Older Americans
Key Indicators of Well-Being
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Federal Interagency Forum on Aging-Related Statistics
The Federal Interagency Forum on Aging-Related Statistics (Forum) was founded in 1986 to foster
collaboration among Federal agencies that produce or use statistical data on the older population. Forum
agencies as of June 2016 are listed below.
Consumer Product Safety Commission
http://www.cpsc.gov
Department of Commerce
U.S. Census Bureau
http://www.census.gov
Department of Health and Human Services
Administration for Community Living
http://www.acl.gov
Agency for Healthcare Research and Quality
http://www.ahrq.gov
Centers for Medicare and Medicaid Services
http://www.cms.gov
National Center for Health Statistics
http: //www. cdc. gov/nchs
National Institute on Aging
http://www.nia.nih.gov
Office of the Assistant Secretary for Planning and
Evaluation
http://aspe.hhs.gov
Substance Abuse and Mental Health Services
Administration
http://www.samhsa.gov
Department of Housing and Urban
Development
http://www.hud.gov
Department of Labor
Bureau of Labor Statistics
http://www.bls.gov
Employee Benefits Security Administration
http://www.dol.gov/ebsa
Department of Veterans Affairs
http://www.va.gov
Environmental Protection Agency
http://www3 - epa. gov/
Office of Management and Budget
Office of Statistical and Science Policy
http://www.whitehouse.gov/omb/inforeg_statpolicy
Social Security Administration
Office of Research, Evaluation, and Statistics
http://www.ssa.gov
Copyright information: All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation
as to source, however, is appreciated. Recommended citation: Federal Interagency Forum on Aging-Related Statistics. Older Americans 2016: Key
Indicators of Well-Bang. Federal Interagency Forum on Aging-Related Statistics. Washington, DC: U.S. Government Printing Office. August 2016.
Report availability: Single copies of this report are available at no charge through the National Center for Health Statistics while supplies last. Requests
may be sent to the Information Dissemination Staff, National Center for Health Statistics, 3311 Toledo Road, Room 5412, Hyattsville, MD 20782.
Copies may also be ordered by calling 1-866-441-NCHS (6247) or by e-mailing nchsquery@cdc.gov. This report is also available on the World Wide
Web at http://www.agingstats.gov
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Older Americans 2016
Key Indicators of Well-Being
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Foreword
Older Americans (those age 65 and over) are a vibrant
and growing part of our Nation. They also experience
unique challenges to their economic well-being, health,
and independence. To inform decisions regarding the
support and well-being of older Americans, robust
statistics reflecting these experiences are needed. Although
many Federal agencies provide statistics on aspects of
older Americans' lives, it can be difficult to fit the pieces
together into a comprehensive representation. Thus, it has
become increasingly important for policymakers and the
general public to have an accessible, easy-to-understand
portrait of how older Americans fare.
Older Americans 2016: Key Indicators ofWell-Being
(Older Americans 2016) provides a comprehensive,
easy-to-understand picture of our older population. It
is the seventh such chartbook prepared by the Federal
Interagency Forum on Aging-Related Statistics (Forum).
Readers will find here an accessible compendium of
indicators drawn from the most reliable official statistics.
Indicators are categorized into six broad groups:
Population, Economics, Health Status, Health Risks and
Behaviors, Health Care, and Environment.
The Forum's recent review of the Older Americans
chartbook resulted in the addition of several new
indicators particularly relevant to many of the challenges
currently facing older Americans. Among these additions
are an indicator describing the changing demographics of
Social Security beneficiaries and an indicator describing
transportation access for older Americans. Indicators have
also been added to describe dementia rates (including
Alzheimer's disease rates, among the non-nursing home
population) as well as to examine the number of older
Americans receiving long-term care by different types
of providers. Finally, the Supplemental Poverty Measure
(SPM) for Americans age 65 and over has been added.
The SPM extends the official poverty measure by taking
into account many government programs designed to
assist low-income families that are not included in the
official poverty measure.
Although Federal agencies currently collect and report
substantial information on the population age 65 and
over, other important gaps in our knowledge remain.
In Older Americans 2012, the Forum identified six such
areas where more data are needed: informal caregiving,
residential care, elder abuse, functioning and disability,
mental health and cognitive functioning, pension
measures, and end-of-life issues. In Older Americans 2016,
we provide updated information on the data availability
for these specific areas, in addition to a special feature on
informal caregiving.
We continue to appreciate users' requests for greater detail
for many existing indicators. We also extend an invitation
to all of our readers and partners to let us know what else
we can do to make our reports more accessible and useful.
Please send any comments to agingforum@cdc.gov.
The Older Americans reports reflect the Forum's
commitment to advancing our understanding of where
older Americans stand today and what challenges they
may face tomorrow. I congratulate the Forum agencies
for joining together to present the American people with
such valuable tools for understanding the well-being of the
older population. Last, but not least, none of this work
would be possible without the continued cooperation of
millions of American citizens who willingly provide the
data that are summarized and analyzed by staff in the
Federal agencies for the American people.
Katherine K. Vfollman
Chief Statistician
Office of Management and Budget
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Acknowledgments
Older Americans 2016: Key Indicators of Well-Being is a
report of the Federal Interagency Forum on Aging-Related
Statistics (Forum). This report was prepared by the Forum's
planning committee and reviewed by the Forum's principal
members, which include Vicki Gottlich and Robert
Hornyak (retired), Administration for Community Living
(ACL); Steven B. Cohen, Agency for Healthcare Research
and Quality (AHRQ); Dorinda Allard, Bureau of Labor
Statistics (BLS); Karen Humes and Roberto Ramirez, U.S.
Census Bureau; Debra Reed-Gillette, Centers for Medicare
& Medicaid Services (CMS); Kathleen Stralka, U.S.
Consumer Product Safety Commission (CPSC); Lynn
Ross, Department of Housing and Urban Development
(HUD); Joseph Piacentini and Anja Decressin, Employee
Benefits Security Administration (EBSA); Kathy Sykes,
Environmental Protection Agency (EPA); Charles Rothwell
and Jennifer Madans, National Center for Health Statistics
(NCHS); John Haaga and John Phillips, National Institute
on Aging (NIA); Ruth Katz and William Marton, Office
of the Assistant Secretary for Planning and Evaluation
(ASPE), Department of Health and Human Services;
Katherine K. Wallman, Office of Management and Budget
(OMB); Daryl Kade, Substance Abuse and Mental Health
Services Administration (SAMHSA); Howard lams, Social
Security Administration (SSA); and DatTran and Richard
Allman, Department of Veterans Affairs (VA).
The Forum's planning committee and contributing staff
members include Forum Staff Director, Traci Cook; Susan
Jenkins and Kristen Robinson, ACL; David Kashihara
AHRQ; Emy Sok, BLS; Amy Symens Smith and Wan He,
U.S. Census Bureau; Kathleen Stralka, CPSC; Katherine
Giuriceo and Lisa Mirel, CMS; Meena Bavan, HUD;
Allan Beckmann and Lynn Shniper, EBSA; Kathy Sykes,
EPA; Julie Dawson Weeks and Ellen Kramarow, NCHS;
John Phillips, and Prisca Fall, NIA; Helen Zayac Lament,
ASPE; Jennifer Park, OMB; Beth Han, and Jennifer
Solomon, SAMHSA; Howard lams and Brad Trenkamp,
SSA; Hazel Hiza, USDA; and Carolyn Stoesen,VA.
In addition to the 16 agencies of the Forum, the
Department of Agriculture (USDA) was invited to
contribute to this report. The Forum greatly appreciates
the efforts of Hazel Hiza and TusaRebecca Schap, Center
for Nutrition Policy and Promotion, USDA, in providing
valuable information from their agency. Other staff
members of Federal agencies who provided data and
assistance include Jennifer Klocinski, ACL; Rachel Krantz-
Kent and Geoffrey Paulin, BLS; William Dean, Maria
Diacogiannis, Deborah Kidd, Chris McCormick, Maggie
Murgolo, Joseph Regan, and Laura Saffron, CMS; Ellen
Baldridge, David Mintz, and Rhonda Thompson, EPA;
Carolyn Lynch, HUD; Elizabeth Arias, Robin Cohen,
Nazik Elgaddal, Ginny Freid, Lauren Harris-Kojetin,
Cynthia L. Ogden, Eunice Park-Lee, and Manisha
Sengupta, NCHS; Vicky Cahan, NIA; Lynn Fisher, SSA;
and Peter Ahn and Tom Garin, VA.
The Forum is also indebted to the people outside the
Federal government who contributed to this chartbook:
Gwen Fisher, Cathy Liebowitz, and David Weir, University
of Michigan; andXianfen Li, Harris Corporation.
Member agencies of the Forum provided funds and
valuable staff time to produce this report. NCHS and
its contractor, American Institutes for Research (AIR),
facilitated the production, printing, and dissemination
of this report. Melissa Diliberti, Ashley Roberts, Katie
Mallory, Susan Armstrong, and Kathryn Low managed
the report's production process and designed the layout;
Richard Devens, First XV Communications, provided
consultation and editing services.
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About This Report
Introduction
Older Americans 2016: Key Indicators ofWell-Being (Older
Americans 2016) is the seventh in a series of reports by the
Federal Interagency Forum on Aging-Related Statistics
(Forum) describing the overall condition of the U.S.
population age 65 and over. The reports use data from
over a dozen national data sources to construct broad
indicators of well-being for the older population and to
monitor changes over time. By following these data trends,
the reports make more information available targeted
toward efforts to improving the lives of older Americans.
The Forum periodically conducts a conceptual and
methodological review of report indicators and format
according to an established indicator selection criteria (see
"Selection Criteria for Indicators"). This review ensures
that the report features the most current topics and the
most reliable, accurate, and accessible statistics.
After conducting a conceptual framework and literature
review in preparation for this report, the Forum modified
several existing indicators and added four new indicators:
Social Security Beneficiaries, Dementia, Long-Term Care
Providers, and Transportation. The 2016 report also
contains a newly established Environment domain.
This report is intended to stimulate relevant and timely
public discussions, encourage exchanges between the data
and policy communities, and foster improvements in
Federal data collection on older Americans. By examining
a broad range of indicators, researchers, policymakers, and
service providers can better understand the areas of well-
being that are improving for older Americans as well as the
areas that require more attention.
Structure of the Report
By presenting data in a nontechnical, user-friendly format,
Older Americans 2016 complements other more technical
and comprehensive reports from the individual Forum
agencies. The report includes 41 indicators grouped in six
sections: Population, Economics, Health Status, Health
Risks and Behaviors, Health Care, and Environment.
There is also a special feature this year on Informal
Caregiving.
Each indicator includes
A paragraph describing the relevance of the indicator to
the well-being of the older population.
One or more charts that illustrate important aspects of
the data.
Bulleted data highlights.
The data used in the indicators are presented in tables in
the back of the report. Data source descriptions and a
Glossary are also provided in the back matter.
Selection Criteria for Indicators
The Forum chose these indicators because they meet the
following criteria:
Easy to understand by a wide range of audiences.
Based on reliable, nationwide data sponsored, collected,
or disseminated by the Federal government.
Objectively based on substantial research that connects
the indicator to the well-being of older Americans.
Balanced so that no single section dominates the
report.
Measured periodically (but not necessarily annually) so
that they can be updated, making possible, description
of trends over time.
Representative of large segments of the aging
population, rather than one particular group.
Considerations When Examining the
Indicators
The data in Older Americans 2016 usually describe the
U.S. population age 65 and over. More specific age groups
(e.g., ages 6574, 7584, and 85 and over) are reported
whenever possible.
Data availability and analytical relevance may factor
into the determination of the age groups presented in
an indicator. For example, data for the age range 85
and over may not appear in an indicator because small
survey sample sizes have resulted in statistically reliable
data for that age range not being available. On the other
hand, data for the population younger than age 65 are
sometimes included in an indicator if the inclusion allows
for a more comprehensive interpretation of the indicator's
content. For example, in "Indicator 12: Participation in
Labor Force," a comparison with a younger population
provided an opportunity for an enhanced interpretation
of labor force trends among people age 65 and over. In
order to show trends in the amount of savings reserved
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for retirement by the entire population, data on public
and private retirement assets are included for the total
population in "Indicator 11: Net Worth."
To standardize the age distribution of the population age
65 and over across years, some estimates have been age
adjusted by multiplying age-specific rates by time-constant
weights. If an indicator has been age adjusted, this will be
stated in the note under the chart(s) as well as under the
corresponding table(s).
The reference population (the base population sampled
at the time of data collection) for each indicator is
labeled under each chart and table and is defined in
the Glossary. Whenever possible, the indicators include
data on the U.S. resident population (both people living
in the community and people living in institutions).
However, many indicators show data only for the civilian
noninstitutionalized population. Because the older
population residing in nursing homes (and other long-
term care institutional settings) is not included in samples
based on the noninstitutionalized population, use caution
when attempting to generalize the findings from these
data sources to the entire population age 65 and over. This
is especially true for the older age groups. For example,
in 2014, 10 percent of the population age 85 and over
was not included in the civilian noninstitutionalized
population as defined by the U.S. Census Bureau.
Civilian noninstitutionalized population as a percentage of the total resident
population, by age: July 1, 2014.
Survey Years
The reader should be aware that the range of years
presented in each chart varies because data availability is
not uniform across the data sources.
Accuracy of the Estimates
Most estimates in this report are based on a sample of the
population and are therefore subject to sampling error.
Standard tests of statistical significance have been used
to determine whether differences between populations
exist at generally accepted levels of confidence or whether
they occurred by chance. Unless otherwise noted, only
differences that are statistically significant at the 0.05 level
are discussed in the text. To indicate the reliability of the
estimates, standard errors for selected estimates in the
chartbook can be found on the Forum's website at http://
www. agingstats. gov.
Where possible, data estimates have been obtained from
the true unrounded value of the original data. Data are
rounded to one decimal place in the data tables and are
shown as whole numbers in the report text unless a finer
breakdown is needed to show a significant difference
between two estimates that would otherwise round to the
same number. While figures display rounded numbers, the
figures are created using unrounded estimates.
Finally, the data in some indicators may not sum to totals
because of rounding.
Sources of Data
The data used to create the charts are provided in the
tables in the back of the chartbook along with data that
are described in the bullets below each chart. The source
of the data for each indicator is noted below the chart.
Descriptions of the data sources can be found in the back
matter. Additional information about these data sources
and contact information for the agency providing the
data are available on the Forum's website at http://www.
agingstats.gov.
Data Needs
In Older Americans 2012, the Forum identified six
areas where better data were needed to support research
and policy efforts related to older Americans: informal
caregiving, residential care, elder abuse, functioning
and disability, mental health and cognitive functioning,
pension measures, and end-of-life issues.
Since then, the Federal statistical community and the
Forum have made significant improvements to enhance
data availability related to these data needs, many of
which are reflected in Older Americans 2016. This report
includes a new indicator on dementia using data from the
2011 National Health and Aging Trends Study (NHATS)
as well as a special feature on informal caregiving based
on data from the 2011 National Study of Caregiving
(NSOC). Data from the 2015 NHATS and NSOC will
be available in late 2016. A new indicator on long-term
care providers, with data from the new 2014 National
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Study of Long-Term Care Providers, addresses residential
care data needs. The indicator on functional limitations
presents disability prevalence among those 65 and over,
using questions developed by the United Nations-
sponsored Washington Group on Disability Statistics and
collected as part of the National Health Interview Survey.
The report also includes a new indicator on social security
beneficiaries. This indicator is based on data from the
Master Beneficiary Record (MBR) which are published
annually in the Statistical Supplement to the Social
Security Bulletin.
Other key indicators were identified by the Forum for
inclusion in this year's report, such as new measures on
oral health, cancer screenings, and transportation. Data
on other topics of continued interest, like end-of-life, have
been covered in other Federal reports.
With continued discussion on measurement issues and the
effect of survey technique on estimates of the incidence
of elder abuse1 as well as with the number of older adults
with substance use disorders in the U.S. projected to
double by 2020,2 the Forum continues to identify elder
abuse and substance use disorder as ongoing areas of data
need and will follow up with forthcoming survey findings.
Mission
The Forum's mission is to encourage cooperation and
collaboration among Federal agencies in order to improve
the quality and utility of data on the aging population.
The specific goals of the Forum are
Widening access to information on the aging
population through periodic publications and other
means.
Promoting communication among data producers,
researchers, and public policymakers.
Coordinating the development and use of statistical
databases among Federal agencies.
Identifying information gaps and data inconsistencies.
Investigating questions of data quality.
Encouraging cross-national research and data collection
on the aging population.
Addressing concerns regarding collection, access, and
dissemination of data.
More Information
For more information about Older Americans 2016 or
other Forum activities, contact
Traci Cook
Staff Director
Federal Interagency Forum on Aging-Related Statistics
3311 Toledo Road
Hyattsville, MD 20782
Phone: (301) 458-4082
Fax: (301) 458-4021
E-mail: agingforum@cdc.gov
Website: http://www.agingstats.gov
Older Americans on the Internet
Additional material can be found at http://www.
agingstats.gov. The website contains
Data for all of the indicators in Excel spreadsheets
(with standard errors, when available).
Data source descriptions.
PowerPoint slides of the charts.
The Forum's website also provides other Forum
publications, workshop documents, agency contacts,
subject area contact lists for Federal statistics, and
information about the Forum.
Additional Online Resources
Administration for Community Living
A Profile of Older Americans
http: //www. aoa. acl. gov/Aging_Statis tics/Pro file/index, aspx
Aging Integrated Database
http://www.agid.acl.gov/
ACL Program Evaulations and Related Reports
http://www.aoa.acl.gov/program_results/program_
evaluation, aspx
Agency for Healthcare Research and Quality
Research Tools and Data
http://www.ahrq.gov/research/index.html
Bureau of Labor Statistics
Bureau of Labor Statistics Data
http: //www. bis. gov/data
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U.S. Census Bureau
Age Data
http://www.census.gov/topics/population/age-and-sex.
html
Statistical Abstract of the United States
http://www.census.gov/library/publications/time-series/
statistical_abstracts.html
Longitudinal Employer-Household Dynamics
http://lehd.did.census.gov/led/
Centers for Medicare & Medicaid Services
CMS Research, Statistics, Data, and Systems
http://www.cms.gov/research-statistics-data-and-systems/
research-statistics-data-and-systems.html
Department of Housing and Urban Development
Policy Development and Research Information Services
http://www.huduser.gov
Department of Veterans Affairs
Veteran Data and Information
http://wwwl .va.gov/vetdata
Employee Benefits Security Administration
EBSAs Research
http://www.dol.gov/ebsa/publications/research.html
Environmental Protection Agency
Information Resources
http://www.epa.gov/healthresearch/aging-and-
sustainability-listserve
National Center for Health Statistics
Longitudinal Studies of Aging
http://www.cdc.gov/nchs/lsoa.htm
Health, United States
http://www.cdc.gov/nchs/hus.htm
Health Indicators Warehouse
http: //www. healthindicators. gov/
National Institute on Aging
NIA Centers on the Demography of Aging
http://www.agingcenters.org/
National Archive of Computerized Data on Aging
http://www.icpsr.umich.edu/NACDA
Publicly Available Datasets for Aging-Related Secondary
Analysis
http://www.nia. nih.gov/research/dbsr/publicly-available-
databases-aging-related-secondary-analyses-behavioral-
and-social
Office of the Assistant Secretary for Planning and
Evaluation, HHS
Office of Disability, Aging, and Long-Term Care Policy
http://www.aspe.hhs.gov/_/office_specific/daltcp.cfm
Office of Management and Budget
Federal Committee on Statistical Methodology
https://fcsm.sites.usa.gov
Social Security Administration
Social Security Administration Statistical Information
http://www.ssa.gov/policy
Substance Abuse and Mental Health Services
Administration
Center for Behavioral Health Statistics and Quality
http://www.samhsa.gov/data
Center for Mental Health Services
http://www.samhsa.gov/about-us/who-we-are/offices-
centers/cmhs
Other Resources
FedStats.gov
https://fedstats.sites.usa.gov
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Table of Contents
Foreword iii
Acknowledgements iv
About This Report v
List of Tables xi
Highlights xvii
POPULATION
Indicator 1: Number of Older Americans 2
Indicator 2: Racial and Ethnic Composition 4
Indicator 3: Marital Status 5
Indicator 4: Educational Attainment 6
Indicator 5: Living Arrangements 8
Indicator 6: Older Veterans 9
ECONOMICS
Indicator 7: Poverty 12
Indicator 8: Income 13
Indicator 9: Sources of Income 14
Indicator 10: Social Security Beneficiaries 16
Indicator 11: Net Worth 18
Indicator 12: Participation in Labor Force 20
Indicator 13: Housing Problems 22
Indicator 14: Total Expenditures 24
HEALTH STATUS
Indicator 15: Life Expectancy 26
Indicator 16: Mortality 27
Indicator 17: Chronic Health Conditions 28
Indicator 18: Oral Health 29
Indicator 19: Respondent-Assessed Health Status 30
Indicator 20: Dementia 31
Indicator 21: Depressive Symptoms 32
Indicator 22: Functional Limitations 34
HEALTH RISKS AND BEHAVIORS
Indicator 23: Vaccinations 38
Indicator 24: Cancer Screenings 39
Indicator 25: Diet Quality 40
Indicator 26: Physical Activity 41
Indicator 27: Obesity 42
Indicator 28: Cigarette Smoking 43
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HEALTH CARE
Indicator 29: Use of Health Care Services 46
Indicator 30: Health Care Expenditures 48
Indicator 31: Prescription Drugs 50
Indicator 32: Sources of Health Insurance 52
Indicator 33: Out-of-Pocket Health Care Expenditures 53
Indicator 34: Sources of Payment for Health Care Services 54
Indicator 35: Veterans' Health Care 55
Indicator 36: Residential Services 56
Indicator 37: Personal Assistance and Equipment 58
Indicator 38: Long-Term Care Providers 60
ENVIRONMENT
Indicator 39: Use of Time 64
Indicator 40: Air Quality 66
Indicator 41: Transportation 68
SPECIAL FEATURE
Informal Caregiving 69
References 75
Tables 81
Data Sources 159
Glossary 171
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List of Tables
Indicator 1: Number of Older Americans
Table la. Number of people (in millions) age 65 and over and age 85 and over, selected years, 19002014,
and projected years, 2020-2060 82
Table Ib. Percentage of people age 65 and over and age 85 and over, selected years, 19002014, and
projected years, 2020-2060 83
Table Ic. Population of countries or areas with at least 10 percent of their population age 65 and over, 2015 84
Table Id. Percentage of the population age 65 and over, by state, 2014 86
Table le. Percentage of the population age 65 and over, by county, 2014 87
Table If. Number and percentage of people age 65 and over and age 85 and over, by sex, 2014 87
Indicator 2: Racial and Ethnic Composition
Table 2. Population age 65 and over, by race and Hispanic origin, 2014 and projected 2060 88
Indicator 3: Marital Status
Table 3- Marital status of the population age 65 and over, by age group and sex, 2015 88
Indicator 4: Educational Attainment
Table 4a. Educational attainment of the population age 65 and over, selected years 19652015 89
Table 4b. Educational attainment of the population age 65 and over, by sex and race and Hispanic origin,
2015 89
Indicator 5: Living Arrangements
Table 5a. Living arrangements of the population age 65 and over, by sex and race and Hispanic origin, 2015 90
Table 5b. Percentage of population age 65 and over living alone, by sex and age group, selected years,
1970-2015 90
Indicator 6: Older Veterans
Table 6a. Percentage of population age 65 and over who are veterans, by age group and sex, 2000, 2010,
and 2015, and projected 2020 and 2025 91
Table 6b. Number of veterans age 65 and over, by age group and sex, 2000, 2010, and 2015, and projected
2020 and 2025 91
Indicator 7: Poverty
Table 7a. Poverty rate by age, by official poverty measure and Supplemental Poverty Measure, 19662014 92
Table 7b. Percentage of the population age 65 and over living in poverty, by selected characteristics, 2014 93
Indicator 8: Income
Table 8a. Income distribution of the population age 65 and over, 19742014 94
Table 8b. Median income of householders age 65 and over, in current and in 2014 dollars, 19742014 95
Indicator 9: Sources of Income
Table 9a. Percentage distribution of per capita family income for persons age 65 and over, by income
quintile and source of income, 2014 96
Table 9b. Percentage of people age 55 and over with family income from specified sources, by age group,
2014 97
Table 9c. Number of participants (in thousands) in private pension plans, by type of plan, 19752013 98
Table 9d. Number of participants (in thousands) in private defined benefit pension plans and percent of
participants retired or separated from employer, 19752013 99
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Table 9e. Number of participants (in thousands) in defined benefit and defined contribution retirement
plans, by selected type ofplan, 1999-2013 100
Table 9f- Percentage of workers in private sector and state and local government with access to retirement
benefits, by type of retirement plan, 2015 100
Indicator 10: Social Security Beneficiaries
Table lOa. Percentage distribution of people who began receiving Social Security benefits in 2014, by age
and sex 101
Table lOb. Percentage distribution of female Social Security beneficiaries age 62 and over, by type of benefit
received, selected years 1960-2014 101
Indicator 11: Net Worth
Table lla. Median household net worth, in 2013 dollars, by selected characteristics of head of household,
selected years 1983-2013 102
Table lib. Value of household financial assets held in retirement investment accounts, by selected
characteristics of head of household, 2007 and 2013 103
Table lie. Amount of funds (in millions of dollars) held in retirement assets, by sector and type ofplan,
1975-2014 104
Indicator 12: Participation in Labor Force
Table 12. Labor force participation rates (annual averages) of persons age 55 and over, by sex and age group,
1963-2015 105
Indicator 13: Housing Problems
Table 13a. Prevalence of housing problems among older-owner/renter households, by type of problem,
selected years, 2009-2013 107
Table 13b. Prevalence of housing problems among older-member households, by type of problem, selected
years, 2009-2013 107
Table 13c. Prevalence of housing problems among all U.S. households except those households with one
or more persons age 65 and over, by type of problem, selected years, 20092013 108
Table 13d. Prevalence of housing problems among older-owner/renter intergenerational households, by
type of problem, selected years, 20092013 108
Table 13e. Prevalence of housing problems among older-member intergenerational households, by type of
problem, selected years, 2009-2013 109
Table 13f Prevalence of housing problems among all older households: householder, spouse, or member(s)
age 65 and over, by type of problem, selected years, 20092013 109
Indicator 14: Total Expenditures
Table 14. Percentage distribution of total household annual expenditures, by age of reference person, 2014 110
Indicator 15: Life Expectancy
Table 15a. Life expectancy at ages 65 and 85, by race and sex, 19812014 Ill
Table 15b. Life expectancy at birth, age 65, and age 85, by race and Hispanic origin and sex, 2014 113
Indicator 16: Mortality
Table 16a. Death rates among people age 65 and over, by selected leading causes of death, 19812014 114
Table 16b. Death rates among people age 65 and over, by selected leading causes of death, sex, and race and
Hispanic origin, 2014 115
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Indicator 17: Chronic Health Conditions
Table 17a. Percentage of people age 65 and over who reported having selected chronic health conditions,
by sex and race and Hispanic origin, 20132014 116
Table 17b. Percentage of people age 65 and over who reported having selected chronic health conditions,
1997_1998 through 2013-2014 116
Indicator 18: Oral Health
Table 18a. Percentage of people age 65 and over who had dental insurance, had a dental visit in the past
year, or had no natural teeth, by age group, 2014 117
Table 18b. Percentage of people age 65 and over who had dental insurance, had a dental visit in the past
year, or had no natural teeth, by sex and race and Hispanic origin, 2014 117
Indicator 19: Respondent-Assessed Health Status
Table 19- Percentage of people age 65 and over with respondent-assessed good to excellent health status, by
race and Hispanic origin, sex, and age group, 20122014 118
Indicator 20: Dementia
Table 20a. Number and percentage of the non-nursing home population age 65 and over with dementia, by
age group, 2011 119
Table 20b. Percentage of the non-nursing home population age 65 and over with dementia, by sex and age
group, 2011 119
Table 20c. Percentage of the non-nursing home population age 65 and over with dementia, by sex and
educational attainment, 2011 119
Table 20d. Percentage of the non-nursing home population age 65 and over with dementia, by age group
and educational attainment, 2011 119
Indicator 21: Depressive Symptoms
Table 21a. Percentage of people age 51 and over with clinically relevant depressive symptoms, by age group
and sex, selected years 1998-2014 120
Table 21 b. Percentage of people age 51 and over with clinically relevant depressive symptoms, by age group
and sex, 2014 120
Indicator 22: Functional Limitations
Table 22a. Percentage of people age 65 and over with a disability, by sex and functional domain, 2010 and
2014 121
Table 22b. Percentage of people age 65 and over with a disability, by age group and functional domain,
2014 122
Table 22c. Percentage of people age 65 and over with a disability, by race and Hispanic origin and
functional domain, 2014 122
Table 22d. Percentage of Medicare beneficiaries age 65 and over who have limitations in performing
activities of daily living (ADLs) or instrumental activities of daily living (lADLs), or who are in a long-term
care facility, 1992-2013 123
Table 22e. Percentage of Medicare beneficiaries age 65 and over who have limitations in performing
activities of daily living (ADLs) or instrumental activities of daily living (lADLs), or who are in a long-term
care facility, by sex and age group, 2013 123
Indicator 23: Vaccinations
Table 23a. Percentage of people age 65 and over who reported having been vaccinated against influenza and
pneumococcal disease, by race and Hispanic origin, selected years, 19892014 124
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Table 23b. Percentage of people age 65 and over who reported having been vaccinated against influenza and
pneumococcal disease, by selected characteristics, 2014 124
Indicator 24: Cancer Screenings
Table 24. Percentage of women ages 5074 who had breast cancer screening and percentage of people ages
5075 who had colorectal cancer screening, by sex and age group, selected years, 20002013 125
Indicator 25: Diet Quality
Table 25- Healthy Eating Index-2010 average total scores and component scores expressed as a percentage
of the HEI maximum score for the population age 65 and over, by age group, 20112012 126
Indicator 26: Physical Activity
Table 26a. Percentage of people age 65 and over who reported participating in leisure-time aerobic and
muscle-strengthening activities that meet the 2008 Federal physical activity guidelines, by age group,
1998-2014 127
Table 26b. Percentage of people age 65 and over who reported participating in leisure-time aerobic and
muscle-strengthening activities that meet the 2008 Federal physical activity guidelines, by sex and race and
Hispanic origin, 2014 128
Indicator 27: Obesity
Table 27- Percentage of people age 65 and over overweight and with obesity, by sex and age group, selected years,
1976-2014 129
Indicator 28: Cigarette Smoking
Table 28a. Percentage of people age 65 and over who are current cigarette smokers, by sex and race, selected
years, 1965-2014 130
Table 28b. Percentage distribution of people age 18 and over, by cigarette smoking status, sex, and age
group, 2014 131
Table 28c. Percentage of people age 65 and over who are current cigarette smokers, by sex and poverty
status, 2014 131
Indicator 29: Use of Health Care Services
Table 29a. Use of Medicare-covered health care services per 1,000 Medicare beneficiaries age 65 and over,
1992-2013 132
Table 29b. Use of Medicare-covered home health care and skilled nursing facility services per 1,000
Medicare beneficiaries age 65 and over, by age group, 2013 132
Indicator 30: Health Care Expenditures
Table 30a. Average annual health care costs, in 2012 dollars, for Medicare beneficiaries age 65 and over, by
age group, 1992-2012 133
Table 30b. Total amount and percentage distribution of annual health care costs among Medicare
beneficiaries age 65 and over, by major cost component, 2008 and 2012 133
Table 30c. Average annual health care costs among Medicare beneficiaries age 65 and over, by selected
characteristics, 2012 134
Table 30d. Average annual health care costs among Medicare beneficiaries age 65 and over, by age group and
major cost component, 2012 135
Table 30e. Percentage of noninstitutionalized Medicare beneficiaries age 65 and over who reported problems
with access to health care, 1992-2012 135
Indicator 31: Prescription Drugs
Table 3la. Average prescription drug costs, in 2012 dollars, among noninstitutionalized Medicare
beneficiaries age 65 and over, by sources of payment, 19922012 136
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Table 31b. Percentage distribution of annual prescription drug costs among noninstitutionalized Medicare
beneficiaries age 65 and over, 2012 136
Table 31c. Number of Medicare beneficiaries age 65 and over who enrolled in Part D prescription drug
plans or who were covered by retiree drug subsidy payments, 2006 and 2014 137
Table 3Id. Average prescription drug costs among noninstitutionalized Medicare beneficiaries age 65 and
over, by selected characteristics, selected years 20002012 137
Indicator 32: Sources of Health Insurance
Table 32a. Percentage of noninstitutionalized Medicare beneficiaries age 65 and over with supplemental
health insurance, by type of insurance, 19912013 138
Table 32b. Percentage of people ages 5564 with health insurance coverage, by poverty status and type of
insurance, 2014 139
Table 32c. Percentage of people ages 5564 with health insurance coverage, by type of insurance,
2010-2014 139
Indicator 33: Out-of-Pocket Health Care Expenditures
Table 33a. Percentage of people age 55 and over with out-of-pocket expenditures for health care service use,
by age group, 1977, 1987, 1996, and 2000-2013 140
Table 33b. Ratio of out-of-pocket expenditures to household income per person among people age 55 and
over, by selected characteristics, 1977, 1987, 1996, and 2000-2013 140
Table 33c. Percentage distribution of total out-of-pocket health care expenditures among people age 55 and
over, by age group and type of health care service, 20002013 141
Indicator 34: Sources of Payment for Health Care Services
Table 34a. Average cost per beneficiary and percentage distribution of sources of payment for health care
services for Medicare beneficiaries age 65 and over, by type of service, 2012 144
Table 34b. Average cost per beneficiary and percentage distribution of sources of payment for health care
services for Medicare beneficiaries age 65 and over, by income, 2012 144
Indicator 35: Veterans' Health Care
Table 35a. Total number of veterans age 65 and over who are enrolled in the Veterans Health
Administration, by age group, 1999-2014 and projected 2019-2034 145
Table 35b. Percentage of enrolled veterans age 65 and over with service-connected disabilities, by
service-connected disability rating, 2004-2014 and projected 2019-2034 145
Indicator 36: Residential Services
Table 36a. Percentage distribution of Medicare beneficiaries age 65 and over residing in selected residential
settings, by age group, 2013 146
Table 36b. Percentage distribution of Medicare beneficiaries age 65 and over with limitations in
performing activities of daily living (ADLs) and instrumental activities of daily living (lADLs), by residential
setting, 2013 146
Table 36c. Percent availability of specific services among Medicare beneficiaries age 65 and over residing in
community housing with services, 2013 146
Table 36d. Percentage distribution of annual income of Medicare beneficiaries age 65 and over, by
residential setting, 2013 147
Table 36e. Characteristics of services available to Medicare beneficiaries age 65 and over residing in
community housing with services, 2013 147
Indicator 37: Personal Assistance and Equipment
Table 37a. Percentage distribution of noninstitutionalized Medicare beneficiaries age 65 and over who have
limitations in performing activities of daily living (ADLs), by type of assistance, 19922013 148
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Table 37b. Percentage distribution of noninstitutionalized Medicare beneficiaries age 65 and over who have
limitations in performing activities of daily living (ADLs), by type of assistance, age group, and sex, 2013 148
Table 37c. Percentage of noninstitutionalized Medicare beneficiaries age 65 and over who have limitations
in performing instrumental activities of daily living (lADLs) and who receive personal assistance, by age
group, 1992-2013 149
Table 37d. Percentage of noninstitutionalized Medicare beneficiaries age 65 and over who have limitations
in performing instrumental activities of daily living (lADLs) and who receive personal assistance, by sex and
age group, 2013 149
Indicator 38: Long-Term Care Providers
Table 38a. Number of users of long-term care services, by sector and age group, 2013 and 2014 150
Table 38b. Percentage of users of long-term care services needing any assistance with activities of daily living
(ADLs), by sector and activity, 2013 and 2014 150
Indicator 39: Use of Time
Table 39a. Average number of hours per day and percentage of day that people age 55 and over spent doing
selected activities on an average day, by age group, 2014 151
Table 39b. Average number of hours and percentage of total leisure time that people age 55 and over spent
doing selected leisure activities on an average day, by age group, 2014 151
Indicator 40: Air Quality
Table 40a. Percentage of people age 65 and over living in counties with "poor air quality," by selected
pollutant measures, 2000-2014 152
Table 40b. Counties with "poor air quality" for any standard in 2014 152
Indicator 41: Transportation
Table 41. Percentage of noninstitutionalized Medicare beneficiaries age 65 and over who made a change in
transportation mode due to a health or physical problem, by age group and type of change, 2013 155
Special Feature: Informal Caregiving
Table CGI. Number of informal caregivers, by age group and sex, 2011 156
Table CG2. Number of informal caregivers and percentage distribution of caregiving hours provided, by
relationship to care recipient, 2011 156
Table CG3- Percentage of caregivers providing assistance, by sex of caregiver and type of assistance, 2011 157
Table CG4. Percentage of caregiver recipients, caregivers, and hours of help provided, by level of assistance
needed by care recipients, 2011 157
Table CG5- Percentage of informal caregivers reporting positive and negative aspects of caregiving, by level
of impact, 2011 157
XVI
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Highlights
Older Americans 2016: Key Indicators ofWell-Being is
one in a series of periodic reports to the Nation on the
condition of older adults in the United States. In this
report, 41 indicators depict the well-being of older
Americans in the areas of Population, Economics, Health
Status, Health Risks and Behaviors, Health Care, and
Environment. This year's report also includes a special
feature on informal caregiving. Selected highlights from
each section of the report follow.
Population
In 2014, 46 million people age 65 and over lived in the
United States, accounting for 15 percent of the total
population. The older population in 2030 is projected
to be more than twice as large as in 2000, growing
from 35 million to 74 million and representing 21
percent of the total U.S. population (Indicator 1:
Number of Older Americans).
In 2014, non-Hispanic single-race Whites, Blacks,
and Asians accounted for 78 percent, 9 percent, and
4 percent of the U.S. older population, respectively.
Hispanics (of any race) were 8 percent of the
older population (Indicator 2: Racial and Ethnic
Composition).
In 2015, older men were much more likely than older
women to be married. About 74 percent of men ages
6574 were married, compared with over one-half
(58 percent) of women in the same age group. The
proportion who were married was lower at older ages:
42 percent of women ages 7584 and 17 percent of
women age 85 and over were married in 2015- For
men, the proportion who were married was also lower
at older ages, but not as low as for older women. Even
among men age 85 and over, the majority (59 percent)
were married in 2015 (Indicator 3: Marital Status).
In 2015, 84 percent of the population age 65 and
over were high school graduates or more, and 27
percent had a Bachelor's degree or more (Indicator 4:
Educational Attainment).
In 2015, older men were more likely to live with their
spouse than were older women. About 70 percent of
older men lived with their spouse while less than half
(45 percent) of older women did. In contrast, older
women were more likely than older men to live alone
(36 percent versus 20 percent) (Indicator 5: Living
Arrangements).
In 2010, there were 9-2 million veterans age 65 and
over in the United States. This number is expected to
drop to 8.9 million by 2025, an expected decrease of
about 2.7 percent (Indicator 6: Older Veterans).
Economics
In 1966, 29 percent of people age 65 and over lived
below the poverty threshold. By 2014, the proportion
of the older population living in poverty had decreased
dramatically to 10 percent (Indicator 7: Poverty).
Between 1974 and 2014, there was a decrease in the
proportion of older people with an income below
poverty (from 15 percent to 10 percent) and with low
income (from 35 percent to 23 percent), and there
was an increase in the proportion of people with high
income (from 18 percent to 36 percent) (Indicator 8:
Income).
For persons age 65 and over, two-thirds of income in
2014 was from retirement benefits including Social
Security which accounted for about half of average
total family income (Indicator 9: Sources of Income).
The type of Social Security benefits received by women
age 62 and over dramatically changed between 1960
and 2014. The percentage who received spouse-only
benefits decreased from 33 percent to 9 percent, and
the percentage who received widow-only benefits
decreased from 23 percent to 14 percent. In contrast,
the percentage who received earned worker benefits
increased from 43 percent in I960 to 77 percent in
2014 (Indicator 10: Social Security Beneficiaries).
In 2013, the median net worth of households headed
by White people age 65 and over ($255,000) was
almost five times that of the median net worth of
households headed by older Black people ($56,700).
This difference was less than in 1998, when the median
net worth of households headed by older White people
was about six times higher than that of households
headed by older Black people (Indicator 11: Net
Worth).
In 2015, labor force participation rates for women
age 55 and over remained high after rising over the
past four decades. This trend continued through the
recent recession, but leveled off since the beginning
of the recovery. Among men age 55 and over, labor
participation rates increased in the mid-1990s,
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following declines in the rates in the previous decades.
Since the recent recession, participation rates among
men have been fairly flat (Indicator 12: Participation in
Labor Force).
While housing cost burden has generally increased
over time, between 2009 and 2013 the prevalence of
cost burden decreased from 40 to 36 percent for older
owner/renter households and from 39 to 34 percent
for older-member households. For households headed
by older Americans with children in their homes,
housing cost burden remained relatively the same at
approximately 40 percent. (Indicator 13: Housing
Problems).
As a share of total expenditures, health care increased
dramatically with age in 2014. For the group age 75
and over, the share (16 percent) was more than double
the share for the age 4554 group (7 percent) and
larger than the share the oldest group allocated to
transportation (14 percent) or the share allocated to
food (12 percent) (Indicator 14: Total Expenditures).
Health Status
Life expectancy varies by race, but the difference
decreases with age. In 2014, life expectancy at birth
was 3-4 years higher for White people than for Black
people. At age 65, White people can expect to live
an average of 1.1 years longer than Black people.
Among those who survive to age 85, however, the
life expectancy among Black people is slightly higher
(6.9 years) than White people (6.5 years) (Indicator 15:
Life Expectancy).
Between 1999 and 2014, age-adjusted death rates
for all causes of death among people age 65 and over
declined by 20 percent. Death rates declined for heart
disease, cancer, chronic lower respiratory disease,
stroke, diabetes, and influenza and pneumonia.
Death rates for Alzheimer's disease and unintentional
injuries increased over the same period (Indicator 16:
Mortality).
The prevalence of certain chronic health conditions
differed by sex in 20132014. Women reported higher
levels of asthma and arthritis than men. Men reported
higher levels of heart disease, cancer, and diabetes
(Indicator 17: Chronic Health Conditions).
In 2014, about 62 percent of people age 65 and over
had a dental visit in the past year. The percentage
visiting a dentist was higher among people ages 6574
than among people age 85 and over (66 percent versus
56 percent) (Indicator 18: Oral Health).
In 20122014, older non-Hispanic White people were
more likely to report good to excellent health than
their non-Hispanic Black and Hispanic counterparts
(80 percent versus 65 and 66 percent, respectively)
(Indicator 19: Respondent-Assessed Health Status).
In 2011, among people ages 6574, men were more
likely to have dementia than women, but among adults
age 85 and over, women were more likely to have
dementia than men (Indicator 20: Dementia).
The prevalence of clinically meaningful depressive
symptoms for the U.S. population over age 50
remained fairly stable between 1998 and 2014.
Although women over 50 have consistently higher
prevalence of depressive symptoms than men, in
2014 both men and women had higher prevalence of
depressive symptoms in middle adulthood and after age
80, with the lowest prevalence occurring among those
ages 65 to 79 (Indicator 21: Depressive Symptoms).
In 2014, 22 percent of the population age 65 and over
reported having a disability as defined by limitations in
vision, hearing, mobility, communication, cognition,
and self-care. Women were more likely to report any
disability than men (24 percent versus 19 percent)
(Indicator 22: Functional Limitations).
Health Risks and Behaviors
In 2014, 70 percent of people age 65 and over reported
receiving a flu shot in the past 12 months; however,
there were differences by race and ethnicity. About
72 percent of non-Hispanic Whites reported receiving
a flu shot, compared with 57 percent of non-Hispanic
Blacks and 61 percent of Hispanics (Indicator 23:
Vaccinations).
A higher proportion of women in 2013 received a
mammogram in the past 2 years than met colorectal
cancer screening guidelines. For example, 71 percent of
women ages 5064 received a mammogram compared
with 54 percent who met colorectal cancer screening
guidelines (Indicator 24: Cancer Screenings).
During 20112012, people age 75 and over met the
dietary recommendations for whole fruits, while people
age 65 and over met the dietary recommendations for
total protein foods. Overall diet quality, as measured by
the Total Healthy Eating Index-2010 score, was 68 out
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of 100 for people age 65 and over (Indicator 25: Diet
Quality).
In 2014, about 12 percent of people age 65 and over
reported participating in leisure-time aerobic and
muscle-strengthening activities that met the 2008
Federal physical activity guidelines. The percentage of
older people meeting the physical activity guidelines
decreased with age, ranging from 15 percent among
people ages 6574 to 5 percent among people age 85
and over (Indicator 26: Physical Activity).
As with other age groups, the percentage of people age
65 and over with obesity has increased since 1988
1994. In 2011-2014, about 35 percent of people age
65 and over had obesity, compared with 22 percent in
1988-1994 (Indicator 27: Obesity).
The percentage of people age 65 and over who were
current cigarette smokers declined between 1965 and
2014, with larger declines occuring among men than
among women. Levels of cigarette smoking have been
stable in the past decade. In 2014, 10 percent of men
and 8 percent of women age 65 and over were current
smokers (Indicator 28: Cigarette Smoking).
Health Care
While the number of hospital stays remained fairly
stable from 1992 to 2013, the average length of stay in
the hospital decreased steadily over time. In 1992, the
average length of stay in the hospital for a Medicare
beneficiary was 8.4 days; by 2013 the average length
of stay had decreased to 5-3 days (Indicator 29: Use of
Health Care Services).
After adjusting for inflation, health care costs per
capita increased slightly among those ages 6574
between 1992 and 2012. In all years, average costs
were substantially higher for those age 85 and over
compared with those in the younger age groups
(Indicator 30: Health Care Expenditures).
Average prescription drug costs for noninstitutionalized
Americans age 65 and over increased rapidly for
many years but were relatively stable from 2005
to 2012. Medicare coverage of prescription drugs,
which includes a low-income subsidy for beneficiaries
with low income and assets, began in January 2006
(Indicator 31: Prescription Drug Costs).
Enrollment in Medicare Advantage (MA)/Capitated
Payment Plans has grown rapidly in recent years. In
2005, 16 percent of Medicare beneficiaries age 65 and
over were enrolled in an MA plan, compared with
34 percent in 2013 (Indicator 32: Sources of Health
Insurance).
