The Aging Demographic Tsunami and Implications for Emergency Management
The aging of the population is one of the most important demographic trends in the United States. The U.S. population is aging, growing increasingly diverse, and more frequently receiving health care at home. In addition, an increasing number of Americans are migrating to areas that are at a higher risk of hazard.
The use of the metaphor “demographic tsunami,” refers to the aging population, also referred to as the “baby boomers,” or those individuals born between 1946 and 1964. The term “Baby Boom” is used to identify a massive increase in births following World War II. The term “tsunami,” a series of traveling waves in water is used here to describe each year from 1946–1964 as a wave of aging. America’s graying population has the ability to transform politics, healthcare systems, transportation, banking, housing, and labor markets and has serious planning implications for emergency management.
Demographics
On January of 2011 the Baby Boomers began turning 65 at a rate of 10,000 per day and will continue to do so until the year 2030. Between 2010 and 2050, the United States is projected to experience rapid growth in its aging population. In 2050, the number of Americans aged 65 and older is projected to be 88.5 million, more than double its projected population of 40.2 million in 2010. And in 2060, the number of persons 65 and older will reach 92 million.
Case Study: Texas
Today, people are living longer and the U.S. population in general is increasingly older. According to the Texas State Demographer recent report, “Introduction to Migration in Texas,” beginning in 2005, Texas has experienced the largest annual population growth of any state. Texas seniors, those over 65 years of age, are projected to more than triple in size from 2010 to 2050, approaching 7.9 million. The age category including those 45 to 64 years of age is projected to be the second fastest growing age group, growing 55% by 2050 to a population of over 9.3 million. Much of the population growth in Texas is projected to come from the large urban counties of Harris, Dallas, Tarrant, Bexar, and Travis, but the fastest growth is projected to occur in the suburban rings surrounding these counties. This momentous growth in Texas population is due to natural increase and net migration. In the past 60 years, Texas has attracted significant numbers of migrants to the state. Migration is an important component of population change. Migration’s most immediate impact is on the size of the population. But, migration also has more subtle effects. Over time, continuing net inmigration would substantially alter the future age structure of Texas. Even in the absence of net inmigration, the Texas population is expected to continue growing through natural increase.
However, if historical migration patterns were to continue, this would lead to much greater population growth. Also, continuing inmigration would change the future population composition. This is especially true for the population age structure. Migrants tend to be young adults in their 20s and 30s and a continuation of historical migration patterns would give Texas a younger population than it would have otherwise. The Texas population projections show that continuing inmigration will lead to larger elderly populations. Larger elderly populations will likely place heavier demands on social security, health care, and other services. However, we also see that continuing inmigration should lead to more workers per retiree. In this circumstance, migration would reduce the relative size of the aged population. Consequently, the future patterns of Texas migration could have important implications for our ability to maintain an adequate support system for our elderly population.
Family Caregiving: Texas
In a 2015, More than three-quarters (77%) of Texas registered voters age 45 and older believe that being cared for at home with caregiver assistance is the ideal situation when the basic tasks of life become more difficult due to aging or illness. According to an AARP Texas report, in fact, over half (54%) of Texas registered voters age 45 and older say they are providing (20%) or have provided care (43%) on an unpaid basis for an adult loved one who is ill, frail, elderly or who has a disability.
Most Texas caregivers are helping or have helped their loved ones with shopping (90%), transportation (87%), meal preparation (85%), household chores (83%), as well as more complex care like managing medications and other nursing and medical tasks (73%). About seven in ten (71%) of these caregivers say it is at least somewhat likely that they will need to provide this type of care in the future. As such, these caregivers believe it is important to be able to provide care so that their loved ones can keep living independently in their own home and to have more caregiver resources and training that allows family caregivers to continue to provide in-home care.
Ethnicity
The baby boomer cohort is projected to substantially increase its racial and ethnic diversity over the next four decades. The percentage of the 65 and older population that is Hispanic will rise from 7 percent in 2010 to 20 percent in 2050 which is a six fold increase, from 2.9 million to 17.5 million. In the same time period, among those individuals 85 and older, the Hispanic population will increase nine times, from 305,000 to 2.9 million. Also, among those 65 and older, 12 percent are expected to be single-race black and 9 percent Asian in 2050. White alone population for this time period decreases from 85 percent to 77 percent.
Geographic Distribution
In 2011, 51 percent of persons 65 or older lived in 9 states: California (4.4 million); Florida (3.4 million); New York (2.7 million); Texas (2.7 million); Pennsylvania (2.0 million); and Ohio, Illinois, Michigan, North Carolina with each over 1 million. While in the general population, as of 2003, 53 percent of the nation’s population lived in the 673 U.S. coastal counties, an increase of 33 million people since 1980.
Living Arrangements
In 2012, 57 percent of noninstitutionalized persons 65 or older lived with their spouse. Approximately 13.2 million or 72% of older men and 10.3 million or 45% of older women lived with their spouse. About 28% or 11.8 million of all noninstitutionalized persons in 2012 lived alone. This represented 36 percent of older women and 19% of older men. Almost half of women age 75 or older live alone. For people 80 or older, most were living at home although there were difference between men and women. Women were equally likely in the 80’s to live at home alone (46%) or with others (46.2%) while men in their 80’s were 71.4 percent more likely to live at home with others. Only 23.7 percent of men in their 80’s live at home alone. Living alone and being female has its own set of concerns and implications, especially financial insecurity.
