Attitudes toward and the treatment of old people have varied substantially in different societies and historical periods. In some preliterate cultures, elders were valued as custodians of wisdom and teachers of survival skills. In others, they were considered a liability and even abandoned when they could not keep up with nomadic groups or were a drain on a subsistence economy. Native American tribes respected elders, and among early colonial settlers such as the Puritans, elders were revered as evolved spiritual persons. However, in the United States, as in Europe, the industrial revolution and reliance on science and up-to-date education meant that older workers were often considered obsolete. And the rise of individualism and mobility rather than family and community meant that older people were apt to live alone.
Increasing Life Expectancy
Because twentieth-century advances in public health increased longevity, the number of old people increased tremendously as a proportion of the population in many developed countries, including the United States. In 1776, the average American lived to age thirty-five and in 1876 to age forty. In 1900, only one in twenty-five Americans was sixty-five or older. In 2000, 35 million Americans sixty-five or older represented 12.7 percent of the U.S. population, or about one in every eight Americans. As the U.S. Bureau of the Census reports, during the twentieth century the population under age sixty-five tripled, but the population over age sixty-five increased by a factor of eleven. The fastest-growing category of Americans is those aged eighty-five or older. In 2050, there will be 18.2 million Americans over eighty-five. More U.S. residents were also reaching age 100. In 2000, there were 68,000 people 100 or more, but in 2050, 834,000 people are expected to reach that age.
Life expectancy at age 65 increased by only 2.4 years between 1900 and 1960, but it grew 3.5 years between 1960 and 2000. People reaching 65 in 2000 had, on average, an additional life expectancy of 17.9 years, or 19.2 years for females and 16.3 years for males. The gender gap meant that over age 65 there were about 140 women for every 100 men, and over age 85, there were about 240 women for every 100 men. Baby boomers, the 76 million Americans born between 1946 and 1964, will begin to get social security benefits starting in 2011. By 2030, there will be about 70 million elders in the United States.
Public and Private Assistance
The increase in longevity and the growing aged population resulted in many government programs. The Social Security Act of 1935, passed during Franklin Roosevelt's presidency during the Great Depression, was a retirement insurance plan designed to provide retirees with some income and also to encourage them to leave the workforce to make room for younger workers. In 1965, Congress passed the Older Americans Act, which set up the Administration on Aging (AOA) as part of the Department of Health, Education, and Welfare, now the Department of Health and Human Services. In 1972, the Older Americans Act was amended to set up Supplemental Security Income (SSI) for those without sufficient social security eligibility. The 1973 amendments to the Older Americans Act set up state and area agencies on aging and local service providers to dispense information and operate programs. As of 2002, more than 2,500 information and assistance programs across the country helped older Americans and caregivers through nearly 14 million contacts annually. Available programs included adult day care, community senior centers, congregate and home-delivered meals, consumer protection, elder abuse prevention, energy assistance, financial services, health insurance, counseling, home health care, home repair and modification, homemaker/chore services, housing options, legal assistance, pension counseling, respite services, reverse mortgages, SSI and food stamps, and transportation services.
The growth in the aged population and in the programs available to it have expanded the professions serving the old. Many new occupations arose, such as care managers for elders and lawyers working in elder law. Two of the leading organizations for professionals in aging, the American Society on Aging and the National Council on Aging, had their historic first joint conference in 2001, attended by 4,000 professionals.
Medicare, federal health insurance for seniors, was established in 1965, with Part A covering hospitalization for all social security recipients and the optional Part B covering other medical services. Medicare picks up 45 percent of an elder's health care costs but does not cover long-term care, although some private insurance does in part. Many senior citizens purchased so-called "Medigap" private insurance to supplement Medicare. The issue of financing Medicare and social security provoked much discussion and political activity in the late twentieth and early twenty-first centuries. To lower costs, in 2000 the age at which social security became available was raised to sixty-seven for those born after 1960.
These government programs have been supported, supplemented, and criticized by senior-citizen advocacy groups. The American Association of Retired Persons (AARP), founded in 1958, advocates for older Americans and is the largest voluntary association in the world, with 35 million members. It provides discounts and services for members, who must be fifty or older. In an article entitled "'Long Goodbye' to Benefits" in its July/August 2001 Bulletin, AARP protested employers nationwide for cutting health insurance benefits to retirees. Families USA, another advocacy organization, also protested Medicare cuts and other benefit losses to elders.