From 1977 to 2013, the percentage of household
income that people age 65 and over allocated to
out-of-pocket spending for health care services
increased among those in the poor/near poor income
category from 12 percent to 17 percent (Indicator 33:
Out-of-Pocket Health Care Expenditures).
Medicare paid for almost 60 percent of all health care
costs of enrollees age 65 and over in 2012. Medicare
financed all hospice costs and most hospital, physician,
home health care, and short-term institution costs
(Indicator 34: Sources of Payment for Health Care
Services).
The number of veterans age 65 and over enrolled with
the Veterans Health Administration has been steadily
increasing since 1999, when eligibility for this benefit
was reformed, and the number of veterans age 85 and
over enrolled is projected to exceed 1 million by 2034
(Indicator 35: Veterans' Health Care).
In 2013, about 3 percent of the Medicare population
age 65 and over resided in community housing with
at least one service available. About 4 percent resided
in long-term care facilities. Among those age 85 and
over, 8 percent resided in community housing with
services, and 15 percent resided in long-term care
facilities. Among those ages 6574, about 98 percent
resided in traditional community settings (Indicator
36: Residential Services).
In 2013, about two-thirds of people who had difficulty
with one or more activities of daily living (ADLs)
received personal assistance or used special equipment:
7 percent received personal assistance only, 35 percent
used equipment only, and 25 percent used both
personal assistance and equipment (Indicator 37:
Personal Assistance and Equipment).
In 2014, about 1.2 million people age 65 and over were
residents of nursing homes. Nearly 780,000 people of
that age lived in residential care communities such as
assisted living facilities. In both settings, people age
85 and over were the largest age group among residents
(Indicator 38: Long-Term Care Providers).
Environment
The proportion of leisure time that older Americans
spent socializing and communicatingsuch as visiting
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friends or attending or hosting social eventsdeclined
with age. In 2014, the percentage of leisure time spent
socializing and communicating was about 11 percent
for those ages 5564 and 9 percent for those age 75
and over (Indicator 39: Use of Time).
The percentage of people age 65 and over living in
counties that experienced poor air quality decreased
from 66 percent in 2000 to 16 percent in 2014
(Indicator 40: Air Quality).
In 2013, about 33 percent of the noninstitutionalized
Medicare population age 65 and over limited their
driving to daytime because of a health or physical
problem. The percentage of people who limited
their driving to daytime was greater for those age
85 and over (55 percent) than for those age 6574
(25 percent) (Indicator 41: Transportation).
Special Feature
"Informal caregivers" are family members or friends who
are not paid and assist older adults who have functional
limitations with everyday tasks such as bathing, dressing,
preparing a meal, or managing money. Informal
caregivers are a diverse population that includes spouses,
children, and other relatives such as daughters-in-law,
grandchildren, and friends.
In 2011, an estimated 18 million informal caregivers
provided 1.3 billion hours of care on a monthly basis.
More informal caregivers were women (11.1 million)
than men (6.9 million), and about half of informal
caregivers were middle-aged (ages 4564).
Almost half of informal caregivers were a child of the
care recipient. Although spouses made up only 21
percent of informal caregivers, they accounted for more
than 31 percent of the total hours of informal care
provided.
Some types of care provided differ by caregiver
gender. For example, men were more likely to provide
assistance with mobility, whereas women were more
likely to assist with self-care and medical care.
Most informal caregivers reported positive impacts of
caregiving; however, almost half said they have things
they cannot handle or do not have enough time for
themselves.
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/
Population
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Population
INDICATOR l: Number of Older Americans
The growth of the population age 65 and over affects many aspects of our society, presenting challenges to families,
businesses, health care providers, and policymakers, among others, to meet the needs of aging individuals.
Population age 65 and over and age 85 and over, selected years, 1900-2014, and projected years,
2020-2060
40 -
20 -
0
1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010 2020 2030 2040 2050 2060
NOTE: Some data for 2020-2050 have been revised and differ from previous editions of Older Americans.
Reference population: These data refer to the resident population.
SOURCE: U.S. Census Bureau, 1900 to 1940, 1970, and 1980, U.S. Census Bureau, 1983, Table 42; 1950, U.S. Census Bureau, 1953, Table 38;
1960, U.S. Census Bureau, 1964, Table 155; 1990, U.S. Census Bureau, 1991, 1990 Summary Table File; 2000, U.S. Census Bureau, 2001, Census
2000 Summary File 1; U.S. Census Bureau, Table 1: Intercensal Estimates of the Resident Population by Sex and Age for the U.S.: April 1,
2000, to July 1, 2010 (US-ESTOOINT-01); U.S. Census Bureau, 2011. 2010 Census Summary File 1; U.S. Census Bureau, Annual Estimates of the
Resident Population for Selected Age Groups by Sex for the United States, States, Counties, and Puerto Rico Commonwealth and Municipios:
April 1, 2010, to July 1, 2014 (PEPAGESEX); U.S. Census Bureau, Table 3: Projections of the Population by Sex and Selected Age Groups for the
United States: 2015 to 2060 (NP2014-T3).
In 2014, 46 million people age 65 and over lived in
the United States, accounting for 15 percent of the
total population. The older population grew from
3 million in 1900 to 46 million in 2014. The oldest-
old population (those age 85 and over) grew from just
over 100,000 in 1900 to 6 million in 2014.
The "Baby Boomers" (those born between 1946 and
1964) started turning 65 in 2011, and the number
of older people will increase dramatically during the
20142030 period. The older population in 2030 is
projected to be twice as large as their counterparts
in 2000, growing from 35 million to 74 million
and representing nearly 21 percent of the total
U.S. population.
The growth rate of the older population is projected to
slow after 2030, when the last Baby Boomers enter the
ranks of the older population. From 2030 onward, the
proportion of those who are age 65 and over will be
relatively stable, ranging from 21 percent to 24 percent,
even though the absolute number of people age 65 and
over is projected to continue to grow. The oldest-old
population is projected to grow rapidly after 2030,
when the Baby Boomers move into this age group.
The U.S. Census Bureau projects that the population
age 85 and over could grow from 6 million in 2014
to 20 million by 2060. Some researchers predict that
death rates at older ages will decline more rapidly than
is reflected in the U.S. Census Bureau's projections,
which could lead to faster growth of this population.3"5
2
_L
1900
1910 1920 1930 1940 1950
1970 1980
1990
2000 2010
2020
2060
-------
Percentage of population age 65 and over, by county and state, 2014
Percentage by county
25.0 or greater
20.0 to 24.9
15.0 to 19.9
10.0 to 14.9
Less than 10.0
U.S. total is 14.5 percent.
Data values are rounded
to the nearest tenth.
Reference population: These data refer to the resident population.
SOURCE: U.S. Census Bureau, Annual Estimates of the Resident Population for Selected Age Groups by Sex for the United States, States,
Counties, and Puerto Rico Commonwealth and Municipios: April 1, 2010, to July 1, 2014 (PEPAGESEX).
The proportion of the population age 65 and over
varies by state and is partly affected by the state
fertility and mortality levels and partly by the number
of older and younger people who migrate to and
from the state. In 2014, Florida was the state with
the highest proportion of people age 65 and over
(19 percent). Maine, West Virginia, Vermont, Montana,
Pennsylvania, Delaware, Hawaii, and Oregon also
had high proportions (16 percent or over).
The proportion of the population age 65 and over
varies even more by county. In 2014, 53 percent of
Sumter County, Florida, was age 65 and over, the
highest proportion in the country. In several Florida
counties, the proportion was over 30 percent. At the
other end of the spectrum was Chattahoochee County,
Georgia, with only 4.1 percent of its population age
65 and over.
Older women outnumbered older men in the United
States, and the proportion who are female increased
with age. In 2014, women accounted for 56 percent of
the population age 65 and over and for 66 percent of
the population age 85 and over.
The United States is fairly young for a developed
country, with 15 percent of its population age 65 and
over in 2015- Japan had the highest percentage of
persons age 65 and over (27 percent) among countries
with a population of at least 1 million. The older
population made up more than 15 percent of the
population in most European countries and above
20 percent in Germany, Italy, Greece, and Finland.
Data for this indicator's charts and bullets can be found in
Tables la through If on pages 8287.
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Population
INDICATOR 2: Racial and Ethnic Composition
As the older population grows larger, it will also grow more diverse, reflecting the demographic changes in the U.S.
population as a whole over the last several decades. By 2060, programs and services for older people will require greater
flexibility to meet the needs of a more diverse population.
Population age 65 and over, by race and Hispanic origin, 2014 and projected 2060
Non-Hispanic White
alone
Non-Hispanic Black
alone
Non-Hispanic Asian Non-Hispanic all other races
alone alone or in combination
Hispanic or
Latino (any race)
2014
2060 (projected)
NOTE: The presentation of racial and ethnic composition data in this table has changed from previous editions of Older Americans. Unlike in
previous editions, Hispanics are not counted in any race group. The term "non-Hispanic White alone" is used to refer to people who reported
being White and no other race and who are not Hispanic. The term "non-Hispanic Black alone" is used to refer to people who reported being
Black or African American and no other race and who are not Hispanic, and the term "non-Hispanic Asian alone" is used to refer to people
who reported only Asian as their race and who are not Hispanic. The use of single-race populations in this chart does not imply that this is
the preferred method of presenting or analyzing data. The U.S. Census Bureau uses a variety of approaches. The race group "non-Hispanic All
other races alone or in combination" includes people who reported American Indian and Alaska Native alone who are not Hispanic; people
who reported Native Hawaiian and Other Pacific Islander alone who are not Hispanic; and all people who reported two or more races who are
not Hispanic. "Hispanic" refers to an ethnic category; Hispanics may be of any race.
Reference population: These data refer to the resident population.
SOURCE: U.S. Census Bureau, Annual Estimates of the Resident Population by Sex, Age, Race, and Hispanic Origin for the United States and
States: April 1, 2010, to July 1, 2014 (PEPASR6H); U.S. Census Bureau, Table 1. Projected Population by Single Year of Age, Sex, Race, and
Hispanic Origin for the United States: 2014 to 2060 (NP2014_D1).
In 2014, non-Hispanic single-race Whites, Blacks,
and Asians accounted for 78 percent, 9 percent, and
4 percent of the U.S. older population, respectively.
Hispanics (of any race) were 8 percent of the older
population.
Projections indicate that by 2060 the composition
of the older population will be 55 percent non-
Hispanic White alone, 12 percent non-Hispanic
Black alone, and 9 percent non-Hispanic Asian
alone. Hispanics will be 22 percent of the older
population in 2060.While the older population will
increase among all racial and ethnic groups, the older
Hispanic population is projected to grow the fastest,
from 3-6 million in 2014 to 21.5 million in 2060.
The older Hispanic population is expected to be larger
than the older non-Hispanic Black alone population in
2060. The older non-Hispanic Asian alone population
is also projected to experience rapid growth. In 2014,
nearly 2 million older single-race non-Hispanic Asians
lived in the United States; by 2060, this population is
projected to be about 8.5 million.
Data for this indicator's charts and bullets can be found in
Table 2 on page 88.
4
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INDICATOR 3: Marital Status
Marital status can strongly affect one's emotional and economic well-being. Among other factors, it influences living
arrangements and the availability of caregivers for older Americans with an illness or disability.
Marital status of the population age 65 and over, by sex and age group, 2015
Percent
100
80
60
40
20
Men
74 74
Percent
100
80
3 3
W=
Never married Divorced
Women
42
Widowed Married Never married Divorced
65-74 D 75-84 D 85 and over
Widowed
Married
NOTE: Married includes married, spouse present; married, spouse absent; and separated.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement.
In 2015, older men were much more likely than older
women to be married. About 74 percent of men ages
6574 were married, compared with over one-half
(58 percent) of women in the same age group. The
proportion who were married was lower at older ages:
42 percent of women ages 7584 and 17 percent of
women age 85 and over were married in 2015- For
men, the proportion who were married was also lower
at older ages, but not as low as for older women. Even
among the oldest old (those age 85 and over), the
majority of men (59 percent) were married in 2015-
Widowhood was more common among older women
than among older men in 2015- Women age 65 and
over were more likely than men of the same age to
be widowed (34 percent compared with 12 percent).
Nearly three-quarters (73 percent) of women age 85
and over were widowed, compared with 34 percent of
men.
Relatively small proportions of older men (11 percent)
and women (13 percent) were divorced in 2015- A
small proportion (5 percent) of the older population
had never married.
All comparisons presented for this indicator are significant at
the 0.10 confidence level. Data for this indicator's charts and
bullets can be found in Table 3 on page 88.
5
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Population
INDICATOR^ Educational Attainment
Educational attainment has effects throughout the life course, which in turn plays a role in well-being at older ages.
Higher levels of education are usually associated with higher incomes, higher standards of living, and above-average
health.
Educational attainment of the population age 65 and over, selected years, 1965-2015
Percent
100
80
60
40
20
High school graduate or more V
Bachelor's degree or more V
1965
1970
1975
1980
1985
1990
1995
2000
2005
2010
2015
NOTE: A single question that asks for the highest grade or degree completed is used to determine educational attainment. Prior to 1995,
educational attainment was measured using data on years of school completed.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement.
In 1965, 24 percent of the older population had
graduated from high school and only 5 percent had
at least a Bachelor's degree. By 2015, 84 percent were
high school graduates or more and 27 percent had a
Bachelor's degree or more.
In 2015, 85 percent of older men and 83 percent
of older women had at least a high school diploma.
Older men attained at least a Bachelor's degree more
often than older women (32 percent compared with
23 percent, respectively).
I960
1970
1980
1990
2000
2010
2016
-------
Educational attainment of the population age 65 and over, by race and Hispanic origin, 2015
54
Total
Non-Hispanic White
alone
Black alone Asian alone
High school graduate or more Q Bachelor's degree or more
Hispanic
(of any race)
NOTE: The term "non-Hispanic White alone" is used to refer to people who reported being White and no other race and who are not Hispanic.
The term "Black alone" is used to refer to people who reported being Black or African American and no other race, and the term "Asian alone"
is used to refer to people who reported only Asian as their race. The use of single-race populations in this chart does not imply that this is the
preferred method of presenting or analyzing data. The U.S. Census Bureau uses a variety of approaches.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement.
Despite the overall increase in educational attainment
among older Americans, substantial educational
differences exist among racial and ethnic groups. In
2015, 89 percent of non-Hispanic Whites age 65
and over had completed high school. The percentages
of older Asians and Blacks who had completed high
school (74 percent and 75 percent, respectively) were
not statistically different. In contrast, 54 percent of
older Hispanics had completed high school.
In 2015, older Asians had the highest proportion
with at least a Bachelor's degree (34 percent). About
29 percent of older non-Hispanic Whites had this level
of education. The proportions were 17 percent and
12 percent, respectively, for older Blacks and Hispanics.
All comparisons presented for this indicator are significant at
the 0.10 confidence level. Data for this indicator's charts and
bullets can be found in Tables 4a and4b on page 89.
7
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Population
INDICATOR 5: Living Arrangements
The living arrangements of America's older population are linked to income, health status, and the availability of caregivers.
Living arrangements of the population age 65 and over, by sex and race and Hispanic origin, 2015
Women
D Alone
With nonrelatives
D With other relatives
With spouse
Total
Non- Black
Hispanic alone
White alone
Asian
alone
Hispanic
(of any
race)
Total
Non- Black
Hispanic alone
White alone
Asian Hispanic
alone (of any
race)
NOTE: Living with other relatives indicates no spouse present. Living with nonrelatives indicates no spouse or other relatives present. The
term "non-Hispanic White alone" is used to refer to people who reported being White and no other race and who are not Hispanic. The term
"Black alone" is used to refer to people who reported being Black or African American and no other race, and the term "Asian alone" is used to
refer to people who reported only Asian as their race. The use of single-race populations in this chart does not imply that this is the preferred
method of presenting or analyzing data. The U.S. Census Bureau uses a variety of approaches.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement.
In 2015, older men were more likely to live with their
spouse than were older women. About 70 percent of
older men lived with their spouse, while less than half
(45 percent) of older women did. In contrast, older
women were more likely than older men to live alone
(36 percent versus 20 percent).
Living arrangements of older people differed by race
and Hispanic origin. Older Black, Asian, and Hispanic
women were more likely than non-Hispanic White
women to live with relatives other than a spouse. For
example, in 2015, 26 percent of older Asian women,
30 percent of older Black women, and 34 percent
of older Hispanic women lived with other relatives,
compared with only 12 percent of older non-Hispanic
White women. The percentages of Asian and Black
women were not different.
Older non-Hispanic White women and Black women
were more likely than women of other races to live
alone. In 2015, 37 percent of non-Hispanic White
and 43 percent of Black women lived alone, compared
with about 20 percent for older Asian women and
23 percent for older Hispanic women. The percentages
of older Asian and older Hispanic women living alone
were not different.
The percentage of older Black men living alone was
about three times as high as the percentage of older
Asian men (30 percent versus 10 percent). The
percentage of older Black men living alone was also
higher than that of older non-Hispanic White men
(20 percent).
Older Hispanic and Black men were more likely
(13 and 14 percent, respectively, which did not differ)
than non-Hispanic White men (4 percent) to live
with relatives other than a spouse. The percentage
of Asian men living with relatives other than a
spouse (10 percent) was lower than the percentages
for Hispanic and Black men and higher than the
percentages for non-Hispanic White men.
All comparisons presented for this indicator are significant at
the 0.10 confidence level. Data for this indicator's charts and
bullets can be found in Tables 5a and 5b on page 90.
8
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INDICATOR 6: Older Veterans
Veteran status among America's older population is associated with higher median family income, lower percentages
of individuals who are uninsured or covered by Medicaid, higher percentages of functional limitations in activities of
daily living or instrumental activities of daily living, greater likelihood of having any disability, and less likelihood of
rating their general health status as good or better.6 The oldest segment of the veteran population will continue to have
significant ramifications with regard to the demand for health care services, particularly in the area of long-term care.7
Percentage of population age 65 and over who are veterans, by sex and age group, 2000, 2015,
and projected 2025
Percent
100 r
80
60
40
20
Men
64
Percent
100 r
80
60
40
20
0
Women
2 1 2
2 3 111^1
65 and over 65-74 75-84 85 and over 65 and over 65-74 75-84 85 and over
D 2000 2015 0 2025 (projected)
Reference population: These data refer to the resident population of the United States and Puerto Rico.
SOURCE: U.S. Census Bureau, Population Projections 2014, and 2010 Census Summary File 1; Department of Veterans Affairs, VetPop2014.
In 2015, there were 9-9 million veterans age 65
and over in the United States and Pueto Rico.
Approximately one out of every two men age 65 and
over in 2015 were veterans.
More than 95 percent of veterans age 65 and over are
male. Over time, the number of male veterans age
65 and over will go from 9-4 million in 2000 to a
projected 9-0 million in 2020.
The number of men age 85 and over who are veterans
increased from 400,000 in 2000 to over 1.4 million
in 2015- The proportion of men age 85 and over who
are veterans increased from 33 percent in 2000 to 66
percent in 2015-
Between 2000 and 2010, the number of female
veterans age 85 and over increased from about 30,000
to 97,000 but is projected to decrease to 56,000 by
2025-
Data for this indicator's charts and bullets can be found in
Tables 6a and 6b on page 91.
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10
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Economics
-------
Economics
INDICATOR?: Poverty
Poverty rates are one way to evaluate economic well-being. People identified as living in poverty are at risk of having
inadequate resources for food, housing, health care, and other needs.
Poverty rate by age, by official poverty measure and Supplemental Poverty Measure, 1966-2014
Percent
100
80
60
40
20
0 i i i i i i i i i i i i i i i i i i i i i
1966 1970 1975 1980 1985
20
15
10
5
0
20
CPS re
T 65 and over SPM
A 65 and over
i i i
TJ
design
i
09 2010 2011 2012 2013 2014
CPS redesign
I I I I I I I I I I I I I I I I I I I I I I I I I
1990 1995 2000 2005 2010
2014
NOTE: Poverty status in the Current Population Survey (CPS) is based on prior year income. The source of the 2013 estimates shown in this figure
is the portion of the CPS Annual Social and Economic Supplement (ASEC) sample which received the redesigned income questions. The 2013
estimates from the traditional ASEC can be found in Table 7a. For further information on the redesigned income questions and the Supplemental
Poverty Measure (SPM), see NOTE for Table 7a. The official poverty measure is based on money income and does not include noncash benefits
such as food stamps. Poverty thresholds reflect family size and composition and are adjusted each year using the annual average Consumer Price
Index. For more detail, see U.S. Census Bureau Series P-60, No. 252. The SPM extends the official poverty measure by taking account of many of
the government programs designed to assist low income families and individuals that are not included in the current official poverty measure and
by using thresholds derived from the Consumer Expenditure Survey by the Bureau of Labor Statistics.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement.
In 1966, 29 percent of people age 65 and over lived
below the poverty threshold. By 2014, the proportion
of the older population living in poverty had decreased
dramatically to 10 percent.
Relative levels of poverty among the different age groups
have changed over time. In 1966, older people had the
highest poverty rate (29 percent), followed by children
(18 percent) and those in the working ages (11 percent).
By 2014, the proportions of the older population and
of those of working age living in poverty were about 10
percent and 14 percent, respectively, while 21 percent
of children lived in poverty. The poverty rate for older
people in 2014 was not different from the poverty rate for
people of working age in 1966.
Poverty rates differed by age and sex among the older
population. Older women (12 percent) were more likely
than older men (7 percent) to live in poverty in 2014.
People ages 65-74 had a poverty rate of 9 percent,
compared with 12 percent of those age 75 and over.
Race and ethnicity are related to poverty among older
men. In 2014, older non-Hispanic White men were less
likely than older Black men, older Hispanic men, and older
Asian men to live in poverty; 5 percent compared with 17
percent for older Black men, 16 percent for older Hispanic
men, and 13 percent for older Asian men. The poverty
rates for older Black men, older Hispanic men, and older
Asian men were not statistically different from each other.
Older non-Hispanic White women (10 percent) were
less likely than older Black women (21 percent), older
Hispanic women (20 percent), and older Asian women
(16 percent) to live in poverty. The poverty rates for older
Black women, older Hispanic women, and older Asian
women were not statistically different from each other.
In 2014, poverty rates for those 65 years and over were
higher under the Supplemental Poverty Measure (14
percent) compared with the official measure (10 percent).
All comparisons presented for this indicator are significant at the
0.10 confidence level. Data for this indicator's charts and bullets
can be found in Tables 7a and 7b on pages 9293.
12
1950
1960
1970
1980
1990
2010
2016
-------
INDICATORS: Income
The percentage of people living below the poverty line does not give a complete picture of the economic situation
of older Americans. Examining the income distribution of the population age 65 and over and their median income
provides additional insights into their economic well-being.
Income distribution of the population age 65 and over, 1974-2014
Percent
100
CPS redesign
80
60
40
20
High income
Middle income
Low income
Poverty
i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i
i i i i
1974
1980
1985
1990
1995
2000
2005
2010
2014
NOTE: Income distribution in the Current Population Survey (CPS) is based on prior year income. The source of the 2013 estimates shown in
this figure is the portion of the CPS Annual Social and Economic Supplement (ASEC) sample that received the redesigned income questions.
The 2013 estimates for the portion of the sample that received the traditional ASEC income questions can be found in Table 8a. For further
information on the redesigned income questions see the NOTE for Table 8a. The income categories are derived from the ratio of the family's
income (or an unrelated individual's income) to the corresponding official poverty threshold. Being in poverty is measured as income less than
100 percent of the poverty threshold. Low income is between 100 and 199 percent of the poverty threshold. Middle income is between 200
percent and 399 percent of the poverty threshold. High income is 400 percent or more of the poverty threshold. Some data have been revised
and differ from previous versions of Older Americans.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement.
Since 1974, the proportion of older people living in
poverty and in the low income group has generally
declined; as a consequence, by 2014, 10 percent of the
older population lived in poverty and 23 percent of the
older population was in the low income group.
In 2014, people in the high income group made up
the largest share of older people by income category
(36 percent). The proportion with a high income
has increased over time. The proportion of the older
population in the middle income group decreased
from 33 percent in 1974 to 31 percent in 2014.
The trend in median household income of the older
population also has been positive. In 1974, the median
household income for householders age 65 and over
was $22,921, when expressed in 2014 dollars. By 2014,
the median household income of the older population
had increased to $36,895-
Data for this indicator's charts and bullets can be found in
Tables 8a and 8b on pages 94-95.
1950
1960
1970
1980
1990
2010
2016
13
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Economics
INDICATOR 9: Sources of Income
Most older Americans are retired from full-time work. Social Security was developed as a floor of protection for their
incomes, to be supplemented by other pension income, income from assets, and, to some extent, continued earnings.
Over time, Social Security has taken on greater importance to older Americans.
Since the early 1960s, Social Security has provided the largest share of aggregate income for older Americans.8 The share
of income from pensions increased rapidly in the 1960s and 1970s, peaked in 1992, and has fluctuated since then at
around one-fifth of aggregate income.8 Asset income generally decreased while earnings generally increased after the
mid-1980s.8
Percentage distribution of per capita family income for persons age 65 and over, by income
quintile and source of income, 2014
Percent
100
80
60
40
20
-2
16
49
67
.2
-2
2
72
h3
^0.6
17
54
D
24
34
13
18
D Other
Cash public assistance
D Asset income
D Pensions
D Social Security
D Earnings
Total
Lowest fifth
Second fifth
Third fifth
Fourth fifth
Highest fifth
NOTE: The definition of "other" includes, but is not limited to, unemployment compensation, workers' compensation, veterans' payments, and
personal contributions. Quintile limits are $12,492, $19,245, $29,027, and $47,129. Estimates may not sum to the totals because of rounding.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement.
In 2014, most persons (86 percent) age 65 and over
lived in families with Social Security income. About
two-fifths (41 percent) lived in families with private
pensions or annuities, while almost a fifth (18 percent)
lived in families with other public pensions. Two-thirds
(67 percent) lived in families with income from assets.
Two-fifths (40 percent) lived in families with earnings,
and about one-tenth (13 percent) were in families
receiving public assistance (cash and noncash) with
other income sources. One-tenth (13 percent) were in
families receiving income from other sources.
The proportion of per capita family income of persons
age 65 and over from specified sources varied across
major sources and levels of income. Overall, Social
Security accounted for 49 percent of per capita family
income. For those in the lowest quintile of income,
Social Security accounted for two-thirds and earnings
accounted for about one-tenth (13 percent) of per
capita family income. For those in the highest income
quintile, Social Security accounted for one-fifth
(18 percent) of per capita family income, pension
income accounted for one-quarter, and earnings
accounted for about two-fifths.
For those age 80 and over, a larger percentage lived
in families with Social Security income (90 percent,
including families of one) and a smaller percentage
(23 percent) had earnings than did the population
age 65-69-
14
-------
Number of participants in private pension plans, by type of plan, 1975-2013
Number (in millions)
140
120
100
80
60
40
20
T Total
T Defined Benefit
Defined Contribution
1975
1980
1985
1990
1995
2000
2005
2010
2013
NOTE: The methodology for calculating participants was changed beginning with the 2005 Form 5500 series in response to the discontinuance
of the IRS Form 5500 Schedule T. For 2004, the revision increases counts of participants by 9 million. Under the current methodology,
participant counts include all workers eligible to participate in a plan. The term "participants" refers to active, retired, and separated vested
participants not yet in pay status. Workers participating in more than one plan are counted separately for each plan in which they participate.
Reference population: These data refer to counts of participants reported by private pension plans on the Form 5500.
SOURCE: U.S. Department of Labor, Employee Benefits Security Administration, Form 5500 filings.
Retirement savings held in private sector employer-
sponsored retirement plans are an important source of
income for older Americans. Over time, the number
of participants in such plans has grown along with the
rising number of participants in defined contribution
plans such as 401 (k) plans. However, the number
of participants in traditional defined benefit plans
in the private sector has remained steady, while the
proportion of these participants that are either retired
or separated from their employer has been increasing.
A growing share of the participants in defined benefit
plans participate in hybrid defined benefit plans, like
cash balance plans, that have some characteristics
that are similar to defined contribution plans. Among
defined benefit plan participants, the share in plans
that are cash balance plans has risen from less than
15 percent in 1999 to over 30 percent in 2013-
Out of the 93 million participants in private sector
employer-sponsored defined contribution plans in
2013, about 77 million were in 401(k)-type plans.
Among participants in 401(k)-type plans, the share in
plans that allow participants to direct all or a portion
of their investments has risen from 85 percent in 1999
to 97 percent in 2013-
Private sector workers most commonly have access
to only a defined contribution plan, while state and
local government workers most commonly have access
to only a defined benefit plan. Among private sector
workers in 2015, 47 percent had access to only a
defined contribution plan, 14 percent had access to
both a defined benefit and a defined contribution plan,
and 4 percent had access to only a defined benefit plan.
The rates for state and local government workers were
6 percent, 27 percent, and 57 percent, respectively.
Data for this indicator's charts and bullets can be found in
Tables 9a through 9f on pages 96-100.
1950
1960
1980
1990
2000
2010
2016
15
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Economics
INDICATOR 10: Social Security Beneficiaries
Social Security benefits provide a baseline for retirement income for the majority of older Americans and are the most
important income source for the aged. In December 2014, 47 million adults age 62 and over received Social Security
benefits.9 About 5-1 million adults ages 6264 received an average of $1,134 per month in benefits and 42 million adults
age 65 and over received an average of $1,309 per month.
In December 2014, most aged beneficiaries received retired worker benefits (about 60 percent of those ages 6264 and
86 percent of those 65 and over). Social Security provides retired worker benefits to workers with full insurance from
work covered by Social Security over a lifetime. Full insurance of the aged usually requires a minimum of 10 years of
covered earnings. About 1.9 million disabled workers ages 6265 also received benefits in 2014, an increase from the
number receiving benefits in 2000.
Percentage distribution of people who began receiving Social Security benefits in 2014, by age
and sex
Percent
50 r
40
30
20
10
41
36
17
18
11 11
12
16
62
63
64
65
Pre-Full Retirement Age
66 Disabled Worker
Conversions3
Full Retirement Age
Men n Women
67-69 70 and over
Post-Full Retirement Age
a At Full Retirement Age (FRA), persons formerly receiving disabled worker benefits are reclassified and begin receiving retired worker benefits.
NOTE: FRA is defined as age 66 for those born between 1943 and 1955. The percentages are not probabilities of a birth cohort claiming at
a particular age. A person begins receiving Social Security benefits the month after he or she becomes entitled. Totals may not sum to 100
percent because of rounding.
Reference population: Persons fully insured for Social Security retired worker benefits who became entitled to benefits in 2014.
SOURCE: Social Security Administration, Master Beneficiary Record.
In 2014, the majority (59 percent) of new Social
Security retired worker beneficiaries became entitled
to benefits prior to Full Retirement Age (FRA) at age
66 and, thus, started receiving reduced monthly Social
Security benefits. Few received a greater amount of
benefits by waiting to claim benefits until after reaching
FRA. Persons begin receiving benefits the month after
entitlement.
Of new Social Security retired worker beneficiaries in
2014, over one-third of men and two-fifths of women
became entitled at age 62 and about one-quarter of
men and women became entitled at ages 6365- In
contrast, 17 percent of men and 12 percent of women
became entitled at FRA, and few (8 percent of both
men and women) became entitled post-FRA.
Of new Social Security retired worker beneficiaries in
2014, 18 percent of men and 16 percent of women
converted from receiving disabled worker benefits to
receiving retired worker benefits.
16
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Percentage distribution of female Social Security beneficiaries age 62 and over, by type of benefit
received, selected years 1960-2014
Worker benefits3
D Dually entitled widow
D Dually entitled spouse
D Worker only
Spouse or widow
benefit only
D Widow onlyb
D Spouse only
1960 1970 1975 1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014
a Worker benefits include retired and disabled worker benefits.
b Widow-only beneficiaries include disabled workers and mothers of surviving children under age 19.
NOTE: All data for 2005 and dual-entitlement data for 1995 and 2000 are based on a 10 percent sample of administrative records. All other
estimates are based on 100 percent of available data. Benefits exclude special age-72 beneficiaries and disabled adult children and include
disabled workers. Totals may not sum to 100 percent because of rounding.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Social Security Administration, Master Beneficiary Record.
In 2014, 77 percent of women beneficiaries age 62 and
over received earned worker benefits.
The remaining portion of women (23 percent) received
benefits only as the spouse or surviving widow of an
entitled worker. In 2014, about 9 percent of women
received spouse-only benefits and 14 percent received
widow-only benefits.
Women entitled to their own earned worker benefits
and to higher auxiliary benefits, such as spouse or
widow benefits, are considered dually entitled. Of
female Social Security beneficiaries age 62 and over in
2014, about 51 percent received only earned worker
benefits, 12 percent received both earned worker and
spouse benefits, and 15 percent received both earned
worker and widow benefits.
The type of benefits received by women age 62 and
over dramatically changed between I960 and 2014.
The percentage of female Social Security beneficiaries
who received spouse-only benefits decreased from
33 percent to 9 percent, and the percentage receiving
widow-only benefits decreased from 23 percent to
14 percent. In contrast, the percentage of female
Social Security beneficiaries who received earned
worker benefits increased from 43 percent in I960
to 77 percent in 2014.
Data for this indicator's charts and bullets can be found in
Tables lOa and lOb on page 101.
1950
1960
1970
1980
1990
2000
2010
2016
17
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Economics
INDICATOR 11: Net Worth
Net worth (the value of real estate, stocks, bonds, retirement investment accounts, and other assets minus debts) is an
important indicator of economic security and well-being. Greater net worth allows a family to maintain its standard of
living when income falls due to job loss, health problems, or family changes such as divorce.
Median household net worth, in 2013 dollars, by race and educational attainment of head of
household age 65 and over, selected years, 1983-2013
Dollars (in thousands)
$700 r
600
BOO
400
300
200
100
0
1983
1989
1992
1995
1998
2001
2004
2007
2010
2013
NOTE: Median net worth is measured in constant 2013 dollars. Net worth includes assets held in investment retirement accounts such as
individual retirement accounts, Keoghs, and 401(k)-type plans. All observations are weighted for analysis. The term "household" in this
indicator is from the codebook of the 2013 Survey of Consumer Finance (www.federalreserve.gov/econresdata/). The data are for the "primary
economic unit" (PEU). The PEU consists of an economically dominant single individual or couple (married or living partners) in a household
and all other members of the household who are financially interdependent with the individual or couple. In the majority of cases, the PEU and
household are identical.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Survey of Consumer Finances.
Overall between 1983 and 2013, the median net
worth, in 2013 dollars (including the value of
retirement investment accounts), of households headed
by people age 65 and over almost doubled, from
$116,500 to $210,500. The rate of change was quite
variable over this time period. The largest increase
was between 1995 and 1998. In addition, there was a
decrease between 2001 and 2004 and between 2007
and 2013-
Between 1983 and 2013, the median net worth of
households headed by White people age 65 and over
almost doubled, from $137,300 to $255,000. The
median net worth of households headed by Black
people age 65 and over almost tripled over the same
period, increasing from $20,200 to $56,700.
In 1983, the median net worth of households headed
by White people age 65 and over was almost seven
times that of households headed by Black people
age 65 and over. In 2013, the median net worth of
households headed by older White people was about
four and a half times that of households headed by
older Black people.
In 2013, the median net worth of households headed
by married people age 65 and over ($319,800)
was more than twice as high as that of households
headed by unmarried people in the same age group
($119,300).
Between 1983 and 2013, the median net worth of
people age 65 and over either without a high school
diploma or with some college had similar increases
(33 percent and 22 percent, respectively). In 2013,
households headed by persons age 65 and over who
attended college had a median net worth almost four
and a half times greater than persons without a high
school diploma.
18
1950
1960
1970
1980
1990
-------
With the shift from traditional defined benefit pension
plans to investment retirement accounts such as
401(k)-type Individual Retirement Accounts (IRAs),
financial assets held in individual retirement accounts
have become prevalent among older Americans. Data
from the Survey of Consumer Finances show public
and private retirement assets for all ages, broken out by
age group. The proportion of American families headed
by people age 65 and over with retirement accounts
to all households headed by people age 65 and over
remained about two-fifths in 2007 and 2013-
The median retirement account value for households
headed by a person age 65 and over almost doubled
between 2007 and 2013, increasing from $68,000
to $118,000. (These retirement accounts are more
likely to be held by later birth cohorts.) People seldom
withdraw account money as annuity payments or
regular payments; rather, most are taken as ad hoc
distributions. Tax laws require that the account funds
be distributed based on life expectancy beginning in
the year after 70 and a half years of age.
Amount of funds held in retirement assets, by sector and type of plan, 1975-2014
Dollars (in trillions)
$25 r
20
15
10
HHHll
CTi CTi CTi CTi CTi CTi CTi CTi CTi CTi CTi CTi CTi CTi CTi CTi CTi CTi CTi CTi CTi CTi CTi CTi CTi
OOOOOOOOOOiHiHiHiHiH
ooooooooooooooo
r\ir\ir\ir\ir\ir\ir\ir\ir\ir\ir\ir\ir\ir\ir\i
Public defined
benefit plan3
Private defined
benefit plan3
Public defined
contribution plan
Private defined
contribution plan
Individual retirement
account
a Public and private defined benefit plans do not include claims of pension funds on sponsor.
Reference population: Public and private retirement assets for total population.
SOURCE: Federal Reserve Board Z.I Statistical Release for Dec. 10, 2015.
Retirement savings held in public and private pension
plans or IRAs play a large role in the net worth of older
Americans. In 2014, IRAs held about $7-4 trillion in
assets, public and private defined contribution plans
held about $6.3 trillion in assets, and public and private
defined benefit plans held about $8.0 trillion in assets.
Over time, an increasing proportion of retirement
assets has shifted from traditional defined benefit plans
to individual account-based retirement vehicles such
as defined contribution plans and IRAs.
While defined contribution plans are more commonly
provided in the private sector, defined benefit plans
have been largely dominant in the public sector.
Data for this indicator's charts and bullets can be found in
Tables lla through lie on pages 102-104.
o _/ o
1950
1960
1970
1980
1990
2010
2016
19
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Economics
INDICATOR 12: Participation in Labor Force
The labor force participation rate is the percentage of a population that is in the labor forcethat is, either working
(employed) or actively looking for work (unemployed). Some older Americans work out of economic necessity. Others
may be attracted by the social contact, intellectual challenges, or sense of value that work often provides.
Labor force participation rates (annual averages) of men age 55 and over, by age group,
1963-2015
55-61
62-64
Percent
100 r
80
60
40
20
0 I i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i
1963 1970 1975 1980 1985 1990 1995 2000 2005 2010 2015
NOTE: Data for 1994 and later years are not strictly comparable with data for 1993 and earlier years due to a redesign of the survey and
methodology of the Current Population Survey.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Bureau of Labor Statistics, Current Population Survey.
In 2015, the labor force participation rate for men
ages 5561 was 75 percent, far below the rate in 1963
(90 percent). The participation rate for men ages
6264 declined from 76 percent in 1963 to a low of
45 percent in 1995- In 2015, the participation rate for
men ages 6264 increased to 56 percent.
Men ages 6569 also experienced a gradual rise in labor
force participation following a period of decline in the
late 1960s and 1970s. The labor force participation rate
for men ages 6569 declined from a high of 43 percent
in 1967 to 24 percent in 1985- Their participation rate
from the mid-1980s to the early 1990s remained in the
range of 24 to 26 percent. In the mid-1990s, the labor
force participation rate for men in this age group began
to increase and reached 37 percent in 2011; it has
remained mostly unchanged since then.
From 1963 to 2015, the participation rate for men age
70 and over showed a somewhat similar pattern as men
ages 6569- In 1993, the labor force participation rate
for men age 70 and over reached a low of 10 percent
after declining from 21 percent in 1963- Since the
mid-1990s, the participation rate for men ages 70 and
over has trended higher but has leveled off in recent
years. The rate was 16 percent in 2015-
20
1950
1960
1970
1980
2000
2010
-------
The labor force participation rate for older women reflects changes in the work experience of successive generations of
women. Many women now in their 60s and 70s did not work outside the home when they were younger, or they moved
in and out of the labor force. As new cohorts of women Baby Boomers approach older ages, they are participating in the
labor force at higher rates than in previous generations.
Labor force participation rates (annual averages) of women age 55 and over, by age group,
annual averages, 1963-2015
Percent
100 r
80
60
40
20
55-61
62-64
I I I I I I I
1963
1970
1975
1980
1985
1990
1995
2000
2005
2010
2015
NOTE: Data for 1994 and later years are not strictly comparable with data for 1993 and earlier years due to a redesign of the survey and
methodology of the Current Population Survey.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Bureau of Labor Statistics, Current Population Survey.
Among women age 55 and over, the labor force
participation rate rose over the past four decades. The
increase has been largest among women ages 5561,
rising from 44 percent in 1963 to 66 percent in 2010,
with a majority of the increase occurring after 1985-
For women ages 6264, 6569, and 70 and over, labor
force participation rates began increasing in the mid-
1980s but have leveled off in recent years.
In 2015, 64 percent of women ages 5561 were in the
labor force, compared with 44 percent in 1963- Over
the same period, the labor force participation rate for
women ages 6264 increased from 29 percent to 45
percent, and the rate for women ages 6569 increased
from 17 percent to 28 percent.
The difference between labor force participation rates
for men and women has narrowed over time. Among
those ages 55-61, for example, the gap between men's
and women's rates in 2015 was 11 percentage points,
compared with 46 percentage points in 1963-
Data for this indicator's charts and bullets can be found in
Table 12 on pages 105-106.
1950
1960
1970
1980
1990
2000
2010
21
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Economics
INDICATOR 13: Housing Problems
Most older Americans live in adequate, affordable housing. Some, however, live in costly, physically inadequate, and
crowded housing, which can pose serious problems for an older person's physical or psychological well-being. While
housing cost burden has remained the most prevalent housing problem for all older American households over the years,
some older American households and intergenerational households continue to face physically inadequate housing
problems, such as housing that lacks complete plumbing or has multiple and major upkeep problems. These households
also have crowded housing situations, which are households that have more than one person per room.
Percentage of older American households and all other U.S. households that report housing cost
burden, selected years 1985-2013
Percent
100 r
80
60
40
20
All older-owner/renter households
All other households
A All older-member households (not householder or spouse)
1985
1989
1995 1997
1999 2001
2003 2005 2007
2009
2011
2013
NOTE: Housing cost burden refers to expenditures on housing and utilities that exceed 30 percent of household income. All older-owner/
renter households are households with a householder or spouse age 65 and over; all older-member households are households with a
member age 65 and over who is not the householder or spouse; and all other households are households without one or more persons age
65 and over. Some data for 2009 have been revised and differ slightly from previous editions of Older Americans.
Reference population: These data refer to the resident noninstitutionalized population. People residing in noninstitutional group homes are excluded.
SOURCE: U.S. Department of Housing and Urban Development, American Housing Survey.
Approximately 39 percent of both older-owner/
renter households (households with a householder or
spouse age 65 and over) and older-member households
(households with a member age 65 and over who
is not the householder or spouse) have housing
problems. The most prevalent housing problem
remains cost burden (expenditures on housing and
utilities that exceed 30 percent of household income).
While cost burden has generally increased over
time, between 2009 and 2013 the prevalence of cost
burden decreased from 40 to 36 percent for older-
owner/renter households and from 39 to 34 percent
for older-member households. In comparison, the
prevalence of housing cost burden for all other U.S.
households (households without one or more persons
age 65 and over) decreased from 36 to 34 percent over
the same time period.
22
1950
1970
1980
1990
2000
2010
2016
-------
Cost burden is also the most dominant housing problem for intergenerational households, or households with older
people (age 65 and over) and children (age 19 or younger) living in the household. For some intergenerational
households, crowded housing continues to be fairly prevalent.
Percentage of older American households and intergenerational households that report housing
cost burden, selected years 1985-2013
Percent
100 r
80
60
40
20
Older-owner/renter households with children
A All older-member households
All older-owner/renter households
Older-member households
with children
1985
1989
1995 1997 1999 2001 2003 2005 2007 2009 2011
2013
NOTE: Housing cost burden refers to expenditures on housing and utilities that exceed 30 percent of household income. All older-owner/
renter households are households with a householder or spouse age 65 and over; all older-member households are households with
a member age 65 and over who is not the householder or spouse; older-owner/renter households with children are households with a
householder or spouse age 65 and over and children (age 19 or younger); and older-member households with children are households with
a member age 65 and over and children (age 19 or younger). Some data for 2009 have been revised and differ slightly from previous editions
of Older Americans.
Reference population: These data refer to the resident noninstitutionalized population. People residing in noninstitutional group homes are
excluded.
SOURCE: U.S. Department of Housing and Urban Development, American Housing Survey.
Older-owner/renter and older-member
intergenerational households are likely to represent
households where grandparents are helping to raise
their grandchildren or where three generations are
living within the same household. From 2009 to
2013, housing cost burden remained relatively the
same at approximately 40 percent for older-owner/
renter intergenerational households. For older-member
intergenerational households, housing problems
overall decreased, largely as a result of housing cost
burden decreasing from 46 to 37 percent between
2009 and 2013-
Data for this indicator's charts and bullets can be found in
Tables 13a through 13f on pages 107-109.
1950
1970
1980
1990
2000
2010
2016
23
-------
Economics
INDICATOR 14: Total Expenditures
Household expenditures are another indicator of economic well-being and show how the older population allocates
resources to food, housing, health care, and other needs. Expenditures may vary with changes in work status, health
status, or income.
Percentage distribution of total household annual expenditures, by expenditure category and
age group of reference person, 2014
Percent
80
60
40
20
.
_
18
32
17
9
19
34
16
13
19
32
17
12
19
37
14
16
Food
D Housing
D Transportation
D Health care
Personal insurance and pensions
55-64
65 and
65-74
75 and over
NOTE: Other expenditures include apparel, personal care, entertainment, reading, education, alcohol, tobacco, cash contributions, and
miscellaneous expenditures. Data from the Consumer Expenditure Survey by age group represent average annual expenditures for consumer
units by the age of the reference person, that is the person listed as the owner or renter of the home. For example, the data on people
age 65 and over reflect consumer units with a reference person age 65 and over. The Consumer Expenditure Survey collects and publishes
information from consumer units, which are generally defined as a person or group of people who live in the same household and are related
by blood, marriage, or other legal arrangement (i.e., a family) or people who live in the same household who are unrelated but make financial
decisions together. A household usually refers to a physical dwelling and may contain more than one consumer unit (e.g., roommates who are
sharing an apartment but who are financially independent from each other). However, for convenience, the term "household" is substituted for
"consumer unit" in this text.
Reference population: These data refer to the resident noninstitutionalized population.
SOURCE: Bureau of Labor Statistics, Consumer Expenditure Survey.
