5S597 2007
305.260973–dc22
2007005881
Printed in the United States of America by Lightning Source.
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Contents
Contributors vii
Preface ix
1 Older Immigrants 1
Judith Treas and Jeanne Batalova
2 Older Immigrants: Cultural Issues in Access to Health
Care (Commentary) 25
Charlotte Ikels
3 Immigration and an Aging America: Downward Spiral or
Virtuous Circle? (Commentary) 37
Charles Hirschman
4 Population Aging and Benefit Sustainability: The Impact
of Baby Boomer Aging on the Health Care System 52
Stephen Crystal
5 What Havoc Will the Boomers Wreak? (Commentary) 71
Robert L. Kane
6 Demographic Reflections on the Aging of the Baby Boom
and Its Implications for Health Care (Commentary) 80
Vicki A. Freedman
7 Perspectives on the Economic Implications of the Aging
of Baby Boomers 91
Eric R. Kingson
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vi Contents
8 Futures for the Baby Boom: Described, Inscribed,
and Prescribed 115
David J. Ekerdt
9 Immigration Effects on Health Care for Older People 123
Jacqueline L. Angel
10 Migration and Health Care for Older People: Developing
a Global Perspective (Commentary) 158
Chris Phillipson
11 Immigration, Race/Ethnicity, and Health Care
(Commentary) 170
Robert A. Hummer
12 The Aging of the Second Demographic Transition 179
Mary Elizabeth Hughes and Linda J. Waite
13 The Second Demographic Transition, Aging Families, and
the Aging of the Institutionalized Life Course
(Commentary) 212
Dale Dannefer and Robin S. Patterson
14 Some Thoughts on Aging, Marriage,
and Well-Being in Later Life (Commentary) 230
David M. Blau
15 The Impact of Demographic Changes on Relations
Between Age Groups and Generations: A Comparative
Perspective 239
Gunhild O. Hagestad and Peter Uhlenberg
16 The Future of Intergenerational Relationships—Variability
and Vulnerabilities (Commentary) 262
Maximiliane E. Szinovacz
17 Demographic Transitions, Age, and Culture (Commentary) 283
Christine L. Fry
Author Index 301
Subject Index 311
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Contributors
Jacqueline L. Angel, PhD David J. Ekerdt, PhD
Lyndon B. Johnson School of Director, Gerontology Center
Public Affairs and Department University of Kansas
of Sociology Lawrence, KS
University of Texas, Austin
Austin, TX Vicki A. Freedman, PhD
Department of Health Systems
Jeanne Batalova, PhD and Policy
Migration Policy Institute School of Public Health
Washington, DC University of Medicine &
Dentistry of New Jersey
David M. Blau, PhD New Brunswick, NJ
Department of Economics and
Carolina Population Center Christine L. Fry, PhD
University of North Carolina at Professor of Anthropology,
Chapel Hill Emerita
Chapel Hill, NC Loyola University of
Chicago
Stephen Crystal, PhD Bisbee, AZ
Associate Institute Director for
Health Services Research Gunhild O. Hagestad, PhD
Director, Center for Agder University College
Pharmacotherapy, Chronic Kristiansand, and NOVA
Disease Management, and Norwegian Social Research
Outcomes Oslo, Norway
Rutgers University
New Brunswick, NJ Charles Hirschman, PhD
Center for Studies in Demography
Dale Dannefer, PhD and Ecology
Chair, Department of Sociology Department of Sociology
Case Western Reserve University University of Washington
Cleveland, OH Seattle, WA
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viii Contributors
Mary Elizabeth Hughes, PhD Syracuse University
Department of Population, Syracuse, NY
Family and Reproductive
Health Robin S. Patterson, MA
Johns Hopkins Bloomberg Department of Sociology
School of Public Health Case Western Reserve University
Baltimore, MD Cleveland, OH
Robert A. Hummer, PhD Chris Phillipson, PhD
Population Research Center Centre for Social Gerontology
Department of Sociology School of Social Relations
University of Texas, Austin Keele University
Austin, TX Staffordshire, United Kingdom
Charlotte Ikels, PhD Maximiliane E. Szinovacz, PhD
Department of Anthropology Director of the Gerontology
Case Western Reserve Institute
University Department of Gerontology
Cleveland, OH University of Massachusetts
Boston
Robert L. Kane, MD Boston, MA
Minnesota Chair in Long-Term
Care and Aging Judith Treas, PhD
University of Minnesota Department of Sociology
School of Public Health University of California, Irvine
Minneapolis, MN Irvine, CA
Eric R. Kingson, PhD Linda J. Waite, PhD
School of Social Work Department of Sociology
College of Human Services and University of Chicago
Health Professions Chicago, IL
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Preface
This is the 19th volume in a series on the broad topic of “Societal
Impact on Aging.” Lawrence Erlbaum Associates published the first five
volumes of this series under the series title of “Social Structure and
Aging.” The present volume is the 14th published under the Springer
Publishing Company imprint. It is the edited proceedings of a confer-
ence held at the Pennsylvania State University, October 10–11, 2005.