To continue to use Texas as a case example, a 2014 AARP Texas Financial Security Survey was conducted as a telephone survey among 894 age 40–64 year old adults in the state of Texas. According to the survey, many Texas adults age 40–64 are on a path of financial insecurity that will not lead to a financially secure retirement. Of those surveyed, one in four has less than $5,000 in savings, and four in ten has experienced difficulty making ends meet in the recent past. Also, those surveyed revealed that over half do not have enough or they have just enough money for everyday expenses. In addition to everyday expenses, many face obstacles to saving such as costly health needs, children’s education, and debt. One in five does not have access to any workplace retirement savings tools and many recognize their retirement insecurity as over half of those surveyed are anxious about having enough money for their retirement, and four in five wish they had saved more. Texas women in particular are vulnerable. One in three women surveyed, has less than $5,000 in savings and one in five does not have access to any workplace retirement savings tools. Many Texas women recognize their retirement insecurity as over three in five of those surveyed are anxious about having enough money for their retirement, and four in five wish they had saved more.
Income
In 2010, Social Security constitutes 90% or more of the income received by 36 percent of beneficiaries. Almost 3.6 million people 65 or older, or 8.7 percent in 2011 were below the poverty level. The median income of older persons 65 or older in 2011 was $27,707 for males and 415, 362 for females. Eighty-one percent live in metropolitan areas in 2011.
Health and Disability
The 2010 Census found that approximately 56.7 million (18.7 percent) people living in the United States had some kind of disability. As a generally accepted understanding of prevalence, the risk of having a disability increased with successively older age groups. At 70.5 percent, people in the oldest age group (people 80 years and older) were about 8 times as likely to have a disability as people in the youngest age group (children less than 15 years old), at 8.4 percent. Severe disability and the need for personal assistance also increased with age. The probability of severe disability was 1-in-20 for people aged 15 to 24, while 1-in-4 for those aged 65 to 69. Among the oldest group, more than half (55.8 percent) had a severe disability. Of individuals 55 to 64 years old and nearing retirement, about 6.0 percent needed assistance with one or more [activities of daily living]. The percentage needing assistance for those aged 80 and older was about 5 times as large (30.2 percent). For individuals with greater assistance needs, their disability is often associated with relocation out of the non-institutionalized population and into nursing homes or other assisted living facilities. Approximately 1.3 million of the 40.4 million people aged 65 and older were living in nursing facilities in 2010. Were this population included, the disability rates for older age groups, and for people overall, would likely be higher.
Most persons 65+ have at least one chronic condition and many have multiple disabilities. In 2009–2011, the most frequently occurring medical conditions among older adults were: arthritis (51%), all types of heart disease (31%), any cancer (24%), diabetes (20%) and hypertension (72 % 2007–2010). About 28 percent of persons 60+ self report height/weight combinations that place them among the obese. According to the National Center for Health Statistics, 35 percent of men and 38 percent of women age 65+ in 2011, report activities of daily living limitations. Additionally, 92 percent of institutionalized beneficiaries of Medicare had difficulties with one or more activities of daily living such as bathing, dressing, eating and getting around the house.
Implications for Emergency Management
The ripple effects of the aging demographic tsunami will be felt throughout the fabric of American life for many years. These emergency management community challenges will continue throughout the next four to six decades. Considerations for the aging demographic tsunami will affect every facet of the emergency management lifecycle. Growth in the elderly population creates both opportunities and challenges in an emergency environment.
Emergency Managers Considerations for Planning and Response
· Community planners and local governments will need to gain a better understanding of aging issues and plan for changes in family structures, communication, local infrastructure, transportation, health and diverse linguistic needs during disasters.
· Emergency managers will need to adjust their practices toward the dynamics of an aging population that will be ethnically diverse and primarily female.
· Many of the older population will require medical personnel and/or family members to accompany them as caregivers during evacuations.
· Evacuation vehicles and aircraft must have accessible features to evacuate properly and shelter managers will need to consider medical staff, equipment, and medication supplies to accommodate the ever growing aging population.
· Emergency managers must learn to serve an increasingly growing racial and ethnic population. Many may speak languages other than English.
· The older population is migrating to more urban cities and coastal states which is also a target of the evolving terrorist threat to attack densely populated areas.
· The older population is migrating to more urban and coastal states which will bring challenges to evacuation, accessible transportation and housing during and after natural disasters.
· There is also a potential for domestic terrorism due to anti-minority/anti-immigrant sentiments as the general and older population becomes more racially and ethnically diverse.
· The elderly will receive many medical services at home, previously provided in hospitals, nursing homes, and other facilities, which will also present a challenge to emergency managers before, during and after disasters.
· Sheltering and evacuations will need to plan for more durable medical equipment in transit and sheltering.
· The adjustments to the emergency management lifecycle due to the aging demographic will require long-range strategic thinking on a variety of important social and political trends.
Angi English has a Master’s in Security Studies from the Naval Postgraduate School’s Center for Homeland Defense and Security and a Master’s in Educational Psychology from Baylor University. She lives in Austin, Texas.