' Housing accounted for the largest share (nearly one-
third or more on average) of total expenditures for all
groups of households with a reference person (i.e., a
selected household owner or renter) age 55 and over. In
2014, the share was 37 percent for households with a
reference person age 75 and over.
' As a share of total expenditures, health care
expenditures increased dramatically with age. For the
group age 75 and over, the share (16 percent) was
nearly twice as high as it was for the group age 5564
(9 percent); in addition, the share that those age 75
and over allocated to health care was slightly higher
than this group allocated to transportation (4 percent).
Among the age groups studied, the share of total
expenditures allocated to food ranged between 12 and
13 percent.
Data for this indicator's charts and bullets can be found in
Table 14 on page 110.
24
-------
ealth Status
-------
Health Status
INDICATOR 15: Life Expectancy
Life expectancy is a summary measure of the overall health of a population. It represents the average number of years of
life remaining to a person at a given age if death rates remain constant. Improvements in health have resulted in increased
life expectancy. However, there are differences in life expectancy by socioeconomic status, and these differences have been
increasing over time.10 Life expectancy in the United States is lower than in many other industrialized countries.11
Life expectancy at ages 65 and 85, by race and sex 1981-2014
Years of life
2B r
20
15
10
Black or African American women, at a
T White women, at age 65
Black or African American men, at age 65
-White women, at age 85
p White women, at age 8 y B|ack or African American women, at age 85
Awhite men, at age 85
Black or African American men, at age 85
1981
1985
1990
1995
2000
2005
2010
2014
NOTE: Life expectancy estimates are from annual life tables produced by the National Center for Health Statistics found at http://www.cdc.
gov/nchs/products/life_tables.htm. Some estimates have been revised and may differ from previous editions of Older Americans due to
changes in methodology and to the use of intercensal population estimates for 2001-2009. See Appendix II, Life Expectancy, of Health, United
States, 2015 for a description of the changes in life table methodology.
Reference population: These data refer to the resident population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System.
Americans are living longer than ever before. Life
expectancies at both age 65 and age 85 have increased.
Under current mortality conditions, people who
survive to age 65 can expect to live an average of
19-3 more years. In 2014, the life expectancy of people
who survive to age 85 was 7.0 years for women and
5.9 years for men.
Life expectancy varies by race, but the difference
decreases with age. In 2014, life expectancy at birth
was 3-4 years higher for White people than for Black
people. At age 65, White people can expect to live
an average of 1.1 years longer than Black people.
Among those who survive to age 85, however, the
life expectancy for Black people is slightly higher
(6.9 years) than White people (6.5 years).
In 2014, women had higher life expectancy than men.
At age 65, women can expect to live 2.5 years longer.
At age 85, women can expect to live 1.1 years longer.
Differences by sex are seen among the White, Black,
and Hispanic populations.
Life expectancy in 2014 among the Hispanic
population was higher than among non-Hispanic
Whites or non-Hispanic Blacks. Hispanic people who
survive to age 65 can expect to live 1.8 years longer
than non-Hispanic Whites and 3-0 years longer than
non-Hispanic Blacks.
Data for this indicator's charts and bullets can be found in
Tables 15a and 15b on pages 111-113.
26
1950
1960
1970
1980
1990
2010
-------
INDICATOR 16: Mortality
Overall, death rates for the population age 65 and over have declined in recent decades. However, for some causes of
death, rates among older Americans have increased in recent years. There are differences in death rates by sex and race
and Hispanic origin for many causes of death.
Death rates among people age 65 and over, by selected leading causes of death, 1981-2014
ICD-10
T Heart disease
Diabetes
Unintentional injuries
Alzheimer's disease
Chronic lower respiratory diseases
T Influenza and pneumonia
1985
1990
1995
2000
2005
2010
2014
NOTE: Death rates for 1981-1998 are based on the 9th revision of the International Classification of Diseases (ICD-9). Starting in 1999,
death rates are based on ICD-10. For the period 1981-1998, causes were coded using ICD-9 codes that are more comparable with codes for
corresponding ICD-10 categories and may differ from other published estimates. See http://www.cdc.gov/nchs/data/nvsr/nvsr49/nvsr49_02.
pdf for information on the comparability of death rates between ICD-9 and ICD-10. Some data from 2000-2009 have been revised and differ
from previous versions of Older Americans. Rates are age adjusted using the 2000 standard population.
Reference population: These data refer to the resident population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System.
In 2014, the leading cause of death among people
age 65 and over was heart disease (1,062 deaths
per 100,000 people), followed by cancer (915 per
100,000), chronic lower respiratory diseases (277 per
100,000), stroke (247 per 100,000), Alzheimer's
disease (200 per 100,000), diabetes (119 per 100,000),
unintentional injuries (105 per 100,000), and influenza
and pneumonia (97 per 100,000).
Between 1999 and 2014, age-adjusted death rates
for all causes of death among people age 65 and over
declined by 20 percent. Death rates declined for heart
disease, cancer, chronic lower respiratory disease,
stroke, diabetes, and influenza and pneumonia. Death
rates for Alzheimer's disease and unintentional injuries
increased over the same period.
Heart disease and cancer were the top two leading
causes of death in 2014 among all people age 65 and
over. They were also the top two leading causes of
death for both men and women as well as for non-
Hispanic Whites, non-Hispanic Blacks, and Hispanics.
Diabetes was the seventh leading cause of death among
non-Hispanic Whites, but the fourth leading cause
among non-Hispanic Blacks and Hispanics.
Other causes of death varied among older Americans
by sex and race and Hispanic origin. For example, in
2014 women had higher death rates from Alzheimer's
disease than men (222 per 100,000 compared with
161 per 100,000), while men had higher rates of
death from unintentional injuries (131 per 100,000
compared with 86 per 100,000). Rates of death for
heart disease and stroke were higher among non-
Hispanic Blacks than among non-Hispanic Whites and
Hispanics.
Data for this indicator's charts and bullets can be found in
Tables 16a and 16b on pages 114-115.
1950
1960
1970
1980
1990
2000
2010
27
-------
Health Status
INDICATOR 17: Chronic Health Conditions
Chronic diseases and conditions such as heart disease, stroke, cancer, diabetes, and arthritis are among the most common
and costly health conditions.12 The majority of older adults have multiple chronic conditions, which contribute to
frailty and disability13 Many of the negative effects of chronic conditions are caused by health risk behaviors that can
be changed.12 The six leading causes of death among older Americans in 2014 were chronic diseases (see "Indicator 16:
Mortality").
Percentage of people age 65 and over who reported having selected chronic health conditions,
by sex, 2013-2014
Percent
100 r
80
60
40
20
- 35
Heart disease Hypertension
Stroke
Asthma
Men
Chronic bronchitis
or emphysema
n Women
Cancer
Diabetes
Arthritis
NOTE: Data are based on a 2-year average from 2013-2014.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.
The prevalence of certain chronic health conditions
differed by sex. Women reported higher levels of
asthma and arthritis than men. Men reported higher
levels of heart disease, cancer, and diabetes than
women.
There were differences by race and ethnicity in the
prevalence of certain chronic health conditions. In
20132014, among people age 65 and over, non-
Hispanic Blacks reported higher levels of hypertension
and diabetes than non-Hispanic Whites (71 percent
compared with 54 percent for hypertension, and
32 percent compared with 18 percent for diabetes).
Hispanics also reported higher levels of diabetes
(32 percent) than non-Hispanic Whites, but lower
levels of arthritis than non-Hispanic Whites (44
percent compared with 50 percent).
The prevalence of some chronic health conditions
among people age 65 and over has increased over time.
The percentage of people who reported hypertension,
asthma, cancer, and diabetes was higher in 20132014
compared with 1997-1998.
Data for this indicator's charts and bullets can be found in
Tables 17a and 17b on page 116.
28
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INDICATOR 18: Oral Health
Oral health is an important component of an older person's general health and well-being. Oral health reflects overall
health status and is related to the risk and treatment of various chronic conditions.14 Regular dental care is not covered
under Medicare.
Percentage of people age 65 and over who had dental insurance, had a dental visit in the past
year, and had no natural teeth, by age group, 2014
Percent
100
80
60
40
20
25
Dental insurance Dental visit in past year No natural teeth
65 and over D 65-74 D 75-84 D 85 and over
NOTE: Dental insurance is estimated from questions on whether the respondent's private health insurance plan covers dental care and
whether the respondent has a single service plan covering dental care. Dental visits in the past year were estimated from responses to the
question, "About how long has it been since you last saw or talked to a dentist?" The percentage with no natural teeth was estimated from
responses to the question, "Have you lost all of your upper and lower natural (permanent) teeth?" All estimates were calculated from the
sample adult component of the National Health Interview Survey.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.
About 25 percent of people age 65 and over reported
having dental insurance in 2014. The percentage with
dental insurance declines with age, from 30 percent
among people ages 6574 to 16 percent among people
age 85 and over.
In 2014, about 62 percent of people age 65 and over
had a dental visit in the past year. The percentage
visiting a dentist was higher among people ages 6574
than among people age 85 and over (66 percent versus
56 percent).
The prevalence of edentulism, having no natural teeth,
was nearly twice as high among people age 85 and over
(31 percent) as among people ages 6574 (16 percent).
The percentage of older women with dental insurance
was lower than the percentage of older men with dental
insurance. Similar percentages of men and women age
65 and over had a dental visit in the past year and had
no natural teeth.
Non-Hispanic Black people age 65 and over had higher
levels of edentulism and lower levels of dental visits
than non-Hispanic Whites and Hispanics.
Data for this indicator's charts and bullets can be found in
Tables 18a and 18b on page 117.
29
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Health Status
INDICATOR 19: Respondent-Assessed Health Status
Asking people to rate their health as excellent, very good, good, fair, or poor provides an indicator of health status easily
measured in surveys. It represents physical, emotional, and social aspects of health and well-being. Self-rated health has
been shown to predict mortality and health care expenditures.15'16
Percentage of people age 65 and over with respondent-assessed good to excellent health status,
by age group and race and Hispanic origin, 2012-2014
65 and over
Total
65-74
Non-Hispanic White
75-84 85 and over
Non-Hispanic Black | Hispanic (of any race)
NOTE: Data are based on a 3-year average from 2012-2014. Total includes all other races not shown separately. See data sources for the
definition of race and Hispanic origin in the National Health Interview Survey.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.
During the period 20122014, 78 percent of people
age 65 and over rated their health as good, very good,
or excellent. The levels of health reported by older men
and older women were similar.
The proportion of people reporting good to excellent
health was lower among the oldest age groups. About
80 percent of those age 6574 reported good or better
health. At age 85 and over, 68 percent of people
reported good or better health. This pattern was also
evident within racial and ethnic groups.
Regardless of age, older non-Hispanic White men and
women were more likely to report good to excellent
health than their non-Hispanic Black and Hispanic
counterparts. Non-Hispanic Blacks and Hispanics were
similar to one another in the percentages of positive
health evaluations that they reported.
Data for this indicator's charts and bullets can be found in
Table 19 on page 118.
30
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INDICATOR 20: Dementia
Dementias, including Alzheimer's disease and other related disorders that cause memory impairment and cognitive
decline, affect the health and well-being of the U.S. population (see "Indicator 16: Mortality").17 Dementia is a condition
overwhelmingly faced by older adults, although there are some conditions in which the onset is seen in people under age
65. Increasing age is one of the strongest risk factors for dementia.
Percentage of the non-nursing home population age 65 and over with dementia, by age group
and sex, 2011
Percent
B0r
40
30
20
10
11
65 and over
NOTE: The estimate of dementia presented here includes Alzheimer's disease and other related dementias such as frontotemporal, Lewy
body, mixed, and vascular dementia, which are often indistinguishable from Alzheimer's disease in their presentation and outcomes.
Dementia status in the National Health and Aging Trends Study (NHATS) was determined using three types of information: (1) a report (by
the respondent or proxy) that a doctor told the sample person that he or she had dementia or Alzheimer's disease; (2) a score indicating
probable dementia on a screening instrument administered to proxy respondents during the interview; and (3) cognitive tests that evaluate
memory, orientation, and executive function administered to the respondent during the interview. See http://nhats.org/scripts/documents/
DementiaTechnicalPaperJuly_2_4_2013_10_23_15.pdf for details on dementia measurements in NHATS.
Reference population: These data refer to Medicare beneficiaries not living in nursing homes.
SOURCE: National Health and Aging Trends Study.
There are sex differences in the prevalence of dementia.
Although women overall are more likely than men
to have dementia, this pattern is not consistent
at all age groups. In 2011, for those people ages
6574, men were more likely to have dementia than
women (5 percent versus 3 percent, respectively).
For those adults age 85 and over, women were more
likely to have dementia than men (30 percent versus
24 percent).
In addition to the higher prevalence of dementia
among women age 85 and over, the size of the
population of women in this age group is larger than
that of men. As a result, far more women than men
age 85 and over have dementia. Over 900,000 women
in this age group have dementia, compared with just
under 400,000 men.
Most people with dementia live in the community.
However, the prevalence of dementia among nursing
home residents is higher than among the non-nursing
home population. It is estimated that in 2011, between
4l percent and 68 percent of nursing home residents
had moderate or severe cognitive impairment.18
The prevalence of dementia decreased with educational
level. In 2011, among people age 65 and over,
21 percent with less than a high school education had
dementia, compared with 5 percent of people who
had a bachelor's degree or more. These differences by
educational level are seen for both men and women
and in all age groups.
Data for this indicator's charts and bullets can be found in
Tables 20a through 20d on page 119.
31
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Health Status
INDICATOR 21: Depressive Symptoms
Depressive symptoms are an important indicator of general well-being and mental health among older adults. People
who report many depressive symptoms often experience higher rates of physical illness, greater functional disability,
higher health care resource utilization,19 and dementia.20
Percentage of people age 51 and over with clinically relevant depressive symptoms, by sex and
age group, selected years, 1998-2014
Percent
50 r
40
30
20
10
Men
Percent
50 r
40
30
1212 12u 1212 1! 11 niQ l?u n rn 12
Illllllll
20
10
0
Women
17
19 1819
19
15
1998 2000 2002 2004 2006 2008 2010 2012 2014 1998 2000 2002 2004 2006 2008 2010 2012 2014
G 51-64 | 65 and over
NOTE: The definition of "clinically relevant depressive symptoms" is four or more symptoms out of a list of eight depressive symptoms from
an abbreviated version of the Center of Epidemiological Studies Depression Scale (CES-D), adapted by the Health and Retirement Study (MRS).
The CES-D scale is a measure of depressive symptoms and is not to be used as a diagnosis of clinical depression. A detailed explanation
concerning the "four or more symptoms" cut-off can be found in the following documentation: http://hrsonline.isr.umich.edu/sitedocs/userg/
dr_005.pdf. Percentages are based on weighted data using the preliminary respondent weights from the 2014 Early Release MRS Tracker File.
Some data for 1998-2008 have been revised and differ from previous editions of Older Americans.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Health and Retirement Study.
Older women were more likely to report clinically
relevant depressive symptoms than were older men. In
2014, 15 percent of women age 65 and over reported
depressive symptoms, compared with 10 percent of
men. There was no significant change in this difference
between the sexes from 1998 to 2014.
The percentage of people age 51 and over reporting
clinically relevant symptoms has remained relatively
stable over the past few years. Between 1998 and 2014,
the percentage of men in this age group who reported
depressive symptoms ranged between 11 and 12
percent. For women in this age group, the percentage
reporting these symptoms ranged between 16 and
19 percent.
32
1950
1980
2000
2010
2016
-------
Percentage of people age 51 and over with clinically relevant depressive symptoms, by age group
and sex, 2014
Percent
so
40
30
20
10
17
51-54 55-59 60-64 65-69 70-74
| Total | Men Q Women
75-79
80-84
85 and over
NOTE: The definition of "clinically relevant depressive symptoms" is four or more symptoms out of a list of eight depressive symptoms from an
abbreviated version of the Center of Epidemiological Studies Depression Scale (CES-D), adapted by the Health and Retirement Study (MRS). The
CES-D scale is a measure of depressive symptoms and is not to be used as a diagnosis of clinical depression. A detailed explanation concerning
the "four or more symptoms" cut-off can be found in the following documentation: http://hrsonline.isr.umich.edu/sitedocs/userg/dr_005.pdf.
Percentages are based on weighted data using the preliminary respondent weight from MRS 2014.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Health and Retirement Study.
The prevalence of depressive symptoms varies by age.
In 2014, the proportion of people age 51 and over with
clinically relevant symptoms was higher for the younger
age group (17 percent among those ages 5154) and
the older age group (15 to 16 percent among those
age 80 and over) than for people ages 6579 (10 to
13 percent).
In 2014, the percentage of men 85 and over
(14 percent) reporting clinically relevant depressive
symptoms was almost twice that of men in their 70s
(about 8 percent), and was slightly higher than those in
their 50s and 60s (roughly 12 percent). Prevalence of
clinically relevant depressive symptoms among women
age 51 and over shows a clear U-shaped pattern, with
the highest rates among those ages 5154 (21 percent)
and those ages 80-84 (19 percent).
Data for this indicator's charts and bullets can be found in
Tables 21 a and 21 b on page 120.
33
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Health Status
INDICATOR 22: Functional Limitations
As people age, illness or injury may result in disability, including limitations in vision, hearing, mobility, communication,
cognition, or self-care. These changes may have important implications for work and retirement policies, health and long-
term care needs, and policies affecting the built environment, all of which affect the well-being of the older population
and the ability to fully and independently participate in society.
Percentage of people age 65 and over with a disability, by sex and functional domain, 2010 and
2014
Percent
100 r
80
60
40
20
Men
Percent
100 r
80
60
20 19
14
11
40
20
2 2
Any Vision Hearing Mo- Commu- Cog- Self-
disability bility nication nition care
Women
25 24
2010
3343
Any Vision Hearing Mo- Commu- Cog- Self-
disability bility nication nition care
2014
NOTE: Disability is defined as "a lot" or "cannot do/unable to do" when asked about difficulty with seeing, even if wearing glasses (vision);
hearing, even if wearing hearing aids (hearing); walking or climbing steps (mobility); communicating, for example, understanding or being
understood by others (communication); remembering or concentrating (cognition); and self-care, such as washing all over or dressing (self-
care). Any disability is defined as having difficulty with at least one of these activities. The data source and measures presented have changed
from previous editions of Older Americans. Data labels in this chart are based on rounded values.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.
In 2014, 22 percent of the population age 65 and over
reported having a disability as defined by limitations in
vision, hearing, mobility, communication, cognition,
and self-care. Women were more likely to report any
disability than men (24 percent versus 19 percent).
Difficulties with mobility (walking or climbing stairs)
were the most commonly reported disability for those
age 65 and over in 2014 (17 percent of women and
11 percent of men).
Between 2010 and 2014, the percentage of the total
population age 65 and over with hearing difficulties
increased, while the percentage with mobility
difficulties decreased.
Disability increases with age. In 2014, 42 percent
of people age 85 and over reported any disability,
compared with 17 percent of people ages 6574.
People age 85 and over also had higher levels of
disability than people ages 6574 in all the individual
domains of functioning.
Non-Hispanic Blacks age 65 and over were more likely
to report having any disability than non-Hispanic
Whites (26 percent compared with 21 percent).
The percentage of those age 65 and over reporting
difficulties with cognition and self-care was higher
among Hispanics compared with non-Hispanic Whites
(6 percent versus 3 percent, and 5 percent versus
2 percent, respectively).
34
-------
Difficulties performing activities of daily living (ADLs), such as bathing, dressing, and toileting, and instrumental
activities of daily living (lADLs), such as housework, shopping, and managing money, affect the ability to live
independently. Tracking these changes over time is helpful to planning for the care needs of the older population.
Percentage of Medicare beneficiaries age 65 and over who have limitations in performing
activities of daily living (ADLs) or instrumental activities of daily living (IADLs), or who are in a
long-term care facility, selected years 1992-2013
Percent
100 r
80
60
°
40
20
Limitations in
performing lADLs only
D Limitations in
performing 1-2 ADLs
Limitations in
performing 3-4 ADLs
D Limitations in
performing 5-6 ADLs
In long-term care facility
1992
1997
2001
2005
2009
2013
NOTE: A residence is considered a long-term care facility if it is certified by Medicare or Medicaid; has three or more beds, is licensed as a
nursing home or other long-term care facility, and provides at least one personal care service; or provides 24-hour, 7-day-a-week supervision
by a caregiver. Limitations in performing activities of daily living (ADL) refer to difficulty performing (or inability to perform for a health reason)
one or more of the following tasks: bathing, dressing, eating, getting in/out of chairs, walking, or using the toilet. Limitations in performing
instrumental activities of daily living (IADL) refer to difficulty performing (or inability to perform for a health reason) one or more of the
following tasks: using the telephone, light housework, heavy housework, meal preparation, shopping, or managing money. Percentages are
age adjusted using the 2000 standard population. Estimates may not sum to the totals because of rounding.
Reference population: These data refer to Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Access to Care.
In 2013, 44 percent of people age 65 and over enrolled
in Medicare reported limitations in activities of daily
living, instrumental activities of daily living, or were
living in a long-term care facility. Roughly 12 percent
had difficulty performing one or more lADLs but had
no ADL limitations. Approximately 29 percent had
difficulty performing at least one ADL, and 4 percent
were in a facility.
The age-adjusted proportion of people age 65 and over
with limitations in activities of daily living, instrumental
activities of daily living, or who were living in a long-
term care facility was lower in 2013 than in 1997
(44 percent compared with 49 percent). There was a
decrease in the percentage with limitations from 1992 to
1996. From 1996 to 2013, the overall percentages did
not significantly change, although a smaller proportion
of this population was in a facility than in earlier years.
Women reported higher levels of limitations than
men. In 2013, about 49 percent of female Medicare
beneficiaries age 65 and over had difficulty performing
ADLs or lADLs, or were in a long-term care
facility, compared with 37 percent of male Medicare
beneficiaries in this age group.
Levels of limitation varied by age. Among Medicare
beneficiaries age 85 and over, 74 percent had difficulty
performing ADLs or lADLs or were in a long-term
care facility, compared with 48 percent of people ages
7584 and 34 percent of people ages 6574.
Data for this indicator's charts and bullets can be found in
Tables 22a through 22e on pages 121123.
1950
1960
1970
1980
1990
2010
2016
35
-------
36
-------
Health Risks
and Behaviors
-------
Health Risks and Behaviors
INDICATOR 23: Vaccinations
Vaccinations against influenza and pneumococcal disease are recommended for older Americans, who are at increased
risk for these diseases and their complications as they age.21'22'23 Influenza (flu) vaccinations are given annually, and
pneumococcal (pneumonia) vaccinations are usually given once or twice in a lifetime.
Percentage of people age 65 and over who reported having been vaccinated against influenza
and pneumococcal disease, by race and Hispanic origin, selected years 1989-2014
Percent
100 r
80
60
40
20
Influenza
Influenza
Y non-Hispanic White Hispanic
Pneumococcal disease
non-Hispanic White
Influenza
non-Hispanic Black
Pneumococcal disease
non-Hispanic Black
A Pneumococcal disease
Hispanic
1989
1991
1993 19941995
1997
2000
2005
2010
2014
NOTE: For influenza, the percentage vaccinated consists of people who reported having a flu shot during the past 12 months. Beginning with
data from 2005, receipt of nasal spray flu vaccine is included in the estimate of flu vaccinations. For pneumococcal disease, the percentage
refers to people who reported ever having a pneumonia vaccination. Questions concerning the use of influenza and pneumonia vaccinations
differed slightly on the National Health Interview Survey across the years for which data are shown. For details, see Health, United States, 2015
Appendix II. See data sources for the definition of race and Hispanic origin in the National Health Interview Survey. Some data for 2005-2010
have been revised and differ from previous editions of Older Americans.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.
In 2014, 70 percent of people age 65 and over reported
receiving a flu shot in the past 12 months; however,
there were differences by race and ethnicity. About
72 percent of non-Hispanic Whites reported receiving
a flu shot, compared with 57 percent of non-Hispanic
Blacks and 61 percent of Hispanics.
In 2014, about 61 percent of people age 65 and over
had ever received a pneumonia vaccination. Despite
increases in the rates for all groups over time, non-
Hispanic Whites (65 percent) were more likely to
have received a pneumonia vaccination in 2014
than non-Hispanic Blacks (50 percent) or Hispanics
(45 percent).
The percentage of older people receiving vaccinations
increased with age. In 2014, about 78 percent of
persons age 85 and over had received a flu shot,
compared with 73 percent of persons age 7584 and
67 percent of persons age 6574. In that same year,
69 percent of persons 85 and over had ever received a
pneumonia vaccination compared with 56 percent of
persons age 6574.
In 2014, people age 65 and over who had not
graduated from high school were less likely to be
vaccinated against both flu and pneumonia than were
people who had more education (64 percent versus
72 percent for the flu vaccination and 55 percent
versus 63 percent for the pneumonia vaccination).
Data for this indicator's charts and bullets can be found in
Tables 23a and23b on page 124.
38
1950
1960
1970
1980
1990
-------
INDICATOR 24: Cancer Screenings
Health care services and screenings can help prevent disease or detect it at an early, treatable stage. The U.S. Preventive
Services Task Force recommends colorectal cancer screenings for people ages 5075 and breast cancer screenings (i.e.,
mammography) for women ages 5074.24>25
Percentage of women ages 50-74 who had breast cancer screening and percentage of people
age 50-75 who had colorectal cancer (CRC) screening, by sex and age group, selected years,
2000-2013
Percent
100 r
80
60
40
20
Breast cancer screening, female (50-64)
A Breast cancer screening, female (65-74) y CRC screening, male (65-75)
T CRC screening, female (50-64)
:
A CRC screening, male (50-64)
CRC screening, female (65-75)
2000
2003
2005
2008
2010
2013
NOTE: Breast cancer screening is defined as reporting having had a mammogram in the last 2 years. Colorectal cancer screening (CRC) is
defined as reporting a fecal occult blood test (FOBT) in the past year, a sigmoidoscopy procedure in the past 5 years with FOBT in the past 3
years, or a colonoscopy in the past 10 years. Questions concerning use of CRC screening and mammography differed slightly on the National
Health Interview Survey across the years for which data are shown. For details, see Health, United States, 2015, Appendix II. Breast cancer
screening is reported for women ages 50-74, and CRC screening is reported for men and women ages 50-75.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.
The percentage of people ages 5075 who received
colorectal cancer screening increased from 2000 to
2013- The percentage increased for both men and
women.
In 2013, the percentage receiving colorectal cancer
screening was higher among people ages 6575 than
among people ages 5064 (70 percent versus 51
percent for men and 69 percent versus 54 percent
for women).
Women ages 5064 were slightly more likely than
men of the same age to have received colorectal cancer
screening in 2013 (54 percent versus 51 percent). There
were no differences by sex among people ages 6575-
The percentage of women ages 5064 who received a
mammogram in the past 2 years declined from 2000
to 2013 (79 percent versus 71 percent). There were no
significant changes in the percentage of women ages
6574 receiving a mammogram.
A higher proportion of women in 2013 received a
mammogram in the past 2 years than met colorectal
cancer screening guidelines. For example, 71 percent of
women ages 5064 received a mammogram compared
with 54 percent who met colorectal cancer screening
guidelines.
Data for this indicator's charts and bullets can be found in
Table 24 on page 125.
1950
1960
1970
1980
1990
2010
39
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Health Risks and Behaviors
INDICATOR 25: Diet Quality
The majority of older Americans report a variety of chronic health conditions,26 many of which are related to poor
quality diet. Healthy eating helps to prevent and reduce risk for many of the most common chronic conditions including
hypertension, heart disease, diabetes, osteoporosis, some cancers and obesity27'28 Among older adults, healthy eating is
also associated with a sense of well-being and improved quality of life.27'28'2930 The Healthy Eating Index (HEI) provides
a comprehensive analytic approach to characterizing complex diets and allows researchers to make associations between
total diet and health outcomes.
The HEI-201031 has 12 components, nine of which are adequacy components and three are moderation components.
Intakes of the various components of a healthy diet that are equal to or better than the standards set for each component
are assigned a maximum score. A higher score indicates a higher quality diet that aligns with the 2010 Dietary Guidelines
for Americans. Scores are averaged across all adults based on usual dietary intakes.
Healthy Eating Index-2010 average component scores expressed as a percentage of the HEI
maximum score for the population age 65 and over, by age group, 2011-2012
[A higher score reflects an average diet that is closer to the standard.]
Percent
100
80
60
40
gg 100
100 100 99
20
81
79 80
63
91
72
76
76
57
54
36
38
Total
fruit
Whole
fruit
Total
vegetables
Greens
and
beans
Whole
grains
Dairy
Total
protein
foods
Seafood
and plant
proteins
Fatty
acids
Dietary adequacy components3
D 65-74 D 75 and over
Refined Sodium Empty
grains calories1
Dietary moderation
componentsb
a Higher scores reflect higher intakes.
b Higher scores reflect lower intakes.
c Empty calories are calories from solid fats (i.e., sources of saturated fats and trans fats) and added sugars (i.e., sugars not naturally occurring).
Reference population: These data refer to the resident noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey,
and U.S. Department of Agriculture, Center for Nutrition Policy and Promotion, and National Cancer Institute. Healthy Eating Index-2010.
During 2011-2012, total HEI-2010 scores for age
groups age 65 and over, 6574, and 75 and over were
68.3, 68.4, and 67-8, respectively.
Older Americans age 75 and over, met the dietary
recommendations for whole fruits, while Americans
from the age groups 65 and over, 6574, and 75 and
over met the dietary recommendations for total protein
foods.
40
The diet quality of older Americans can better align
with the 2010 Dietary Guidelines for Americans by
increasing dietary intakes of whole grains, vegetables
and legumes, fat-free or low-fat milk products, and
foods and beverages that are lower in sodium and have
fewer calories from solid fats and added sugars.
Data for this indicator's charts and bullets can be found in
Table 25 on page 126.
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INDICATOR 26: Physical Activity
Physical activity is important for people of all ages. It improves overall health and reduces the risk of many health
problems.32 For older adults, exercise can reduce the risk of certain chronic diseases and may offer psychological and
cognitive benefits.33 Physical activity can reduce pain and improve functioning.34 Exercise is recommended as an
intervention to prevent falls in older adults.35
Percentage of people age 65 and over who reported participating in leisure-time aerobic and
muscle-strengthening activities that meet the 2008 Federal physical activity guidelines, by age
group, 1998-2014
Percent
50 r
40
30
20
10
75-84
1998
2000
2002
2004
2006
2008
2010
2012
2014
NOTE: This measure of physical activity reflects the 2008 Federal physical activity guidelines for Americans (available from: http://www.health.
gov/PAGuidelines/). The 2008 Federal guidelines recommend that adults age 65 and over who are fit and have no limiting chronic conditions
perform at least 150 minutes (2 hours and 30 minutes) a week of moderate-intensity, or 75 minutes (1 hour and 15 minutes) a week of
vigorous-intensity aerobic physical activity or an equivalent combination of moderate- and vigorous-intensity aerobic activity. Aerobic activity
should be performed in episodes of at least 10 minutes, and preferably, it should be spread throughout the week. In addition, they should
perform muscle-strengthening activities that are moderate or high intensity and involve all major muscle groups on two or more days a week,
because these activities provide additional health benefits. The measure shown here presents the percentage of people who fully met both the
aerobic activity and muscle-strengthening guidelines, irrespective of their chronic condition status.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.
In 2014, about 12 percent of people age 65 and over
reported participating in leisure-time aerobic and
muscle-strengthening activities that met the 2008
Federal physical activity guidelines. The percentage of
older people meeting the physical activity guidelines
decreased with age, ranging from 15 percent among
people ages 6574 to 5 percent among people age
85 and over.
Men age 65 and over were more likely than women
in the same age group to meet the physical activity
guidelines in 2014 (15 percent versus 9 percent). Non-
Hispanic Whites age 65 and over reported higher levels
of physical activity than their non-Hispanic Black and
Hispanic counterparts (13 percent compared with
9 percent and 7 percent, respectively).
The percentage of older Americans meeting the 2008
Federal physical activity guidelines increased over time.
In 1998, about 6 percent of people age 65 and over
met the guidelines, compared with 12 percent in 2014.
Although only 12 percent of people age 65 and over
met the guidelines for both aerobic and muscle-
strengthening activities in 2014, 37 percent met the
guidelines for aerobic activity and 17 percent met the
guidelines for muscle-strengthening activities that year.
Data for this indicator's charts and bullets can be found in
Tables 26a and26b on pages 127-128.
1950
1960
1970
1980
1990
41
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Health Risks and Behaviors
INDICATOR 27: Obesity
Obesity is a major cause of preventable disease and premature death.36 It is associated with increased risk of coronary
heart disease; Type 2 diabetes; endometrial, colon, postmenopausal breast, and other cancers; asthma and other
respiratory problems; osteoarthritis; and disability3738
Percentage of people age 65 and over with obesity, by sex and age group, selected years,
1988-2014
Percent
100 r
80
60
40
20
Men
T 65-74
A 75 and over
Percent
100 r
80
60
40
20
1988-
1994
1999- 2003-
2002 2006
2007-
2010
2011- 1988-
2014 1994
Women
T 65-74
A 75 and over
1999- 2003-
2002 2006
2007-
2010
2011-
2014
NOTE: Data are based on measured height and weight. Height was measured without shoes. Obese is defined by a BMI of 30 kilograms/
meter2 or greater. The percentage of people with obesity is a subset of the percentage of those who are overweight. See glossary for the
definition of BMI. Beginning in 1999, the National Health and Nutrition Examination Survey has been in the field continuously with data
released every 2 years. Two survey cycles are often combined to create increased sample size, especially for subgroup estimates. Some data
have been revised and differ from previous editions of Older Americans.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey.
As with other age groups, the percentage of people age
65 and over with obesity increased since 19881994.
In 20112014, about 35 percent of people age 65
and over had obesity, compared with 22 percent in
1988-1994.
In 20112014, approximately 41 percent of women
ages 65-74 and 31 percent of women age 75 and over
had obesity. This is an increase from 19881994, when
27 percent of women ages 6574 and 19 percent of
women age 75 and over had obesity.
Older men followed similar trends. About 24 percent
of men ages 6574 and 13 percent of men age 75 and
over had obesity in 19881994, compared with 36
percent of men ages 6574 and 27 percent of men age
75 and over in 2011-2014.
Over the past 15 years between 1999-2002 and 2011-
2014, there has been an increase in the prevalence of
obesity for both men and women.
Data for this indicator's charts and bullets can be found in
Table 27 on page 129.
42
1950
1960
1980
1990
2000
2010
2016
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INDICATOR 28: Cigarette Smoking
Smoking affects nearly every organ of the body; it causes diminished health status and diseases such as cancer,
cardiovascular disease, and chronic obstructive lung diseases.39
Percentage of people age 65 and over who are current cigarette smokers, by sex, selected years,
1965-2014
Percent
50 r
40
30
20
10
T Men
Women
i i i i i i
i i i i i i i i i i i
i i i i i i
1965
1974
1979
1983
1990
1995
2000
2005
2010
2014
NOTE: Questions concerning cigarette smoking differed slightly on the National Health Interview Survey across the years for which data are
shown. Data starting in 1997 are not strictly comparable with data for earlier years due to the 1997 National Health Interview Survey (NHIS)
questionnaire redesign. For details, see Health, United States, 2015, Appendix II.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.
The percentage of people age 65 and over who were
current cigarette smokers declined between 1965 and
2014, with larger declines among men than women.
Levels of cigarette smoking have been stable in the past
decade. In 2014, 10 percent of men and 8 percent of
women age 65 and over were current smokers.
In 2014, the percentage of older men who were
current smokers was higher among Blacks than Whites
(14 percent versus 9 percent). The percentages for older
women were similar for Whites and Blacks (both were
8 percent).
A large percentage of both men and women age 65 and
over were former smokers. In 2014, about 50 percent
of older men previously smoked cigarettes, while
30 percent of women age 65 and over were former
smokers.
The percentage of people age 65 and over who were
current smokers was higher among those that lived
below the poverty threshold than among those with
incomes above the poverty threshold. In 2014,
14 percent of people age 65 and over with incomes less
than 100 percent of the poverty threshold were current
smokers, compared with 7 percent of people in the 200
percent or more of poverty threshold income category.
Data for this indicator's charts and bullets can be found in
Tables 28a through 28c on pages 130-131.
1950
1960
1970
1980
1990
2000
2010
2016
43
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44
-------
ealth Care
-------
Health Care
INDICATOR 29: Use of Health Care Services
Most older Americans have health insurance through Medicare. Medicare covers a variety of services, including inpatient
hospital care, physician services, hospital outpatient care, home health care, skilled nursing facility care, hospice services,
and (beginning in January 2006) prescription drugs. Utilization rates for many services change over time because of
changes in physician practice patterns, medical technology, Medicare payment amounts, and patient demographics.
Medicare-covered hospital and skilled nursing facility stays per 1,000 Medicare beneficiaries age
65 and over in fee-for-service, 1992-2013
Stays per 1,000 beneficiaries
BOO
450
400
350
300
250
200
150
100
50
0
T Hospital stays
T Skilled nursing facility stays
1992
1995
2000
2005
2010
2013
NOTE: Data are for Medicare beneficiaries in fee-for-service only. Beginning in 1994, managed care beneficiaries were excluded from the
denominator of all utilization rates because utilization data are not available for them. Prior to 1994, managed care beneficiaries were included
in the denominators; they made up 7 percent or less of the Medicare population. See glossary for definition of fee-for-service.
Reference population: These data refer to the Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare claims and enrollment data.
Between 1992 and 1999, the hospitalization rate
increased from 306 hospital stays per 1,000 Medicare
beneficiaries to 365 per 1,000. After 1999, the rate
decreased until 2009 and then increased slightly to
338 per 1,000 beneficiaries in 2010. Since 2010, the
rate has continued to decrease, reaching 276 per 1,000
beneficiaries in 2013- The average length of a hospital
stay decreased from 8.4 days in 1992 to 5-3 days in
2013-
Skilled nursing facility stays increased from 28 per
1,000 Medicare beneficiaries in 1992 to 80 per 1,000
in 2010. Much of the increase occurred from 1992 to
1997- The number of skilled nursing facility stays has
dropped slightly after 2011, decreasing to 73 per 1,000
beneficiaries in 2013-
46
1950
1960
1970
1980
1990
-------
Medicare-covered physician and home health care visits per 1,000 Medicare beneficiaries age 65
and over in fee-for-service, 1992-2013
Visits per 1,000 beneficiaries
16,000
14,000
12,000
10,000
8,000
6,000
4,000
2,000
0
A Physician visits and consultations
1992
1995
2000
2005
2010
2013
NOTE: Data are for Medicare beneficiaries in fee-for-service only. Physician visits and consultations include all settings, such as physician
offices, hospitals, emergency rooms, and nursing homes. The database used to generate rates of physician visits and consultations in previous
Older Americans reports is no longer available. This chart uses two different databases based on the availability of data to estimate rates
of physician visits and consultations. The first database provides data that begins with 1999 data through 2006 and the second database
provides data beginning with 2007. As a result, some data for 2007-2009 have been revised and differ from previous editions of Older
Americans. Beginning in 1994, managed care beneficiaries were excluded from the denominator of all utilization rates because utilization data
are not available for them. Prior to 1994, managed care beneficiaries were included in the denominators; they made up 7 percent or less of the
Medicare population. See glossary for definition of fee-for-service.
Reference population: These data refer to Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare claims and enrollment data.
The number of physician visits and consultations
increased from 11,395 per 1,000 Medicare beneficiaries
in 1999 to 14,587 per 1,000 Medicare beneficiaries
in 2013-
The number of home health care visits increased
from 3,822 per 1,000 Medicare beneficiaries in 1992
to 8,376 per 1,000 Medicare beneficiaries in 1996.
Home health care use increased during this period in
part because of an expansion in the coverage criteria
for the Medicare home health care benefit.40 Home
health care visits declined after 1997 to 2,295 per
1,000 beneficiaries in 2001. The decline coincided
with changes in Medicare payment policies for home
health care resulting from implementation of the
Balanced Budget Act of 1997- Since 2001, the visit
rate increased to 3,864 per 1,000 beneficiaries in 2009
and has declined since that time to 3,276 per 1,000
beneficiaries in 2013-
Use of skilled nursing facility and home health
care increased with age. In 2013, there were about
67 skilled nursing facility stays per 1,000 Medicare
beneficiaries ages 6574, compared with about 204
per 1,000 beneficiaries age 85 and over. Home health
care agencies made 1,475 visits per 1,000 beneficiaries
ages 6574, compared with 8,604 visits per 1,000
beneficiaries for those age 85 and over.
Data for this indicator's charts and bullets can be found in
Tables 29a and 29b on page 132.
1950
1970
1980
2000
2010
2016
47
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Health Care
INDICATOR 30: Health Care Expenditures
Health care costs per capita for the oldest Medicare beneficiaries (age 85 and over) are higher than for any other age group
but have remained relatively stable over time. Health care costs per capita, however, for those ages 65-74 did increase
between 1992 and 2012.
Health care costs post a major concern for older Americans. Among Medicare beneficiaries age 65 and over, these costs
vary by demographic characteristics such as income, health status, and access to health care. On average, individuals with
no chronic health conditions incur lower health care costs. The percentage of Medicare beneficiaries reporting difficulty
obtaining health care remains low.
Average annual health care costs, in 2012 dollars, for Medicare beneficiaries age 65 and over by
age group, 1992-2012
Dollars
$40,000 |-
35,000
30,000
25,000
20,000
15,000
10,000
5,000
0
85 and over
1992
1994
1996
1998
2000
2002
2004
2006
2008
2010
2012
NOTE: Data include both out-of-pocket costs and costs covered by insurance. Dollars are inflation adjusted to 2012 using the Consumer Price
Index (Series CPI-U-RS). Some data have been revised from previously published figures as a result of a CPI adjustment.
Reference population: These data refer to Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Cost and Use.
After adjusting for inflation, annual health care costs
per capita increased slightly among those ages 6574
between 1992 and 2012.
Average annual costs were substantially higher for
Medicare beneficiaries age 85 and over compared with
those in other age groups.
Average annual health care costs for Medicare
beneficiaries varied by demographic characteristics. In
2012, low-in come individuals incurred higher health
care costs; those with less than $10,000 in income
averaged $24,596 in health care costs, whereas those
with more than $30,000 in income averaged only
$14,687-
Access to health care is determined by a variety of
factors related to the cost, quality, and availability of
health care services. The percentage of older Americans
who reported they delayed getting care because of
cost declined from about 10 percent in 1992 to about
5 percent in 1997 and remained relatively constant
thereafter, fluctuating between 4 and 6 percent. The
percentage of Medicare beneficiaries who reported
difficulty obtaining health care fluctuated between
2 and 3 percent.
48
1950
1960
1970
1980
1990
-------
Health care costs can be broken down among different types of goods and services. The amount of money older
Americans spend on health care and the type of health care that they receive provide an indication of the health status
and needs of older Americans in different age and income groups.
Percentage distribution of annual health care costs among Medicare beneficiaries age 65 and
over, by major cost component, 2008 and 2012
Percent
100
80
60
40
20
36
-3
-3
35
Other (short-term institution/
hospice/dental)
Prescription drugs
D Home health care
Nursing home/long-term institution
D Physician/outpatient hospital
Inpatient hospital
2008
2012
NOTE: Data include both out-of-pocket costs and costs covered by insurance. Dollars are not inflation adjusted. Estimates may not sum to the
totals because of rounding.
Reference population: These data refer to Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Cost and Use.
The percentage distribution of health care services
remained relatively constant between 2008 and 2012.
Outpatient hospital and physician services were the
largest components of health care costs, accounting
for 35 percent of total health care costs in 2012. In
the same year, long-term care facilities accounted
for 12 percent of total costs, and prescription drugs
accounted for 17 percent of health care costs.
Inpatient hospital care accounted for 22 percent
of total costs in 2012. "Other" costs (short-term
institutions, hospice, and dental care) constituted
10 percent of total costs.
The mix of services varied with age. In 2012, the
biggest difference occurred for long-term care facility
services: average costs were $7,175 among Medicare
beneficiaries age 85 and over, compared with just
$718 among Medicare beneficiaries ages 6574. Costs
of home health care and "other" services were also
higher at older ages.
Data for this indicator's charts and bullets can
Tables 30a through 30e on pages 133135.
in
49
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Health Care
INDICATOR 31: Prescription Drugs
Prescription drug costs have increased rapidly in recent years as more new drugs become available. Lack of prescription
drug coverage has created a financial hardship for many older Americans. Medicare coverage of prescription drugs began
in January 2006including a low-income subsidy for beneficiaries with low incomes and assets.
Average prescription drug costs, in 2012 dollars, among noninstitutionalized Medicare
beneficiaries age 65 and over, by sources of payment, 1992-2012
Dollars
$3,500 r
3,000
2,500
2,000
1,500
1,000
500
1992
1994
1996
1998
2000
2002
2004
2006 2008
2010 2012
NOTE: Dollars have been inflation adjusted to 2012 using the Consumer Price Index (Series CPI-U-RS). Some data have been revised from
previously published figures as a result of a CPI adjustment. Reported costs have been adjusted to account for underreporting of prescription
drug use. The adjustment factor changed in 2006 with the initiation of the Medicare Part D prescription drug program. Public programs
include Medicare, Medicaid, Department of Veterans Affairs, and other State and Federal programs.
Reference population: These data refer to noninstitutionalized Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Cost and Use.
Average prescription drug costs for noninstitutionalized
Americans age 65 and over increased rapidly for many
years but were relatively stable from 2005 to 2012. The
average costs per person were $3,201 in 2012.
Average out-of-pocket spending and costs covered
by private insurance decreased after the introduction
of the Medicare Part D prescription drug program
in 2006. There was a corresponding increase in drug
costs covered by public insurance. Older Americans
paid about 60 percent of prescription drug costs out
of pocket in 1992, compared with about 22 percent
in 2012. Private insurance covered 18 percent of
prescription drug costs for noninstitutionalized older
Americans in 2012 and public programs covered about
60 percent.
Prescription drug costs varied significantly among
individuals. In 2012, approximately 5 percent of
noninstitutionalized older Americans incurred
no prescription drug costs compared with about
18 percent who incurred costs of $5,000 or more.
Chronic conditions are associated with higher
prescription drug costs. In 2012, older Americans with
no chronic conditions incurred average prescription
drug costs of $1,389- Those with five or more chronic
conditions incurred $8,263 in prescription drug costs,
on average.
50
1950
1960
1970
1980
2000
2010
-------
Under Medicare Part D, beneficiaries may join a stand-alone prescription drug plan or a Medicare Advantage plan that
provides prescription drug coverage in addition to other Medicare-covered services. In situations where beneficiaries
receive drug coverage from a former employer, the former employer may be eligible to receive a retiree drug subsidy from
Medicare to help cover the cost of the drug benefit.