The series of Penn State Gerontology Center conferences originated
from the deliberations of a subcommittee of the Committee on Life
Course Perspectives of the Social Science Research Council chaired by
Matilda White Riley in the early 1980s. That subcommittee was charged
with developing an agenda and mechanisms that would serve to en-
courage communication between scientists who study societal structures
that might affect the aging of individuals and those scientists who are
concerned with the possible effects of contextual influences on individ-
ual aging. The committee proposed a series of conferences that would
systematically explore the interfaces between social structures and be-
havior, and in particular to identify mechanisms through which society
influences adult development. When the first editor was named director
of the Penn State Gerontology Center in 1985, he was able to implement
this conference program as one of the center’s major activities.
The previous 18 volumes in this series have dealt with the societal
impact on aging in psychological processes (Schaie & Schooler, 1989);
age structuring in comparative perspective (Kertzer & Schaie, 1989);
self-directedness and efficacy over the life span (Rodin, Schooler, &
Schaie, 1990); aging, health behaviors, and health outcomes (Schaie,
Blazer, & House, 1992); caregiving in families (Zarit, Pearlin, &
Schaie, 1993); aging in historical perspective (Schaie & Achenbaum,
1993); adult intergenerational relations (Bengtson, Schaie, & Burton,
1995); older adults’ decision making and the law (Smyer, Schaie, &
Kapp, 1996); the impact of social structures on decision making in the
elderly (Willis, Schaie, & Hayward,1997); the impact of the workplace
on aging (Schaie & Schooler, 1998); mobility and transportation in the
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x Preface
elderly (Schaie & Pietrucha, 2000); the evolution of the aging self
(Schaie & Hendricks, 2000); societal impact on health behavior in
the elderly (Schaie, Leventhal, & Willis, 2002); mastery and control in
the elderly (Zarit, Pearlin, & Schaie, 2002); impact of technology on the
elderly (Charness & Schaie, 2003); religious influences on health and
well-being in the elderly (Schaie, Krause, & Booth, 2004); historical in-
fluences on lives and aging (Schaie & Elder, 2005); and the impact of
social structures on self-regulation in the elderly (Schaie & Carstensen,
2006).
The strategy for each of these volumes has been to commission re-
views on three major topics by established subject-matter specialists who
have credibility in aging research. We then invited two formal discussants
for each chapter—usually one drawn from the writer’s discipline and
one from a neighboring discipline. This format has provided a suitable
antidote against the perpetuation of parochial orthodoxies and made
certain that questions are raised in regard to the validity of iconoclastic
departures in new directions.
To focus each conference, the organizers have chosen three aspects
of the conference topic that are of broad interest to gerontologists. So-
cial and behavioral scientists with a demonstrated track record are then
selected and asked to interact with those interested in theory building
within a multidisciplinary context.
The present volume focuses on the impact of demographic changes
on the well-being of older persons. Significant demographic changes
are altering the structure of the American population. As in most other
countries, there will be a rapid increase in the number and proportion
of older individuals in the U.S. population. Large-scale immigration is
changing the ethnic composition of cohorts as they age. Changes in
marriage, cohabitation, divorce, and childbearing are altering family
experiences and kinship networks over the life course. These changes
also affect the size and composition of the population of working age that
provides the base for economic support of the elderly and that provides
most of the care for older persons who are suffering from disabilities and
disabling chronic diseases and who consequently become functionally
dependent.
In this volume, we examine the implications of changes in the Amer-
ican population structure for the role and support of older people. These
influences include the roles of changing age distribution, immigration,
increasing longevity, and family change. Massive immigration in recent
years is of interest because immigrants are taking on a major role in the
care of frail elderly and because it will lead to an increasing number
of immigrant elderly in the future. Changes in family patterns and age
