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Chapter 2

Chapter 2 Book Notes

Health Studies
Course Code
Ingrid L.Stefanovic

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Health, Illness, and Optimal Aging- Biological and Psychological Perspectives
Chapter 2: Demography Of Aging
-20th century, most countries had pyramid shaped population profiles, with children and
young people greatly outnumbering those who were older
-By the centurys end, however, the pyramid shape had changed as the percentage of the
population who were children decreased and the number of middle aged and older
persons increased
-Global trend of all nations the increased of older people
-The increase in thr number of older citizens is creating problems for developing countries
that do nto have adequate resources or the economic stability to support a large older
adult population
-In the United States, ethnic diversity in the older population is growing
-Not only European Americans, this group now includes substantial numbers of Asian,
Latino, and African Americans
-The greater number, ethnic diversity, and increasing age of the population will complicate
treatment and service delivery in the areas of health and social care, as well as affecting
transportation, business, education, and even recreation.
-This chapter examines the dynamics of the population growth in the United States,
focusing particularly on the increase in numbers of older adults, with an overview of how
life expectancy has changed in the past 100 years
-How increasing numbers of older people may affect the economy of the country
-Also report the geographic distribution of older people
-Next, we look at population changes in other parts of the world
-Morbidity and mortality rates of these countries and the difficulties of providing
resources for their aging populations
-Last part: addresses demographic factors as they relate to the rate of aging; how do
gender, martial status, ethnicity and socioeconomic status affect the mortality and/or
morbidity of an individual
-The worldwide demographic shift highlights the fact that aging is not strictly genetically
determined but is plastic, or susceptible to influence. Nonetheless, the demographics of
morbidity and mortality also demonstrate the opposing principle – that aging process also
exhibit cumulative effects, which can manifest either as aging acceleration or deceleration
Population Aging in the United States
Changing demographic profiles
-In 1905, children and young people made up the largest segment of the population with
only a small percentage of people 65 years of age and older
-Broad base of finants and children and less adults
-By 1975, the demographic profile of the country had changed

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Health, Illness, and Optimal Aging- Biological and Psychological Perspectives
oThe largest cohort consisted of the baby boomers, who were then between the
ages of 10 and 30
oThere was also a slight widening at the top of the pyramid as more people in their
60s and 70s survived into their 80s and 90s
oOn the other hand, the indentation in the middle of the 1975 pyramid
characterized those between the ages of 35 and 45, the result of the low birthrate
during the Depression
-For the first time in over a century, the growth rate of the older population in the 2000
census did not exceed that of the rest of the population
oAlthough the total population increased by 13.2%, the population of older adults
increased by just 12%
oFurthermore, the proportion of those 65 and older in the total population dropped
from 12.6% in 1990 to 12.4% in 2000.
oThis will change as the baby boomers begin to turn 65 in the year 2011.
-Figure 2.1
oThe bottom two thirds of the pyramid will have squared off considerably by that
oMany more survive into their 70s and 80s, although there will be relatively few
who are 85 and oldr, compared with the rest of the population
oBy 2030, the baby boomers will have swelled the ranks of older people, becoming
the grandparent boomers
oIt is projected that as many as 70 million people in the United States will be 65 or
older by 2030
oContinue to shape to one that is rectangular: Atchley (2000) argues that countries
with rectangular population distributions tend to be more prosperous and more
politicially stable than those with the classic pyramid shape
-85+ in the United States
oAbout 100, 000 people were over the age of 85 in the United States in 1900
oThis age group represents 1.5% is the fastest growing segment of the older
oIt increased by 38% in the 1900s, from 3.1 million in 1990 to 4.2 million in 2000
oThis number is expected to quadruple in the first half of this century, nearing a
projected 18.9 million by the year 2050
oIt is estimated, that about 14000 centenarians lived in the United States in 1980
oThis more than tripled in the past 20 years; the 2000 census reported 50 454
oFour out of five were women, reflecting the change in gender ratio with age
oSouth Dakota had the highest proportion of centenarians in its population – 1 of
every 3056 people
oThe chances of becoming a centenarian greatly improved during the 20th century
oA person born in 1879 had a 1 in 400 chance of living to be 100 years old, but a
person born in 1980 has a 1 in 87 chance of living to 100

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Health, Illness, and Optimal Aging- Biological and Psychological Perspectives
oThere is still a concern about the economic stress that growing numbers of older
adults may place on the country
oMore than any other age group, those 85 and older have the greatest health and
social care needs, and an increase in their numbers may have a major impact on
the resources of the nation
-Age Dependency Ratios
oThe working units of the population will outnumber those who are dependent on
oFurthermore, in many cases, older adults are beneficial to the economic health of
the country rather than a burden
-A total dependency ratio (TDR) compares the number of economically nonproductive
citizens (below age 18 and age 65 and older) with the number of working aged adults
-Although not entirely accurate (some individuals make considerable money in early or
late life and some working aged adults are disabled, unemployed, or taking time out to
raise children), the age dependency ratio is a rough estimate of the number of people who
need to be supported by workers. This equation is simple:
-TDR = (a + c)/b
-Where a = children < 18, b = adults 18 to 65, and c = adults 65 and older
-A serious concern is that the growing percentage of older adults in the population will
create a crisis in TDRs and place an overwhelming burden on working aged adults
-Problem: competition for services between the old and the young
-The amount that children and elders cost working family members and society depends
on such factors as the level of services provided and the savings, pensions, investments
and other types of benefits that older adults can draw on
-Older adults are healthier than ever before, which may lessen the expected burden of
health care costs
-With the economic instability, older people are still less likely to live in poverty than in
the past
-In poor families in the United States, Social Security payments to grandparents are often
the most stable source of income for the family as a whole
-Countries that have economic surpluses, such as the US and Europe are able to provide
sufficient resources for the dependent members of their societies
Life Expectancy
-Life expectancy is the average number of years a person in a particular cohort can expect
to live
-A child born today can expect to live at least 30 years longer than one born a century ago
-Although life expectancy in 1900 was about 47 years a female born in 1999 can expect to
live 79 years and a male, almost 74 years
-In 1900, the leading causes of death in the United States were infectious diseases such as
tuberculosis, pneumonia, influenza and gastroenteritis
-Very few deths were caused by heart diseas, and death from lung cancer was extremely
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