Number of Medicare beneficiaries age 65 and over who enrolled in Part D prescription drug plans
or who were covered by retiree drug subsidy payments, 2006 and 2014
Enrollment (in millions)
35 r
30
25
20
15
10
11.4
24.2
D No low-income subsidy
Low-income subsidy
2.6
Part D plan Retiree drug subsidy
2006
Part D plan Retiree drug subsidy
2014
NOTE: Some data for 2006 have been revised and differ from previous editions of Older Americans.
Reference population: These data refer to Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare claims and enrollment data.
The number of Medicare beneficiaries age 65 and over
enrolled in Part D prescription drug plans increased
from 16.9 million (46 percent of beneficiaries) in
2006 to 31.1 million (69 percent of beneficiaries) in
2014. In 2014, 61 percent of Part D beneficiaries were
enrolled in stand-alone plans and 39 percent were in
Medicare Advantage plans. Approximately 2.6 million
beneficiaries age 65 and over were covered by the
retiree drug subsidy in 2014. About 11.7 million
beneficiaries who were not in Part D plans and were
not covered by the retiree drug subsidy in 2014
either had drug coverage through another source (e.g.,
TRICARE, Federal Employees Health Benefits plan,
Department of Veterans' Affairs, current employer) or
did not have drug coverage.
In 2014, 6.9 million Part D beneficiaries were receiving
low-income subsidies. Many of these beneficiaries had
drug coverage through the Medicaid program prior to
enrollment in Part D.
Data for this indicator's charts and bullets can
Tables 31a through 31d on pages 136137.
m
51
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Health Care
INDICATOR 32: Sources of Health Insurance
Medicare is the primary insurance provider for all eligible beneficiaries over age 65- Medicare covers mostly acute
care services and requires beneficiaries to pay part of the cost, leaving about half of health spending to be covered by
other sources. Many beneficiaries have supplemental insurance to fill these gaps and to pay for services not covered by
Medicare. Prior to 2006, many beneficiaries received prescription drug coverage through supplemental insurance. Since
January 2006, beneficiaries have had the option of receiving prescription drug coverage under Medicare through stand-
alone prescription drug plans or through some Medicare Advantage health plans.
Percentage of noninstitutionalized Medicare beneficiaries age 65 and over with supplemental
health insurance, by type of insurance, 1991-2013
Percent
50 r V Private (Medigap)a
T Private (employer- or union-sponsored)
Medicare Advantage/Capitated Payment Plans
1991
1995
2000
2005
2010
2013
a Includes people with private supplement of unknown sponsorship.
NOTE: Medicare Advantage/Capitated Payment Plans include Health Maintenance Organizations (HMOs), Preferred Provider Organizations
(PPOs), and private fee-for-service (PFFS) plans. Not all types of plans were available in all years. Since 2003, these types of plans have been
known collectively as Medicare Advantage and/or Medicare Part C. Estimates are based on beneficiaries' insurance status in the fall of each year.
Categories are not mutually exclusive (i.e., individuals may have more than one supplemental policy). Chart excludes beneficiaries whose primary
insurance is not Medicare (approximately 1 to 3 percent of beneficiaries). Medicaid coverage was determined from both survey responses
and Medicare administrative records. TRICARE coverage was added to Medicare Current Beneficiary Survey Access to Care files beginning in
2003. Previous versions of Older Americans did not include data on TRICARE coverage. Adding TRICARE coverage changes the percentage of
beneficiaries in the "No supplement" group. Some data for 2009 have been revised and differ from previous editions of Older Americans.
Reference population: These data refer to noninstitutionalized Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Access to Care.
Most Medicare beneficiaries have a private insurance
supplement, either provided by a former employer or
purchased as a Medigap policy.
The percentage of Medicare beneficiaries with
Medicaid coverage has increased from 10 percent in
2000 to 13 percent in 2013-
Between 1991 and 2013, enrollment in Medicare
Advantage/Capitated Payment Plans and other public
health plans, which are usually equivalent to Medicare
supplements because they offer extra benefits, varied
between 6 percent and 34 percent.
About 11 percent of Medicare beneficiaries reported
having no health insurance supplement in 2013-
While almost all older Americans have health insurance
via Medicare, many people younger than age 65 have
no health insurance. In 2014, about 10 percent of
people ages 5564 were uninsured. The percentage
of people not covered by health insurance varied by
poverty status. In 2014, 25 percent of people ages
5564 who lived below the poverty line had no health
insurance, compared with 5 percent for people who
had incomes greater than or equal to 200 percent
of the poverty threshold. The percent of people ages
5564 without health insurance declined significantly
from 14 percent in 2013 to 10 percent in 2014.
Data for this indicator's charts and bullets can be found in
Tables 32a through 32c on pages 138139.
52
1950
1960
1970
1980
1990
2010
2016
-------
INDICATOR 33: Out-of-Pocket Health Care Expenditures
Large out-of-pocket expenditures for use of health care services have been shown to encumber access to care, affect health
status and quality of life, and leave insufficient resources for other necessities.41'42 The percentage of household income that
is allocated to health care expenditures is a measure of health care expense burden placed on older people.
Ratio of out-of-pocket expenditures to household income per person among people age 65 and
over, by income category and age group, 1977 and 2013
Percent
50 r
40
30
20
10
Percent
50 r
40
Poor/near poor income category
17
12
Low/middle/high income category
65 and over 65-74
75-84 85 and over 65 and over 65-74
1977 2013
75-84 85 and over
NOTE: Out-of-pocket health care expenditures exclude personal spending for health insurance premiums. Including expenditures for
out-of-pocket premiums in the estimates of out-of-pocket spending would increase the percentage of household income spent on health
care. People are classified into the "poor/near poor" income category if their household income is below 125 percent of the poverty level;
otherwise, people are classified into the "low/middle/high" income category. The poverty level is calculated according to the U.S. Census
Bureau guidelines for the corresponding year. The ratio of a person's out-of-pocket expenditures to their household income was calculated
based on the person's per capita household income. For people whose ratio of out-of-pocket expenditures to income exceeded 100 percent,
the ratio was capped at 100 percent. For people with out-of-pocket expenditures and with zero income (or negative income), the ratio was set
at 100 percent. For people with no out-of-pocket expenditures the ratio was set to zero.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey (MEPS) and MEPS predecessor surveys.
In 1977, the average per-person percentage of
household income attributable to out-of-pocket
spending for health care services for poor/near-
poor persons age 65 and over was 12 percent. This
average increased to 17 percent in 2013- The average
percentage for the low/middle/high income category
was lower, at 5 percent in 1977 and 4 percent in 2013-
The percentage of people age 65 and over with
out-of-pocket spending for health care services
increased between 1977 and 2013, from 83 percent
to 93 percent.
From 2000 to 2006, more than half of out-of-pocket
health care spending by people age 65 and over was
for prescription drugs. By 2013, only about one-third
of out-of-pocket spending for this group was for
prescription drugs.
In 2013, nearly half (47 percent) of out-of-pocket
expenses for people age 85 and over were for home
health care and other miscellaneous health expenses.
This proportion is substantially higher than for persons
ages 6574 (12 percent) or ages 7584 (14 percent).
Data for this indicator's charts and bullets can
Tables 33a through 33c on pages 140143.
in
53
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Health Care
INDICATOR 34: Sources of Payment for Health Care Services
Medicare's payments are focused on acute care services such as hospitals and physicians. Historically, long-term care
facilities, prescription drugs, and dental care have been primarily financed out of pocket or by other payers. Medicare
coverage of prescription drugs, including a low-income subsidy, began in January 2006.
Average cost per beneficiary and percentage distribution of sources of payment for health care
services for Medicare beneficiaries age 65 and over, by type of service, 2012
Percent
100
80
60
40
20
$16,959 $343 $3,627 $550 $933 $4,050 $1,801 $2,793 $447 $2,032
Average cost
per beneficiary
D Other
Out-of-pocket
D Medicaid
Medicare
Hospice
Inpatient
hospital
Home
health
Short-term Physician/
institution medical
Out- Prescription
patient drugs
hospital
Dental
Long-term
care facility
* Estimates are considered unreliable. Data with an asterisk have a relative standard error of 20 to 30 percent.
NOTE: "Other" refers to private insurance, Department of Veterans Affairs, uncollected liability, and other public programs. Estimates may not
sum to 100 percent because of rounding or suppression due to high relative standard errors.
Reference population: These data refer to Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Cost and Use.
Medicare paid for almost 60 percent of all health care
costs of Medicare beneficiaries age 65 and over in
2012. Medicare financed all hospice costs and most
hospital, physician, home health care, and short-term
institution costs.
Medicaid covered 7 percent of all health care costs
of Medicare beneficiaries age 65 and over, and other
payers (primarily private insurers) covered another
16 percent. Medicare beneficiaries age 65 and over paid
18 percent of their health care costs out of pocket (not
including insurance premiums).
In 2012, about 44 percent of long-term care facility
costs for Medicare beneficiaries age 65 and over were
covered by Medicaid; another 45 percent of these
costs were paid out of pocket. About 51 percent of
prescription drug costs for Medicare beneficiaries age
65 and over were covered by Medicare, 28 percent were
covered by third-party payers other than Medicare and
Medicaid (consisting mostly of private insurers), and
21 percent were paid out of pocket. About 77 percent
of dental care received by older Americans was paid out
of pocket.
Sources of payment for health care other than Medicare
varied by income. In general, individuals with lower
incomes relied heavily on Medicaid, while those with
higher incomes relied more on private insurance. As
shown in Indicator 33 (Out-of-Pocket Health Care
Expenditures), people in the poor/near poor income
category spent a higher percentage of their household
income on health care services than did people in the
low/middle/high income category.
Data for this indicator's charts and bullets can be found in
Tables 34a and34b on page 144.
54
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INDICATOR 35: Veterans' Health Care
The number of veterans age 65 and over who are enrolled in and receive health care from the Veterans Health
Administration (VHA), within the Department of Veterans Affairs (VA), has been steadily increasing since eligibility
for this benefit was reformed in 1999- Older veterans continue to turn to VHA for their health care needs, despite their
eligibility for other sources of health care. VHA fills important gaps in older veterans' health care needs not currently
covered or fully covered by Medicare, such as long-term services and supports (nursing home care for eligible veterans
and community-based care for all enrolled veterans) and specialized services for the disabled, including acute mental
health services. In addition, VHA provides access to these important services in rural and highly rural communities.
Number of veterans age 65 and over who are enrolled in the Veterans Health Administration, by
age group, selected years 1999-2014 and projected 2019-2034
Number
6,000,000
5,000,000
4,000,000
3,000,000
2,000,000
1,000,000
D 85 and over
80-84
75-79
D 70-74
65-69
1999
2004
2009
2014
2019
2024
2029
2034
Projected
NOTE: Department of Veterans Affairs (VA) enrollees are veterans who have signed up to receive health care from the Veterans Health
Administration (VHA). Counts for 2019, 2024, 2029, and 2034 are projections from the 2015 VA Enrollee Health Care Projection Model.
Reference population: These data refer to the count of unique VHA enrollees per fiscal year.
SOURCE: Department of Veterans Affairs, Office of the Assistant Deputy Under Secretary for Health for Policy and Planning, 2015 VA Enrollee
Health Care Projection Model.
In 2014, approximately 4.3 million veterans age 65
and over were enrolled with VHA, out of a total of
9-1 million enrolled veterans (48 percent).
The percentages of older veterans among the enrollee
population are expected to increase as the Vietnam-
era enrollee cohort gets older. In 2014, approximately
23 percent of enrollees were age 75 and over; by 2034,
approximately 32 percent of enrollees are projected to
be age 75 and over.
Among enrollees age 65 and over, 36 percent had
been disabled by an injury or illness that was incurred
or aggravated during active military service. In 2014,
about 13 percent of enrollees with service-connected
disabilities had a disability rating of 70 percent or
more. Among enrollees of all ages, approximately
42 percent had been adjudicated for service-connected
conditions in 2014, since service-connected disability
ratings are more prevalent among younger enrollees.
As a result, service-connected disability ratings are
projected to increase as younger enrollees age into the
65 and over age groups.
Data for this indicator's charts and bullets can be found in
Tables 35a and 35b on page 145.
1950
1960
1970
1980
1990
2000
2010
2034
55
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Health Care
INDICATOR 36: Residential Services
Most older Americans live independently in traditional communities. Others live in licensed long-term care facilities, and
still others live in communities with access to various services through their place of residence. Such services may include
meal preparation, laundry and cleaning services, and help with medications. Availability of such services through the
place of residence may help older Americans maintain their independence and avoid institutionalization.
Percentage distribution of Medicare beneficiaries age 65 and over residing in selected residential
settings, by age group, 2013
Long-term care facilities
D Community housing
with services
Traditional community
65 and over
65-74
75-84
85 and over
NOTE: Community housing with services applies to respondents who reported they lived in retirement communities or apartments, senior
citizen housing, continuing care retirement facilities, assisted living facilities, staged living communities, board and care facilities/homes,
and similar situations AND who reported they had access to one or more of the following services through their place of residence: meal
preparation, cleaning or housekeeping services, laundry services, or help with medications. Respondents were asked about access to these
services, but not whether they actually used the services. A residence (or unit) is considered a long-term care facility if it is certified by
Medicare or Medicaid; or has 3 or more beds, is licensed as a nursing home or other long-term care facility, and provides at least one personal
care service; or provides 24-hour, 7-day-a-week supervision by a non-family, paid caregiver.
Reference population: These data refer to Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Access to Care.
In 2013, about 3 percent of the Medicare population
age 65 and over resided in community housing with
at least one service available. About 4 percent resided
in long-term care facilities, and 93 percent resided in
traditional community.
The percentage of people residing in community
housing with services and in long-term care facilities
was higher for the older age groups than for the
6574 age group. Among individuals age 85 and over,
8 percent resided in community housing with services,
15 percent resided in long-term care facilities. Among
individuals ages 6574, about 98 percent resided in
traditional community settings.
Among residents of community housing with services,
86 percent reported access to meal preparation
services; 79 percent reported access to cleaning or
housekeeping services; 69 percent reported access to
laundry services; and 49 percent reported access to help
with medications. These numbers reflect percentages
reporting availability of specific services, not necessarily
the number that actually used these services.
About 53 percent of residents in community housing
with services reported that there were separate charges
for at least some services.
56
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Percentage distribution of Medicare beneficiaries age 65 and over with limitations performing
activities of daily living (ADLs) and instrumental activities of daily living (lADLs), by residential
setting, 2013
D Limitations in 3 or more ADLs
Limitations in 1-2 ADLs
D Limitations only in lADLs
No functional limitations
Overall
Traditional
community
Community housing
with services
Long-term care
facilities
NOTE: Community housing with services applies to respondents who reported they lived in retirement communities or apartments, senior
citizen housing, continuing care retirement facilities, assisted living facilities, staged living communities, board and care facilities/homes,
and similar situations, AND who reported they had access to one or more of the following services through their place of residence: meal
preparation, cleaning or housekeeping services, laundry services, or help with medications. Respondents were asked about access to
these services, but not whether they actually used the services. A residence (or unit) is considered a long-term care facility if it is certified
by Medicare or Medicaid; or has 3 or more beds, is licensed as a nursing home or other long-term care facility, and provides at least one
personal care service; or provides 24-hour, 7-day-a-week supervision by a non-family, paid caregiver. Long-term care facility residents with no
limitations may include individuals with limitations in performing certain lADLs, such as doing light or heavy housework or meal preparation.
These questions were not asked of facility residents.
Reference population: These data refer to Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Access to Care.
People living in community housing with services
had more limitations in performing activities of daily
living (ADLs) and instrumental activities of daily
living (lADLs) than traditional community residents,
but not as many as those living in long-term care
facilities. About 49 percent of individuals living in
community housing with services had at least one ADL
limitation, compared with 29 percent of traditional
community residents and 83 percent of long-term care
facility residents in 2013- Approximately 36 percent of
individuals living in community housing with services
had no ADL or IADL limitations.
Residents of community housing with services tended
to have somewhat lower incomes than traditional
community residents and higher incomes than long-
term care facility residents. About 70 percent of long-
term care facility residents had incomes of $20,000 or
less in 2013, compared with 28 percent of traditional
community residents and 41 percent of residents of
community housing with services.
About 61 percent of people living in community
housing with services reported they could continue
living there if they needed substantial care.
Data for this indicator's charts and bullets can be found in
Tables 36a through 36e on pages 146147.
57
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Health Care
INDICATOR 37: Personal Assistance and Equipment
As the proportion of the older population residing in long-term care facilities has declined, the use of personal assistance and/
or special equipment among those with limitations has increased. This assistance helps older people living in the community
maintain their independence.
Percentage distribution of noninstitutionalized Medicare beneficiaries age 65 and over who have
limitations in performing activities of daily living (ADLs), by type of assistance, selected years
1992-2013
D None
Personal assistance
and equipment
n Equipment only
Personal assistance only
1992
1997
2001
2005
2009
2013
NOTE: Limitations in performing activities of daily living (ADLs) refer to difficulty performing (or inability to perform for a health reason) one or
more of the following tasks: bathing, dressing, eating, getting in/out of chairs, walking, or using the toilet. Respondents who report difficulty
with an activity are subsequently asked about receiving help or supervision from another person with the activity and about using special
equipment or aids. In this chart, personal assistance does not include supervision. Percentages are age adjusted using the 2000 standard
population. Estimates may not sum to the totals because of rounding.
Reference population: These data refer to noninstitutionalized Medicare beneficiaries who have limitations in performing one or more ADLs.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Access to Care.
Between 1992 and 2013, the age-adjusted proportion
of people age 65 and over who had difficulty with one
or more activities of daily living (ADLs) and who did
not receive personal assistance or use special equipment
for these activities decreased from 42 percent to
32 percent. Over the same period, the percentage
of people using equipment only increased from 28
percent to 35 percent, while the percentage of people
who used personal assistance only decreased from
9 percent to 7 percent.
In 2013, about two-thirds of people who had difficulty
with one or more ADLs received personal assistance
or used special equipment: 7 percent received personal
assistance only, 35 percent used equipment only,
and 25 percent used both personal assistance and
equipment.
In 2013, men age 65 and over were more likely than
women to have received no assistance with their
limitations (36 percent compared with 30 percent),
but women were more likely than men to have received
personal assistance and used equipment (27 percent
compared with 23 percent). There were no differences
in the percentages of women and men with limitations
in performing ADLs who received personal assistance
only or used equipment only.
In 2013, only 13 percent of people age 85 and over
with limitations in performing ADLs did not receive
assistance or use equipment compared with 41 percent
of people ages 6574. In addition, people age 85 and
over were more likely to receive personal assistance
and use equipment compared with younger age
groups. There were no differences by age group in the
percentage of people with limitations in performing
ADLs who received personal assistance only.
58
1950
1960
1970
1980
1990
2000
2010
2016
-------
Percentage of noninstitutionalized Medicare beneficiaries age 65 and over who have limitations
in performing instrumental activities of daily living (lADLs) and who receive personal assistance,
by age group, selected years 1992-2013
Percent
100 i-
80
60
40
20
69
1992
1997 2001 2005 2009
65 and over d 65-74 75-84 d 85 and over
2013
NOTE: Limitations in performing instrumental activities of daily living (lADLs) refer to difficulty performing (or inability to perform for a health
reason) one or more of the following tasks: using the telephone, light housework, heavy housework, meal preparation, shopping, or managing
money. Respondents who report difficulty with an activity are subsequently asked about receiving help from another person with the activity.
In this chart, personal assistance does not include supervision or special equipment.
Reference population: These data refer to noninstitutionalized Medicare beneficiaries who have limitations in performing one or more lADLs.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Access to Care.
In 2013, slightly more than two-thirds of people age
65 and over who had difficulty with one or more
instrumental activities of daily living (lADLs) received
personal assistance.
In 2013, people ages 6574 were less likely to receive
assistance with lADLs than people ages 7584 and
85 and over.
Between 1992 and 2013, there were increases in the
percentages of people ages 6574 and 7584 who
received assistance with lADLs. Among people 85 and
over, there was no significant increase.
Men age 85 and over were more likely than women of
the same age group to receive personal assistance with
theirIADLsin2013-
Data for this indicator's charts and bullets can
Tables 37a through 37d on page 148-149.
in
1950
1960
1970
1980
2000
2010
59
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Health Care
INDICATOR 38: Long-Term Care Providers
Long-term care refers to a broad range services and supports to meet the needs of frail older adults and other people who are
limited in their abilities for self-care because of chronic illness or a disability. Long-term care services include health care-
related services and services that are not health-care related; they include assistance with activities of daily living (ADLs),
assistance with instrumental activities of daily living (lADLs), and health maintenance tasks. Care can be provided in the
home or in a variety of other settings.43'44
Number of users of long-term care services, by sector and age group, 2013 and 2014
Millions
5 r
D 85 and over
75-84
D 65-74
Less than 65
Nursing homes
Residential care
communities
Adult day
services centers
Home health
agencies
Hospices
NOTE: Long-term care services are provided by paid, regulated providers. They comprise both health care-related and non-health care-related
services, including post-acute care and rehabilitation. People can receive more than one type of service. The estimated number of users of
nursing homes, residential care communities, and adult day services centers represents participants or residents enrolled on the day of data
collection in 2014. The estimated number of users of home health agencies represents patients who ended care (i.e., were discharged) in
2013. The estimated number of users of hospice represents patients who received care at any time in 2013. The number in each age group is
calculated by applying the percentage distribution by age to the estimated total number of users. See http://www.cdc.gov/nchs/data/series/
sr_03/sr03_038.pdf for definitions.
Reference population: These data refer to the resident population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Study of Long-Term Care Providers.
In 2014, about 1.2 million people age 65 and over
were residents of nursing homes. In the same year,
nearly 780,000 people age 65 and over lived in
residential care communities such as assisted living
facilities. In both settings, people age 85 and over were
the largest share by age group among residents.
In 2014, approximately 280,000 participants received
care in adult day services centers. About two-thirds of
the participants (180,000) were age 65 and over.
Nearly 5 million people received care from a home
health agency in 2013- People ages 7584 (about
1.5 million) made up the largest share by age group
of people receiving care from a home health agency.
Nearly equal numbers (about 1.3 million) of people
ages 6574 and age 85 and over received home health
care.
In 2013, 1-3 million people received hospice care.
Nearly 50 percent (630,000) of the hospice patients
were age 85 and over.
60
-------
Percentage of users of long-term care services needing any assistance with activities of daily
living (ADLs), by sector and activity, 2013 and 2014
Percent
100
- 96
80
60
40
20
Nursing homes
Residential care
communities
Adult day
services centers
Home health
agencies
| Bathing | Dressing Q Toileting Q Walking or locomotion Q Transferring in/out of bed or chair Q Eating
NOTE: Long-term care services are provided by paid, regulated providers. They comprise both health care-related and non-health care-related
services, including post-acute care and rehabilitation. People can receive more than one type of service. Users of formal long term care include
persons of all ages. In nursing homes, 85 percent of residents were age 65 and over. In residential care communities, 93 percent of residents
were age 65 and over. In adult day services centers, 64 percent of participants were age 65 and over. Among home health care patients,
83 percent were age 65 and over. Data were not available for hospice patients. Participants, patients, or residents were considered needing
any assistance with a given activity if they needed help or supervision from another person or used special equipment to perform the activity.
See http://www.cdc.gov/nchs/data/series/sr_03/sr03_038.pdf for definitions.
Reference population: These data refer to the resident population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Study of Long-Term Care Providers.
In 2014, most residents of nursing homes needed
help with activities of daily living (ADLs). Nearly
all (96 percent) needed help with bathing, and most
needed help with dressing, toileting, and walking
(92 percent, 88 percent, and 91 percent, respectively).
In 2014, 62 percent of residents of residential care
communities needed assistance with bathing. About
29 percent needed help with walking, and 30 percent
needed assistance transferring in or out of beds or
chairs.
In 2014, less than half of adult day center participants
needed assistance with ADLs. About 41 percent needed
help with bathing and 34 percent needed help with
walking.
The majority of home health care patients in 2013
needed assistance with all six ADLs. Nearly all (96
percent) needed help with bathing.
Assistance with bathing was the most common need
across all sectors, while assistance with eating was the
least common.
Data for this indicator's charts and bullets can
Tables 38a and 38b on page 150.
in
61
-------
62
-------
, \
Environmen
-------
Environment
INDICATOR 39: Use of Time
How individuals spend their time reflects their financial, health and personal situations, employment status, needs, and
desires. Time-use data show that as Americans get older, they spend more of their time in leisure activities.
As people age, they are less likely to be employed. In 2014, a majority (61 percent) of people ages 5564 were employed
compared with 25 percent of those ages 6574 and 8 percent of those age 75 and over.45 This change in employment status is
reflected in how older Americans spent their time.
Percentage of day that people age 55 and over spent doing selected activities on an average day,
by age group, 2014
Percent
100
80
60
An
20
n
23
17
4
29
6
10
2
;! ^
-3
5 P
33
9
5
Sleeping
D Leisure activities
D Work and work-related
activities
D Household activities
Care for and
helping others
D Eating and drinking
and services
-3 D Other activities
-3
55-64
65-74
75 and over
NOTE: "Other activities" includes activities such as educational activities; organizational, civic, and religious activities; and telephone calls.
Chart includes people who did not work at all.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Bureau of Labor Statistics, American Time Use Survey.
On an average day, people ages 5564 spent 17 percent
of their time (4 hours) working or doing work-related
activities, compared with 6 percent (about 1 hour
and 20 minutes) for people ages 6574 and 1 percent
(20 minutes) for people age 75 and over.
In 2014, older Americans spent, on average, more
than one-quarter of their time in leisure activities. This
proportion increased with age: Americans age 75 and
over spent 33 percent of their time in leisure activities,
compared with 23 percent for those age 5564.
64
-------
Leisure activities are those done when free from duties such as working, shopping, doing household chores, or caring for
others. During these times, individuals have flexibility in choosing what to do.
Percentage of total leisure time that people age 55 and over spent doing selected leisure
activities on an average day, by age group, 2014
Percent
100 r
80
60
40
20
D Socializing and communicating
Watching TV
D Participation in sports, exercise,
and recreation
D Relaxing and thinking
D Reading
Cl Other leisure activities
55-64
65-74
75 and over
NOTE: "Other leisure activities" includes activities such as playing games, using the computer for leisure, doing arts and crafts as a hobby,
experiencing arts and entertainment (other than sports), and engaging in related travel.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Bureau of Labor Statistics, American Time Use Survey.
Watching TV was the activity that occupied the most
leisure activity timemore than one-half of the total-
for Americans age 55 and over.
Americans age 75 and over spent a higher percentage
of their leisure time reading than did Americans ages
5564 (14 percent versus 7 percent) and relaxing and
thinking (9 percent versus 6 percent). Americans age
75 and over spent just over an hour per day reading,
compared with 22 minutes per day for Americans
ages 55-64.
In general, older Americans spend more time reading
for leisure than do those under age 65- In 2014,
Americans age 65 and over spent 49 minutes per day
reading for leisure.
The proportion of leisure time that older Americans
spent socializing and communicatingsuch as
visiting friends or attending or hosting social events
declined with age. For Americans ages 5564, about
11 percent of leisure time was spent socializing and
communicating, compared with 9 percent for those
age 75 and over.
Data for this indicator's charts and bullets can
Tables 39a and 39b on page 151.
in
65
-------
Environment
INDICATOR 40: Air Quality
As people age, their bodies are less able to compensate for the effects of environmental hazards. Air pollution can
aggravate chronic heart and lung diseases, leading to increased medication use, more visits to health care providers,
admissions to additional emergency rooms and hospitals, and even death. An important indicator for environmental
health is the percentage of older adults living in areas that have measured air pollutant concentrations above the level of
the national standards of the Environmental Protection Agency (EPA).
Counties with instances of "poor air quality" for any standard in 2014
Counties with "poor air quality" Other monitored counties ] Unmonitored counties
NOTE: The term "poor air quality" is defined as air quality concentrations above the level of the National Ambient Air Quality Standards
(NAAQS). The term "any standard" refers to any NAAQS for ozone, particulate matter, nitrogen dioxide, sulfur dioxide, carbon monoxide,
or lead. Measuring concentrations above the level of a standard is not equivalent to violating the standard. The level of a standard may
be exceeded on multiple days before the exceedance is considered a violation of the standard.
Reference population: These data refer to the resident population.
SOURCE: U.S. Environmental Protection Agency, Office of Air Quality Planning and Standards, Air Quality System; U.S. Census Bureau, 2010
Population.
In 2014, approximately 57 million people lived in
counties where monitored air was unhealthy at times
because of high levels of at least one of the six principal
air pollutants: ozone, PM, nitrogen dioxide, sulfur
dioxide, carbon monoxide, and lead. About 12 percent,
or nearly 7 million people, of those living in counties
where monitored air quality was unhealthy at times
were age 65 and over. The vast majority of areas that
experienced unhealthy air did so because of one or both
of two pollutantsozone and PM .
66
-------
Ozone and particulate matter (PM), especially the smaller, fine particle pollution called PM25, have the greatest potential
to affect the health of older adults. Fine particle pollution has been linked to premature death, cardiac arrhythmias and
heart attacks, asthma attacks, and the development of chronic bronchitis. Ozone, even at low levels, can exacerbate
respiratory diseases such as chronic obstructive pulmonary disease or asthma.46"50
Percentage of people age 65 and over living in counties with instances of "poor air quality," by
selected pollutant measures, 2000-2014
Percent
100 r
80
60
40
20
Any standard T
^M^^«
Ozone
Particulate Matter
(PM25)
2000
2002
2004
2006
2008
2010
2012
2014
NOTE: The term "poor air quality" is defined as air quality concentrations above the level of the National Ambient Air Quality Standards
(NAAQS). The term "any standard" refers to any NAAQS for ozone, particulate matter, nitrogen dioxide, sulfur dioxide, carbon monoxide,
or lead. Data for previous years have been computed using the standards in effect as of August 2015 to enable comparisons over time.
This results in percentages that are not comparable to those in previous publications of Older Americans. Measuring concentrations above
the level of a standard is not equivalent to violating the standard. The level of a standard may be exceeded on multiple days before the
exceedance is considered a violation of the standard.
Reference population: These data refer to the resident population.
SOURCE: U.S. Environmental Protection Agency, Office of Air Quality Planning and Standards, Air Quality System; U.S. Census Bureau, 2010
Population.
The percentage of people age 65 and over living in
counties that experienced poor air quality for any
standard decreased from 66 percent in 2000 to
16 percent in 2014.
In 2014, about 11 percent of people age 65 and over
lived in counties with poor air quality for ozone,
compared with 51 percent in 2000.
A comparison of 2000 and 2014 showed a reduction in
exposure to PM2 pollution. In 2000, about 50 percent
of people age 65 and over lived in a county where
PM2 concentrations were at times above the EPA
standard, compared with 9 percent of people age 65
and over in 2014.
Data for this indicator's charts and bullets can
Tables 40a and 40b on pages 152-154.
m
1950
1970
1980
2000
2010
2016
67
-------
Environment
INDICATOR 41: Transportation
The ability to travel independently to appointments, to the grocery store, and to visit friends plays an important role in the
daily lives of older adults. For many older adults, the ability to travel independently may change due to health or physical
problems. However, access to modes of transportation such as riding with a friend or using public transit may help older
adults continue to get the services they need.
Percentage of noninstitutionalized Medicare beneficiaries age 65 and over who made a change in
transportation mode due to a health or physical problem, by type of change and age group, 2013
Percent
100 r
80 -
60 -
40 -
20 -
55
58
11
25
39
19
11
47
25
19
27
45
34
26
37
Limits driving to daytime
Has given up driving altogether Has trouble getting places
65 and over D 65-74 D 75-84 D 85 and over
Has reduced travel
Reference population: These data refer to noninstitutionalized Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Access to Care.
In 2013, 33 percent of the noninstitutionalized
Medicare population age 65 and over had limited
their driving to daytime because of a health or physical
problem. The percentage of people who had limited
their driving to daytime was greater for those age
85 and over (55 percent) than for those ages 6574
(25 percent).
Furthermore, 19 percent of the noninstitutionalized
Medicare population age 65 and over had given up
driving altogether, about 24 percent had trouble getting
places, and 34 percent had reduced their travel because
of a health or physical problem.
Data for this indicator's charts and bullets can be found in
Table 41 on page 155.
68
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Special Feature
-------
Special Feature
SPECIAL FEATURE: Informal Caregiving
Despite efforts to stay healthy and avoid disease, many older adults will eventually develop some degree of limitations
and need paid or unpaid help with basic daily living activities. Family members or friends provide the majority of this
assistance, without pay, as informal caregivers, including help with everyday tasks such as bathing, dressing, preparing a
meal, or managing money. At least 90 percent of older adults receiving help with daily activities receive some informal
care, and about two-thirds receive only informal care.51>52>53>54
In 2011, an estimated 18 million informal caregivers provided 1.3 billion hours of care on a monthly basis to Medicare
beneficiaries age 65 and over. Informal caregivers are a diverse population that includes spouses, children, and other
relatives such as daughters-in-law, grandchildren, and friends. Caregivers range in age from teenagers to older adults.
About half are employed. Research has shown that the financial, emotional, and physical demands of caregiving can be
high and that the resulting stress or burden can threaten the ability of caregivers to maintain their efforts.55
This special feature provides some information about the population of informal caregivers of older adults with
functional limitations.
Number of informal caregivers, by age group and sex, 2011
Number (in millions)
6 r
P
R
Men
D Women
Less than 45
45-54
55-64
65-74
75 and over
Reference population: People of all ages who, in the last month, helped with one or more self-care, household, or medical activities for a
Medicare enrollee age 65 or over who had a chronic disability.
SOURCE: National Study on Caregiving.
In 2011, many more caregivers were women
(11.1 million) than men (6.9 million), and most
informal caregivers were middle-aged (ages 4564).
Of the approximately 2.7 million caregivers in the
youngest group (those less than 45), most were adult
children or grandchildren.
70
-------
Percentage distribution of informal caregivers and number of caregiving hours provided, by
relationship to care recipient, 2011
Percent
BO
40
30
10
22
Spouse
Daughter Son Other relative
| Percentage of caregivers O Percentage of caregiving hours
Non-relative
Reference population: People of all ages who, in the last month, helped with one or more self-care, household, or medical activities for a
Medicare enrollee age 65 or over who had a chronic disability.
SOURCE: National Study on Caregiving.
In 2011, almost half of informal caregivers were a
child of the care recipient, more frequently a daughter
(29 percent) than a son (18 percent).
Although spouses were only 21 percent of informal
caregivers, they provided more than 31 percent of the
total hours of care in 2011.
Other relatives providing informal care included
granddaughters (5 percent) and daughters-in-law
(3 percent).
71
-------
Special Feature
Percentage of caregivers providing assistance, by type of assistance and sex, 2011
Percent
100
80
60
40
20
86 86 86
76
58
Self-care
Mobility
| Total
Men
Transportation
Women
Medical or health care
NOTE: Respondents reported whether they helped with different types of activities. Self-care activities include bathing, dressing, eating, and
toileting. Mobility-related activities include getting out of bed, getting around inside one's home or building, and leaving one's home or
building. Health or medical care tasks were assistance with diet, foot care, giving injections, and managing medical tasks, such as ostomy care,
IV therapy assistance, or blood tests.
Reference population: People of all ages who, in the last month, helped with one or more self-care, household, or medical activities for a
Medicare enrollee age 65 or over who had a chronic disability.
SOURCE: National Study on Caregiving.
There were small gender differences in the type of
care provided by informal caregivers.
Almost half of all caregivers assisted with self-
care activities, but a slightly larger proportion of
women caregivers (52 percent) than male caregivers
(46 percent) provided such care.
There were larger gender differences in mobility
assistance: 76 percent of men provided mobility
assistance, compared with 69 percent of women.
The vast majority of caregivers assisted with trans-
portation, and there were no gender differences
in providing this type of help.
Men were less likely (55 percent) than women
(58 percent) to assist with medical or health care.
72
-------
Percentage of informal caregivers reporting positive and negative aspects of caregiving, by level
of impact, 2011
Percent
100
80
60
40
20
99
90
35
37
H
24
42
27
26
Substantial impact
D Some impact
More Brought Satisfied that
confident you closer recipient is
about to care well-cared
abilities recipient for
Positive
Financial Emotional Physical Have more Don't have
difficulties difficulties difficulties things than time for
you can yourself
handle
Negative
Reference population: People of all ages who, in the last month, helped with one or more self-care, household, or medical activities for a
Medicare enrollee age 65 or over who had a chronic disability. Estimates may not sum to the totals because of rounding.
SOURCE: National Study on Caregiving.
In 2011, most caregivers reported substantial positive
impacts of caregiving. For example, 69 percent
identified substantial positive impacts of being
closer to the care recipient.
About 86 percent reported that informal caregiving
gives them satisfaction that the care recipient is well
cared for.
Caregivers also reported negative aspects of caregiving;
almost half said they have more things than they can
handle or don't have time for themselves. Less than one
in five caregivers reported that these negative impacts
were a substantial problem.
Data for this indicator's charts and bullets can be found in
Tables CGI through CG6 on pages 156157.
73
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74
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39 Tobacco use. (2010, September). CDC Vital Signs. Retrieved from http://www.cdc.gov/vitalsigns/pdf/2010-09-
vitalsigns.pdf
40 Health Care Financing Administration. (1999). A profile of Medicare home health: Chartbook (Publication No. 1999-
771-472). Washington, DC: U.S. Government Printing Office.
41 Altman, A, Cooper, P. F, & Cunningham, P. J. (1999). The case of disability in the family: Impact on health care
utilization and expenditures for nondisabled members. TheMilbank Quarterly, 77(1), 3975-
42 Rasell, E., Bernstein, J., &Tang, K. (1994). The impact of health care financing on family budgets. International Journal
of Health Services, 24(4), 691-714.
43 U.S. Department of Health and Human Services, (n.d.). What is long-term care? Retrieved from http://longtermcare.
gov/the-basics/what-is-long-term-care
44 Harris-Kojetin, L., Sengupta, M., Park-Lee, E., Valverde, R., Caffrey, C., Rome, V., & Lendon, J. (2016). Long-term
care providers and services users in the United States: Data from the National Study of Long-Term Care Providers,
2013-2014. Vital and Health Statistics 3(38). Retrieved from http://www.cdc.gov/nchs/data/series/sr_03/sr03_038.pdf
45 Bureau of Labor Statistics, Current Population Survey. (2014). Employment and earnings online.
46 U.S. Environmental Protection Agency, Office of Research and Development, National Center for Environmental
Assessment. (1996, July). Air quality criteria for ozone and related photochemical oxidants (EPA Report No.
600/P-93/004aF). Retrieved from http://nepis.epa.gov/
47 U.S. Environmental Protection Agency, Office of Research and Development, Environmental Criteria and Assessment
Office. (1993, August). Air quality criteria for oxides of nitrogen (EPA Report No. 600/8-91/049aF). Retrieved from
http://nepis.epa.gov/
48 U.S. Environmental Protection Agency, Office Research and Development, National Center for Environmental
Assessment. (2000, July). Air quality criteria for carbon monoxide (EPA Report No. 600/P-99/001F). Retrieved from
http://cfpub.epa.gov/ncea/risk/recordisplay.cfm?deid= 18163
49 U.S. Environmental Protection Agency, Office of Research and Development, National Center for Environmental
Assessment. (2002, April). Air quality criteria for paniculate matter, third external review draft, volume II (EPA Report No.
600/P-99/002aC). Retrieved from http://cfpub.epa.gov/ncea/risk/recordisplay.cfm?deid=29503&CFID=58108299&CF
TOKEN=39147464
50 Pope, C. A., Ill, Burnett, R. T, Thun, M. J., Calle, E. E., Krewski, D., Ito, K., & Thurston, G. D. (2002). Lung cancer,
cardiopulmonary mortality, and long-term exposure to fine particulate air pollution. The Journal of the American Medical
Association 287(9): 1132-41.
51 Freedman, V. A, Spillman, B. C., Andreski, P. M., Cornman, J. C., Crimmins, E. M., Kramarow, E., ... Waidmann,
T.A. (2013). Trends in late-life activity limitations in the United States: An update from five national surveys. Demography
50(2): 661-671-
52 Kaye, H., Harrington, C., & LaPlante, M. (2010). Long-term care: Who gets it, who provides it, who pays, and how
much? Health Affairs 29(1): 11-21.
53 Spillman, B. C. (2009). Analyses of informal caregiving 2004. Washington DC: U.S. Department of Health and Human
Services, Office of the Assistant Secretary for Planning and Evaluation, Office of Disability, Aging and Long-Term Care
Policy. Retrieved from https://aspe.hhs.gov/sites/default/files/pdf/77l46/NHATS-IC.pdf
54 Spillman, B. C., & Black, K. (2005). Staying the course: Trends in family caregiving (Paper #2005-17). Retrieved from
AARP website: http://assets.aarp.org/rgcenter/il/2005_17_caregiving.pdf
78
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References
55 Spillman, B. C. (2014). Why do elders receiving informal home care transition to long stay nursing home residency? Retrieved
from U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation
website: http://aspe.hhs.gov/basic-report/why-do-elders-receiving-informal-home-care-transition-long-stay-nursing-
home-residency
56 U.S. Department of Agriculture and U.S. Department of Health and Human Services. (2010). Dietary guidelines for
Americans (7th ed.). Washington, DC: U.S. Government Printing Office. Retrieved from http://www.cnpp.usda.gov/
dietaryguidelines.htm
57 Freedman, L. S., Guenther, P. M., Krebs-Smith, S. M., & Kott, P. S. (2008). A population's mean Healthy Eating
Index-2005 scores are best estimated by the score of the population ratio when one 24-hour recall is available. Journal of
Nutrition, 138(9): 1725-1729-
58 Zuvekas, S., & Cohen, J. W. (2002). A guide to comparing health care expenditures in the 1996 MEPS to the 1987
NMES. Inquiry 39(1): 76-86. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12067078
59 Explanatory notes and estimates of error. Employment and Earnings 5/(l):26986. U.S. Department of Labor, Bureau
of Labor Statistics. January 2004.
60 Cohen, J. W., & Taylor, A. K. (1999). The provider system and the changing locus of expenditure data: Survey
strategies from fee-for-service to managed care. In: A. C. Monheit, R. Wilson, R.H. Arnett III (Eds.), Informing American
health care policy: The dynamics of medical expenditures and insurance surveys, 19771996 (pp.4366). San Francisco, CA:
Jossey-Bass Publishers.
61 Population estimates for cities and towns and estimates of housing units are covered in a separate document.
62 For more information on the accuracy of the population estimates, see http://www.census.gov/population/www/
documentation/ twps0100/E2%20County%20Totals_FINAL.pdf.
63 Domestic migration sums to 0 at the national level and therefore has no effect on the estimates.
64 Citro, C. F, & Michael, R. T (Eds.). (1995). Measuring poverty: A new approach. Washington DC: National Academy
Press.
65 Interagency Technical Working Group. (2010, March). Observations From the Interagency Technical Working Group
on developing a Supplemental Poverty Measure. Retrieved from https://www.census.gov/hhes/povmeas/methodology/
supplementalresearch/SPM_TWGObservations.pdf.
66 Short, K. (2015, September). The Supplemental Poverty Measure: 2014 (Current Population Report P60-254). Retrieved
from U.S. Census Bureau website: http://www.census.gov/content/dam/Census/library/publications/2015/demo/p60-
254.pdf.
67 Data files can be downloaded from http://www.census.gov/hhes/povmeas/data/supplemental/public-use.html.
68 Cagetti, M., & DeNardi, M. (2008). Wealth inequality: data and models. Macroeconomic Dynamics, 12, 285-313-
69 Meijer, E., Karoly, L., & Michaud, P. C. (2010). Using Matched Survey and Administrative Data to Estimate Eligibility
for the Medicare Part D Low-Income Subsidy Program. Social Security Bulletin, 70(2), 6382.
70 Bucks, B. K., Kennickell, A. B., March, T. L., & Moore, K.B. (2009, February). Changes in U.S. Family Finances
from 2004 to 2007: Evidence from the Survey of Consumer Finances. Federal Reserve Bulletin, pp. AlA56.
71 U.S. Department of Health and Human Services, National Heart, Lung, and Blood Institute. (1998). Clinical
guidelines on the identification, evaluation, and treatment of overweight and obesity in adults (NIH Publication No. 98-
4083). Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK2003/pdf/Bookshelf_NBK2003.pdf
72 WHO. International statistical classification of diseases and related health problems, tenth revision (ICD-10). 2008 ed.
Geneva, Switzerland. 2009-
73 U.S. Census Bureau. Poverty definition, thresholds and guidelines. Retrieved from http://www.census.gov/hhes/www/
poverty/methods/definitions.html.
79
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80
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Tables
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Tables
INDICATOR l: Number of Older Americans
Table la. Number of people (in millions) age 65 and over and age 85 and over, selected years, 1900-2014, and projected years,
2020-2060
Year
65 and over
85 and over
Estimates
1900
1910
1920
1930
1940
1950
1960
1970
1980
1990
2000
2005
2010
2014
Projections
2020
2030
2040
2050
2060
3.1
3.9
4.9
6.6
9.0
12.3
16.2
20.1
25.5
31.2
35.0
36.7
40.3
46.2
56.4
74.1
82.3
88.0
98.2
0.1
0.2
0.2
0.3
0.4
0.6
0.9
1.5
2.2
3.1
4.2
4.7
5.5
6.2
6.7
9.1
14.6
19.0
19.7
NOTE: Some data for 2020-2050 have been revised and differ from previous editions of Older Americans.
Reference population: These data refer to the resident population.
SOURCE: U.S. Census Bureau, 1900 to 1940,1970, and 1980, U.S. Census Bureau, 1983, Table 42; 1950, U.S. Census Bureau, 1953, Table 38; 1960, U.S. Census Bureau,
1964, Table 155; 1990, U.S. Census Bureau, 1991,1990 Summary Table File; 2000, U.S. Census Bureau, 2001, Census 2000 Summary File 1; U.S. Census Bureau, Table 1:
Intercensal Estimates of the Resident Population by Sex and Age for the U.S.: April 1, 2000, to July 1, 2010 (US-ESTOOINT-01); U.S. Census Bureau, 2011. 2010 Census
Summary File 1/U.S. Census Bureau, Annual Estimates of the Resident Population for Selected Age Groups by Sex for the United States, States, Counties, and Puerto
Rico Commonwealth and Municipios: April 1, 2010, to July 1, 2014 (PEPAGESEX); U.S. Census Bureau, Table 3: Projections of the Population by Sex and Selected Age
Groups for the United States: 2015 to 2060 (NP2014-T3).