As older Americans required more costly services, some resentment arose among those still in the workforce, and intergenerational programs began to combat "ageism." Benefits from the government and other sources were particularly crucial for older people with low incomes, a disproportionate number of whom were women. The poverty rate was nearly 12 percent for older women, compared to 7 percent for older men. Older people who lived alone were more likely to be poor, and most American widows did live alone. In 1999, 45 percent of women over sixty-five were widows. Older women's median income was $10,943 in 1999, while for older men it was $19,079.
Medicare cuts in the late twentieth and early twenty-first centuries resulted in the closing of many nursing homes because costs exceeded reimbursement, according to the nursing home industry. New alternatives also reduced the number of seniors in nursing homes. The May 2001 issue of U.S. News and World Report stated that nursing home residents numbered just 1.5 million in the United States. About 800,000 elders lived in assistedliving facilities with private apartments and staff to provide some care, while 625,000 lived in continuing-care retirement communities that offered all levels of care from independent living to full care. In addition, some 6 million chronically ill and disabled elderly people received various levels of care at home. Another 1.5 million seniors living in independent apartments received simpler services such as prepared dinners, U.S. News and World Report found.
Many of the alternatives to nursing homes were very expensive and little was covered by the government. Some low-income elders lived in subsidized housing, but long waiting lists for these apartments were common. The assisted-living industry was not well regulated, and abuses occurred.
Diversity
The racial and cultural diversity of the aged population also grew. By 2000, the elder Hispanic population was one of the fastest growing. In 1990, 5.6 percent of the Hispanic population was sixty-five or older, but demographers expected that the percentage would be 14.1 by 2020. In the Asian American and Pacific Islander populations, demographers expected the greatest increase of those over sixty-five—358 percent. Demographers also estimated that the number of African American elders would increase 102 percent by 2020. African American life expectancy in 2000 was only 70.2 years, compared to an average life expectancy of 76.5 years for all elders. This discrepancy is largely because more than 68 percent of old African Americans are poor, marginally poor, or economically vulnerable.
The Administration on Aging's budget under Title 6 of the Older Americans Act provided grants and aid to American Indians, Alaska Natives, and Native Hawaiian elders, and those older persons received nearly 3 million congregate and home-delivered meals annually.
Diversity in sexual orientation is also significant. The AOA estimates that between 1.75 and 3.5 million Americans aged sixty and over are lesbian, gay, bisexual, or transgendered, and that number will enlarge with the aging population's growth.
Retirement
Mandatory retirement was a greatly contested issue in the late twentieth century. In 1967, the Age Discrimination in Employment Act was passed. In 1978, due to the advocacy of the Gray Panthers and other organizations, the act was amended to raise the age of mandatory retirement from sixty-five to seventy for most occupations.
The options for activities after retirement increased along with the aging population. Millions of elders began attending special college programs or taking regular college courses. Many travel programs served elders of means, and corporations generally geared up to serve an aging market. Elderhostel sponsored learning vacations all over the world for older people, as well as sponsoring service programs in which elders volunteer. Many retirees volunteered in their communities, worked part-time, or started small businesses. A wealth of advice books were published on such topics as how to have a good old age, and some employers provided retirement counseling for those who left the workforce. Lifestyles became very different for the healthy old as creative pursuits expanded horizons.
Bibliography
Atchley, Robert C. Social Forces and Aging. 9th ed. Belmont, Calif.: Wadsworth, 2000.
Dychtwald, Ken. Healthy Aging: Challenges and Solutions. Gaithersburg, Md.: Aspen, 1999.
Jacobs, Ruth Harriet. Be an Outrageous Older Woman. New York: HayerPerennial, 1997.
Shapiro, Joseph P. "Growing Old in a Good Home." U.S. News and World Report, 21 May 2000, 56–61.
U.S. Administration on Aging. The Many Faces of Aging. Washington, D.C.: 2001. Available at http://www.aoa.dhhs.gov.
