Chapter 2.doc

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26 Apr 2012
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Chapter 2- Demography of Aging
Aging In The World
Changing Demographic Profiles
1905
Children and young people made up the largest segment of the population, w/ only a small percentage of people 65
yrs of age and older
This created a pyramid shaped profile, w/ a broad base of infants and children and relatively few older adults
Pyramid-shaped population profiles result from high fertility rates and high mortality rates
1975
Infants and children were no longer the largest population groups instead, the largest cohort consisted of the baby
boomers, who were then b/w the ages of 10 and 30
There 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
The indentation in the middle of the 1975 pyramid characterized those b/w the ages of 35 and 45, the result of the
low birthrate during the Depression
2010
The bottom 2/3 of this pyramid will have squared off considerably by that time
There will be comparable numbers of children and young and middle-aged adults
Many more will survive into their 70s and 80s, although there will be relatively few who are 85 and older, compared
w/ the rest of the population
2030
The baby boomers will have swelled the ranks of older people, becoming the grandparent boomers
The demographic profile continues to change from a pyramid shape to one that is rectangular
Although it is true that the older population is healthier than ever before, there is concern about the economic stress
that growing numbers of older adults may place on the country
More 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 major impact on the resources of the nation
Age dependency ratio
The sheer number of older adults will present daunting challenged for subsequent generations, but there still will be
more younger and middle-aged than older people
Therefore, the working units of the population will outnumber those who are dependent on them
Furthermore, in many cases, older adults are beneficial to the economic health of the country rather than a burden
Total dependency ratio (TDR)
Compares the number of economically non-productive citizens (below age 18 and 65 or older) w/ the number of
working-aged adults
Although not entirely accurate, the age dependency ratio is a rough estimate of the number of people who need to be
supported by workers
The equation: TDR = (a + c)/b, where a= children < 18, b= adults 18-65, and c =adults 65+
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
An increase in TDRs may result in competition for services b/w the old and young and TDRs don’t translate directly
to dollars spent
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.
Although there has been a considerable downturn in economic stability recently, w/ the uncertainty of the stock
market and failure of some retirement funding, older people are still less likely to live in poverty than in the past
Life expectancy
The avg number of years a person in a particular cohort can expect to live
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In 1900, the leading cause of death in the US were infectious diseases like TB, pneumonia, influenza, and
gastroenteritis and very few deaths were caused by heart disease, and death from lung cancer was very rare
Death was distributed throughout the life span; people of all ages died of smallpox and tetanus, childbirth was
associated w/ high mortality rates, and infant mortality was quite high
The discovery of how infectious diseases spread occurred in the late 19th and early 20th centuries, leading to the
development of public health measure to control the spread of communicable diseases and development of vaccines
and drugs
Since the 1930s, the primary causes of death have shifted away from infectious diseases to ones that are more
chronic in nature (heart disease, cancer, stroke, chronic obstructive pulmonary disease, pneumonia and influenza)
The conditions that have fostered the extension of life expectancy include a decrease in infant and maternal mortality
rates, improved sanitation practices, better nutrition, and improved medical care
Longevity comes at a cost b/c chronic diseases like arthritis, diabetes, and hypertension have replaced the acute
diseases of years ago
Generally, chronic diseases are not curable, the main goal of treatment is management of the illness to decrease its
rate of progression and therefore limit disability
This dramatic increase in life expectancy has evoked two major controversies: (1) likely that individual differences
exist in the compression or extension of morbidity and (2) whether there is a max life span in humans, hasn’t been
resolved
Geographic location and residence
Although older people tend to be residentially stable, they may move they retire. E.g. retirees may move where the
cost of living is lower or the climate more temperate
In later years, after the death of a spouse or if one partner experiences poor health, older people often return to the
state in which they spent their younger years, seeking familiar environment and family members
-Thus, states that have high levels of in-migration of elders tend to host the young-old, who are relatively
healthy and have a fair among of disposable income, providing net gains
-The more frail will often return home, however, and the financial burden of their care is provided by their
home states
Graying of rural America
Population demographics in rural and urban areas have changed considerably in the past 100 years and this shift in
population dynamics is due to several factors, including out-migration of younger people and in-migration of retiring
old people, as well as aging in place
Older people who live in rural areas are not a homogenous group but a diverse population who have chosen to live
outside urban areas for a variety of reasons
-They are often dissimiliar in resources, health, and family relationships
-1st group of rural older adults consists of lifelong farmers who have lived in the area all of their lives
-2nd group consists of older people who retire to rural areas after working and raising a family in an urban or
suburban environment
-3rd group consists of older people who lives in small communities rather than on farms
Ethnic populations account for about 7% of rural older people (African Americans- largest then Mexican Americans)
-The health of both these groups is generally poorer than that of other older adults living in rural areas
Older people in rural areas are an important asset to their community as they bring financial resources to the area and
often take on roles as community leaders
Thus, rural older adults are unique and important part of the aging demographics throughout the world
International Aging
Demographically, the European countries and Japan have the greatest % of older adults in their populations
Most nations have increasing numbers of older adults in their populations however, it is predicted that by 2030, there
will be more than twice as many older people in developing countries as in developed nations
-This unprecedented increase in number of older adults is due to the public health advances that have been
introduced in developing countries, extending life expectancy
Fig 2.2 (pg. 26) depicts the avg annual rate of population increase from 1950 to 2000 and projects it to 2030
Great differences exist in the economic resources of the developed and developing countries
-Developing countries often have high % of people living at or below the poverty level
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