82
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Tables
INDICATOR l: Number of Older Americans
Table Ib. Percentage of people age 65 and over and age 85 and over, selected years, 1900-2014, and projected years, 2020-2060
Year
65 and over
85 and over
Estimates
1900
1910
1920
1930
1940
1950
1960
1970
1980
1990
2000
2005
2010
2014
Projections
2020
2030
2040
2050
2060
4.1
4.3
4.7
5.4
6.8
8.1
9.0
9.9
11.3
12.6
12.4
12.4
13.0
14.5
16.9
20.6
21.7
22.1
23.6
0.2
0.2
0.2
0.2
0.3
0.4
0.5
0.7
1.0
1.2
1.5
1.6
1.8
1.9
2.0
2.5
3.9
4.8
4.7
NOTE: Some data for 2020-2050 have been revised and differ from previous editions of Older Americans.
Reference population: These data refer to the resident population.
SOURCE: U.S. Census Bureau, 1900 to 1940,1970, and 1980, U.S. Census Bureau, 1983, Table 42; 1950, U.S. Census Bureau, 1953, Table 38; 1960, U.S. Census Bureau,
1964, Table 155; 1990, U.S. Census Bureau, 1991,1990 Summary Table File; 2000, U.S. Census Bureau, 2001, Census 2000 Summary File 1; U.S. Census Bureau, Table 1:
Intercensal Estimates of the Resident Population by Sex and Age for the U.S.: April 1, 2000, to July 1, 2010 (US-ESTOOINT-01); U.S. Census Bureau, 2011. 2010 Census
Summary File 1/U.S. Census Bureau, Annual Estimates of the Resident Population for Selected Age Groups by Sex for the United States, States, Counties, and Puerto
Rico Commonwealth and Municipios: April 1, 2010, to July 1, 2014 (PEPAGESEX); U.S. Census Bureau, Table 3: Projections of the Population by Sex and Selected Age
Groups for the United States: 2015 to 2060 (NP2014-T3).
83
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Tables
INDICATOR l: Number of Older Americans
Table Ic. Population of countries or areas with at least 10 percent of their population age 65 and over, 2015
Country or area
Japan
Germany
Italy
Greece
Finland
Sweden
Lithuania
Estonia
Latvia
Austria
Portugal
France
Bulgaria
Denmark
Slovenia
Hungary
Belgium
Croatia
Czech Republic
Netherlands
Switzerland
Spain
United Kingdom
Canada
Serbia
Puerto Rico
Norway
Ukraine
Romania
Poland
Georgia
Australia
Hong Kong
United States
New Zealand
Belarus
Slovakia
Uruguay
Bosnia and Herzegovina
Russia
Korea, South
Cuba
Macedonia
Ireland
Taiwan
Moldova
Argentina
Cyprus
Total
126,920
80,854
61,855
10,776
5,477
9,802
2,884
1,265
1,987
8,666
10,825
66,554
7,187
5,582
1,983
9,898
11,324
4,465
10,645
16,948
8,122
48,146
64,088
35,100
7,177
3,598
5,208
44,429
21,666
38,562
4,931
22,751
7,141
321,369
4,438
9,590
5,445
3,342
3,867
142,424
49,115
11,031
2,096
4,892
23,415
3,547
43,432
1,189
Population (number in thousands)
65 and over
33,750
17,346
13,110
2,204
1,107
1,959
552
242
377
1,639
2,045
12,472
1,345
1,043
365
1,805
2,065
814
1,917
3,046
1,443
8,546
11,366
6,223
1,264
630
850
7,019
3,408
6,044
766
3,520
1,096
47,830
649
1,385
782
469
528
19,384
6,395
1,428
267
617
2,922
414
5,018
137
Percent
65 and over
26.6
21.5
21.2
20.5
20.2
20.0
19.1
19.1
19.0
18.9
18.9
18.7
18.7
18.7
18.4
18.2
18.2
18.2
18.0
18.0
17.8
17.7
17.7
17.7
17.6
17.5
16.3
15.8
15.7
15.7
15.5
15.5
15.3
14.9
14.6
14.4
14.4
14.0
13.7
13.6
13.0
12.9
12.7
12.6
12.5
11.7
11.6
11.5
See notes at end of table.
84
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Tables
INDICATOR l: Number of Older Americans
Table Ic. Population of countries or areas with at least 10 percent of their population age 65 and over, 2015continued
Population (number in thousands)
Percent
Country or area
Total
65 and over
65 and over
Albania
Israel
Armenia
Chile
China
3,029
8,049
3,056
17,508
1,367,485
342
873
327
1,789
136,890
11.3
10.8
10.7
10.2
10.0
NOTE: Table excludes countries and areas with less than 1,000,000 total population.
SOURCE: U.S. Census Bureau, International Data Base, accessed on October 1, 2015.
85
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Tables
INDICATOR l: Number of Older Americans
Table Id. Percentage of the population age 65 and over, by state, 2014
State (listed alphabetically)
United States
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Percent
14.5
15.3
9.4
15.9
15.7
12.9
12.7
15.5
16.4
11.3
19.1
12.4
16.1
14.3
13.9
14.3
15.8
14.3
14.8
13.6
18.3
13.8
15.1
15.4
14.3
14.3
15.4
16.7
14.4
14.2
15.9
14.7
15.3
14.7
14.7
14.2
15.5
14.5
16.0
State (ranked by percentage)
United States
Florida
Maine
West Virginia
Vermont
Montana
Pennsylvania
Delaware
Hawaii
Oregon
New Hampshire
Arizona
Iowa
South Carolina
Rhode Island
Arkansas
Ohio
Connecticut
Michigan
Missouri
Alabama
New Mexico
South Dakota
Wisconsin
Massachusetts
Tennessee
Kentucky
North Carolina
New Jersey
New York
Oklahoma
Nebraska
Mississippi
Kansas
Minnesota
Idaho
Indiana
North Dakota
Nevada
Percent
14.5
19.1
18.3
17.8
16.9
16.7
16.7
16.4
16.1
16.0
15.9
15.9
15.8
15.8
15.7
15.7
15.5
15.5
15.4
15.4
15.3
15.3
15.3
15.2
15.1
15.1
14.8
14.7
14.7
14.7
14.5
14.4
14.3
14.3
14.3
14.3
14.3
14.2
14.2
See notes at end of table.
86
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Tables
INDICATOR l: Number of Older Americans
Table Id. Percentage of the population age 65 and over, by state, 2014continued
State (listed alphabetically)
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Puerto Rico
Percent
16.7
15.7
15.8
15.3
15.1
11.5
10.0
16.9
13.8
14.1
17.8
15.2
14.0
17.4
State (ranked by percentage)
Washington
Wyoming
Illinois
Virginia
Maryland
Louisiana
California
Colorado
Georgia
Texas
District of Columbia
Utah
Alaska
Puerto Rico
Percent
14.1
14.0
13.9
13.8
13.8
13.6
12.9
12.7
12.4
11.5
11.3
10.0
9.4
17.4
NOTE: Puerto Rico is not included in the U.S. average.
Reference population: These data refer to the resident population.
SOURCE: U.S. Census Bureau, Annual Estimates of the Resident Population for Selected Age Groups by Sex for the United States, States, Counties, and Puerto
Commonwealth and Municipios: April 1, 2010, to July 1, 2014 (PEPAGESEX).
Rico
Table le. Percentage of the population age 65 and over, by county, 2014
Reference population: These data refer to the resident population.
SOURCE: U.S. Census Bureau, Annual Estimates of the Resident Population for Selected Age Groups by Sex for the United States, States, Counties, and Puerto Rico
Commonwealth and Municipios: April 1, 2010, to July 1, 2014 (PEPAGESEX).
Data for this table can be found at http://www.agingstats.gov.
Table If. Number and percentage of people age 65 and over and age 85 and over, by sex, 2014
Age and sex
Number (in thousands)
Percent
65 and over
Men
Women
85 and over
Men
Women
46,243
20,351
25,892
6,162
2,109
4,053
100.0
44.0
56.0
100.0
34.2
65.8
Reference population: These data refer to the resident population.
SOURCE: U.S. Census Bureau, Annual Estimates of the Resident Population for Selected Age Groups by Sex for the United States, States, Counties, and Puerto Rico
Commonwealth and Municipios: April 1, 2010 to July 1, 2014 (PEPAGESEX).
87
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Tables
INDICATOR 2: Racial and Ethnic Composition
Table 2. Population age 65 and over, by race and Hispanic origin, 2014 and projected 2060
Race and Hispanic or Latino origin
Total
Non-Hispanic or Latino
White alone
Black alone
Asian alone
All other races alone or in combination
Hispanic or Latino (any race)
2014
Number (in thousands)
46,243
36,208
4,017
1,869
598
3,551
2060 projections
Percent
100.0
78.3
8.7
4.0
1.3
7.7
Number (in thousands)
98,164
53,566
11,954
8,491
2,644
21,508
Percent
100.0
54.6
12.2
8.7
2.7
21.9
NOTE: The presentation of racial and ethnic composition data in this table has changed from previous editions of Older Americans. Unlike in previous editions,
Hispanics are not counted in any race group. The term "non-Hispanic White alone" is used to refer to people who reported being White and no other race and who
are not Hispanic. The term "non-Hispanic Black alone" is used to refer to people who reported being Black or African American and no other race and who are not
Hispanic, and the term "non-Hispanic Asian alone" is used to refer to people who reported only Asian as their race and who are not Hispanic. The use of single-race
populations in this table does not imply that this is the preferred method of presenting or analyzing data. The U.S. Census Bureau uses a variety of approaches. The
race group "non-Hispanic All other races alone or in combination" includes people who reported American Indian and Alaska Native alone who are not Hispanic;
people who reported Native Hawaiian and Other Pacific Islander alone who are not Hispanic; and all people who reported two or more races who are not Hispanic.
"Hispanic" refers to an ethnic category; Hispanics may be of any race.
Reference population: These data refer to the resident population.
SOURCE: U.S. Census Bureau, Annual Estimates of the Resident Population by Sex, Age, Race, and Hispanic Origin for the United States and States: April 1, 2010, to
July 1, 2014 (PEPASR6H); U.S. Census Bureau, Table 1. Projected Population by Single Year of Age, Sex, Race, and Hispanic Origin for the United States: 2014 to 2060
(NP2014_D1).
INDICATOR 3: Marital Status
Table 3. Marital status of the population age 65 and over, by age group and sex, 2015
Sex and marital status
Total
Married
Widowed
Divorced
Never married
Men
Married
Widowed
Divorced
Never married
Women
Married
Widowed
Divorced
Never married
65 and over
100.0
58.6
24.4
12.2
4.8
100.0
72.4
11.9
10.8
4.9
100.0
47.6
34.3
13.3
4.8
65-74
100.0
65.4
13.9
15.1
5.6
100.0
73.9
6.8
13.4
5.9
100.0
57.9
20.1
16.6
5.4
75-84
100.0
56.0
31.0
9.3
3.7
100.0
73.8
15.6
7.5
3.2
100.0
42.2
42.9
10.8
4.1
85 and over
100.0
32.1
59.3
5.2
3.5
100.0
58.6
33.9
4.3
3.3
100.0
17.4
73.3
5.6
3.7
NOTE: Married includes married, spouse present; married, spouse absent; and separated.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement.
88
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Tables
INDICATOR^ Educational Attainment
Table 4a. Educational attainment of the population age 65 and over, selected years 1965-2015
Educational attainment
High school graduate or more
Bachelor's degree or more
High school graduate or more
Bachelor's degree or more
1965
23.5
5.0
2005
74.0
18.9
1970
28.3
6.3
2006
75.2
19.5
1975
37.3
8.1
2007
76.1
19.2
1980
40.7
8.6
2008
77.4
20.5
1985
48.2
9.4
2009
78.3
21.7
1990
Percent
55.4
11.6
2010
79.5
22.5
1995
63.8
13.0
2011
80.7
23.2
2000
69.5
15.6
2012
81.1
24.3
2001
70.0
16.2
2013
82.6
25.3
2002
69.9
16.7
2014
83.7
26.3
2003
71.5
17.4
2015
84.3
26.7
2004
73.1
18.7
NOTE: A single question that asks for the highest grade or degree completed is used to determine educational attainment. Prior to 1995, educational attainment was
measured using data on years of school completed.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement.
Table 4b. Educational attainment of the population age 65 and over, by sex and race and Hispanic origin, 2015
Sex and race and Hispanic origin
High school graduate or more
Bachelor's degree or more
Percent
Total
Sex
Men
Women
Race and Hispanic origin
Non-Hispanic White alone
Black alone
Asian alone
Hispanic (any race)
84.3
85.5
83.4
89.1
74.8
74.4
54.2
26.7
31.8
22.5
28.9
17.5
34.0
11.5
NOTE: The term "non-Hispanic White alone" is used to refer to people who reported being White and no other race and who are not Hispanic. The term "Black alone"
is used to refer to people who reported being Black or African American and no other race, and the term "Asian alone" is used to refer to people who reported only
Asian as their race. The use of single-race populations in this table does not imply that this is the preferred method of presenting or analyzing data. The U.S. Census
Bureau uses a variety of approaches.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement.
89
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Tables
INDICATOR 5: Living Arrangements
Table 5a. Living arrangements of the population age 65 and over, by sex and race and Hispanic origin, 2015
Sex and race and Hispanic origin
Men
Non-Hispanic White alone
Black alone
Asian alone
Hispanic (any race)
Women
Non-Hispanic White alone
Black alone
Asian alone
Hispanic (any race)
Total
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
With spouse
70.0
72.0
50.0
78.2
66.6
45.2
47.9
24.4
52.2
39.7
With other relatives
Percent
6.0
4.4
13.7
9.5
12.8
16.4
12.2
30.2
26.0
34.4
With nonrelatives
3.7
3.3
6.3
2.8
5.2
2.6
2.6
2.1
1.4
3.2
Alone
20.2
20.3
29.9
9.5
15.4
35.8
37.2
43.3
20.4
22.8
NOTE: Living with other relatives indicates no spouse present. Living with nonrelatives indicates no spouse or other relatives present. The term "non-Hispanic White
alone" is used to refer to people who reported being White and no other race and who are not Hispanic. The term "Black alone" is used to refer to people who
reported being Black or African American and no other race, and the term "Asian alone" is used to refer to people who reported only Asian as their race. The use
of single-race populations in this table does not imply that this is the preferred method of presenting or analyzing data. The U.S. Census Bureau uses a variety of
approaches. Totals may not sum to 100 percent because of rounding.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement.
Table 5b. Percentage of population age 65 and over living alone, by sex and age group, selected years, 1970-2015
Year
1970
1980
1990
2000
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
65-74
11.3
11.6
13.0
13.8
15.6
15.5
16.1
16.9
16.7
16.3
16.4
16.3
16.7
16.3
17.1
18.5
Men
75 and over
19.1
21.6
20.9
21.4
22.9
23.2
23.2
22.7
22.0
21.5
22.6
22.2
22.2
23.0
22.6
23.0
Women
65-74
31.7
35.6
33.2
30.6
29.6
29.4
28.9
28.5
28.0
29.1
27.7
27.7
27.2
27.0
26.9
27.7
75 and over
37.0
49.4
54.0
49.5
49.8
49.9
47.8
48.0
48.8
50.1
47.4
46.5
46.3
45.0
46.0
46.3
Not available.
Reference population: These data refer to the civilian noninstitutionalized population.
Source: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement.
90
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Tables
INDICATOR 6: Older Veterans
Table 6a. Percentage of population age 65 and over who are veterans, by age group and sex, 2000, 2010, and 2015, and projected 2020
and 2025
Year
Estimates
2000
2010
2015
Projections
2020
2025
65 and over
65-74
Men Women Men Women
64.3
51.3
45.4
35.6
28.1
NOTE: Some data for 2020 have been revised
Reference population
SOURCE: U.S. Census
: These data refer to the
1.7 65.2 1.1
1.3 42.8 1.1
1.3 40.0 1.3
1.5 28.5 1.7
1.7 17.7 2.0
75-84
Men Women
70.9 2.7
60.8 1.1
49.3 1.1
42.3 1.1
40.5 1.3
85 and
Men
32.6
68.3
66.2
60.6
50.0
over
Women
1.0
2.5
1.7
1.4
1.2
and differ from previous editions of Older Americans.
resident population of the United States and Puerto Rico.
Bureau, Population Projections 2014, and 2010 Census Summary File 1;
Table 6b. Number of veterans age 65
Age group and sex
2000
and over, by age group and sex, 2000
Estimates
2010
1 Department of Veterans Affairs, VetPop2014.
, 2010, and 2015, and projected
2015
2020 and 2025
Projections
2020
2025
Number (in thousands)
65 and over
Men
Women
65-74
Men
Women
75-84
Men
Women
85 and over
Men
Women
9,723
9,374
349
5,628
5,516
112
3,667
3,460
207
427
398
30
9,169
8,866
303
4,377
4,253
124
3,403
3,321
82
1,389
1,292
97
9,934
9,591
343
5,360
5,174
186
3,060
2,972
88
1,513
1,444
69
9,428
8,976
452
4,696
4,405
291
3,199
3,097
102
1,533
1,474
59
8,924
8,316
609
3,478
3,079
398
3,990
3,836
154
1,457
1,401
56
NOTE: Some data for 2020 have been revised and differ from previous editions of Older Americans. Estimates may not sum to the totals because of rounding.
Reference population: These data refer to the resident population of the United States and Puerto Rico.
SOURCE: U.S. Census Bureau, Population Projections 2014, and 2010 Census Summary File 1; Department of Veterans Affairs, VetPop2014.
91
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Tables
INDICATOR?: Poverty
Table 7a. Poverty rate by age, by official poverty measure and Supplemental Poverty Measure, 1966-2014
65 and over
Year
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
Under 18
17.6
16.6
15.6
14.0
15.1
15.3
15.1
14.4
15.4
17.1
16.0
16.2
15.9
16.4
18.3
20.0
21.9
22.3
21.5
20.7
20.5
20.3
19.5
19.6
20.6
21.8
22.3
22.7
21.8
20.8
20.5
19.9
18.9
17.1
16.2
16.3
16.7
17.6
17.8
17.6
17.4
18.0
19.0
20.7
22.0
18-64
10.5
10.0
9.0
8.7
9.0
9.3
8.8
8.3
8.3
9.2
9.0
8.8
8.7
8.9
10.1
11.1
12.0
12.4
11.7
11.3
10.8
10.6
10.5
10.2
10.7
11.4
11.9
12.4
11.9
11.4
11.4
10.9
10.5
10.1
9.6
10.1
10.6
10.8
11.3
11.1
10.8
10.9
11.7
12.9
13.8
Total
28.5
29.5
25.0
25.3
24.6
21.6
18.6
16.3
14.6
15.3
15.0
14.1
14.0
15.2
15.7
15.3
14.6
13.8
12.4
12.6
12.4
12.5
12.0
11.4
12.2
12.4
12.9
12.2
11.7
10.5
10.8
10.5
10.5
9.7
9.9
10.1
10.4
10.2
9.8
10.1
9.4
9.7
9.7
8.9
8.9
65-74
12.4
11.9
10.3
10.6
10.3
9.9
10.0
8.8
9.7
10.6
10.6
10.0
10.1
8.6
8.8
9.2
9.1
8.8
8.6
9.2
9.4
9.0
9.4
8.9
8.6
8.8
8.4
8.0
8.1
75-84
17.4
16.7
15.2
15.3
15.3
16.0
14.6
14.6
14.9
14.0
15.2
14.1
12.8
12.3
12.5
11.3
11.6
9.8
10.6
10.4
11.1
11.0
9.7
10.9
10.0
9.8
10.7
9.4
9.2
85 and over
21.2
21.3
18.4
18.7
17.6
18.9
17.8
18.4
20.2
18.9
19.9
19.7
18.0
15.7
16.5
15.7
14.2
14.2
14.5
13.9
13.6
13.8
12.6
13.4
11.4
13.0
12.7
11.6
12.2
See notes at end of table.
92
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Tables
INDICATOR?: Poverty
Table 7a. Poverty rate by age, by official poverty measure and Supplemental Poverty Measure, 1966-2014continued
65 and over
Year
2011
2012
2013 (traditional)
2013 (redesign)
2014
2009
2010
2011
2012
2013 (traditional)
2013 (redesign)
2014
Under 18
21.9
21.8
19.9
21.5
21.1
17.0
17.9
18.0
18.0
16.4
18.1
16.7
18-64
13.7
13.7
13.6
13.3
13.5
14.4
15.2
15.5
15.5
15.4
14.9
15.0
Total
8.7
9.1
9.5
10.2
10.0
Supplemental
14.9
15.8
15.1
14.8
14.6
15.5
14.4
65-74
7.4
7.9
8.3
8.8
8.7
Poverty Peasure
12.6
13.3
12.7
12.3
12.1
13.5
12.5
75-84
10.0
9.9
10.9
11.1
11.3
17.0
17.7
17.6
17.1
17.3
17.0
16.2
85 and over
11.5
12.3
11.8
14.2
12.7
19.1
21.8
19.2
20.9
20.1
22.0
19.6
Data not available.
NOTE: Poverty status in the Current Population Survey (CPS) is based on prior year income. The 2014 CPS Annual Social and Economic Supplement (ASEC) included
redesigned questions for income that were implemented to a subsample of the 98,000 addresses using a probability split panel design. The source for "2013 (traditional)" in
this table is the portion of the sample (68,000) which received a set of income questions similar to those used in 2013; the source for "2013 (redesign)" is the portion of the
2014 CPS ASEC sample (30,000) which received the redesigned income questions. The redesigned income questions were used for the entire 2015 CPS ASEC sample. The
official poverty measure is based on money income and does not include noncash benefits such as food stamps. Poverty thresholds reflect family size and composition and
are adjusted each year using the annual average Consumer Price Index. The Supplemental Poverty Measure (SPM) extends the official poverty measure by taking account
of many of the government programs designed to assist low income families and individuals that are not included in the current official poverty measure and by using
thresholds derived from the Consumer Expenditure Survey by the Bureau of Labor Statistics. For more detail, see U.S. Census Bureau Series P-60, No. 252. Additional years
of data are available at agingstats.gov.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement.
Table 7b. Percentage of the population age 65 and over living in poverty, by selected characteristics, 2014
65 and over
Selected characteristic
Both Sexes
Total
Non-Hispanic White alone
Black alone
Asian alone
Hispanic (any race)
Male
Total
Non-Hispanic White alone
Black alone
Asian alone
Hispanic (any race)
Female
Total
Non-Hispanic White alone
Black alone
Asian alone
Hispanic (any race)
Total
10.0
7.8
19.2
14.7
18.1
7.4
5.3
16.7
13.1
16.2
12.1
9.9
20.9
16.0
19.6
Living alone
18.0
14.8
28.4
34.6
32.9
13.6
10.4
25.4
29.5
26.2
20.2
17.0
30.0
37.0
36.8
Married couples
5.0
3.8
7.5
10.5
12.7
5.1
3.7
8.5
11.0
13.2
4.9
3.9
6.3
9.9
12.2
65-74
8.7
6.4
19.0
14.0
16.1
7.2
4.9
17.9
13.0
15.8
10.1
7.8
19.8
14.9
16.3
75 and over
11.7
9.7
19.6
15.8
21.3
7.6
5.8
14.3
13.4
16.8
14.7
12.6
22.6
17.7
24.5
NOTE: The poverty level is based on money income and does not include noncash benefits such as food stamps. Poverty thresholds reflect family size and composition and
are adjusted each year using the annual average Consumer Price Index. For more detail, see U.S. Census Bureau, Series P-60, No. 252. The term "non-Hispanic White alone"
is used to refer to people who reported being White and no other race and who are not Hispanic. The term "Black alone" is used to refer to people who reported being
Black or African American and no other race, and the term "Asian alone" is used to refer to people who reported only Asian as their race. The use of single-race populations
in this table does not imply that this is the preferred method of presenting or analyzing data. The U.S. Census Bureau uses a variety of approaches.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement.
93
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Tables
INDICATORS: Income
Table 8a. Income distribution of the population age 65 and over, 1974-2014
Year
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013 (traditional)
2013 (redesign)
2014
Poverty
14.6
15.3
15.0
14.1
14.0
15.2
15.7
15.3
14.6
13.8
12.4
12.6
12.4
12.5
12.0
11.4
12.2
12.4
12.9
12.2
11.7
10.5
10.8
10.5
10.5
9.7
9.9
10.1
10.4
10.2
9.8
10.1
9.4
9.8
9.7
8.9
8.9
8.7
9.1
9.5
10.2
10.0
Low income
34.6
35.0
34.7
35.9
33.4
33.0
33.5
32.8
31.4
29.7
30.2
29.4
28.4
27.8
28.4
29.1
27.0
28.0
28.6
29.8
29.5
29.1
29.5
28.1
26.8
26.2
27.5
28.1
28.0
28.5
28.1
26.6
26.2
26.3
26.5
24.8
25.6
24.9
24.6
23.6
22.1
22.5
Middle income
32.6
32.3
31.8
31.5
34.2
33.6
32.4
33.1
33.3
34.1
33.8
34.6
34.4
35.1
34.5
33.6
35.2
36.3
35.6
35.0
35.6
36.1
34.7
35.3
35.3
36.4
35.5
35.2
35.3
33.8
34.6
35.2
35.7
33.3
33.7
35.1
34.0
34.2
33.7
33.0
30.9
31.1
High income
18.2
17.4
18.5
18.5
18.5
18.2
18.4
18.9
20.7
22.4
23.6
23.4
24.8
24.7
25.1
25.9
25.6
23.3
22.9
23.0
23.2
24.3
25.1
26.0
27.5
nn
27.1
26.7
26.2
27.5
27.5
28.1
28.6
30.6
30.1
31.2
31.5
32.2
32.6
33.8
36.8
36.4
NOTE: Income distribution in the Current Population Survey (CPS) is based on prior year income. The 2014 CPS Annual Social and Economic Supplement (ASEC)
included redesigned questions for income that were implemented to a subsample of the 98,000 addresses using a probability split panel design. The source for
"2013 (traditional)" in this table is the portion of the sample (68,000 addresses) that received a set of income questions similar to those used in 2013; the source for
"2013 (redesign)" is the portion of the 2014 CPS AS EC sample (30,000 addresses) that received the redesigned income questions. The redesigned income questions
were used for the entire 2015 CPS AS EC sample. The income categories are derived from the ratio of the family's income (or an unrelated individual's income) to the
corresponding official poverty threshold. Being in poverty is measured as income less than 100 percent of the poverty threshold. Low income is between 100 and 199
percent of the poverty threshold. Middle income is between 200 percent and 399 percent of the poverty threshold. High income is 400 percent or more of the poverty
threshold. Some data have been revised and differ from previous versions of Older Americans.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement.
94
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Tables
INDICATORS: Income
Table 8b. Median income of householders age 65 and over, in current and in 2014 dollars, 1974-2014
Year
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013 (traditional)
2013 (redesign)
2014
Number (in thousands)
14,263
14,802
14,816
15,225
15,795
16,544
16,912
17,312
17,671
17,901
18,155
18,596
18,998
19,412
19,716
20,156
20,527
20,921
20,682
20,806
21,365
21,486
21,408
21,497
21,589
22,478
22,469
22,476
22,659
23,048
23,151
23,459
23,729
24,113
24,834
25,270
25,737
26,843
27,924
28,729
29,069
29,946
Current dollars
$5,292
5,585
5,962
6,347
7,081
7,879
8,781
9,903
11,041
11,718
12,799
13,254
13,845
14,443
14,923
15,771
16,855
16,975
17,135
17,751
18,095
19,096
19,448
20,761
21,729
22,797
23,083
23,118
23,152
23,787
24,516
26,036
27,798
28,305
29,744
31,354
31,461
33,118
33,848
35,611
37,297
36,895
2014 dollars
$22,921
22,353
22,563
22,595
23,590
23,975
24,029
24,743
26,017
26,499
27,787
27,820
28,544
28,803
28,707
29,084
29,622
28,785
28,338
28,649
28,607
29,479
29,231
30,544
31,542
32,402
31,732
30,913
30,466
30,618
30,727
31,563
32,641
32,319
32,706
34,597
34,162
34,862
34,902
36,194
37,907
36,895
NOTE: Income distribution in the Current Population Survey (CPS) is based on prior year income. The 2014 CPS Annual Social and Economic Supplement (ASEC)
included redesigned questions for income that were implemented to a subsample of the 98,000 addresses using a probability split panel design. The source for "2013
(traditional)" in this table is the portion of the sample (68,000 addresses) that received a set of income questions similar to those used in 2013; the source for "2013
(redesign)" is the portion of the 2014 CPS AS EC sample (30,000 addresses) that received the redesigned income questions. The redesigned income questions were
used for the entire 2015 CPS AS EC sample. Some data have been revised and differ from previous versions of Older Americans.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement.
95
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Tables
INDICATOR 9: Sources of Income
Table 9a. Percentage distribution of per capita family income for persons age 65 and over, by income quintile and source of income,
2014
Source of income
Total
Percentage of income from
Earnings
Retirement benefits
Social Security
Railroad Retirement
Government employee pensions
Private pensions or annuities
Asset income
Cash public assistance
Other
Number (in thousands)
Total Lowest fifth Second fifth
100.0
23.7
64.7
48.7
0.2
5.6
10.1
6.4
2.0
3.3
45,079
100.0
13.1
70.8
66.7
0.1
1.0
3.0
5.8
7.6
2.6
8,630
100.0
13.8
79.8
72.3
0.2
2.1
5.3
2.4
1.6
2.3
9,114
Third fifth
100.0
21.0
71.0
53.6
0.3
4.9
12.2
4.2
0.6
3.3
9,120
Fourth fifth Highest fifth
100.0
30.4
58.5
34.2
0.3
8.7
15.3
6.3
0.3
4.5
9,100
100.0
39.6
43.6
17.8
0.1
11.2
14.5
13.1
0.1
3.7
9,115
NOTE: The definition of "other" includes, but is not limited to, unemployment compensation, workers' compensation, veterans' payments, and personal contributions.
Quintile limits are $12,492, $19,245, $29,027, and $47,129. Estimates may not sum to the totals because of rounding.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement.
96
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Tables
INDICATOR 9: Sources of Income
Table 9b. Percentage of people age 55 and over with family income from specified sources, by age group, 2014
Source of family income
Earnings
Wages and salaries
Self-employment
Retirement benefits
Social Security
Benefits other than Social Security
Other public pensions
Railroad Retirement
Government employee pensions
Military
Federal
State or local
Private pensions or annuities
Asset income
Interest
Other income from assets
Dividends
Rent or royalties
Estates or trusts
Veterans' benefits
Unemployment compensation
Workers' compensation
Cash public assistance and noncash benefits
Cash public assistance
Supplemental Security Income
Other
Noncash benefits
Food
Energy
Housing
Personal contributions
Number (in thousands)
55-61
83.7
80.6
10.8
31.4
22.2
16.1
7.1
0.1
7.0
1.0
1.9
4.5
12.0
66.9
66.0
25.4
21.0
9.0
0.3
2.7
4.3
1.1
15.0
7.6
6.9
1.2
11.6
9.5
2.9
2.9
2.4
29,434
62-64
72.9
69.2
10.4
57.3
46.6
29.6
13.4
0.5
13.0
1.2
2.9
9.5
23.0
68.9
67.6
28.0
22.7
11.2
0.4
4.1
3.5
0.9
13.8
6.9
6.3
0.7
10.7
8.8
2.6
3.0
1.8
10,983
Total
40.2
37.0
6.4
89.1
86.0
47.7
17.7
0.4
17.4
2.0
4.7
12.1
40.9
67.1
65.7
28.4
23.1
10.3
0.4
5.6
1.4
0.5
13.3
5.2
4.8
0.5
11.0
7.4
3.3
3.9
1.4
45,994
65-69
57.1
53.3
8.6
83.2
78.7
43.0
17.4
0.3
17.1
1.7
4.2
12.4
35.7
69.0
68.1
29.2
23.9
10.9
0.4
6.8
2.1
0.7
12.6
5.3
4.9
0.6
10.2
7.3
2.8
3.3
1.3
15,728
65 and over
70-74
40.4
36.6
7.3
91.7
89.4
50.9
18.5
0.6
18.0
2.0
5.2
12.6
44.4
68.1
66.6
28.1
22.4
10.6
0.2
5.0
1.4
0.4
13.0
4.9
4.5
0.5
10.8
7.2
2.9
3.8
1.2
11,209
75-79
30.6
28.0
4.8
92.4
90.2
51.7
18.0
0.3
17.7
2.0
5.2
12.0
45.7
65.6
64.0
28.3
23.1
10.4
0.4
4.5
0.9
0.4
13.7
5.2
4.9
0.4
11.6
7.7
4.4
4.5
1.4
8,002
80 and over
22.8
20.9
3.4
92.2
90.0
48.0
17.2
0.4
16.8
2.3
4.6
11.2
41.2
64.5
62.6
27.6
22.5
9.0
0.6
5.4
0.7
0.4
14.3
5.2
4.9
0.4
12.1
7.6
3.8
4.4
1.7
11,054
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement.
97
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Tables
INDICATOR 9: Sources of Income
Table 9c. Number of participants (in thousands) in private pension plans, by type of plan, 1975-2013
Defined
Year
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2004a
2005
2006
2007
2008
2009
2010
2011
2012
2013
Total
44,511
47,679
50,236
52,371
55,097
57,903
60,564
63,243
69,147
73,895
74,665
76,672
78,223
77,685
76,405
76,924
77,662
81,914
83,870
85,117
87,452
91,716
94,985
99,455
101,794
103,329
106,579
107,354
106,296
106,335
115,707
117,406
121,995
123,854
124,853
129,268
129,724
129,581
130,584
131,631
Benefit
33,004
34,207
34,997
36,103
36,810
37,979
38,903
38,633
40,025
40,980
39,692
39,989
39,958
40,722
39,958
38,832
39,027
39,531
40,267
40,338
39,736
41,111
40,392
41,552
41,427
41,613
42,067
42,078
42,179
41,707
41,918
41,925
42,146
42,280
42,344
41,820
41,423
40,876
39,809
39,084
Contribution
11,507
13,472
15,239
16,268
18,287
19,924
21,661
24,610
29,122
32,915
34,973
36,682
38,265
36,963
36,447
38,091
38,634
42,383
43,603
44,778
47,716
50,605
54,593
57,903
60,368
61,716
64,511
65,275
64,117
64,627
73,789
75,481
79,849
81,574
82,510
87,448
88,301
88,705
90,775
92,547
" The number of participants for 2004 was revised using the new definition summarized in the note below.
NOTE: The methodology for calculating participants was changed beginning with the 2005 Form 5500 series in response to the discontinuance of the IRS Form 5500
Schedule T. For 2004, the revision increases counts of participants by 9 million. Under the current methodology, participant counts include all workers eligible to
participate in a plan. The term "participants" refers to active, retired, and separated vested participants not yet in pay status. Workers participating in more than one
plan are counted separately for each plan in which they participate.
Reference population: These data refer to counts of participants reported by private pension plans on the Form 5500.
SOURCE: U.S. Department of Labor, Employee Benefits Security Administration, Form 5500 filings.
98
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Tables
INDICATOR 9: Sources of Income
Table 9d. Number of participants (in thousands) in private defined benefit pension plans and percent of participants retired or
separated from employer, 1975-2013
Year
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
Number of participants
33,004
34,207
34,997
36,103
36,810
37,979
38,903
38,633
40,025
40,980
39,692
39,989
39,958
40,722
39,958
38,832
39,027
39,531
40,267
40,338
39,736
41,111
40,392
41,552
41,427
41,613
42,067
42,078
42,179
41,707
41,925
42,146
42,280
42,344
41,820
41,423
40,876
39,809
39,084
Percent retired or separated from employer
17.5
19.5
19.8
19.6
20.0
20.7
22.8
23.2
25.4
26.6
27.2
28.7
28.9
31.3
32.1
32.5
34.4
36.2
37.9
39.3
41.1
43.7
44.0
45.0
45.4
46.6
47.5
48.6
49.5
50.6
51.6
52.7
54.1
55.2
56.7
58.5
59.6
60.4
61.0
Reference population: These data refer to participants in private defined benefit pension plans who filed a Form 5500.
SOURCE: U.S. Department of Labor, Employee Benefits Security Administration, Form 5500 filings.
99
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Tables
INDICATOR 9: Sources of Income
Table 9e. Number of participants (in thousands) in defined benefit and defined contribution retirement plans, by selected type of
plan, 1999-2013
Defined benefit
Defined contribution
Cash balance
Year
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
Total
41,427
41,613
42,067
42,078
42,179
41,707
41,925
42,146
42,280
42,344
41,820
41,423
40,876
39,809
39,084
Number
6,175
7,016
7,820
8,244
9,346
9,808
10,135
10,185
10,520
10,812
11,760
12,040
12,150
11,833
11,956
Share of total
participants
in defined
benefit plans
14.9
16.9
18.6
19.6
22.2
23.5
24.2
24.2
24.9
25.5
28.1
29.1
29.7
29.7
30.6
401(k)-type plans
401(k)-type plans that allow
participants to direct all or
portion of investments
Total
60,368
61,716
64,511
65,275
64,117
64,627
75,481
79,849
81,574
82,510
87,448
88,301
88,705
90,775
92,547
Number
46,203
48,348
51,814
53,296
53,842
54,892
65,652
70,295
72,178
73,156
72,499
72,165
72,968
74,881
76,640
Number
39,493
43,834
47,530
49,250
50,255
51,250
62,009
66,555
68,642
69,542
69,478
69,627
70,517
72,532
74,354
Share of total
participants in
401(k)-type plans
85.5
90.7
91.7
92.4
93.3
93.4
94.5
94.7
95.1
95.1
95.8
96.5
96.6
96.9
97.0
Reference population: These data refer to participants in private pension plans who filed a Form 5500.
SOURCE: U.S. Department of Labor, Employee Benefits Security Administration, Form 5500 filings.
Table 9f. Percentage of workers in private sector and state and local government with access to retirement benefits, by type of
retirement plan, 2015
Type of employment
Private sector, all workers
State and local government, all workers
Defined contribution
only
47
6
Defined benefit and defined
contribution
14
27
Defined benefit
only
4
57
Reference population: These data refer to civilian workers in establishments covered by unemployment insurance.
SOURCE: National Compensation Survey, March 2015, Bureau of Labor Statistics.
100
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Tables
INDICATOR 10: Social Security Beneficiaries
Table lOa. Percentage distribution of people who began receiving Social Security benefits in 2014, by age and sex
Pre-Full Retirement Age
Sex
Men
Women
Total
years
100
100
Age
62
36
41
Age
63
6
7
Age
64
6
7
Age
65
11
11
Full Retirement Age
Age
66
17
12
Disabled
Worker
Conversions3
18
16
Post-Full Retirement Age
Age
66
3
2
Age
67-69
3
3
Age
70 and
over
2
3
" At Full Retirement Age (FRA), persons formerly receiving disabled worker benefits are reclassified and begin receiving retired worker benefits.
NOTE: FRA is defined as age 66 for those born between 1943 and 1955. The percentages are not probabilities of a birth cohort claiming at a particular age. A person
begins receiving Social Security benefits the month after he or she becomes entitled. Totals may not sum to 100 percent because of rounding.
Reference population: Persons fully insured for Social Security retired worker benefits who became entitled to benefits in 2014.
SOURCE: Social Security Administration, Master Beneficiary Record.
Table lOb. Percentage distribution of female Social Security beneficiaries age 62 and over, by type of benefit received, selected years
1960-2014
Type of benefit
Worker benefit only3
Spouse or widow
benefit only
Spouse only
Widow only*
Dual entitlement
Worker and
spouse
Worker and widow
1960
38.7
32.8
23.4
2.4
2.1
1970
42.1
22.4
26.8
3.4
5.0
1975
42.3
19.6
26.1
4.4
7.4
1980
41.0
17.6
25.4
6.2
9.6
1985
38.5
16.4
24.9
8.7
11.5
1990
36.9
15.3
24.3
10.4
13.0
1995
36.2
14.3
23.6
11.5
14.4
2000
38.0
12.9
21.5
12.0
15.6
2005
41.4
11.4
19.3
12.0
16.0
2010
46.3
9.6
17.0
12.1
15.5
2011
47.5
9.3
15.9
12.0
15.3
2012
48.7
8.0
15.3
11.9
15.1
2013
49.9
8.8
14.7
11.8
11.6
2014
51.1
8.6
14.4
11.6
14.6
" Worker benefits include retired and disabled worker benefits.
b Widow-only beneficiaries include disabled workers and mothers of surviving children under age 19.
NOTE: All data for 2005 and dual-entitlement data for 1995 and 2000 are based on a 10 percent sample of administrative records. All other estimates are based on
100 percent of available data. Benefits exclude special age-72 beneficiaries and disabled adult children and include disabled workers. Totals may not sum to 100
percent because of rounding.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Social Security Administration, Master Beneficiary Record.
101
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Tables
INDICATOR 11: Net Worth
Table lla. Median household net worth, in 2013 dollars, by selected characteristics of head of household, selected years 1983-2013
In dollars
Selected characteristic
Age of family head
45-54
55-64
65 and over
65-74
75 and over
Marital status,3 family head
age 65 and over
Married
Unmarried
Race, family head
age 65 and over
White
Black
Education, family head
age 65 and over
No high school diploma
High school diploma only
Some college or more
1983
$122,780
153,690
116,480
135,980
79,820
157,050
75,490
137,340
20,160
65,160
149,320
317,980
1989
$177,320
177,450
137,560
140,270
131,140
240,810
74,910
173,890
41,280
72,300
144,610
441,210
1992
$127,220
184,900
149,090
160,360
141,190
246,330
104,150
176,940
45,220
63,220
176,600
319,920
1995
$140,710
175,330
153,290
168,420
141,160
239,230
116,540
177,740
37,950
87,130
161,970
307,830
1998
$151,000
182,840
196,530
209,430
179,830
311,210
125,230
225,010
40,370
77,770
209,140
345,520
2001
$176,390
243,310
221,150
233,750
205,320
368,090
121,700
283,390
64,150
96,390
215,550
521,690
2004
$178,560
284,850
219,380
234,540
201,130
349,350
142,550
259,490
64,740
67,180
216,790
442,700
2007
$207,720
284,850
247,910
268,800
239,380
327,970
180,870
278,680
98,580
114,300
210,190
574,590
2010
$125,550
191,512
227,630
221,490
231,770
347,340
132,840
272,640
101,650
74,270
179,130
450,040
2013
$105,350
165,660
210,500
232,100
195,000
319,800
119,300
255,000
56,700
86,650
147,250
387,000
" "Married" includes legally married couples."Unmarried" includes cohabitating couples, separated, divorced, widowed, and never married.
NOTE: Median net worth is measured in constant 2013 dollars. Net worth includes assets held in investment retirement accounts such as individual retirement
accounts, Keoghs, and 401(k)-type plans. All observations are weighted for analysis. The term "household" in this indicator is from the codebook of the 2013 Survey of
Consumer Finance (www.federalreserve.gov/econresdata/). The data are for the "primary economic unit" (PEU). The PEU consists of an economically dominant single
individual or couple (married or living partners) in a household and all other members of the household who are financially interdependent with the individual or
couple. In the majority of cases, the PEU and household are identical. All data are for households with positive values.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Survey of Consumer Finances.
102
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Tables
INDICATOR 11: Net Worth
Table lib. Value of household financial assets held in retirement investment accounts, by selected characteristics of head of household,
2007 and 2013
2007
Selected characteristic
Age of family head
45-54
55-64
65 and over
65-74
75 and over
Marital status,3 family head
age 65 and over
Married
Unmarried
Race, family head
age 65 and over
White
Other raceb
Education, family head
age 65 and over
No high school diploma'
High school diploma only
Some college or more
Lowest
quartile
$24,000
33,000
18,000
23,000
15,000
21,000
16,000
18,000
19,000
8,000
11,000
31,000
In dollars
Middle
quartiles
$71,000
112,000
68,000
87,000
39,000
83,000
39,000
69,000
125,000
34,000
39,000
130,000
Highest
quartile
$199,000
301,000
202,000
231,000
124,000
224,000
139,000
197,000
488,000
91,000
84,000
354,000
Percent
holding
65.0
61.0
40.8
51.7
30.0
53.5
28.9
45.3
12.6
19.1
35.1
59.1
Lowest
quartile
$20,000
26,000
40,000
50,000
33,000
60,000
20,000
45,000
23,000
5,000
24,000
60,000
2013
In dollars
Middle
quartiles
$87,000
104,000
118,000
149,000
69,000
160,000
68,000
124,000
110,000
22,000
62,000
170,000
Highest
quartile
$240,000
300,000
295,000
400,000
174,000
440,000
165,000
330,000
300,000
50,000
135,000
491,000
Percent
holding
56.5
59.3
39.4
48.0
29.0
51.0
28.7
44.9
15.8
9.1
31.4
55.5
" "Married" includes legally married couples."Unmarried" includes cohabitating couples, separated, divorced, widowed, and never married.
b "Other race" includes Black, Hispanic, and Other. The figures for 2007 are based on 28 real observations. This category is dominated by household heads who belong
to the "Other" racial category.
c The figures for households headed by a person without a high school diploma in 2013 are based on 25 real observations.
NOTE: Median net worth is measured in constant 2013 dollars. Net worth includes assets held in investment retirement accounts such as individual retirement
accounts, Keoghs, and 401(k)-type plans. All observations are weighted for analysis. The term "household" in this indicator is from the codebook of the 2013 Survey of
Consumer Finance (www.federalreserve.gov/econresdata/). The data are for the "primary economic unit" (PEU). The PEU consists of an economically dominant single
individual or couple (married or living partners) in a household and all other members of the household who are financially interdependent with the individual or
couple. In the majority of cases, the PEU and household are identical. All data are for households with positive values.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Survey of Consumer Finances.
103
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Tables
INDICATOR 11: Net Worth
Table lie. Amount of funds (in millions of dollars) held in retirement assets, by sector and type of plan, 1975-2014
All sectors
Year
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Individual retirement
accounts (IRAs)
$38,000
68,000
107,000
159,000
241,000
329,000
404,000
468,000
546,000
637,000
776,000
873,000
993,000
1,056,000
1,288,000
1,467,000
1,728,000
2,150,000
2,651,000
2,629,000
2,619,000
2,532,000
2,993,000
3,299,000
3,425,000
4,207,000
4,748,000
3,681,000
4,488,000
5,029,000
5,241,000
5,907,000
6,966,000
7,443,000
Defined
contribution
$74,612
84,341
92,766
110,620
133,307
163,363
174,363
208,297
254,655
287,475
431,714
469,697
551,750
597,132
715,197
737,198
890,757
974,323
1,111,304
1,186,477
1,467,738
1,679,084
2,223,790
2,585,459
2,955,912
2,905,379
2,638,370
2,402,674
2,992,979
3,328,948
3,706,573
4,089,707
4,364,497
3,268,405
3,986,583
4,507,019
4,493,069
5,000,368
5,891,192
6,298,411
Defined
benefit3
$315,782
356,824
388,647
452,980
515,723
622,636
673,378
818,105
974,341
1,067,492
1,368,996
1,494,230
1,567,113
1,674,304
1,918,853
1,962,358
2,274,407
2,427,769
2,684,968
2,853,227
3,299,521
3,660,841
4,159,755
4,581,283
5,084,432
4,977,000
4,782,651
4,369,875
5,182,865
5,586,436
5,922,727
6,382,102
6,678,779
5,303,013
5,845,781
6,395,589
6,388,358
6,770,005
7,648,274
7,964,469
Private
Defined
contribution
$74,612
84,341
92,766
110,620
133,307
158,812
169,597
202,201
246,783
278,883
420,382
455,466
535,617
577,118
688,709
708,546
853,052
930,324
1,057,931
1,127,009
1,389,546
1,582,489
1,950,745
2,240,694
2,531,038
2,500,499
2,254,552
2,054,726
2,551,316
2,822,627
3,146,539
3,448,388
3,664,143
2,733,992
3,327,103
3,763,657
3,766,231
4,220,842
5,003,857
5,342,952
only
Defined
benefit3
$169,719
190,962
204,503
240,687
279,781
349,622
364,853
460,731
560,398
588,721
795,064
816,033
803,294
812,800
921,494
899,857
1,051,654
1,079,860
1,195,109
1,275,964
1,466,122
1,590,232
1,763,538
1,907,730
2,074,645
1,978,987
1,810,236
1,639,303
1,994,538
2,132,170
2,281,326
2,393,189
2,516,486
1,897,817
2,126,880
2,387,116
2,429,469
2,627,787
2,875,486
2,932,973
Public only
Defined
contribution
$4,551
4,766
6,096
7,872
8,592
11,332
14,231
16,133
20,014
26,488
28,652
37,705
43,999
53,373
59,468
78,192
96,595
273,045
344,765
424,874
404,880
383,818
347,948
441,663
506,321
560,034
641,319
700,354
534,413
659,480
743,362
726,838
779,526
887,335
955,459
Defined
benefit3
$146,063
165,862
184,144
212,293
235,942
273,014
308,525
357,374
413,943
478,771
573,932
678,197
763,819
861,504
997,359
1,062,501
1,222,753
1,347,909
1,489,859
1,577,263
1,833,399
2,070,609
2,396,217
2,673,553
3,009,787
2,998,013
2,972,415
2,730,572
3,188,327
3,454,266
3,641,401
3,988,913
4,162,293
3,405,196
3,718,901
4,008,473
3,958,889
4,142,218
4,772,788
5,031,496
Not available.
" Public and private defined benefit plans do not include claims of pension funds on sponsor.
Reference population: Public and private retirement assets for total population.
SOURCE: Federal Reserve Board Z.I Statistical Release for Dec. 10, 2015.
104
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Tables
INDICATOR 12: Participation in Labor Force
Table 12. Labor force participation rates (annual averages) of persons age 55 and over, by sex and age group, 1963-2015
Men
Year
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
55-61
89.9
89.5
88.8
88.6
88.5
88.4
88.0
87.7
86.9
85.6
84.0
83.4
81.9
81.1
80.9
80.3
79.5
79.1
78.4
78.5
77.7
76.9
76.6
75.8
76.3
75.8
76.3
76.7
76.1
75.7
74.9
73.8
74.3
74.8
75.4
75.5
75.4
74.3
74.9
75.4
74.9
74.4
74.7
62-64
75.8
74.6
73.2
73.0
72.7
72.6
70.2
69.4
68.4
66.3
62.4
60.8
58.6
56.1
54.6
54.0
54.3
52.6
49.4
48.0
47.7
47.5
46.1
45.8
46.0
45.4
45.3
46.5
45.5
46.2
46.1
45.1
45.0
45.7
46.2
47.3
46.9
47.0
48.2
50.4
49.5
50.8
52.5
65-69
40.9
42.6
43.0
42.7
43.4
43.1
42.3
41.6
39.4
36.8
34.1
32.9
31.7
29.3
29.4
30.1
29.6
28.5
27.8
26.9
26.1
24.6
24.4
25.0
25.8
25.8
26.1
26.0
25.1
26.0
25.4
26.8
27.0
27.5
28.4
28.0
28.5
30.3
30.2
32.2
32.8
32.6
33.6
70 and over
20.8
19.5
19.1
17.9
17.6
17.9
18.0
17.6
16.9
16.6
15.6
15.5
15.0
14.2
13.9
14.2
13.8
13.1
12.5
12.2
12.2
11.4
10.5
10.4
10.5
10.9
10.9
10.7
10.5
10.7
10.3
11.7
11.6
11.5
11.6
11.1
11.7
12.0
12.1
11.5
12.3
12.8
13.5
55-61
43.7
44.5
45.3
45.5
46.4
46.2
47.3
47.0
47.0
46.4
45.7
45.3
45.6
45.9
45.7
46.2
46.6
46.1
46.6
46.9
46.4
47.1
47.4
48.1
48.9
49.9
51.4
51.7
52.1
53.6
53.8
55.5
55.9
56.4
57.3
57.6
57.9
58.3
58.9
61.1
62.5
62.1
62.7
Women
62-64
28.8
28.5
29.5
31.6
31.5
32.1
31.6
32.3
31.7
30.9
29.2
28.9
28.9
28.3
28.5
28.5
28.8
28.5
27.6
28.5
29.1
28.8
28.7
28.5
27.8
28.5
30.3
30.7
29.3
30.5
31.7
33.1
32.5
31.8
33.6
33.3
33.7
34.1
36.7
37.6
38.6
38.7
40.0
65-69
16.5
17.5
17.4
17.0
17.0
17.0
17.3
17.3
17.0
17.0
15.9
14.4
14.5
14.9
14.5
14.9
15.3
15.1
14.9
14.9
14.7
14.2
13.5
14.3
14.3
15.4
16.4
17.0
17.0
16.2
16.1
17.9
17.5
17.2
17.6
17.8
18.4
19.5
20.0
20.7
22.7
23.3
23.7
70 and over
5.9
6.2
6.1
5.8
5.8
5.8
6.1
5.7
5.6
5.4
5.3
4.8
4.8
4.6
4.6
4.8
4.6
4.5
4.6
4.5
4.5
4.4
4.3
4.1
4.1
4.4
4.6
4.7
4.7
4.8
4.7
5.5
5.3
5.2
5.1
5.2
5.5
5.8
5.9
6.0
6.4
6.7
7.1
See notes at end of table.
105
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Tables
INDICATOR 12: Participation in Labor Force
Table 12. Labor force participation rates (annual averages) of persons age 55 and over, by sex and age group, 1963-2015continued
Men
Year
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
55-61
75.2
75.4
75.8
75.4
75.6
75.4
75.5
75.7
74.9
74.9
62-64
52.4
51.7
53.0
55.1
54.6
53.2
54.6
54.0
56.2
55.8
65-69
34.4
34.3
35.6
36.3
36.5
37.4
37.1
37.2
36.1
36.8
70 and over
13.9
14.0
14.6
14.8
14.7
15.4
16.2
15.9
15.7
15.8
55-61
63.8
63.8
64.6
65.5
65.6
65.3
65.2
64.4
64.0
63.5
Women
62-64
41.5
41.8
42.0
44.0
45.3
44.7
44.1
45.2
44.7
45.2
65-69
24.2
25.7
26.4
26.6
27.0
27.3
27.6
27.6
27.5
27.9
70 and over
7.1
7.7
8.1
8.3
8.3
8.4
8.5
9.1
9.2
9.2
NOTE: Data for 1994 and later years are not strictly comparable with data for 1993 and earlier years due to a redesign of the survey and methodology of the Current
Population Survey.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Bureau of Labor Statistics, Current Population Survey.
106
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Tables
INDICATOR 13: Housing Problems
Table 13a. Prevalence of housing problems among older-owner/renter households/ by type of problem, selected years,
2009-2013
2009
House-
holds
% Persons" %
House-
holds
2011
% Persons" %
Number (in
Total
Number and percent with
One or more housing problems
Housing cost burden (>30%)
Physically inadequate housing
Crowded housing
24,115
10,169
9,614
1,003
48
100.0
42.2
39.9
4.2
0.2
32,473
12,629
11,877
1,252
73
100.0
38.9
36.6
3.9
0.2
26,419
11,199
10,621
1,120
76
100.0
42.4
40.2
4.2
0.3
House-
holds
2013
% Persons" %
thousands)
35,799
14,013
13,251
1,380
105
100.0
39.1
37.0
3.9
0.3
28,330
10,905
10,316
1,063
106
100.0
38.5
36.4
3.8
0.4
38,327
13,541
12,809
1,290
147
100.0
35.3
33.4
3.4
0.4
" Older-owner/renter households are defined as households with a householder or spouse age 65 and over.
b Number of persons age 65 and over.
NOTE: Some data for 2009 have been revised and differ slightly from previous editions of Older Americans. Additional years of data are available atagingstats.gov.
Reference population: These data refer to the resident noninstitutionalized population. People residing in noninstitutional group homes are excluded.
SOURCE: U.S. Department of Housing and Urban Development, American Housing Survey.
Table 13b. Prevalence of housing problems among older-member households/ by type of problem, selected years, 2009-2013
2009
Total
Number and percent with
One or more housing problems
Housing cost burden (>30%)
Physically inadequate housing
Crowded housing
House-
holds
2,022
902
787
98
123
%
100.0
44.6
38.9
4.9
6.1
Persons"
2,225
1,025
890
107
151
%
100.0
46.1
40.0
4.8
6.8
House-
holds
2011
% Persons"
2013
%
Number (in thousands)
2,111 100.0 2,363 100.0
924 43.8 1,028 43.5
819 38.8 907 38.4
101 4.8 111 4.7
123 5.8 147 6.2
House-
holds
2,115
818
711
81
129
%
100.0
38.7
33.6
3.8
6.1
Persons"
2,366
940
820
92
156
%
100.0
39.7
34.7
3.9
6.6
" Older-member households are defined as households with one or more members age 65 and over and exclude households with a householder or spouse age 65
and over.
b Number of persons (excluding householder and spouse) age 65 and over.
NOTE: Some data for 2009 have been revised and differ slightly from previous editions of Older Americans. Additional years of data are available atagingstats.gov.
Reference population: These data refer to the resident noninstitutionalized population. People residing in noninstitutional group homes are excluded.
SOURCE: U.S. Department of Housing and Urban Development, American Housing Survey.
107
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Tables
INDICATOR 13: Housing Problems
Table 13c. Prevalence of housing problems among all U.S. households except those households9 with one or more persons age 65 and
over, by type of problem, selected years, 2009-2013
2009
House-
holds
%
Persons
%
House-
holds
2011
%
Number (in
Total
Number and percent with
One or more housing problems
Housing cost burden (>30%)
Physically inadequate housing
Crowded housing
85,740
34,522
30,976
4,628
2,318
100.0
40.3
36.1
5.4
2.7
233,778
96,151
83,254
11,725
14,254
100.0
41.1
35.6
5.0
6.1
86,377
36,483
32,703
5,103
2,609
100.0
42.2
37.9
5.9
3.0
Persons
%
House-
holds
2013
%
Persons
%
thousands)
234,244
100,963
87,475
13,005
15,935
100.0
43.1
37.3
5.6
6.8
85,406
32,285
28,606
4,744
2,262
100.0
37.8
33.5
5.6
2.6
230,689
87,835
74,587
11,807
14,101
100.0
38.1
32.3
5.1
6.1
" Households with no persons age 65 and over.
NOTE: Some data for 2009 have been revised and differ slightly from previous editions of Older Americans. Additional years of data are available at agingstats.gov.
Reference population: These data refer to the resident noninstitutionalized population. People residing in noninstitutional group homes are excluded.
SOURCE: U.S. Department of Housing and Urban Development, American Housing Survey.
Table 13d. Prevalence of housing problems among older-owner/renter intergenerational households,9 by type of problem, selected
years, 2009-2013
2009
House-
holds
% Persons" %
House-
holds
2011
% Persons" %
House-
holds
2013
% Persons" %
Number (in thousands)
Total
Number and percent with
One or more housing problems
Housing cost burden (>30%)
Physically inadequate housing
Crowded housing
845
383
347
41
37
100.0
45.2
41.1
4.9
4.3
1,049
453
409
46
51
100.0
43.2
39.0
4.4
4.8
1,128
536
485
53
63
100.0
47.5
43.0
4.7
5.6
1,377
623
560
57
83
100.0
45.3
40.7
4.2
6.0
1,220
532
457
57
89
100.0
43.6
37.4
4.7
7.3
1,494
630
542
65
121
100.0
42.2
36.3
4.4
8.1
" Older-owner/renter intergenerational households are defined as households with a householder or spouse age 65 and over with children age 19 or younger.
b Number of persons age 65 and over.
NOTE: Some data for 2009 have been revised and differ slightly from previous editions of Older Americans. Additional years of data are available atagingstats.gov.
Reference population: These data refer to the resident noninstitutionalized population. People residing in noninstitutional group homes are excluded.
SOURCE: U.S. Department of Housing and Urban Development, American Housing Survey.
108
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Tables
INDICATOR 13: Housing Problems
Table 13e. Prevalence of housing problems among older-member intergenerational households/ by type of problem, selected years,
2009-2013
2009
House-
holds
% Persons" %
House-
holds
2011
% Persons" %
House-
holds
2013
% Persons" %
Number (in thousands)
Total
Number and percent with
One or more housing problems
Housing cost burden (>30%)
Physically inadequate housing
Crowded housing
763
420
348
39
109
100.0
55.1
45.7
5.1
14.3
869
489
405
42
127
100.0
56.3
46.6
4.8
14.7
865
468
408
44
110
100.0
54.0
47.1
5.0
12.7
980
524
453
50
129
100.0
53.5
46.3
5.1
13.2
862
391
319
40
118
100.0
45.3
37.0
4.7
13.7
982
447
364
48
136
100.0
45.5
37.1
4.9
13.9
" Older-member intergenerational households are defined as households with one or more members age 65 and over with children age 19 or younger, and exclude
households with a householder or spouse age 65 and over.
b Number of persons age 65 and over.
NOTE: Some data for 2009 have been revised and differ slightly from previous editions of Older Americans. Additional years of data are available at agingstats.gov.
Reference population: These data refer to the resident noninstitutionalized population. People residing in noninstitutional group homes are excluded.
SOURCE: U.S. Department of Housing and Urban Development, American Housing Survey.
Table 13f. Prevalence of housing problems among all older households: householder, spouse, or member(s) age 65 and over/ by type
of problem, selected years, 2009-2013
2009
2011
2013
House-
holds
Persons3
House-
holds
% Persons3
House-
holds
Persons3
Total
Number and percent with
One or more housing problems
Housing cost burden (>30%)
Physically inadequate housing
Crowded housing
26,138 100.0 34,698 100.0
11,071 42.4 13,654 39.4
10,400 39.8 12,767 36.8
1,101 4.2 1,359 3.9
170 0.7 223 0.6
Number (in thousands)
28,530 100.0 38,162 100.0
12,123 42.5 15,041 39.4
11,440 40.1 14,158 37.1
1,221 4.3 1,491 3.9
198 0.7 252 0.7
30,446 100.0 40,693 100.0
11,723 38.5 14,481 35.6
11,027 36.2 13,630 33.5
1,145 3.8 1,382 3.4
235 0.8 303 0.7
" Number of persons age 65 and over.
NOTE: Some data for 2009 have been revised and differ slightly from previous editions of Older Americans. Additional years of data are available at agingstats.gov.
Reference population: These data refer to the resident noninstitutionalized population. People residing in noninstitutional group homes are excluded.
SOURCE: U.S. Department of Housing and Urban Development, American Housing Survey.
109
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Tables
INDICATOR 14: Total Expenditures
Table 14. Percentage distribution of total household annual expenditures, by age of reference person, 2014
Annual expenditure
Personal insurance and pensions
Health care
Transportation
Housing
Food
Food at home
Food away from home
Other
45-54
12.8
6.9
17.1
31.7
12.2
7.1
5.2
19.3
55-64
12.6
8.8
16.6
32.0
12.1
7.3
4.8
17.9
65
Total
5.2
13.4
15.9
33.9
12.5
7.8
4.7
19.1
and over
65-74
6.5
12.2
17.1
32.4
12.9
7.6
5.3
18.9
75 and over
2.8
15.6
13.9
36.5
11.9
8.0
3.8
19.3
NOTE: Other expenditures include apparel, personal care, entertainment, reading, education, alcohol, tobacco, cash contributions, and miscellaneous expenditures.
Data from the Consumer Expenditure Survey by age group represent average annual expenditures for consumer units by the age of the reference person, that is the
person listed as the owner or renter of the home. For example, the data on people age 65 and over reflect consumer units with a reference person age 65 and over.
The Consumer Expenditure Survey collects and publishes information from consumer units, which are generally defined as a person or group of people who live in the
same household and are related by blood, marriage, or other legal arrangement (i.e., a family) or people who live in the same household who are unrelated but make
financial decisions together. A household usually refers to a physical dwelling and may contain more than one consumer unit (e.g., roommates who are sharing an
apartment but who are financially independent from each other). However, for convenience, the term "household" is substituted for "consumer unit" in this text.
Reference population: These data refer to the resident noninstitutionalized population.
SOURCE: Bureau of Labor Statistics, Consumer Expenditure Survey.
110
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Tables
INDICATOR 15: Life Expectancy
Table 15a. Life expectancy at ages 65 and 85, by race and sex, 1981-2014
All races3
Age and year
At age 65
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Both sexes
16.7
16.8
16.7
16.8
16.7
16.8
16.9
16.9
17.2
17.3
17.4
17.5
17.3
17.4
17.4
17.5
17.7
17.8
17.7
17.6
17.9
17.9
18.1
18.4
18.4
18.7
18.8
18.8
19.1
19.1
19.2
19.3
19.3
19.3
Men
14.4
14.5
14.5
14.6
14.6
14.7
14.8
14.9
15.2
15.1
15.3
15.4
15.3
15.5
15.6
15.7
15.9
16.0
16.1
16.0
16.2
16.3
16.5
16.9
16.9
17.2
17.4
17.4
17.7
17.7
17.8
17.9
17.9
18.0
Women
18.6
18.8
18.6
18.6
18.6
18.6
18.7
18.6
18.8
18.9
19.1
19.2
18.9
19.0
18.9
19.0
19.2
19.2
19.1
19.0
19.2
19.2
19.3
19.6
19.6
19.9
20.0
20.0
20.3
20.3
20.3
20.5
20.5
20.5
White
Both sexes
16.8
16.9
16.8
16.9
16.8
16.9
17.0
17.0
17.3
17.4
17.5
17.6
17.4
17.5
17.6
17.6
17.8
17.8
17.8
17.7
18.0
18.0
18.2
18.5
18.5
18.7
18.9
18.9
19.2
19.2
19.2
19.3
19.3
19.3
Men
14.4
14.5
14.5
14.6
14.6
14.8
14.9
14.9
15.2
15.2
15.4
15.5
15.4
15.6
15.7
15.8
16.0
16.1
16.1
16.1
16.3
16.4
16.6
17.0
17.0
17.3
17.4
17.5
17.7
17.8
17.8
18.0
18.0
18.0
Women
18.8
18.9
18.7
18.7
18.7
18.7
18.8
18.7
19.0
19.1
19.2
19.3
19.0
19.1
19.1
19.1
19.3
19.3
19.2
19.1
19.3
19.3
19.4
19.7
19.7
19.9
20.1
20.0
20.3
20.3
20.3
20.4
20.5
20.5
Black or African American
Both sexes
15.2
15.4
15.5
15.5
15.3
15.4
15.4
15.4
15.5
15.6
15.5
15.7
15.5
15.7
15.6
15.8
16.1
16.1
16.0
16.1
16.2
16.3
16.5
16.8
16.9
17.2
17.3
17.5
17.8
17.8
18.0
18.1
18.1
18.2
Men
13.2
13.3
13.4
13.5
13.3
13.4
13.5
13.4
13.6
13.3
13.4
13.5
13.4
13.6
13.6
13.9
14.2
14.3
14.3
14.1
14.2
14.4
14.5
14.9
15.0
15.2
15.4
15.5
15.9
15.9
16.2
16.2
16.3
16.3
Women
17.0
17.2
17.3
17.2
17.0
17.0
17.1
16.9
17.0
17.4
17.2
17.4
17.1
17.2
17.1
17.2
17.6
17.4
17.3
17.5
17.7
17.8
18.0
18.3
18.3
18.6
18.8
18.9
19.2
19.3
19.4
19.5
19.5
19.6
See notes at end of table.
Ill
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Tables
INDICATOR 15: Life Expectancy
Table 15a. Life expectancy at ages 65 and 85, by race and sex, 1981-2014continued
All races3
Age and year
At age 85
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Both sexes
6.1
6.3
6.1
6.1
6.0
6.0
6.1
6.0
6.2
6.2
6.2
6.2
6.0
6.1
6.0
6.1
6.3
6.3
6.3
6.1
6.1
6.0
6.1
6.3
6.2
6.3
6.4
6.4
6.6
6.5
6.5
6.6
6.6
6.6
Men
5.2
5.3
5.2
5.2
5.1
5.2
5.2
5.1
5.3
5.3
5.3
5.3
5.2
5.2
5.2
5.4
5.5
5.5
5.5
5.4
5.3
5.3
5.4
5.5
5.5
5.6
5.7
5.7
5.8
5.8
5.9
5.9
5.9
5.9
Women
6.6
6.8
6.6
6.5
6.4
6.4
6.4
6.3
6.6
6.7
6.5
6.6
6.4
6.4
6.3
6.4
6.6
6.7
6.6
6.5
6.4
6.4
6.4
6.6
6.6
6.7
6.8
6.7
7.0
6.9
6.9
7.0
7.0
7.0
White
Both sexes
6.1
6.2
6.1
6.0
5.9
6.0
6.0
5.9
6.1
6.2
6.1
6.2
6.0
6.1
6.0
6.0
6.2
6.3
6.2
6.1
6.0
6.0
6.1
6.2
6.2
6.3
6.4
6.3
6.5
6.5
6.5
6.5
6.5
6.5
Men
5.2
5.3
5.2
5.1
5.1
5.1
5.2
5.1
5.3
5.3
5.3
5.3
5.2
5.2
5.2
5.3
5.4
5.4
5.4
5.3
5.3
5.2
5.3
5.5
5.5
5.6
5.7
5.6
5.8
5.8
5.8
5.9
5.9
5.9
Women
6.6
6.7
6.5
6.5
6.4
6.4
6.4
6.3
6.5
6.6
6.5
6.6
6.4
6.4
6.3
6.3
6.6
6.6
6.6
6.5
6.4
6.4
6.4
6.6
6.5
6.7
6.8
6.7
6.9
6.9
6.8
6.9
6.9
6.9
Black or African American
Both sexes
5.7
5.8
6.9
6.8
6.5
6.3
6.4
6.3
6.3
6.5
5.9
5.9
5.9
6.0
5.9
6.0
6.4
6.3
6.2
6.3
6.3
6.2
6.3
6.4
6.4
6.5
6.6
6.6
6.8
6.8
6.8
6.8
6.8
6.9
Men
4.7
4.8
6.0
5.8
5.7
5.5
5.6
5.5
5.6
5.6
5.1
5.1
5.0
5.3
5.1
5.3
5.7
5.5
5.6
5.5
5.3
5.3
5.4
5.4
5.4
5.6
5.6
5.7
5.9
5.9
6.0
6.0
6.0
6.0
Women
6.3
6.5
7.4
7.3
6.9
6.7
6.8
6.6
6.7
7.0
6.3
6.3
6.3
6.3
6.2
6.2
6.7
6.6
6.5
6.7
6.7
6.6
6.7
6.8
6.8
7.0
7.0
7.0
7.2
7.1
7.2
7.2
7.2
7.3
" "All races" includes races not shown separately.
NOTE: Life expectancy estimates are from annual life tables produced by the National Center for Health Statistics found at http://www.cdc.gov/nchs/products/life_
tables.htm. Some estimates have been revised and may differ from previous editions of Older Americans due to changes in methodology and to the use of intercensal
population estimates for 2001-2009. See Appendix II, Life Expectancy, of Health, United States, 2015 tor a description of the changes in life table methodology
Reference population: These data refer to the resident population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System.
112
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Tables
INDICATOR 15: Life Expectancy
Table 15b. Life expectancy at birth, age 65, and age 85, by race and Hispanic origin and sex, 2014
Age
At birth
At age 65
At age 85
At birth
At age 65
At age 85
Both sexes
78.8
19.3
6.6
Both sexes
81.8
21.1
7.5
All races3
Men
76.4
18.0
5.9
Hispanic
Men
79.2
19.6
6.7
Women
81.2
20.5
7.0
Both sexes
79.0
19.3
6.5
White
Men
76.7
18.0
5.9
Black or African American
Women
81.4
20.5
6.9
Non-Hispanic
White
Women
84.0
22.2
7.8
Both sexes
78.8
19.3
6.5
Men
76.5
18.0
5.9
Women
81.1
20.5
6.9
Both sexes
75.6
18.2
6.9
Men
72.5
16.3
6.0
Women
78.4
19.6
7.3
Non-Hispanic
Black or African American
Both sexes
75.2
18.1
6.8
Men
72.0
16.2
6.0
Women
78.1
19.5
7.2
" "All races" includes races not shown separately
NOTE: See data sources for the definition of race and Hispanic origin in the National Vital Statistics System. See http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_ll.
pdf for a description of the methodology used to calculate life expectancy for the Hispanic population.
Reference population: These data refer to the resident population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System.
113
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Tables
INDICATOR 16: Mortality
Table 16a. Death rates among people age 65 and over, by selected leading causes of death, 1981-2014
Year
Total3
Heart
disease
Cancer
Chronic
lower
respiratory Influenza and
Stroke diseases pneumonia
(Number per 100,000
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
5,714
5,610
5,685
5,645
5,694
5,629
5,578
5,625
5,457
5,353
5,291
5,205
5,349
5,270
5,265
5,222
5,179
5,168
5,220
5,169
5,096
5,082
4,992
4,801
4,804
4,640
4,540
4,555
4,373
4,389
4,342
4,279
4,267
4,198
2,547
2,503
2,512
2,450
2,431
2,372
2,316
2,306
2,172
2,091
2,046
1,990
2,024
1,952
1,927
1,878
1,827
1,792
1,767
1,707
1,652
1,616
1,557
1,456
1,422
1,340
1,275
1,246
1,180
1,156
1,116
1,091
1,085
1,062
1,056
1,069
1,078
1,087
1,091
1,101
1,106
1,114
1,133
1,142
1,150
1,151
1,159
1,155
1,153
1,141
1,127
1,119
1,126
1,124
1,105
1,098
1,080
1,061
1,053
1,036
1,024
1,008
988
987
962
946
927
915
624
585
564
546
531
506
496
489
464
448
435
425
435
434
438
433
424
412
433
426
410
402
381
356
331
307
298
288
270
267
258
250
245
247
population)
186
186
204
211
225
228
230
240
240
245
252
253
274
271
271
276
280
269
313
305
303
304
302
288
304
284
286
310
295
292
294
287
290
277
207
181
207
214
243
245
237
263
253
258
245
233
248
238
237
234
236
247
167
169
157
165
159
144
148
129
117
121
107
103
106
99
106
97
Alzheimer's Unintentional
Diabetes disease injuries
106
102
104
103
103
101
102
105
120
120
121
121
128
133
136
139
140
143
150
150
152
154
152
148
149
139
135
130
123
122
126
123
122
119
6
9
16
24
31
35
42
45
47
49
49
49
55
60
65
66
68
67
129
141
151
163
173
177
188
186
187
202
190
197
194
187
184
200
94
88
89
89
89
87
87
90
88
84
83
82
84
84
84
87
87
90
94
89
93
94
95
96
99
97
99
100
97
101
102
103
103
105
" Includes other causes of death not shown separately.
NOTE: Death rates for 1981-1998 are based on the 9th revision of the International Classification of Diseases (ICD-9). Starting in 1999, death rates are based on ICD-
10. For the period 1981-1998, causes were coded using ICD-9 codes that are more comparable with codes for corresponding ICD-10 categories and may differ from
other published estimates. See http://www.cdc.gov/nchs/data/nvsr/nvsr49/nvsr49_02.pdf for information on the comparability of death rates between ICD-9 and ICD-
10. Some data from 2000-2009 have been revised and differ from previous versions of Older Americans. Rates are age adjusted using the 2000 standard population.
Ranking of causes of death are based on crude rates of death, not the age-adjusted rates shown here.
Reference population: These data refer to the resident population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System.
114
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Tables
INDICATOR 16: Mortality
Table 16b. Death rates among people age 65 and over, by selected leading causes of death, sex, and race and Hispanic origin, 2014
All
Sex
Men
Women
Race and Hispanic
origin
Non-Hispanic
White
Non-Hispanic
Black
Hispanic
Total3
4,198
4,838
3,724
4,323
4,609
3,082
Chronic
lower Influenza
Heart respiratory and Alzheimer's Unintentional
disease Cancer Stroke diseases pneumonia Diabetes disease injuries
(Number per 100,000 population)
1,062 915 247 277 97 119 200
1,302 1,140 243 314 116 144 161
887 755 247 252 85 101 222
1,090 944 246 310 98 106 210
1,207 1,023 313 179 97 212 178
766 648 203 126 82 155 156
105
131
86
113
70
67
" Includes other causes of death not shown separately.
NOTE: Rates are age adjusted using the 2000 standard population. Ranking of causes of death are based on crude rates of death, not the age-adjusted rates shown
here.
Reference population: These data refer to the resident population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System.
115
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Tables
INDICATOR 17: Chronic Health Conditions
Table 17a. Percentage of people age 65 and over who reported having selected chronic health conditions, by sex and race and Hispanic
origin, 2013-2014
Sex and
race and Hispanic origin
Total
Sex
Men
Women
Race and Hispanic origin
Non-Hispanic White
Non-Hispanic Black
Hispanic
Heart
disease
29.4
35.0
24.9
30.7
26.4
22.9
Hyper-
tension
55.9
54.9
56.7
54.2
70.6
57.1
Stroke
7.9
8.4
7.4
7.6
10.6
7.8
Chronic
bronchitis or
Asthma emphysema
10.6
8.1
12.7
10.3
13.3
11.2
8.1
7.6
8.6
8.6
7.7
6.0
Cancer
23.4
26.2
21.2
26.0
16.7
12.5
Diabetes
20.8
22.7
19.2
18.3
32.1
32.3
Arthritis
49.0
42.6
54.2
50.1
51.3
43.7
NOTE: Data are based on a 2-year average from 2013-2014. See data sources for the definition of race and Hispanic origin in the National Health Interview Survey.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.
Table 17b. Percentage of people age 65 and over who reported having selected chronic health conditions, 1997-1998 through 2013-
2014
Year
1997-1998
1999-2000
2001-2002
2003-2004
2005-2006
2007-2008
2009-2010
2011-2012
2013-2014
Heart
disease
32.3
29.8
31.5
31.8
30.9
31.9
30.4
30.3
29.4
Hyper-
tension
46.5
47.4
50.2
51.9
53.3
55.7
55.9
55.8
55.9
Stroke Emphysema
8.2
8.2
8.9
9.3
9.3
8.8
8.6
8.3
7.9
5.2
5.2
5.0
5.2
5.7
5.1
6.2
5.1
4.2
Chronic
Asthma bronchitis
7.7
7.4
8.3
8.9
10.6
10.4
11.3
10.4
10.6
6.4
6.2
6.1
6.0
6.1
5.4
6.2
5.7
5.3
Cancer
18.7
19.9
20.8
20.7
21.1
22.5
24.0
24.6
23.4
Diabetes
13.0
13.7
15.4
16.9
18.0
18.6
20.5
20.3
20.8
Arthritis
50.0
49.5
49.5
51.2
48.9
49.0
Not available.
NOTE: Data are based on 2-year averages.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.
116
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Tables
INDICATOR 18: Oral Health
Table 18a. Percentage of people age 65 and over who had dental insurance, had a dental visit in the past year, or had no natural teeth,
by age group, 2014
Age group
Dental insurance
Dental visit in past year
No natural teeth
65 and over
65-74
75-84
85 and over
25.1
29.7
19.8
15.5
62.4
65.7
58.2
56.4
20.7
16.4
25.0
31.4
NOTE: Dental insurance is estimated from questions on whether the respondent's private health insurance plan covers dental care and whether the respondent has
a single service plan covering dental care. Dental visits in the past year were estimated from responses to the question, "About how long has it been since you last
saw or talked to a dentist?" The percentage with no natural teeth was estimated from responses to the question, "Have you lost all of your upper and lower natural
(permanent) teeth?" All estimates were calculated from the sample adult component of the National Health Interview Survey.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.
Table 18b. Percentage of people age 65 and over who had dental insurance, had a dental visit in the past year, or had no natural teeth,
by sex and race and Hispanic origin, 2014
Sex and race and Hispanic origin
Dental insurance
Dental visit in past year
No natural teeth
Sex
Men
Women
Race and Hispanic origin
Non-Hispanic White
Non-Hispanic Black
Hispanic
28.4
22.5
25.7
23.5
20.1
62.2
62.5
66.1
43.0
51.3
20.9
20.5
19.6
28.2
23.2
NOTE: Dental insurance is estimated from questions on whether the respondent's private health insurance plan covers dental care and whether the respondent has
a single service plan covering dental care. Dental visits in the past year were estimated from responses to the question, "About how long has it been since you last
saw or talked to a dentist?" The percentage with no natural teeth was estimated from responses to the question, "Have you lost all of your upper and lower natural
(permanent) teeth?" All estimates were calculated from the sample adult component of the National Health Interview Survey.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.
117
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Tables
INDICATOR 19: Respondent-Assessed Health Status
Table 19. Percentage of people age 65 and over with respondent-assessed good to excellent health status, by race and Hispanic origin,
sex, and age group, 2012-2014
Selected characteristic
Good to excellent health
Both sexes
65 and over
65-74
75-84
85 and over
Men
65 and over
65-74
75-84
85 and over
Women
65 and over
65-74
75-84
85 and over
Fair or poor health
Both sexes
65 and over
65-74
75-84
85 and over
Men
65 and over
65-74
75-84
85 and over
Women
65 and over
65-74
75-84
85 and over
Total
77.5
80.4
75.8
68.1
77.5
79.9
76.1
67.5
77.5
80.8
75.5
68.5
22.5
19.6
24.2
31.9
22.5
20.1
23.9
32.5
22.5
19.2
24.5
31.5
Non-Hispanic
White
80.1
83.1
78.4
70.6
79.6
82.2
77.9
69.0
80.5
84.0
78.7
71.6
19.9
16.9
21.6
29.4
20.4
17.8
22.1
31.0
19.5
16.0
21.3
28.4
Non-Hispanic
Black
65.2
67.5
63.6
55.6
66.5
67.4
67.2
56.3
64.3
67.5
61.5
55.2
34.8
32.5
36.5
44.5
33.5
32.6
32.8
43.7
35.7
32.5
38.5
44.8
Hispanic
(of any race)
66.3
69.4
63.0
54.7
68.5
69.9
67.7
57.9
64.7
69.0
59.6
52.9
33.7
30.6
37.0
45.3
31.6
30.1
32.3
42.1
35.3
31.0
40.4
47.1
NOTE: Data are based on a 3-year average from 2012-2014. Total includes all other races not shown separately. See data sources for the definition of race and
Hispanic origin in the National Health Interview Survey.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.
118
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Tables
INDICATOR 20: Dementia
Table 20a. Number and percentage of the non-nursing home population age 65 and over with dementia, by age group, 2011
Age group
65 and over
65-69
70-74
75-79
80-84
85-89
90 and over
Number
3,632,567
412,085
416,914
670,987
797,865
757,214
577,502
Percent
10.0
3.6
4.8
9.9
15.3
24.0
36.2
Reference population: These data refer to Medicare beneficiaries not living in nursing homes.
SOURCE: National Health and Aging Trends Study.
Table 20b. Percentage of the non-nursing home population age 65 and over with dementia, by sex and age group, 2011
Age group
Men
Women
65 and over
65-74
75-84
85 and over
9.1
5.1
11.4
23.9
10.7
3.3
12.9
29.9
Reference population: These data refer to Medicare beneficiaries not living in nursing homes.
SOURCE: National Health and Aging Trends Study.
Table 20c. Percentage of the non-nursing home population age 65 and over with dementia, by sex and educational attainment, 2011
Educational attainment
Total
Men
Women
Less than high school
High school graduate
Some college
Bachelor's degree or more
20.6
10.0
5.5
4.6
19.2
8.8
5.3
4.5
21.7
10.7
5.7
4.7
Reference population: These data refer to Medicare beneficiaries not living in nursing homes.
SOURCE: National Health and Aging Trends Study.
Table 20d. Percentage of the non-nursing home population age 65 and over with dementia, by age group and educational attainment,
2011
Educational attainment
65-74
75-84
85 and over
Less than high school
High school graduate
Some college
Bachelor's degree or more
11.6
4.0
2.4
1.2
22.9
11.6
6.8
6.0
37.4
27.3
18.6
20.0
Reference population: These data refer to Medicare beneficiaries not living in nursing homes.
SOURCE: National Health and Aging Trends Study.
119
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Tables
INDICATOR 21: Depressive Symptoms
Table 21a. Percentage of people age 51 and over with clinically relevant depressive symptoms, by age group and sex, selected years
1998-2014
Sex
Both sexes
Men
Women
Both sexes
Men
Women
51 and
over
15.2
11.9
17.8
51 and
over
13.9
11.6
15.8
1998
51-64
14.7
11.9
17.0
2008
51-64
14.6
12.6
16.3
65 and
over
15.8
11.8
18.5
65 and
over
13.3
10.5
15.2
51 and
over
15.5
11.5
18.5
51 and
over
14.1
12.0
15.9
2000
51-64
15.4
11.7
18.4
2010
51-64
15.6
13.9
17.1
65 and
over
15.6
11.2
18.5
65 and
over
11.9
8.9
14.2
51 and
over
15.2
11.5
17.9
51 and
over
14.2
11.7
16.2
2002
51-64
15.1
11.6
17.8
2012
51-64
15.6
13.5
17.4
65 and
over
15.4
11.5
18.0
65 and
over
12.5
9.4
14.8
51 and
over
14.7
12.0
16.8
51 and
over
13.7
11.2
15.8
2004
51-64
14.8
12.5
16.7
2014
51-64
14.7
12.2
16.9
65 and
over
14.6
11.1
17.0
65 and
over
12.8
10.1
14.9
2006
51 and 65 and
over 51-64 over
15.6 16.6 14.4
12.4 14.1 10.1
18.1 18.7 17.5
NOTE: The definition of "clinically relevant depressive symptoms" is four or more symptoms out of a list of eight depressive symptoms from an abbreviated version
of the Center of Epidemiological Studies Depression Scale (CES-D), adapted by the Health and Retirement Study (MRS). The CES-D scale is a measure of depressive
symptoms and is not to be used as a diagnosis of clinical depression. A detailed explanation concerning the "four or more symptoms" cut-off can be found in the
following documentation: http://hrsonline.isr.umich.edu/sitedocs/userg/dr_005.pdf. Percentages are based on weighted data using the preliminary respondent
weights from the 2014 Early Release MRS Tracker File. Some data for 1998-2008 have been revised and differ from previous editions of Older Americans.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Health and Retirement Study.
Table 21b. Percentage of people age 51 and over with clinically relevant depressive symptoms, by age group and sex, 2014
Age group
51-54
55-59
60-64
65-69
70-74
75-79
80-84
85 and over
Both sexes
17.4
15.2
13.8
12.5
10.4
12.8
16.2
15.3
Men
11.4
12.0
12.5
11.3
7.0
8.7
12.7
13.9
Women
20.7
18.2
14.9
13.4
13.4
15.9
18.7
16.0
NOTE: The definition of "clinically relevant depressive symptoms" is four or more symptoms out of a list of eight depressive symptoms from an abbreviated version
of the Center of Epidemiological Studies Depression Scale (CES-D), adapted by the Health and Retirement Study (HRS). The CES-D scale is a measure of depressive
symptoms and is not to be used as a diagnosis of clinical depression. A detailed explanation concerning the "four or more symptoms" cut-off can be found in the
following documentation: http://hrsonline.isr.umich.edu/sitedocs/userg/dr_005.pdf. Percentages are based on weighted data using the preliminary respondent weight
from HRS 2014.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Health and Retirement Study.
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INDICATOR 22: Functional Limitations
Table 22a. Percentage of people age 65 and over with a disability, by sex and functional domain, 2010 and 2014
Sex and functional domain
Total
Any disability
Vision
Hearing
Mobility
Communication
Cognition
Self-care
Men
Any disability
Vision
Hearing
Mobility
Communication
Cognition
Self-care
Women
Any disability
Vision
Hearing
Mobility
Communication
Cognition
Self-care
2010
22.6
3.3
4.2
17.1
1.2
2.7
3.0
20.0
2.6
6.0
13.7
1.9
2.8
2.3
24.8
4.0
2.8
19.8
0.6
2.6
3.5
2014
21.6
3.7
6.0
14.2
1.5
3.1
2.3
19.3
3.4
8.1
10.5
1.6
3.1
1.8
23.5
3.9
4.4
17.1
1.4
3.0
2.7
NOTE: Disability is defined as "a lot" or "cannot do/unable to do" when asked about difficulty with seeing, even if wearing glasses (vision); hearing, even if wearing
hearing aids (hearing); walking or climbing steps (mobility); communicating, for example, understanding or being understood by others (communication);
remembering or concentrating (cognition); and self-care, such as washing all over or dressing (self-care). Any disability is defined as having difficulty with at least one
of these activities. The data source and measures presented have changed from previous editions of Older Americans.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey
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Table 22b. Percentage of people age 65 and over with a disability, by age group and functional domain, 2014
Functional domain
Any disability
Vision
Hearing
Mobility
Communication
Cognition
Self-care
65-74
17.4
2.9
5.1
10.6
1.0
2.2
1.6
75-84
21.9
4.1
5.9
14.6
1.8
3.1
1.6
85 and over
41.9
6.3
11.0
30.9
3.6
7.4
7.5
NOTE: Disability is defined as "a lot" or "cannot do/unable to do" when asked about difficulty with seeing, even if wearing glasses (vision); hearing, even if wearing
hearing aids (hearing); walking or climbing steps (mobility); communicating, for example, understanding or being understood by others (communication);
remembering or concentrating (cognition); and self-care, such as washing all over or dressing (self-care). Any disability is defined as having difficulty with at least one
of these activities. The data source and measures presented have changed from previous editions of Older Americans.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.
Table 22c. Percentage of people age 65 and over with a disability, by race and Hispanic origin and functional domain, 2014
Functional domain
Any disability
Vision
Hearing
Mobility
Communication
Cognition
Self-care
Non-Hispanic
White
20.7
3.3
6.1
13.3
1.1
2.6
1.7
Non-Hispanic
Black
26.2
4.6
4.1
20.6
2.4
3.2
4.0
Hispanic
26.0
5.6
7.8
16.9
3.1
6.0
4.6
NOTE: Disability is defined as "a lot" or "cannot do/unable to do" when asked about difficulty with seeing, even if wearing glasses (vision); hearing, even if wearing
hearing aids (hearing); walking or climbing steps (mobility); communicating, for example, understanding or being understood by others (communication);
remembering or concentrating (cognition); and self-care, such as washing all over or dressing (self-care). Any disability is defined as having difficulty with at least one
of these activities. See data sources for the definition of race and Hispanic origin in the National Health Interview Survey. The data source and measures presented
have changed from previous editions of Older Americans.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.
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INDICATOR 22: Functional Limitations
Table 22d. Percentage of Medicare beneficiaries age 65 and over who have limitations in performing activities of daily living (ADLs) or
instrumental activities of daily living (lADLs), or who are in a long-term care facility, 1992-2013
Year
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
Total
48.9
46.9
46.8
45.0
43.2
42.5
42.5
43.8
43.8
43.7
44.3
43.3
42.7
42.1
42.2
42.1
41.3
41.4
42.0
43.7
46.9
44.0
lADLs only
13.7
13.4
14.1
12.9
12.8
12.7
12.4
12.8
13.0
13.4
13.3
12.9
13.1
12.3
12.4
13.8
11.8
12.1
11.9
12.3
11.9
11.7
1-2 ADLs
19.6
18.1
17.7
17.2
16.7
16.6
17.1
17.9
17.4
17.2
18.3
17.6
18.2
18.3
18.0
17.7
18.9
17.6
18.7
19.7
22.0
20.0
3-4 ADLs
6.1
5.9
5.6
5.7
5.0
4.9
5.2
5.1
5.6
5.3
5.2
5.5
4.5
4.7
5.1
4.5
4.5
5.1
5.1
5.2
6.3
5.8
5-6 ADLs
3.5
3.6
3.7
3.4
3.3
3.2
3.1
3.2
3.0
3.0
2.8
3.1
2.7
2.5
2.7
2.3
2.4
2.7
2.8
3.0
3.0
2.8
Long-term
care facility
5.9
5.9
5.7
5.8
5.4
5.1
4.7
4.8
4.8
4.8
4.6
4.2
4.2
4.3
4.1
3.9
3.8
3.9
3.5
3.6
3.7
3.7
NOTE: A residence is considered a long-term care facility if it is certified by Medicare or Medicaid; has three or more beds, is licensed as a nursing home or other
long-term care facility, and provides at least one personal care service; or provides 24-hour, 7-day-a-week supervision by a caregiver. Limitations in performing
activities of daily living (ADLs) refer to difficulty performing (or inability to perform for a health reason) one or more of the following tasks: bathing, dressing, eating,
getting in/out of chairs, walking, or using the toilet. Limitations performing instrumental activities of daily living (lADLs) refer to difficulty performing (or inability to
perform for a health reason) one or more of the following tasks: using the telephone, light housework, heavy housework, meal preparation, shopping, or managing
money. Percentages are age adjusted using the 2000 standard population. Estimates may not sum to the totals because of rounding.
Reference population: These data refer to Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Access to Care.
Table 22e. Percentage of Medicare beneficiaries age 65 and over who have limitations in performing activities of daily living (ADLs) or
instrumental activities of daily living (lADLs), or who are in a long-term care facility, by sex and age group, 2013
Total
Sex
Men
Women
Age group
65-74
75-84
85 and over
Total
44.0
37.3
49.1
33.9
48.4
74.2
lADLs only
11.7
9.0
13.9
10.3
12.8
14.4
1-2 ADLs
20.0
18.4
21.3
16.3
22.7
28.1
3-4 ADLs
5.8
4.7
6.6
4.1
6.7
10.0
5-6 ADLs
2.8
2.6
2.9
1.9
2.6
7.0
Long-term
care facility
3.7
2.6
4.4
1.2
3.6
14.7
NOTE: A residence is considered a long-term care facility if it is certified by Medicare or Medicaid; has three or more beds, is licensed as a nursing home or other
long-term care facility, and provides at least one personal care service; or provides 24-hour, 7-day-a-week supervision by a caregiver. Limitations in performing
activities of daily living (ADLs) refer to difficulty performing (or inability to perform for a health reason) one or more of the following tasks: bathing, dressing, eating,
getting in/out of chairs, walking, or using the toilet. Limitations performing instrumental activities of daily living (lADLs) refer to difficulty performing (or inability to
perform for a health reason) one or more of the following tasks: using the telephone, light housework, heavy housework, meal preparation, shopping, or managing
money. Percentages are age adjusted using the 2000 standard population.
Reference population: These data refer to Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Access to Care.
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INDICATOR 23: Vaccinations
Table 23a. Percentage of people age 65 and over who reported having been vaccinated against influenza and pneumococcal
disease, by race and Hispanic origin, selected years, 1989-2014
Year
1989
1991
1993
1994
1995
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Influenza
Non-Hispanic Non-Hispanic
White Black
32.0
42.8
53.1
56.9
60.0
65.8
65.6
67.9
66.6
65.4
68.7
68.6
67.3
63.2
67.5
69.4
69.9
69.1
65.9
69.1
68.9
70.1
72.4
17.7
26.5
31.1
37.7
39.5
44.6
45.9
49.7
47.9
47.9
49.5
47.8
45.7
39.7
46.8
55.7
50.9
53.0
52.6
53.1
53.0
55.5
57.4
Pneumococcal disease
Hispanic
23.8
33.2
46.2
36.6
49.5
52.7
50.3
55.1
55.7
51.9
48.5
45.4
54.6
41.7
44.9
52.3
54.9
57.0
54.6
57.3
57.8
57.2
60.8
Non-Hispanic Non-Hispanic
White Black
15.0
21.0
28.7
30.5
34.2
45.6
49.5
53.1
56.8
57.8
60.3
59.6
60.9
60.7
62.0
62.2
64.3
64.9
63.6
66.6
63.9
63.6
64.9
6.2
13.2
13.1
13.9
20.5
22.2
26.0
32.3
30.5
33.9
36.9
37.0
38.6
40.5
35.5
44.1
44.5
44.8
45.9
47.8
46.0
48.7
49.8
Hispanic
9.8
11.0
12.2
13.7
21.6
23.5
22.8
27.9
30.4
32.9
27.1
31.0
33.7
27.5
33.4
31.8
36.4
40.1
39.0
43.1
43.4
39.2
45.2
NOTE: For influenza, the percentage vaccinated consists of people who reported having a flu shot during the past 12 months. Beginning with data from 2005,
receipt of nasal spray flu vaccine is included in the estimate of flu vaccinations. For pneumococcal disease, the percentage refers to people who reported
ever having a pneumonia vaccination. Questions concerning the use of influenza and pneumonia vaccinations differed slightly on the National Health
Interview Survey across the years for which data are shown. For details, see Health, United States, 2015 Appendix II. See data sources for the definition of
race and Hispanic origin in the National Health Interview Survey. Some data for 2005-2010 have been revised and differ from previous editions of Older
Americans.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.
Table 23b. Percentage of people age 65 and over who reported having been vaccinated against influenza and pneumococcal
disease, by selected characteristics, 2014
Selected characteristic
Influenza
Pneumococcal disease
Total
Sex
Men
Women
Age group
65-74
75-84
85 and over
Education
Less than high school graduate
High school graduate or higher
70.1
70.2
70.0
67.1
72.9
77.9
64.4
71.7
61.3
58.4
63.7
55.8
69.3
69.4
55.3
62.9
NOTE: For influenza, the percentage vaccinated consists of people who reported having a flu shot during the past 12 months and includes receipt of nasal
spray flu vaccines. For pneumococcal disease, the percentage refers to people who reported ever having a pneumonia vaccination.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.
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INDICATOR 24: Cancer Screenings
Table 24. Percentage of women ages 50-74 who had breast cancer screening and percentage of people ages 50-75 who had colorectal
cancer screening, by sex and age group, selected years, 2000-2013
Selected characteristic
Breast cancer screening
Women
50-64
65-74
Colorectal cancer (CRC) screening
Men
50-64
65-75
Women
50-64
65-75
2000
78.7
74.0
28.6
43.4
31.0
41.3
2003
76.2
74.6
36.3
49.9
34.8
45.8
2005
71.8
72.5
39.2
58.2
41.1
51.9
2008
74.2
72.6
47.3
62.4
49.0
58.6
2010
72.6
71.9
54.0
70.1
55.9
65.9
2013
71.4
75.3
51.2
69.8
54.3
69.1
NOTE: Breast cancer screening is defined as reporting having had a mammogram in the last 2 years. Colorectal cancer (CRC) screening is defined as reporting a
fecal occult blood test (FOBT) in the past year, a sigmoidoscopy procedure in the past 5 years with FOBT in the past 3 years, or a colonoscopy in the past 10 years.
Questions concerning use of CRC screening and mammography differed slightly on the National Health Interview Survey across the years for which data are shown.
For details, see Health, United States, 2015, Appendix II. Breast cancer screening is reported for women ages 50-74, and colorectal cancer screening is reported for
men and women ages 50-75.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.
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INDICATOR 25: Diet Quality
Table 25. Healthy Eating Index-2010 average total scores and component scores expressed as a percentage of the HEI maximum score
for the population age 65 and over, by age group, 2011-2012
65 and over
Dietary component
Total
65-74
75 and over
Total Healthy Eating Index-2010 score
68.3
68.4
67.8
Dietary adequacy components3
Total fruit
Whole fruit
Total vegetables
Greens and beans
Whole grains
Dairy
Total protein foods
Seafood and plant proteins
Fatty acids
Dietary moderation components'1
Refined grains
Sodium
Empty calories'
76.8
99.8
83.3
71.5
42.3
59.9
100.0
98.2
56.0
73.4
36.6
74.9
74.2
99.2
86.4
80.5
38.6
57.6
100.0
99.0
57.4
71.7
35.8
76.5
80.8
100.0
78.6
56.3
47.9
63.5
100.0
91.3
54.1
75.9
38.0
72.6
" Higher scores reflect higher intakes.
b Higher scores reflect lower intakes.
c Empty calories are calories from solid fats (i.e., sources of saturated fats and trans fats) and added sugars (i.e., sugars not naturally occurring).
NOTE: The Healthy Eating Index-2010 (HEI-2010) is a dietary assessment tool comprising 12 components designed to measure quality in terms of how well diets meet
the recommendations of the 2010 Dietary Guidelines for Americans and the USDA Food Patterns.31'56'57 The HEI-2010 has 12 components; intakes equal to or better
than the standards set for each component are assigned a maximum score. For the nine adequacy components (e.g., total fruit), no intake receives a score of zero
and scores increase up to the maximum as the intakes increase toward the standard. The three moderation components (e.g., sodium) are scored in reverse so that
excessively high intakes receive zeroes and as intakes decrease toward the standard, scores increase. Higher scores reflect lower intakes because lower intakes of the
moderation components are more desirable. A higher score indicates a higher quality diet that aligns with the Dietary Guidelines for Americans. Scores are averaged
across all adults based on usual dietary intakes.
Reference population: These data refer to the resident noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey, and U.S. Department of
Agriculture, Center for Nutrition Policy and Promotion and National Cancer Institute. Healthy Eating Index-2010.
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INDICATOR 26: Physical Activity
Table 26a. Percentage of people age 65 and over who reported participating in leisure-time aerobic and muscle-strengthening
activities that meet the 2008 Federal physical activity guidelines, by age group, 1998-2014
65 and over
Year
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Total
5.5
5.9
6.9
6.7
7.1
7.6
7.8
7.9
7.5
7.9
9.5
10.0
10.5
11.3
11.9
11.7
11.7
65-74
7.0
7.7
8.4
7.7
8.8
9.2
9.7
10.5
9.1
9.5
11.3
12.8
13.6
14.3
14.8
14.7
14.5
75-84
3.9
4.5
5.7
6.1
5.8
6.7
6.4
5.7
6.5
6.6
9.3
7.9
7.3
8.9
9.1
9.0
9.0
85 and over
2.0
0.9
1.9
3.1
2.1
2.9
3.5
3.0
3.0
4.1
2.3
2.8
4.0
4.5
4.7
4.2
5.1
NOTE: This measure of physical activity reflects the 2008 Federal physical activity guidelines for Americans (available from: http://www.health.gov/PAGuidelines/).
The 2008 Federal guidelines recommend that adults age 65 and over who are fit and have no limiting chronic conditions perform at least 150 minutes (2 hours and
30 minutes) a week of moderate-intensity, or 75 minutes (1 hour and 15 minutes) a week of vigorous-intensity aerobic physical activity or an equivalent combination
of moderate- and vigorous-intensity aerobic activity. Aerobic activity should be performed in episodes of at least 10 minutes, and preferably, it should be spread
throughout the week. In addition, they should perform muscle-strengthening activities that are moderate or high intensity and involve all major muscle groups on
two or more days a week, because these activities provide additional health benefits. The measure shown here presents the percentage of people who fully met both
the aerobic activity and muscle-strengthening guidelines, irrespective of their chronic condition status.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.
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INDICATOR 26: Physical Activity
Table 26b. Percentage of people age 65 and over who reported participating in leisure-time aerobic and muscle-strengthening
activities that meet the 2008 Federal physical activity guidelines, by sex and race and Hispanic origin, 2014
Activity and race and Hispanic origin
Aerobic and muscle-strengthening activities
Total
Non-Hispanic White
Non-Hispanic Black
Hispanic (of any race)
Aerobic activity
Total
Non-Hispanic White
Non-Hispanic Black
Hispanic (of any race)
Muscle-strengthening activity
Total
Non-Hispanic White
Non-Hispanic Black
Hispanic (of any race)
Total
11.7
12.5
8.9
7.4
36.5
37.9
26.4
29.0
16.5
17.2
13.5
13.4
Men
14.9
15.6
12.9
8.7
41.6
42.9
33.7
30.5
19.1
19.9
17.1
12.5
Women
9.2
9.9
6.2
6.5
32.5
33.9
21.5
27.9
14.5
14.9
11.1
14.0
NOTE: This measure of physical activity reflects the 2008 Federal physical activity guidelines for Americans (available from: http://www.health.gov/PAGuidelines/).
The 2008 Federal guidelines recommend that adults age 65 and over who are fit and have no limiting chronic conditions perform at least 150 minutes (2 hours and
30 minutes) a week of moderate-intensity, or 75 minutes (1 hour and 15 minutes) a week of vigorous-intensity aerobic physical activity or an equivalent combination
of moderate- and vigorous-intensity aerobic activity. Aerobic activity should be performed in episodes of at least 10 minutes, and preferably, it should be spread
throughout the week. In addition, they should perform muscle-strengthening activities that are moderate or high intensity and involve all major muscle groups on
two or more days a week, because these activities provide additional health benefits. The combined measure shown here presents the percentage of people who fully
met both the aerobic activity and muscle-strengthening guidelines, irrespective of their chronic condition status. Total includes all other races not shown separately.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.
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INDICATOR 27: Obesity
Table 27. Percentage of people age 65 and over overweight and with obesity, by sex and age group, selected years, 1976-2014
Sex and age group
Overweight
Both sexes
65 and over
65-74
75 and over
Men
65 and over
65-74
75 and over
Women
65 and over
65-74
75 and over
Obese
Both sexes
65 and over
65-74
75 and over
Men
65 and over
65-74
75 and over
Women
65 and over
65-74
75 and over
1976-1980 1988-1994
60.1
57.2 64.1
53.9
64.4
54.2 68.5
56.5
56.9
59.5 60.3
52.3
22.2
17.9 25.6
17.0
20.3
13.2 24.1
13.2
23.6
21.5 26.9
19.2
1999-2002
68.8
73.3
62.8
72.8
76.2
67.4
65.9
70.9
59.9
29.6
35.7
21.3
26.2
31.6
17.7
32.0
39.0
23.6
2003-2006
69.5
73.8
63.9
73.0
78.0
65.8
66.7
70.3
62.6
30.1
34.8
24.1
29.3
33.0
24.0
30.8
36.4
24.2
2007-2010
72.0
75.7
67.2
75.7
77.5
73.2
69.1
74.2
63.2
35.1
40.8
27.8
35.3
41.5
26.5
34.9
40.3
28.7
2011-2014
70.9
73.5
67.3
74.2
76.1
71.0
68.4
71.2
64.6
34.7
38.6
29.0
32.6
36.2
26.8
36.4
40.7
30.5
Not available.
NOTE: Data are based on measured height and weight. Height was measured without shoes. Overweight is defined as having a body mass index (BMI) greater than
or equal to 25 kilograms/meter2. Obese is defined by a BMI of 30 kilograms/meter2 or greater. The percentage of people with obesity is a subset of the percentage
of those who are overweight. See glossary for the definition of BMI. Beginning in 1999, the National Health and Nutrition Examination Survey has been in the field
continuously with data released every 2 years. Some data have been revised and differ from previous editions of Older Americans.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey.
129
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Tables
INDICATOR 28: Cigarette Smoking
Table 28a. Percentage of people age 65 and over who are current cigarette smokers, by sex and race, selected years, 1965-2014
Year
1965
1974
1979
1983
1985
1987
1988
1990
1991
1992
1993
1994
1995
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Total
28.5
24.8
20.9
22.0
19.6
17.2
18.0
14.6
15.1
16.1
13.5
13.2
14.9
12.8
10.4
10.5
10.2
11.5
10.1
10.1
9.8
8.9
12.6
9.3
10.5
9.5
9.7
8.9
10.6
10.6
9.8
Men
White
27.7
24.3
20.5
20.6
18.9
16.0
16.9
13.7
14.2
14.9
12.5
11.9
14.1
11.5
10.0
10.0
9.8
10.7
9.3
9.6
9.4
7.9
12.6
8.9
9.9
9.3
9.6
8.7
10.3
10.0
9.4
Black or African
American
36.4
29.7
26.2
38.9
nn
30.3
29.8
21.5
24.3
28.3
*27.9
25.6
28.5
26.0
16.3
17.3
14.2
21.1
19.4
18.0
14.1
16.8
16.0
14.3
17.5
14.0
10.0
13.7
17.4
15.5
13.9
Total
9.6
12.0
13.2
13.1
13.5
13.7
12.8
11.5
12.0
12.4
10.5
11.1
11.5
11.5
11.2
10.7
9.3
tg.i
8.6
8.3
8.1
8.3
8.3
7.6
8.3
9.5
9.3
7.1
7.5
7.5
7.5
Women
White
9.8
12.3
13.8
13.2
13.3
13.9
12.6
11.5
12.1
12.6
10.5
11.1
11.7
11.7
11.2
10.5
9.1
9.4
8.5
8.4
8.2
8.4
8.4
8.0
8.6
9.6
9.4
7.0
7.5
7.9
7.6
Black or African
American
7.1
*8.9
*8.5
*13.1
14.5
11.7
14.8
11.1
9.6
*11.1
*10.2
13.6
13.3
10.7
11.5
13.5
10.2
9.3
9.4
8.0
6.7
10.0
9.3
6.4
8.1
11.5
9.4
9.1
9.1
6.5
8.2
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error of 20 to 30 percent.
t The value for all women includes other races who may have very low rates of cigarette smoking. Thus, the weighted average for all women is lower than that for the
race groups shown in the table.
NOTE: Questions concerning cigarette smoking differed slightly on the National Health Interview Survey across the years for which data are shown. Data starting in
1997 are not strictly comparable with data for earlier years due to the 1997 National Health Interview Survey (NHIS) questionnaire redesign. Total includes all other
races not shown separately. See data sources for the definition of race and Hispanic origin in the NHIS. For details, see Health, United States, 2015, Appendix II.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.
130
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Tables
INDICATOR 28: Cigarette Smoking
Table 28b. Percentage distribution of people age 18 and over, by cigarette smoking status, sex, and age group, 2014
Sex and age group
Both sexes
Men
18-44
45-64
65 and over
Women
18-44
45-64
65 and over
Current smokers
Total Every day smokers Some day smokers Former smokers
16.8
21.7
19.4
9.8
16.6
16.8
7.5
12.9
15.0
15.5
8.0
12.9
13.8
6.2
3.9
6.7
3.8
1.7
3.7
3.0
1.3
21.9
14.7
27.8
49.6
11.3
22.0
30.3
Non-smokers
61.3
63.6
52.8
40.6
72.1
61.2
62.2
NOTE: Current cigarette smokers were defined as ever smoking 100 cigarettes in their lifetime and smoking now, every day or some days. Former smokers smoked
at least 100 cigarettes in their lifetime but do not currently smoke. Non-smokers had never smoked or smoked fewer than 100 cigarettes in their lifetime. The sum of
every day smokers and some day smokers may not equal total smokers due to rounding.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.
Table 28c. Percentage of people age 65 and over who are current cigarette smokers, by sex and poverty status, 2014
Poverty threshold
Sex
All
Below 100 percent
100-199 percent
200 percent or more
Both sexes
Men
Women
8.5
9.8
7.5
13.9
21.1
9.5
11.3
14.0
9.7
6.9
7.5
6.3
NOTE: Current cigarette smokers were defined as ever smoking 100 cigarettes in their lifetime and smoking now, every day or some days. Poverty status is calculated
according to the U.S. Census Bureau thresholds for the corresponding year. See glossary for definition of poverty.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.
131
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Tables
INDICATOR 29: Use of Health Care Services
Table 29a. Use of Medicare-covered health care services per 1,000 Medicare beneficiaries age 65 and over, 1992-2013
Year
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
Hospital
stays
306
300
331
336
341
351
354
365
361
364
361
359
353
350
343
336
331
320
338
307
291
276
Skilled nursing
facility stays
28
33
43
50
59
67
69
67
67
69
72
74
75
79
80
81
82
80
80
79
75
73
Utilization measure
Physician visits
and consultations
Number per 1,000
11,395
11,490
11,546
12,232
12,662
12,730
13,302
13,193
14,599
14,839
14,975
15,045
14,767
14,635
14,587
Home health
care visits
3,822
4,648
6,352
7,608
8,376
8,227
5,058
3,708
2,913
2,295
2,358
2,440
2,594
2,770
3,072
3,409
3,609
3,864
3,687
3,555
3,321
3,276
Average length
of hospital stay
Days
8.4
8.0
7.5
7.0
6.6
6.3
6.1
6.0
6.0
5.9
5.9
5.8
5.7
5.7
5.6
5.6
5.6
5.4
5.3
5.3
5.2
5.3
Data not available.
NOTE: Data are for Medicare beneficiaries in fee-for-service only. Physician visits and consultations include all settings, such as physician offices, hospitals, emergency
rooms, and nursing homes. The database used to generate rates of physician visits and consultations in previous Older Americans reports is no longer available. This
table uses two different databases based on availability of data to estimate rates of physician visits and consultations. The first database provides data from 1999
through 2006, and the second database has data beginning with 2007. A comparison of overlapping years shows that the two databases yield slightly different rates.
As a result, some data for 2007-2009 have been revised and differ from previous editions of Older Americans. Beginning in 1994, managed care beneficiaries were
excluded from the denominator of all utilization rates because utilization data are not available for them. Prior to 1994, managed care beneficiaries were included in
the denominators; they made up 7 percent or less of the Medicare population. See glossary for definition of fee-for-service.
Reference population: These data refer to Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare claims and enrollment data.
Table 29b. Use of Medicare-covered home health care and skilled nursing facility services per 1,000 Medicare beneficiaries age 65 and
over, by age group, 2013
Utilization measure
Skilled nursing facility stays
Home health care visits
65-74
67
1,475
75-84
Number per 1,000
185
4,129
85 and over
204
8,604
NOTE: Data are for Medicare beneficiaries in fee-for-service only.
Reference population: These data refer to Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare claims and enrollment data.
132
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Tables
INDICATOR 30: Health Care Expenditures
Table 30a. Average annual health care costs, in 2012 dollars, for Medicare beneficiaries age 65 and over, by age group, 1992-2012
Age group
Total
65-74
75-84
85 and over
Total
65-74
75-84
85 and over
1992
$15,801
11,759
17,291
30,563
2003
$18,279
13,842
20,428
28,723
1993
$16,524
11,986
18,887
30,913
2004
$18,083
13,441
19,692
30,350
1994
$17,443
12,888
19,319
32,688
2005
$18,523
13,984
20,473
29,393
1995
$17,819
12,966
19,499
33,707
2006
$18,342
13,727
20,499
28,780
1996
(Average
$17,551
12,704
19,756
32,134
2007
(Average
$17,668
13,207
19,813
28,141
1997
cost in 2012
$17,558
12,405
19,506
31,813
2008
cost in 2012
$16,752
12,576
19,365
25,265
1998
dollars)
$16,907
11,828
18,809
31,587
2009
dollars)
$16,954
12,967
18,972
26,122
1999
$17,020
12,922
18,048
29,890
2010
$17,211
12,765
20,020
26,564
2000
$17,086
12,724
18,625
29,457
2011
$16,350
12,331
18,786
25,304
2001
$17,535
13,332
19,500
29,255
2012
$16,970
13,206
19,311
25,900
2002
$18,521
14,275
20,112
30,024
NOTE: Data include both out-of-pocket costs and costs covered by insurance. Dollars are inflation adjusted to 2012 using the Consumer Price Index (Series CPI-U-RS).
Some data have been revised from previously published tables as a result of a CPI adjustment.
Reference population: These data refer to Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Cost and Use.
Table 30b. Total amount and percentage distribution of annual health care costs among Medicare beneficiaries age 65 and over, by
major cost component, 2008 and 2012
Major cost component
Total
Inpatient hospital
Physician/outpatient hospital
Nursing home/long-term institution
Home health care
Prescription drugs
Other (short-term institution/hospice/dental)
2008
Total dollars
$593,814,582,768
144,225,616,200
214,888,544,309
72,458,957,283
19,976,448,445
90,800,824,928
51,464,191,603
Percent
100
24
36
12
3
15
9
2012
Total dollars
$718,814,057,899
157,288,552,385
253,728,764,587
88,104,428,735
23,853,729,622
121,139,985,089
74,698,597,482
Percent
100
22
35
12
3
17
10
NOTE: Data include both out-of-pocket costs and costs covered by insurance. Dollars are not inflation adjusted. Estimates may not sum to the totals because of
rounding.
Reference population: These data refer to Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Cost and Use.
133
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Tables
INDICATOR 30: Health Care Expenditures
Table 30c. Average annual health care costs among Medicare beneficiaries age 65 and over, by selected characteristics, 2012
Selected characteristic
Total
Race and ethnicity
Non-Hispanic White
Non-Hispanic Black
Hispanic
Other
Institutional status
Community
Long-term care facility
Annual income
Under $10,000
$10,000-$20,000
$20,001-$30,000
$30,001 and over
Number of chronic conditions
0
1-2
3-4
5 and over
Veteran status (men only)
Yes
No
Cost
$16,970
16,862
18,962
17,002
15,512
13,831
71,739
24,596
19,937
15,662
14,687
6,533
11,445
18,931
30,253
16,274
16,997
NOTE: Data include both out-of-pocket costs and costs covered by insurance. See data sources for the definition of race and Hispanic origin in the Medicare Current
Beneficiary Survey. Chronic conditions include cancer (other than skin cancer), stroke, diabetes, heart disease, hypertension, arthritis, and respiratory conditions
(emphysema/asthma/chronic obstructive pulmonary disease). Annual income includes that of respondent and spouse.
Reference population: These data refer to Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Cost and Use.
134
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Tables
INDICATOR 30: Health Care Expenditures
Table 30d. Average annual health care costs among Medicare beneficiaries age 65 and over, by age group and major cost
component, 2012
Major cost component
Total
Inpatient hospital
Physician/outpatient hospital
Nursing home/long-term institution
Home health care
Prescription drugs
Other (short-term institution/hospice/dental)
65-74
$13,206
2,813
2,718
718
245
2,764
332
75-84
$19,311
4,579
3,218
1,856
755
3,061
650
85 and over
$25,900
4,651
3,082
7,175
1,241
2,356
1,303
NOTE: Data include both out-of-pocket costs and costs covered by insurance.
Reference population: These data refer to Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Cost and Use.
Table 30e. Percentage of noninstitutionalized Medicare beneficiaries age 65 and over who reported problems with access
to health care, 1992-2012
Problem with access to health care
Difficulty obtaining care
Delayed getting care due to cost
Difficulty obtaining care
Delayed getting care due to cost
1992
3.1
9.8
2003
2.3
5.3
1993
2.6
9.1
2004
2.3
5.3
1994
2.6
7.6
2005
2.5
4.8
1995
2.6
6.8
2006
2.8
5.3
1996
2.3
5.5
2007
2.7
4.6
1997
2.4
4.8
2008
2.6
5.2
1998
2.4
4.4
2009
2.8
4.6
1999
2.8
4.7
2010
3.0
5.8
2000
2.9
4.8
2011
3.1
6.4
2001
2.8
5.1
2012
2.7
6.3
2002
2.5
6.1
Reference population: These data refer to noninstitutionalized Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Cost and Use and Access to Care.
135
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Tables
INDICATOR 31: Prescription Drugs
Table 31a. Average prescription drug costs, in 2012 dollars, among noninstitutionalized Medicare beneficiaries age 65 and over, by
sources of payment, 1992-2012
Sources of
payment
Total
Out-of-pocket
Private
Public
Total
Out-of-pocket
Private
Public
1992
$1,041
626
265
150
2003
$2,793
1,047
1,063
683
1993
$1,348
783
338
226
2004
$2,919
1,057
1,122
740
1994
$1,401
762
385
255
2005
$3,287
1,169
1,348
770
1995
$1,435
753
424
259
2006
$3,098
910
992
1,196
1996
$1,508
749
501
258
2007
$3,054
750
757
1,547
1997
$1,612
799
526
288
2008
$3,022
707
717
1,598
1998
$1,840
851
644
345
2009
$3,272
751
733
1,788
1999
$2,018
887
706
425
2010
$3,077
712
625
1,740
2000
$2,233
937
778
519
2011
$3,024
709
573
1,742
2001
$2,434
973
847
614
2012
$3,201
719
563
1,919
2002
$2,658
1,049
968
641
NOTE: Dollars have been inflation adjusted to 2012 using the Consumer Price Index (Series CPI-U-RS). Some data have been revised from previously published tables
as a result of a CPI adjustment. Reported costs have been adjusted to account for underreporting of prescription drug use. The adjustment factor changed in 2006
with the initiation of the Medicare Part D prescription drug program. Public programs include Medicare, Medicaid, Department of Veterans Affairs, and other State
and Federal programs.
Reference population: These data refer to noninstitutionalized Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Cost and Use.
Table 31b. Percentage distribution of annual prescription drug costs among noninstitutionalized Medicare beneficiaries age 65 and
over, 2012
Cost in dollars
Percent of beneficiaries
Total
$0
1-499
500-999
1,000-1,499
1,500-1,999
2,000-2,499
2,500-2,999
3,000-3,499
3,500-3,999
4,000-4,499
4,500-4,999
5,000 or more
100.0
5.4
22.8
13.4
9.0
6.9
5.6
5.4
4.2
3.4
3.1
2.4
18.3
NOTE: Reported costs have been adjusted to account for underreporting of prescription drug use.
Reference population: These data refer to noninstitutionalized Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Cost and Use.
136
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Tables
INDICATOR 31: Prescription Drugs
Table 31c. Number of Medicare beneficiaries age 65 and over who enrolled in Part D prescription drug plans or who were covered by
retiree drug subsidy payments, 2006 and 2014
Part D benefit categories
All Medicare beneficiaries age 65 and over
Enrollees in prescription drug plans
Type of plan
Stand-alone plan
Medicare Advantage plan
Low-income subsidy
Yes
No
Retiree drug subsidy
Other
2006
36,454,840
16,935,231
11,345,012
5,590,219
5,560,171
11,375,060
6,548,138
12,971,471
2014
45,312,272
31,090,534
18,834,209
12,256,326
6,869,995
24,220,540
2,569,243
11,652,495
NOTE: Some data for 2006 have been revised and differ from previous editions of Older Americans.
Reference population: These data refer to Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare claims and enrollment data.
Table 31d. Average prescription drug costs among noninstitutionalized Medicare beneficiaries age 65 and over, by selected
characteristics, selected years 2000-2012
Selected characteristic
Number of chronic conditions
0
1-2
3-4
5 and over
Annual income
Under $10,001
$10,001-$20,000
$20,001-$30,000
$30,001 and over
2000
$837
1,752
3,085
4,212
2,102
2,130
2,387
2,310
2004
$1,108
2,412
3,942
5,351
2,685
2,882
2,962
3,033
2008
$1,312
2,427
3,895
5,651
3,764
3,090
2,942
2,843
2012
$1,389
2,559
4,488
8,263
4,043
3,447
2,894
3,068
NOTE: Dollars have been inflation adjusted to 2012 using the Consumer Price Index (Series CPI-U-RS). Some data have been revised from previously published tables
as a result of a CPI adjustment. Reported costs have been adjusted to account for underreporting of prescription drug use. Chronic conditions include cancer (other
than skin cancer), stroke, diabetes, heart disease, hypertension, arthritis, and respiratory conditions (emphysema/asthma/chronic obstructive pulmonary disease).
Annual income includes that of respondent and spouse.
Reference population: These data refer to noninstitutionalized Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Cost and Use.
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Tables
INDICATOR 32: Sources of Health Insurance
Table 32a. Percentage of noninstitutionalized Medicare beneficiaries age 65 and over with supplemental health insurance, by type of
insurance, 1991-2013
Type of insurance
Private (employer- or
union-sponsored)
Private (Medigap)3
Medicare Advantage/
Capitated Payment
Plans
Medicaid
TRICARE
Other public
No supplement
Private (employer- or
union-sponsored)
Private (Medigap)3
Medicare Advantage/
Capitated Payment
Plans
Medicaid
TRICARE
Other public
No supplement
1991
40.7
44.8
6.3
8.9
4.0
11.3
2003
36.1
34.3
14.8
11.6
4.5
5.7
9.1
1992
41.0
45.0
5.9
9.0
5.3
10.4
2004
36.6
33.7
15.6
11.3
4.2
5.2
9.7
1993
40.8
45.3
7.7
9.4
5.8
9.7
2005
36.1
34.6
15.5
11.8
5.1
5.6
8.9
1994
40.3
45.2
9.1
9.9
5.5
9.3
2006
34.9
32.5
20.7
11.9
5.2
4.3
9.4
1995
39.1
44.3
10.9
10.1
5.0
9.1
2007
35.3
31.5
21.5
11.9
5.1
4.0
10.5
1996
37.8
38.6
13.8
9.5
4.8
9.4
2008
34.2
29.5
23.2
11.7
5.4
3.9
10.5
1997
37.6
35.8
16.6
9.4
4.7
9.2
2009
32.5
27.8
28.5
11.8
5.2
3.6
9.3
1998
37.0
33.9
18.6
9.6
4.8
8.9
2010
31.6
26.5
29.2
12.5
5.0
3.3
9.9
1999
35.8
33.2
20.5
9.7
5.1
9.0
2011
29.8
26.4
31.3
12.9
4.9
3.2
10.0
2000
35.9
33.5
20.4
9.9
4.9
9.7
2012
29.4
25.4
32.3
13.1
5.2
2.7
10.6
2001
36.0
34.5
18.0
10.6
5.4
10.1
2013
28.0
25.4
33.8
12.8
5.0
2.3
10.8
2002
36.1
37.5
15.5
10.7
5.5
12.3
Not available.
" Includes people with private supplement of unknown sponsorship.
NOTE: Medicare Advantage/Capitated Payment Plans include Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and private fee-
for-service (PFFS) plans. Not all types of plans were available in all years. Since 2003 these types of plans have been known collectively as Medicare Advantage and/
or Medicare Part C. Estimates are based on beneficiaries' insurance status in the fall of each year. Categories are not mutually exclusive (i.e., individuals may have
more than one supplemental policy). Table excludes beneficiaries whose primary insurance is not Medicare (approximately 1 to 3 percent of beneficiaries). Medicaid
coverage was determined from both survey responses and Medicare administrative records. TRICARE coverage was added to Medicare Current Beneficiary Survey
Access to Care files beginning in 2003. Previous versions of the Older Americans did not include data on TRICARE coverage. Adding TRICARE coverage to the table
changes the percentage of beneficiaries in the "No supplement" group. Some data for 2009 have been revised and differ from previous editions of Older Americans.
Reference population: These data refer to noninstitutionalized Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Access to Care.
138
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Tables
INDICATOR 32: Sources of Health Insurance
Table 32b. Percentage of people ages 55-64 with health insurance coverage, by poverty status and type of insurance, 2014
Poverty threshold
Type of insurance
Total
Below 100 percent
100-199 percent
200 percent or more
Private
Medicaid
Medicare
Other coverage
Uninsured
71.7
9.7
5.0
3.8
9.7
18.5
43.6
8.8
4.4
24.6
42.3
19.4
13.3
4.7
20.3
85.3
2.9
2.8
3.6
5.4
NOTE: Classification of health insurance is based on a hierarchy of mutually exclusive categories. People with more than one type of health insurance were assigned
to the first appropriate category in the hierarchy. The "uninsured" category includes people who had no coverage as well as those who only had Indian Health Service
coverage or had only a private plan that paid for one type of service such as accidents or dental care. See glossary for definition of poverty.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.
Table 32c. Percentage of people ages 55-64 with health insurance coverage, by type of insurance, 2010-2014
Year
2010
2011
2012
2013
2014
Private
71.8
71.2
70.4
69.1
71.7
Medicaid
6.5
6.8
7.5
7.9
9.7
Medicare
4.4
4.7
4.8
5.5
5.0
Other coverage
4.5
4.3
4.0
4.0
3.8
Uninsured
12.8
13.0
13.2
13.5
9.7
NOTE: Classification of health insurance is based on a hierarchy of mutually exclusive categories. People with more than one type of health insurance were assigned
to the first appropriate category in the hierarchy. The "uninsured" category includes people who had no coverage as well as those who only had Indian Health Service
coverage or had only a private plan that paid for one type of service such as accidents or dental care.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.
139
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Tables
INDICATOR 33: Out-of-Pocket Health Care Expenditures
Table 33a. Percentage of people age 55 and over with out-of-pocket expenditures for health care service use, by age group, 1977,
1987, 1996, and 2000-2013
Age group 1977 1987 1996 2000 2001 2002
55-64 81.9 84.0 89.6 90.2 90.4 90.9
55-61 81.6 83.9 89.5 89.4 90.2 90.7
62-64 82.6 84.3 89.7 92.4 91.1 91.3
65 and over 83.3 88.6 92.4 93.6 94.7 94.4
65-74 83.4 87.9 91.8 93.3 94.1 94.4
75-84 83.8 90.0 92.9 93.5 95.6 94.6
85 and over 80.8 88.6 93.9 95.2 94.6 93.8
NOTE: Out-of-pocket health care expenditures exclude personal spending for
comparability across years; for details, see Zuvekas and Cohen.58
2003
90.4
89.6
92.7
94.7
93.7
95.7
95.8
2004 2005
90.0
89.5
91.6
95.5
95.1
95.8
96.3
health insurance
90.5
89.6
93.3
95.0
94.2
96.1
95.1
2006
88.9
88.4
90.6
95.0
94.1
96.2
95.5
2007
89.5
88.7
91.9
94.3
93.2
95.3
95.6
2008 2009
90.1
89.0
93.0
95.0
94.3
95.7
95.8
88.5
88.6
88.3
94.3
93.8
94.8
95.1
2010
89.4
88.3
92.2
93.7
93.4
94.1
93.9
2011 2012 2013
89.1
87.9
92.0
94.0
93.7
94.9
93.1
90.0
89.4
91.6
94.3
93.6
95.9
93.7
88.2
87.1
91.3
92.7
92.2
94.7
89.9
premiums. Data for the 1987 survey have been adjusted to permit
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey (MEPS) and
Table 33b. Ratio of out-of-pocket expenditures to household income
characteristics, 1977, 1987, 1996, and 2000-2013
Selected characteristic 1977 1987 1996 2000 2001 2002
Total
55-64 5.2 5.8 7.1 7.0 7.6 7.1
55-61 5.1 5.7 6.2 6.1 6.9 6.6
62-64 5.5 5.9 9.5 9.3 9.6 8.5
65 and over 7.2 8.8 8.4 9.1 10.0 10.8
65-74 6.4 7.2 7.7 8.1 8.7 9.5
75-84 8.8 11.0 9.0 10.4 11.4 11.9
85 and over 7.9 12.0 9.8 10.1 11.8 12.7
Income category
Poor/near poor
55-64 16.1 18.1 30.0 29.9 31.2 27.1
55-61 17.5 19.8 27.6 28.1 29.6 26.5
62-64 13.3 14.0 34.3 * 34.9 28.5
65 and over 12.3 15.8 19.2 22.6 23.5 27.6
65-74 11.0 13.7 21.6 24.4 25.7 27.7
75-84 14.4 19.0 18.3 22.9 23.3 28.4
85 and over 12.4 14.7 * 17.6 18.7 25.7
Low/middle/high
55-64 3.9 3.7 3.2 3.4 4.2 4.1
55-61 3.7 3.4 2.9 3.1 3.9 3.8
62-64 4.2 4.6 3.8 4.3 5.3 5.0
65 and over 5.4 7.0 5.6 6.3 7.3 7.2
65-74 5.0 5.9 4.9 5.6 6.2 6.4
75-84 6.2 8.4 6.3 6.9 8.4 8.2
85 and over 5.2 10.9 7.8 7.6 9.3 7.9
Health status category
Poor or fair health
55-64 8.7 8.5 13.0 14.1 13.6 13.3
55-61 8.8 9.0 11.8 12.8 12.9 12.8
62-64 8.6 7.6 15.9 17.4 15.2 14.7
65 and over 9.5 11.0 11.7 13.1 13.9 14.6
65-74 8.7 10.0 10.7 11.8 13.5 14.4
75-84 11.3 12.4 11.8 14.6 14.7 15.2
85 and over 8.9 12.2 * 13.8 13.2 13.5
2003
7.3
6.9
8.4
11.6
9.2
13.4
16.4
29.9
30.0
29.9
27.8
23.4
30.2
32.4
4.5
4.2
5.5
8.0
6.9
9.1
10.3
13.3
12.4
15.9
16.0
13.8
17.5
19.5
MEPS predecessor surveys.
per person among people age 55 and over, by selected
2004
7.5
7.1
8.8
11.6
10.7
11.8
14.9
30.0
29.6
30.9
29.3
29.0
29.4
30.0
4.1
4.0
4.8
8.1
7.4
8.2
11.1
13.8
13.5
14.7
15.2
14.3
15.4
17.9
2005
7.1
6.7
8.2
10.9
9.2
12.5
13.0
27.7
27.9
27.3
27.6
26.2
28.6
28.6
4.2
3.9
5.3
7.4
6.2
8.8
8.2
12.7
11.8
15.3
15.5
14.3
17.1
14.5
2006
7.1
6.6
8.5
10.0
9.1
10.5
12.2
28.8
27.7
31.5
28.1
29.4
27.9
24.9
4.0
3.8
4.8
6.0
5.2
6.5
8.2
13.2
12.9
14.0
12.9
13.1
13.0
12.2
2007
6.0
5.8
6.6
8.6
7.2
10.0
10.1
23.3
24.1
21.2
21.9
20.2
24.5
20.0
3.8
3.5
4.5
5.6
4.9
6.1
7.2
10.0
9.8
10.5
11.3
11.3
11.3
11.2
2008
6.2
5.8
7.3
8.4
7.0
9.5
10.7
24.3
24.2
24.4
19.4
19.4
18.3
21.6
3.8
3.4
4.9
5.9
4.8
7.2
7.4
11.3
10.9
12.2
11.8
11.4
11.2
14.4
2009
6.2
5.8
7.4
8.1
7.0
9.3
9.4
26.1
25.1
28.5
22.4
23.3
21.5
22.5
3.4
3.2
4.0
5.2
4.3
6.2
6.4
9.8
10.2
8.8
10.5
9.6
11.9
10.0
2010
6.1
5.8
7.1
7.8
7.4
7.5
10.2
24.8
24.3
26.1
21.4
27.1
15.3
19.9
3.4
3.0
4.3
5.2
4.3
5.8
7.8
10.9
10.9
11.1
10.9
11.0
9.8
13.2
2011
6.5
6.1
7.6
7.1
6.3
7.7
8.9
25.3
23.8
28.6
20.5
21.0
20.2
20.1
3.4
3.3
3.6
4.7
4.1
5.2
5.7
12.0
11.3
13.6
9.0
8.3
9.9
9.2
2012
5.6
5.7
5.4
7.0
5.9
7.2
10.5
21.7
23.2
18.2
20.0
19.5
17.5
25.2
3.2
3.1
3.3
4.5
3.9
5.0
5.8
9.5
10.0
8.1
9.7
8.8
9.7
11.9
2013
5.6
5.7
5.5
6.5
5.3
6.9
11.0
20.2
21.1
17.4
17.5
15.3
15.9
25.1
3.3
3.1
3.7
4.5
3.8
5.1
6.6
10.0
11.1
7.3
8.7
6.9
8.6
13.5
See notes at end of table.
140
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Tables
INDICATOR 33: Out-of-Pocket Health Care Expenditures
Table 33b. Ratio of out-of-pocket expenditures to household income per person among people age 55 and over, by selected
characteristics, 1977,1987,1996, and 2000-2013continued
Selected characteristic
Excellent, very good,
or good health
55-64
55-61
62-64
65 and over
65-74
75-84
85 and over
1977
3.9
3.9
4.1
6.1
5.3
7.5
7.6
1987
4.6
4.5
4.9
7.1
5.4
9.7
11.8
1996
5.0
4.1
7.3
6.6
6.3
7.2
6.4
2000
4.0
3.5
5.6
6.7
6.2
7.5
7.1
2001
5.2
4.8
6.6
7.6
6.2
9.1
10.6
2002
4.6
4.4
5.6
8.4
7.1
9.6
11.9
2003
5.0
4.9
5.4
8.9
6.9
10.7
13.9
2004
5.0
4.5
6.4
9.4
8.9
9.3
12.8
2005
4.9
4.6
5.6
8.1
6.6
9.2
11.9
2006
4.8
4.3
6.3
8.2
7.1
8.8
12.2
2007
4.4
4.3
5.0
7.0
5.3
9.2
9.2
2008
4.1
3.9
4.8
6.4
5.0
8.3
7.9
2009
4.8
4.1
6.8
6.8
5.7
7.8
9.0
2010
4.3
4.0
5.3
6.1
5.8
6.0
7.8
2011
4.3
3.9
5.2
6.1
5.5
6.3
8.7
2012
4.1
4.0
4.3
5.6
4.7
5.9
9.2
2013
3.9
3.7
4.7
5.5
4.7
6.0
8.8
* Base is not large enough to produce reliable results.
NOTE: Out-of-pocket health care expenditures exclude personal spending for health insurance premiums. Including expenditures for out-of-pocket premiums in
the estimates of out-of-pocket spending would increase the percentage of household income spent on health care in all years. People are classified into the "poor/
near poor" income category if their household income is below 125 percent of the poverty level; otherwise, people are classified into the "low/middle/high" income
category. The poverty level is calculated according to the U.S. Census Bureau guidelines for the corresponding year. The ratio of a person's out-of-pocket expenditures
to their household income was calculated based on the person's per capita household income. For people whose ratio of out-of-pocket expenditures to income
exceeded 100 percent, the ratio was capped at 100 percent. For people with out-of-pocket expenditures, and with zero income (or negative income), the ratio was
set at 100 percent. For people with no out-of-pocket expenditures the ratio was set to zero. These methods differ from those used in Older Americans 2004, which
excluded persons with no out-of-pocket expenditures from the calculations (17 percent of the population age 65 and over in 1977, and 4.5 percent of the population
age 65 and over in 2004). Data from the 1987 survey have been adjusted to permit comparability across years; for details see Zuvekas and Cohen.58
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey (MEPS) and MEPS predecessor surveys.
Table 33c. Percentage distribution of total out-of-pocket health care expenditures among people age 55 and over, by age group and
type of health care service, 2000-2013
Year and type of health care service
2000
Hospital care
Office-based medical provider services
Dental services
Prescription drugs
Other health care
2001
Hospital care
Office-based medical provider services
Dental services
Prescription drugs
Other health care
2002
Hospital care
Office-based medical provider services
Dental services
Prescription drugs
Other health care
2003
Hospital care
Office-based medical provider services
Dental services
Prescription drugs
Other health care
Total
8.5
18.9
20.0
44.7
7.8
9.8
19.8
18.6
45.7
6.1
10.2
21.3
18.1
43.8
6.6
9.2
18.8
16.7
48.5
6.8
55-64
55-61
7.5
19.8
21.3
44.0
7.5
9.4
19.9
20.0
44.3
6.4
9.2
21.6
18.3
43.5
7.4
8.8
18.3
16.7
49.0
7.3
65 and over
62-64
*
16.7
17.0
46.5
8.7
10.7
19.7
15.2
48.9
5.5
13.1
20.3
17.7
44.7
4.3
10.1
19.9
16.9
47.5
5.6
Total
6.4
9.8
15.8
53.6
14.3
5.4
9.4
13.0
56.0
16.2
5.0
10.5
14.0
58.2
12.3
5.2
8.7
11.8
58.3
16.0
65-74
7.3
11.6
17.5
57.1
6.6
5.2
10.5
15.6
57.2
11.5
4.6
12.3
17.6
57.9
7.7
5.9
9.4
14.5
61.3
8.9
75-84
4.6
9.0
15.9
51.5
19.0
5.8
9.6
11.9
58.9
13.8
5.5
9.3
12.3
56.6
16.3
4.5
9.1
9.5
54.5
22.4
85 and over
8.6
6.0
9.6
48.0
27.9
*
6.0
8.3
45.1
*
5.1
7.8
6.2
65.5
15.4
5.1
5.4
9.5
59.8
20.2
See notes at end of table
141
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Tables
INDICATOR 33: Out-of-Pocket Health Care Expenditures
Table 33c. Percentage distribution of total out-of-pocket health care expenditures among people age 55 and over, by age group and
type of health care service, 2000-2013 continued
Year and type of health care service
2004
Hospital care
Office-based medical provider services
Dental services
Prescription drugs
Other health care
2005
Hospital care
Office-based medical provider services
Dental services
Prescription drugs
Other health care
2006
Hospital care
Office-based medical provider services
Dental services
Prescription drugs
Other health care
2007
Hospital care
Office-based medical provider services
Dental services
Prescription drugs
Other health care
2008
Hospital care
Office-based medical provider services
Dental services
Prescription drugs
Other health care
2009
Hospital care
Office-based medical provider services
Dental services
Prescription drugs
Other health care
2010
Hospital care
Office-based medical provider services
Dental services
Prescription drugs
Other health care
Total
9.2
20.1
16.9
46.0
7.8
12.2
19.6
15.7
45.9
6.5
*
19.8
13.9
43.2
5.5
12.4
22.1
21.1
38.8
5.6
14.2
23.1
19.9
35.9
6.8
16.0
23.2
21.6
32.2
7.0
12.2
24.7
20.6
36.3
6.2
56-64
55-61
10.1
18.7
18.5
45.0
7.7
12.8
19.6
16.3
44.7
6.7
9.4
20.9
15.4
48.5
5.8
12.6
21.7
21.3
38.8
5.7
14.7
24.0
19.8
35.8
5.8
13.3
24.6
23.0
32.2
6.9
12.6
24.4
19.2
37.6
6.4
65 and over
62-64
6.9
23.6
12.8
48.7
8.1
10.8
19.9
14.3
49.0
6.1
*
17.4
10.6
32.0
4.9
11.9
23.1
20.7
38.7
5.5
13.3
21.4
20.2
36.3
8.8
*
20.3
18.6
32.1
7.1
11.4
25.4
23.4
33.9
5.8
Total
5.0
10.1
11.8
61.4
11.8
5.4
11.4
15.3
57.8
10.1
7.2
12.3
16.2
51.1
13.2
*
13.7
18.5
47.3
11.6
6.3
15.0
19.6
42.0
17.1
10.6
15.8
18.7
41.3
13.6
7.9
15.8
20.4
44.4
11.4
65-74
5.1
12.4
13.2
61.9
7.4
5.1
11.4
19.4
57.9
6.2
6.6
14.1
19.7
51.5
8.1
4.4
15.5
21.4
49.5
9.2
7.3
17.3
21.4
44.8
9.2
6.4
18.8
23.0
44.2
7.7
7.8
17.5
21.4
46.3
7.0
75-84
4.5
9.2
12.0
64.8
9.5
5.7
12.3
12.6
59.1
10.4
5.9
11.0
15.3
53.2
14.7
*
12.7
16.4
45.4
10.2
5.9
14.9
19.8
41.2
18.2
14.5
14.0
15.4
40.2
15.9
6.8
14.6
22.2
44.0
12.4
85 and over
*
5.3
7.5
51.9
29.5
5.4
8.7
9.8
53.3
22.7
12.2
9.5
7.6
45.2
25.5
*
10.4
14.9
45.3
21.6
4.5
9.3
14.2
35.9
36.1
12.7
11.8
15.0
36.1
24.4
10.8
13.0
13.4
39.3
23.5
See notes at end of table.
142
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Tables
INDICATOR 33: Out-of-Pocket Health Care Expenditures
Table 33c. Percentage distribution of total out-of-pocket health care expenditures among people age 55 and over, by age group and
type of health care service, 2000-2013continued
Year and type of health care service
2011
Hospital care
Office-based medical provider services
Dental services
Prescription drugs
Other health care
2012
Hospital care
Office-based medical provider services
Dental services
Prescription drugs
Other health care
2013
Hospital care
Office-based medical provider services
Dental services
Prescription drugs
Other health care
Total
16.6
24.1
18.3
34.6
6.4
18.0
23.7
17.3
34.9
6.2
16.0
27.2
18.5
30.5
7.9
55-64
55-61
15.5
23.7
18.5
35.0
7.3
15.5
24.3
18.1
36.2
6.0
18.4
25.5
17.7
29.9
8.5
65 and over
62-64
19.1
24.9
18.1
33.7
4.2
*
22.4
15.6
32.1
6.5
10.9
30.8
20.0
31.7
6.7
Total
7.8
15.9
20.0
40.2
16.1
9.2
15.6
22.1
34.2
18.8
7.7
19.2
21.0
33.3
18.8
65-74
8.6
18.0
20.2
42.4
10.9
10.0
19.7
23.0
37.7
9.5
7.4
22.1
23.2
35.7
11.7
75-84
7.4
14.8
24.3
41.5
11.9
8.2
13.5
26.7
39.4
12.2
9.6
16.9
23.6
35.5
14.3
85 and over
6.0
12.0
11.4
30.7
39.9
*
8.6
*
18.4
50.8
5.6
14.5
10.5
22.6
46.9
* Estimate not shown due to a relative standard error greater than 30 percent.
NOTE: Out-of-pocket health care expenditures exclude personal spending for health insurance premiums. Hospital care includes hospital inpatient care and care
provided in hospital outpatient departments and emergency rooms. Office-based medical provider services include services provided by medical providers in
non-hospital-based medical offices or clinic settings. Dental services include care provided by any type of dental provider. Prescription drugs include prescribed
medications purchased, including refills. Other health care includes care provided by home health agencies and independent home health providers and expenses
for eyewear, ambulance services, orthopedic items, hearing devices, prostheses, bathroom aids, medical equipment, disposable supplies, and other miscellaneous
services. The majority of expenditures in the "other" category are for home health services and eyeglasses. Estimates might not sum to 100 percent because of
rounding.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey (MEPS).
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INDICATOR 34: Sources of Payment for Health Care Services
Table 34a. Average cost per beneficiary and percentage distribution of sources of payment for health care services for Medicare
beneficiaries age 65 and over, by type of service, 2012
Type of service
All
Hospice
Inpatient hospital
Home health care
Short-term institution
Physician/medical
Outpatient hospital
Prescription drugs
Dental
Long-term care facility
Average
cost per
beneficiary
$16,959
343
3,627
550
933
4,050
1,801
2,793
447
2,032
Sources of payment
Total
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
Medicare
59.0
100.0
87.0
76.8
70.4
61.5
71.8
50.5
1.8
**
Medicaid
6.8
0.8
**
11.9
1.2
1.4
0.3
**
44.3
Out-of-pocket
17.7
*2.2
19.0
8.8
16.7
7.3
21.3
77.3
45.0
Other
16.4
9.9
**
8.8
20.6
19.6
27.8
20.6
9.7
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error of 20 to 30 percent.
** Estimate not shown due to a relative standard error greater than 30 percent.
NOTE: "Other" refers to private insurance, Department of Veterans Affairs, uncollected liability, and other public programs. Estimates may not sum to the totals
because of rounding or suppression due to high relative standard errors.
Reference population: These data refer to Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Cost and Use.
Table 34b. Average cost per beneficiary and percentage distribution of sources of payment for health care services for Medicare
beneficiaries age 65 and over, by income, 2012
Income
All
Under $10,000
$10,000-$20,000
$20,001-$30,000
$30,001 and over
Average
cost per
beneficiary
$16,959
24,585
19,925
15,649
14,679
Sources of payment
Total
100.0
100.0
100.0
100.0
100.0
Medicare
59.0
61.8
62.8
63.3
54.0
Medicaid
6.8
20.2
11.4
4.1
1.0
Out-of-pocket
17.7
11.2
15.7
17.8
20.9
Other
16.4
6.8
10.1
14.8
23.8
NOTE: Income refers to annual income of respondent and spouse. "Other" refers to private insurance, Department of Veterans Affairs, uncollected liability, and other
public programs. Estimates may not sum to the totals because of rounding.
Reference population: These data refer to Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Cost and Use.
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INDICATOR 35: Veterans' Health Care
Table 35a. Total number of veterans age 65 and over who are enrolled in the Veterans Health Administration, by age group, 1999-2014
and projected 2019-2034
65 and over
Year
Actual
1999
2004
2009
2014
Projected
2019
2024
2029
2034
All ages
4,542,964
7,356,161
8,165,680
9,078,615
9,578,000
9,698,000
9,651,000
9,455,000
Total
1,880,346
3,355,949
3,494,830
4,317,646
4,715,000
4,875,000
4,945,000
4,863,000
65-69
540,126
690,284
724,280
1,486,698
1,135,000
1,004,000
973,000
913,000
70-74
546,299
882,646
675,320
758,428
1,469,000
1,116,000
993,000
966,000
75-79
516,076
847,977
811,308
632,674
746,000
1,359,000
1,031,000
921,000
80-84
213,069
670,116
694,053
680,238
552,000
650,000
1,143,000
861,000
85 and over
64,776
264,926
589,869
759,608
814,000
747,000
804,000
1,202,000
NOTE: Department of Veterans Affairs (VA) enrollees are veterans who have signed up to receive health care from the Veterans Health Administration (VHA). Counts
for 2019-2034 are projections from the 2015 VA Enrollee Health Care Projection Model.
Reference population: These data refer to the count of unique VHA enrollees per fiscal year.
SOURCE: Department of Veterans Affairs, Office of the Assistant Deputy Under Secretary for Health for Policy and Planning, 2015 VA Enrollee Health Care Projection
Model.
Table 35b. Percentage of enrolled veterans age 65 and over with service-connected disabilities, by service-connected disability rating,
2004-2014 and projected 2019-2034
Year
Actual
2004
2009
2014
Projected
2019
2024
2029
2034
70 percent or more
service-connected disability
4.5
6.5
13.2
18.0
21.4
24.4
27.0
10 percent or more
service-connected disability
21.8
24.8
35.9
43.3
48.2
52.0
55.0
No service-connected disability
78.2
75.2
64.1
56.7
51.8
48.0
45.0
NOTE: Department of Veterans Affairs (VA) enrollees service-connected disability ratings reflect the severity of the disability and how much the impairment impacts
the ability to work.
Reference population: These data refer to the count of unique VHA enrollees per fiscal year.
SOURCE: Department of Veterans Affairs, Office of the Assistant Deputy Under Secretary for Health for Policy and Planning, 2015 VA Enrollee Health Care Projection
Model.
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Tables
INDICATOR 36: Residential Services
Table 36a. Percentage distribution of Medicare beneficiaries age 65 and over residing in selected residential settings, by age group,
2013
65 and over
Residential setting
Total
Traditional community
Community housing with services
Long-term care facilities
Number (in thousands)
Total
100.0
93.2
2.8
3.9
40,700
65-74
100.0
97.5
1.3
1.2
21,800
75-84
100.0
93.4
3.1
3.6
12,900
85 and over
100.0
77.1
8.2
14.7
6,000
NOTE: Community housing with services applies to respondents who reported they lived in retirement communities or apartments, senior citizen housing, continuing
care retirement facilities, assisted living facilities, staged living communities, board and care facilities/homes, and similar situations AND who reported they had
access to one or more of the following services through their place of residence: meal preparation, cleaning or housekeeping services, laundry services, or help with
medications. Respondents were asked about access to these services, but not whether they actually used the services. A residence (or unit) is considered a long-term
care facility if it is certified by Medicare or Medicaid; or has 3 or more beds, is licensed as a nursing home or other long-term care facility, and provides at least one
personal care service; or provides 24-hour, 7-day-a-week supervision by a non-family, paid caregiver.
Reference population: These data refer to Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Access to Care.
Table 36b. Percentage distribution of Medicare beneficiaries age 65 and over with limitations in performing activities of daily living
(ADLs) and instrumental activities of daily living (lADLs), by residential setting, 2013
Functional status
Total
No functional limitations
IADL limitation(s) only
1-2 ADL limitations
3 or more ADL limitations
Overall
100.0
55.8
12.2
20.7
11.3
Traditional
community
100.0
58.5
12.1
20.6
8.8
Community housing
with services
100.0
36.4
15.0
32.0
16.7
Long-term
care facilities
100.0
4.9
11.7
16.4
67.0
NOTE: Community housing with services applies to respondents who reported they lived in retirement communities or apartments, senior citizen housing, continuing
care retirement facilities, assisted living facilities, staged living communities, board and care facilities/homes, and similar situations AND who reported they had
access to one or more of the following services through their place of residence: meal preparation, cleaning or housekeeping services, laundry services, or help with
medications. Respondents were asked about access to these services, but not whether they actually used the services. A residence (or unit) is considered a long-term
care facility if it is certified by Medicare or Medicaid; or has 3 or more beds, is licensed as a nursing home or other long-term care facility, and provides at least one
personal care service; or provides 24-hour, 7-day-a-week supervision by a non-family, paid caregiver. Long-term care facility residents with no limitations may include
individuals with limitations in performing certain lADLs, such as doing light or heavy housework or meal preparation. These questions were not asked of facility
residents.
Reference population: These data refer to Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Access to Care.
Table 36c. Percent availability of specific services among Medicare beneficiaries age 65 and over residing in community housing with
services, 2013
Access to service
Percent
Prepared meals
Housekeeping, maid, or cleaning services
Laundry services
Help with medications
86.0
79.4
68.5
49.3
NOTE: Community housing with services applies to respondents who reported they lived in retirement communities or apartments, senior citizen housing, continuing
care retirement facilities, assisted living facilities, staged living communities, board and care facilities/homes, and similar situations AND who reported they had access
to one or more services listed in the table through their place of residence. Respondents were asked about access to these services, but not whether they actually
used the services.
Reference population: These data refer to Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Access to Care.
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INDICATOR 36: Residential Services
Table 36d. Percentage distribution of annual income of Medicare beneficiaries age 65 and over, by residential setting, 2013
Income
Traditional
community
Community housing
with services
Long-term care
facilities
Total
Under $10,000
$10,001-$20,000
$20,001-$30,000
$30,001 and over
100.0
8.3
19.5
17.8
54.4
100.0
8.4
32.8
20.3
38.5
100.0
32.5
37.8
13.7
16.1
NOTE: Community housing with services applies to respondents who reported they lived in retirement communities or apartments, senior citizen housing, continuing
care retirement facilities, assisted living facilities, staged living communities, board and care facilities/homes, and similar situations AND who reported they had
access to one or more of the following services through their place of residence: meal preparation, cleaning or housekeeping services, laundry services, or help with
medications. Respondents were asked about access to these services, but not whether they actually used the services. A residence (or unit) is considered a long-term
care facility if it is certified by Medicare or Medicaid; or has 3 or more beds, is licensed as a nursing home or other long-term care facility, and provides at least one
personal care service; or provides 24-hour, 7-day-a-week supervision by a non-family, paid caregiver. Income refers to annual income of respondent and spouse.
Table excludes data for respondents who reported only that their income was greater or less than $25,000.
Reference population: These data refer to Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Access to Care.
Table 36e. Characteristics of services available to Medicare beneficiaries age 65 and over residing in community housing with
services, 2013
Selected characteristic
Percent
Services included in housing costs
All included
Some included/some separate
All separate
Can continue living there if they need substantial services
Yes
No
100.0
46.5
41.8
11.7
100.0
60.7
39.3
NOTE: Community housing with services applies to respondents who reported they lived in retirement communities or apartments, senior citizen housing, continuing
care retirement facilities, assisted living facilities, staged living communities, board and care facilities/homes, and similar situations AND who reported they had
access to one or more of the following services through their place of residence: meal preparation, cleaning or housekeeping services, laundry services, or help with
medications. Respondents were asked about access to these services, but not whether they actually used the services.
Reference population: These data refer to Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Access to Care.
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INDICATOR 37: Personal Assistance and Equipment
Table 37a. Percentage distribution of noninstitutionalized Medicare beneficiaries age 65 and over who have limitations in performing
activities of daily living (ADLs), by type of assistance, 1992-2013
Year
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
Personal
assistance only
9.2
9.0
8.2
8.2
7.7
5.6
6.1
6.7
6.6
6.3
6.7
6.2
6.9
6.6
6.9
6.0
5.4
6.4
7.0
5.7
7.8
7.0
Equipment
only
28.3
28.6
31.4
32.0
32.5
34.2
30.7
34.7
35.6
36.3
35.7
34.8
33.5
36.3
36.3
37.6
38.1
38.4
36.9
38.6
33.1
35.3
Personal assistance
and equipment
20.9
20.8
22.4
22.1
22.4
21.4
23.0
19.7
20.7
22.0
21.8
22.9
22.2
21.9
23.1
22.1
21.4
23.4
22.5
22.9
24.5
25.4
None
41.6
41.5
38.0
37.7
37.5
38.8
40.2
39.0
37.0
35.3
35.9
36.2
37.4
35.2
33.8
34.3
35.1
31.8
33.6
32.8
34.6
32.4
NOTE: Limitations in performing activities of daily living (ADLs) refer to difficulty performing (or inability to perform for a health reason) one or more of the following
tasks: bathing, dressing, eating, getting in/out of chairs, walking, or using the toilet. Respondents who report difficulty with an activity are subsequently asked about
receiving help or supervision from another person with the activity and about using special equipment or aids. In this table, personal assistance does not include
supervision. Percentages are age adjusted using the 2000 standard population. Estimates may not sum to the totals because of rounding.
Reference population: These data refer to noninstitutionalized Medicare beneficiaries who have limitations in performing one or more ADLs.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Access to Care.
Table 37b. Percentage distribution of noninstitutionalized Medicare beneficiaries age 65 and over who have limitations in performing
activities of daily living (ADLs), by type of assistance, age group, and sex, 2013
Age group and sex
65 and over
Men
Women
65-74
75-84
85 and over
Personal
assistance only
7.0
6.2
7.4
6.7
7.5
6.5
Equipment
only
35.3
34.6
35.6
31.0
39.9
39.9
Personal assistance
and equipment
25.4
22.9
27.0
21.5
26.0
40.5
None
32.4
36.2
30.0
40.8
26.6
13.2
NOTE: Limitations in performing activities of daily living (ADLs) refer to difficulty performing (or inability to perform for a health reason) one or more of the following
tasks: bathing, dressing, eating, getting in/out of chairs, walking, or using the toilet. Respondents who report difficulty with an activity are subsequently asked about
receiving help or supervision from another person with the activity and about using special equipment or aids. In this table, personal assistance does not include
supervision. Estimates for persons age 65 or over are age adjusted using the 2000 standard population.
Reference population: These data refer to noninstitutionalized Medicare beneficiaries who have limitations in performing one or more ADLs.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Access to Care.
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INDICATOR 37: Personal Assistance and Equipment
Table 37c. Percentage of noninstitutionalized Medicare beneficiaries age 65 and over who have limitations in performing instrumental
activities of daily living (lADLs) and who receive personal assistance, by age group, 1992-2013
Year
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
Total
61.6
59.6
61.3
61.9
61.2
63.6
65.7
62.9
62.7
65.2
68.0
66.8
65.4
66.4
63.7
66.3
68.2
66.2
65.7
67.1
69.7
68.1
65-74
58.9
56.6
60.2
59.1
59.8
61.8
64.9
61.5
56.8
60.9
68.1
66.4
64.2
62.7
63.2
65.4
69.7
64.8
64.2
65.6
70.1
63.3
65 and over
75-84
63.2
59.4
59.8
64.5
61.2
63.2
65.3
62.8
64.4
66.5
66.7
65.0
65.6
67.4
61.7
66.0
66.6
67.3
64.5
66.3
66.4
71.2
85 and over
69.2
73.3
71.4
66.1
66.7
71.1
70.1
68.7
76.6
73.7
71.9
72.9
68.8
74.0
70.5
69.7
67.8
67.6
72.2
72.1
75.8
75.8
NOTE: Limitations in performing instrumental actitivites of daily living (lADLs) refer to difficulty performing (or inability to perform for a health reason) one or more of
the following tasks: using the telephone, light housework, heavy housework, meal preparation, shopping, or managing money. Respondents who report difficulty with
an activity are subsequently asked about receiving help from another person with the activity. In this table, personal assistance does not include supervision or special
equipment.
Reference population: These data refer to noninstitutionalized Medicare beneficiaries who have limitations in performing one or more lADLs.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Access to Care.
Table 37d. Percentage of noninstitutionalized Medicare beneficiaries age 65 and over who have limitations in performing instrumental
activities of daily living (lADLs) and who receive personal assistance, by sex and age group, 2013
Age group
Men
Women
65-74
75-84
85 and over
58.5
75.0
83.8
66.0
69.5
71.7
NOTE: Limitations in performing instrumental activities of daily living (lADLs) refer to difficulty performing (or inability to perform for a health reason) one or more of
the following tasks: using the telephone, light housework, heavy housework, meal preparation, shopping, or managing money. Respondents who report difficulty with
an activity are subsequently asked about receiving help from another person with the activity. In this table, personal assistance does not include supervision or special
equipment.
Reference population: These data refer to noninstitutionalized Medicare beneficiaries who have limitations in performing one or more lADLs.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Access to Care.
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INDICATOR 38: Long-Term Care Providers
Table 38a. Number of users of long-term care services, by sector and age group, 2013 and 2014
Age group
Less than 65
65-74
75-84
85 and over
Nursing homes
206,825
220,522
372,558
569,795
Residential care
communities
60,134
86,861
249,725
439,315
Adult day
services centers
102,721
56,440
77,605
45,716
Home health
agencies
863,555
1,258,323
1,534,661
1,282,996
Hospices
75,079
229,260
402,210
634,151
NOTE: Long-term care services are provided by paid, regulated providers. They comprise both health care-related and non-health care-related services, including
post-acute care and rehabilitation. People can receive more than one type of service. The estimated number of users of nursing homes, residential care communities,
and adult day services centers represents participants or residents enrolled on the day of data collection in 2014. The estimated number of users of home health
agencies represents patients who ended care (i.e., were discharged) in 2013. The estimated number of users of hospice represents patients who received care at any
time in 2013. The number in each age group is calculated by applying the percentage distribution by age to the estimated total number of users. See http://www.cdc.
gov/nchs/data/series/sr_03/sr03_038.pdf for definitions.
Reference population: These data refer to the resident population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Study of Long-Term Care Providers.
Table 38b. Percentage of users of long-term care services needing any assistance with activities of daily living (ADLs), by sector and
activity, 2013 and 2014
Activity
Bathing
Dressing
Toileting
Walking or locomotion
Transferring in/out of bed or chair
Eating
Nursing homes
96.4
91.8
87.9
90.7
85.2
58.0
Residential care
communities
62.4
47.4
39.3
29.1
29.7
19.8
Adult day
services centers
41.0
37.1
35.6
33.7
29.8
24.3
Home health
agencies
96.4
88.4
73.2
94.0
87.8
56.7
NOTE: Long-term care services are provided by paid, regulated providers. They comprise both health care-related and non-health care-related services, including
post-acute care and rehabilitation. People can receive more than one type of service. The estimated number of users of nursing homes, residential care communities,
and adult day services centers represents participants or residents enrolled on the day of data collection in 2014. The estimated number of users of home health
agencies represents patients who ended care (i.e., were discharged) in 2013. Users of formal long-term care include persons of all ages. In nursing homes, 85
percent of residents were age 65 and over. In residential care communities, 93 percent of residents were age 65 and over. In adult day services centers, 64 percent
of participants were age 65 and over. Among home health care patients, 83 percent were age 65 and over. Data were not available for hospice patients. Participants,
patients, or residents were considered needing any assistance with a given activity if they needed help or supervision from another person or used special equipment
to perform the activity. See http://www.cdc.gov/nchs/data/series/sr_03/sr03_038.pdf for definitions.
Reference population: These data refer to the resident population.
SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Study of Long-Term Care Providers.
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INDICATOR 39: Use of Time
Table 39a. Average number of hours per day and percentage of day that people age 55 and over spent doing selected activities on an
average day, by age group, 2014
Selected activity
Sleeping
Leisure activities
Work and work-related activities
Household activities
Caring for and helping others
Eating and drinking
Purchasing goods and services
Grooming
Other activities
55 and
Average
hours
per day
8.73
6.48
2.37
2.18
0.36
1.30
0.84
0.65
1.07
over
Percent
of day
36.4
27.0
9.9
9.1
1.5
5.4
3.5
2.7
4.5
55-64
Average
hours
per day
8.43
5.45
4.02
2.01
0.41
1.21
0.82
0.69
0.94
Percent
of day
35.1
22.7
16.8
8.4
1.7
5.0
3.4
2.9
3.9
65-74
Average
hours
per day
8.88
6.94
1.32
2.44
0.36
1.37
0.90
0.62
1.17
Percent
of day
37.0
28.9
5.5
10.2
1.5
5.7
3.8
2.6
4.9
75 and
Average
hours
per day
9.16
8.02
0.33
2.19
0.28
1.41
0.81
0.61
1.19
over
Percent
of day
38.2
33.4
1.4
9.1
1.2
5.9
3.4
2.5
5.0
NOTE: "Other activities" includes activities such as educational activities; organizational, civic, and religious activities; and telephone calls. Table includes people who
did network at all.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Bureau of Labor Statistics, American Time Use Survey.
Table 39b. Average number of hours and percentage of total leisure time that people age 55 and over spent doing selected leisure
activities on an average day, by age group, 2014
55 and over
Average Percent
hours of leisure
Selected leisure activity
Socializing and communicating
Watching TV
Participation in sports, exercise,
and recreation
Relaxing and thinking
Reading
Other leisure activities
per day
0.65
3.78
0.23
0.40
0.61
0.81
time
10.1
58.2
3.6
6.2
9.4
12.5
55-64
Average Percent
hours of leisure
per day
0.58
3.25
0.24
0.30
0.37
0.71
time
10.6
59.6
4.3
5.6
6.8
13.0
65-74
Average Percent
hours of leisure
per day
0.73
4.03
0.27
0.35
0.63
0.93
time
10.5
58.1
3.9
5.0
9.1
13.4
75 and over
Average Percent
hours of leisure
per day
0.71
4.52
0.17
0.69
1.09
0.85
time
8.8
56.3
2.1
8.7
13.5
10.5
NOTE: "Other leisure activities" includes activities such as playing games, using the computer for leisure, doing arts and crafts as a hobby, experiencing arts and
entertainment (other than sports), and engaging in related travel.
Reference population: These data refer to the civilian noninstitutionalized population.
SOURCE: Bureau of Labor Statistics, American Time Use Survey.
151
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Tables
INDICATOR 40: Air Quality
Table 40a. Percentage of people age 65 and over living in counties with "poor air quality," by selected pollutant measures, 2000-2014
Pollutant measures
Particulate Matter (PM25)
Ozone
Any standard
2000
50.1
51.4
65.5
2001
47.7
54.5
64.8
2002 2003
47.1 43.0
53.4 53.5
62.7 63.2
2004 2005
37.8 45.6
34.4 51.1
54.6 62.4
2006
35.5
49.0
59.1
2007
38.4
47.1
57.6
2008 2009
25.7 17.7
35.6 16.4
45.3 27.1
2010
15.0
31.6
38.4
2011
14.1
35.3
40.4
2012
7.2
38.9
41.6
2013 2014
9.4 9.1
14.1 11.3
21.1 16.5
NOTE: The term "poor air quality" is defined as air quality concentrations above the level of the National Ambient Air Quality Standards (NAAQS). The term "any
standard" refers to any NAAQS for ozone, particulate matter, nitrogen dioxide, sulfur dioxide, carbon monoxide, or lead. Data for previous years have been computed
using the the standards in effect as of August 2015 to enable comparisons over time. This results in percentages that are not comparable to those in previous
publications of Older Americans. Measuring concentrations above the level of a standard is not equivalent to violating the standard. The level of a standard may be
exceeded on multiple days before the exceedance is considered a violation of the standard.
Reference population: These data refer to the resident population.
SOURCE: U.S. Environmental Protection Agency, Office of Air Quality Planning and Standards, Air Quality System; U.S. Census Bureau, 2010 Population.
Table 40b. Counties with "poor air quality" for any standard in 2014
State
Alaska
Alaska
Alaska
Alaska
Arizona
Arizona
Arizona
Arizona
Arizona
Arizona
Arizona
California
California
California
California
California
California
California
California
California
California
California
California
California
California
California
California
County
Anchorage Municipality
Fairbanks North Star Borough
Kenai Peninsula Borough
Matanuska-Susitna Borough
Cochise County
Gila County
Maricopa County
Pinal County
Santa Cruz County
Yavapai County
Yuma County
Alameda County
El Dorado County
Fresno County
Imperial County
Inyo County
Kern County
Kings County
Los Angeles County
Madera County
Mariposa County
Merced County
Mono County
Nevada County
Orange County
Placer County
Plumas County
Total population
(in Census 2010)
291,826
97,581
55,400
88,995
131,346
53,597
3,817,117
375,770
47,420
211,033
195,751
1,510,271
181,058
930,450
174,528
18,546
839,631
152,982
9,818,605
150,865
18,251
255,793
14,202
98,764
3,010,232
348,432
20,007
Population 65 and over
(in Census 2010)
21,139
6,375
6,276
7,069
22,688
12,450
462,641
52,071
6,224
50,767
30,646
167,746
26,524
93,421
18,152
3,535
75,437
12,030
1,065,699
17,262
3,821
23,960
1,377
19,174
349,677
53,562
4,154
See notes at end of table.
152
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Tables
INDICATOR 40: Air Quality
Table 40b. Counties with "poor air quality" for any standard in 2014continued
State
California
California
California
California
California
California
California
California
California
California
California
California
Colorado
Colorado
Colorado
Connecticut
Connecticut
Connecticut
Connecticut
Georgia
Hawaii
Idaho
Idaho
Illinois
Indiana
Indiana
Indiana
Indiana
Indiana
Indiana
Iowa
Iowa
Kentucky
Louisiana
Michigan
Missouri
Missouri
Missouri
Missouri
Montana
Nevada
Nevada
Nevada
New Jersey
New Mexico
New Mexico
New Mexico
See notes at end
County
Riverside County
Sacramento County
San Bernardino County
San Diego County
San Joaquin County
San Luis Obispo County
Santa Barbara County
Siskiyou County
Stanislaus County
Tehama County
Tulare County
Ventura County
Alamosa County
Jefferson County
Prowers County
Fairfield County
Hartford County
Middlesex County
Tolland County
Rockdale County
Hawaii County
Lemhi County
Shoshone County
Tazewell County
Daviess County
Gibson County
Marion County
Morgan County
Pike County
Vigo County
Linn County
Muscatine County
Jefferson County
St. Bernard Parish
Allegan County
Iron County
Jackson County
Jefferson County
St. Louis city
Yellowstone County
Clark County
Nye County
Washoe County
Warren County
Bernalillo County
Dona Ana County
Luna County
of table.
Total population
(in Census 2010)
2,189,641
1,418,788
2,035,210
3,095,313
685,306
269,637
423,895
44,900
514,453
63,463
442,179
823,318
15,445
534,543
12,551
916,829
894,014
165,676
152,691
85,215
185,079
7,936
12,765
135,394
31,648
33,503
903,393
68,894
12,845
107,848
211,226
42,745
741,096
35,897
111,408
10,630
674,158
218,733
319,294
147,972
1,951,269
43,946
421,407
108,692
662,564
209,233
25,095
Population 65 and over
(in Census 2010)
258,586
158,551
181,348
351,425
71,181
41,022
54,398
8,782
54,831
10,071
41,779
96,309
1,752
67,411
1,835
124,075
130,119
25,621
18,220
9,066
26,834
1,758
2,537
21,139
4,461
5,122
96,102
8,919
2,175
14,511
27,488
5,843
99,095
3,288
14,438
1,899
83,990
24,394
35,175
20,868
220,445
10,301
50,879
15,292
81,014
25,881
4,907
153
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Tables
INDICATOR 40: Air Quality
Table 40b. Counties with "poor air quality" for any standard in 2014continued
State
North Dakota
Ohio
Ohio
Ohio
Oklahoma
Oklahoma
Oregon
Oregon
Oregon
Pennsylvania
Pennsylvania
Pennsylvania
Pennsylvania
Pennsylvania
Pennsylvania
Pennsylvania
Pennsylvania
Tennessee
Texas
Texas
Utah
Utah
Utah
Utah
Utah
Wisconsin
Wisconsin
Wisconsin
Wyoming
Wyoming
Puerto Rico
County
Williams County
Cuyahoga County
Hamilton County
Morgan County
Adair County
Love County
Crook County
Lake County
Lane County
Allegheny County
Beaver County
Delaware County
Lancaster County
Lebanon County
Philadelphia County
Warren County
Washington County
Sullivan County
Denton County
Tarrant County
Cache County
Davis County
Salt Lake County
Uintah County
Utah County
Brown County
Kenosha County
Oneida County
Carbon County
Sweetwater County
Arecibo Municipio, Puerto Rico
Total population
(in Census 2010)
22,398
1,280,122
802,374
15,054
22,683
9,423
20,978
7,895
351,715
1,223,348
170,539
558,979
519,445
133,568
1,526,006
41,815
207,820
156,823
662,614
1,809,034
112,656
306,479
1,029,655
32,588
516,564
248,007
166,426
35,998
15,885
43,806
96,440
Population 65 and over
(in Census 2010)
3,328
198,541
106,863
2,611
2,934
1,618
4,203
1,612
52,781
205,059
31,660
79,726
77,780
22,729
185,309
7,840
36,366
29,215
46,043
161,385
8,694
24,992
89,367
2,997
33,457
28,789
18,679
7,800
2,044
3,643
15,727
NOTE: The term "poor air quality" is defined as air quality concentrations above the level of the National Ambient Air Quality Standards (NAAQS). The term "any
standard" refers to any NAAQS for ozone, particulate matter, nitrogen dioxide, sulfur dioxide, carbon monoxide, or lead. Measuring concentrations above the level of
a standard is not equivalent to violating the standard. The level of a standard may be exceeded on multiple days before the exceedance is considered a violation of
the standard.
Reference population: These data refer to the resident population.
SOURCE: U.S. Environmental Protection Agency, Office of Air Quality Planning and Standards, Air Quality System; U.S. Census Bureau, 2010 Population.
154
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Tables
INDICATOR 41: Transportation
Table 41. Percentage of noninstitutionalized Medicare beneficiaries age 65 and over who made a change in transportation mode due to
a health or physical problem, by age group and type of change, 2013
65 and over
Type of change
Total
65-74
75-84
85 and over
Limits driving to daytime
Has given up driving altogether
Has trouble getting places
Has reduced travel
33.4
19.1
24.5
33.8
24.8
11.3
18.5
25.9
39.2
21.2
26.5
37.3
55.3
46.5
44.6
58.4
Reference population: These data refer to noninstitutionalized Medicare beneficiaries.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Access to Care.
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Tables
SPECIAL FEATURE: Informal Caregiving
Table CGI. Number of informal caregivers, by age group and sex, 2011
Sex
Less than 45
45-54
55-64
65-74
75 and over
Total
Men
Women
2,738
999
1,740
Number (in thousands)
4,358 4,960
1,727 1,512
2,631 3,449
3,464
1,412
2,052
2,428
1,204
1,224
Reference population: People of all ages who, in the last month, helped with one or more self-care, household, or medical activities for a Medicare enrollee age 65 or
over who had a chronic disability.
SOURCE: National Study on Caregiving.
Table CG2. Number of informal caregivers and percentage distribution of caregiving hours provided, by relationship to care recipient,
2011
Relationship to care recipient
Total
Spouse
Daughter
Son
Other relative
Non-relative
Number of caregivers
(in thousands)
17,949
3,802
5,263
3,287
4,011
1,586
Number of aggregate
Percentage of monthly hours
caregivers (in thousands)
100.0
21.2
29.3
18.3
22.3
8.8
1,342,520
417,018
411,138
213,530
245,508
55,326
Percentage of
caregiving hours
100.0
31.1
30.6
15.9
18.3
4.1
NOTE: Estimates may not sum to the totals because of rounding.
Reference population: People of all ages who, in the last month, helped with one or more self-care, household, or medical activities for a Medicare enrollee age 65 or
over who had a chronic disability.
SOURCE: National Study on Caregiving.
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Tables
SPECIAL FEATURE: Informal Caregiving
Table CG3. Percentage of caregivers providing assistance, by sex of caregiver and type of assistance, 2011
Type of assistance
Total
Men
Women
Self care
Mobility
Transportation
Medical or health care
49.3
71.6
86.4
57.1
45.5
76.4
86.4
55.4
51.6
68.7
86.3
58.1
NOTE: Respondents reported whether they helped with different types of activities. Self-care activities include bathing, dressing, eating, and toileting. Mobility-related
activities include getting out of bed, getting around inside one's home or building, and leaving one's home or building. Health or medical care tasks were assistance
with diet, foot care, giving injections, and managing medical tasks, such as ostomy care, IV therapy assistance, or blood tests.
Reference population: People of all ages who, in the last month, helped with one or more self-care, household, or medical activities for a Medicare enrollee age 65 or
over who had a chronic disability.
SOURCE: National Study on Caregiving.
Table CG4. Percentage of caregiver recipients, caregivers, and hours of help provided, by level of assistance needed by care recipients,
2011
Level of assistance
Care recipients
Caregivers
Hours of help
Household activities only
1-2 self-care/mobility tasks
3 or more self-care/mobility tasks
33.3
39.4
27.3
31.1
38.0
30.9
21.2
32.4
46.4
Reference population: People of all ages who, in the last month, helped with one or more self-care, household, or medical activities for a Medicare enrollee age 65 or
over who had a chronic disability.
SOURCE: National Study on Caregiving.
Table CG5. Percentage of informal caregivers reporting positive and negative aspects of caregiving, by level of impact, 2011
Level of impact
Aspects of caregiving
Some
Substantial
Positive aspects
More confident about abilities
Brought you closer to care receipient
Satisfied that recipient is well-cared for
Negative aspects
Financial difficulties
Emotional difficulties
Physical difficulties
Have more things than you can handle
Don't have time for yourself
34.8
21.2
12.5
11.4
23.7
11.8
27.1
26.4
45.5
68.7
86.3
6.6
13.5
6.3
18.8
15.1
Reference population: People of all ages who, in the last month, helped with one or more self-care, household, or medical activities for a Medicare enrollee age 65 or
over who had a chronic disability.
SOURCE: National Study on Caregiving.
157
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158
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Data sources
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Data Sources
Air Quality System
The Air Quality System (AQS) contains ambient air
pollution data collected by the U.S. Environmental
Protection Agency (EPA) and state, local, and tribal air
pollution control agencies. Data on criteria pollutants
consist of air quality measurements collected by sensitive
equipment at thousands of monitoring stations located
across all 50 states plus the District of Columbia,
Puerto Rico, and the U.S. Virgin Islands. Each monitor
measures the concentration of a particular pollutant in
the air. Monitoring data indicate the average pollutant
concentration during a specified time interval (usually
1 hour or 24 hours). AQS also contains meteorological
data, descriptive information about each monitoring
station (including its geographic location and its operator),
and data quality assurance or quality control information.
The system is administered by EPA, Office of Air Quality
Planning and Standards, Outreach and Information
Division, located in Research Triangle Park, NC.
For more information, contact:
Nick Mangus
U.S. Environmental Protection Agency
Phone: 919-541-5549
Website: http://www.epa.gov/aqs
American Housing Survey
The American Housing Survey (AHS) was mandated by
Congress in 1968 to provide data for evaluating progress
toward "a decent home and a suitable living environment
for every American family." It is the primary source of
detailed information on housing in the United States and
is used to generate a biennial report to Congress on the
conditions of housing in the United States, among other
reports. The survey is conducted for the Department of
Housing and Urban Development by the U.S. Census
Bureau. The AHS encompasses a national survey and
60 metropolitan surveys and is designed to collect data
from the same housing units for each survey. The national
survey, a representative sample of approximately 45,000
housing units as of 2015, is conducted biennially in odd-
numbered years; the metropolitan surveys, representative
samples of 3,000 housing units, are conducted in odd-
numbered years on a 4-year cycle. The AHS collects data
about the inventory and condition of housing in the
United States and the demographics of its inhabitants. The
survey provides detailed data on the types of housing in
the United States and their characteristics and conditions;
financial data on housing costs, utilities, mortgages,
equity loans, and market value; and demographic data
on family composition, income, education, and race and
ethnicity. Rotating supplements to the survey collect
information on neighborhood quality, walkability, public
transportation and recent movers; the health and safety
aspects of a home; accommodations for older and disabled
household members; doubling up of households; working
from home; access to arts and culture; use of housing
counseling; food security; and energy efficiency.
Race and Hispanic origin: Data from this survey are not
shown by race and Hispanic origin in this report.
For more information, contact:
Meena Bavan
U.S. Department of Housing and Urban Development
E-mail: Meena.Bavan@hud.gov
Phone: 202-708-0614
Website: http://www.huduser.gov/portal/datasets/ahs.html
American Time Use Survey
The American Time Use Survey (ATUS) is a nationally
representative sample survey conducted for the Bureau
of Labor Statistics by the U.S. Census Bureau. The
ATUS measures how people living in the United States
spend their time. Estimates show the kinds of activities
people do and the time they spend doing them by sex,
age, educational attainment, labor force status, and other
characteristics, as well as by weekday and weekend day.
ATUS respondents are interviewed one time about
how they spent their time on the previous day, where
they were, and whom they were with. The survey is a
continuous survey, with interviews conducted nearly every
day of the year and a sample that builds over time. About
12,000 members of the civilian noninstitutionalized
population age 15 and over are interviewed each year.
Race and Hispanic origin: Data from this survey are not
shown by race and Hispanic origin in this report.
For more information, contact:
American Time Use Survey Staff
Bureau of Labor Statistics
U.S. Department of Labor
E-mail: atusinfo@bls.gov
Phone: 202-691-6339
Website: http://www.bls.gov/tus/
Consumer Expenditure Survey
The Consumer Expenditure Survey (CE) is conducted for
the Bureau of Labor Statistics by the U.S. Census Bureau.
The survey consists of two separate components, the
160
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Data Sources
Quarterly Interview Survey and the Diary Suvey Data are
integrated before publication. The data presented in this
Chartbook are derived from the integrated data available
on the CE website. The published data are weighted to
reflect the U.S. population.
The Quarterly Interview Survey is designed to obtain data
on the types of expenditures respondents can recall for a
period of 3 months or longer. These include relatively large
expenditures, such as those for property, automobiles,
and major durable goods and those that occur on a
regular basis, such as rent and utilities. Each consumer
unit is interviewed once per quarter for four consecutive
quarters. The Diary Survey is designed to obtain data
on frequently purchased smaller items, including food
and beverages both at home and in food establishments,
housekeeping supplies, tobacco, nonprescription drugs,
and personal care products and services. Each consumer
unit records its expenditures in a diary for two consecutive
1-week periods. Respondents are less likely to recall such
purchases over longer periods.
Race and Hispanic origin: Data from this survey are not
shown by race and Hispanic origin in this report.
For more information, contact:
Bureau of Labor Statistics
U.S. Department of Labor
E-mail: CEXINFO@bls.gov
Phone: 202-691-6900
Website: http://www.bls.gov/cex/
Current Population Survey
The Current Population Survey (CPS) is a nationally
representative sample survey of about 60,000 households
conducted monthly for the Bureau of Labor Statistics
(BLS) by the U.S. Census Bureau. The CPS is the primary
source of information on the labor force characteristics of
the civilian noninstitutionalized population age 16 and
over, including a comprehensive body of monthly data
on the labor force, employment, unemployment, persons
not in the labor force, hours of work, earnings, and other
demographic and labor force characteristics.
In most months, CPS supplements provide additional
demographic and social data. The Annual Social and
Economic Supplement (ASEC) is the primary source
of detailed information on income and poverty in the
United States. The ASEC is used to generate the annual
Population Profile of the United States, reports on
geographical mobility and educational attainment, and
is the primary source of detailed information on income
and poverty in the United States. The ASEC, historically
referred to as the March supplement, now is conducted
in February, March, and April with a sample of about
100,000 addresses. The questionnaire asks about income
from more than 50 sources and records up to 27 different
income amounts, including receipt of many noncash
benefits, such as food stamps and housing assistance.
Race and Hispanic origin: CPS respondents are asked to
identify themselves as belonging to one or more of five
racial groups (White, Black, American Indian and Alaska
Native, Asian, and Native Hawaiian and other Pacific
Islander). People who responded to the question on race
by indicating only one race are referred to as the race alone
or single-race population, and individuals who chose more
than one race category are referred to as the Two or more
races population.
The CPS includes separate questions on Hispanic origin.
People who identify themselves as Hispanic, Latino,
or Spanish are further classified by detailed Hispanic
ethnicity (such as Mexican, Puerto Rican, or Cuban).
People of Hispanic origin may be of any race.
For more information regarding the CPS, its sampling
structure, and estimation methodology, see "Explanatory
Notes and Estimates of Error."59
For more information, contact:
Bureau of Labor Statistics
U.S. Department of Labor
E-mail: cpsinfo@bls.gov
Phone: 202-691-6378
Website: http://www.bls.gov/cps
Additional website: http://www.census.gov/cps/
Decennial Census
Every 10 years, beginning with the first census in 1790,
the United States government conducts a census, or
count, of the entire population as mandated by the U.S.
Constitution. For most data collections, Census Day was
April 1 of the respective year.
For the 2010 Census, the Bureau devised a short-form
questionnaire that asked for the age, sex, race, and
ethnicity (Hispanic or Not Hispanic) of each household
resident; his or her relationship to the person filling out
the form; and whether the housing unit was rented or
owned by a member of the household. The census long
form, which for decades collected detailed socioeconomic
and housing data from a sample of the population
on education, housing, jobs, etc., was replaced by the
American Community Survey (ACS), an ongoing survey
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Data Sources
of about 295,000 addresses per month that gathers largely
the same data as its predecessor.
Race and Hispanic origin: Starting with Census 2000, and
continuing in the 2010 Census, respondents were given
the option of selecting one or more race categories to
indicate their racial identities. People who responded to
the question on race by indicating only one of the six race
categories (White, Black, American Indian and Alaska
Native, Asian, Native Hawaiian and other Pacific Islander,
and Some Other Race) are referred to as the race alone or
single-race population. Individuals who chose more than
one of the race categories are referred to as the Two or
More Races population. The six single-race categories
which made up nearly 98 percent of all respondents
and the Two or More Races category sum to the total
population. Because respondents were given the option of
selecting one or more race categories in Census 2000 and
the 2010 Census, these data are not directly comparable
with data from the 1990 or earlier censuses.
As in earlier censuses, the 2010 Census included a
separate question on Hispanic origin. In the 2010 Census,
people of Spanish/Hispanic/Latino origin could identify
themselves as Mexican, Mexican American or Chicano,
Puerto Rican, Cuban, or Another Hispanic, Latino, or
Spanish origin. People of Hispanic origin may be of any
race.
For more information, contact:
Sex and Age Statistics Branch
Phone: 301-763-2378
Website: https://www.census.gov/2010census/
Federal Reserve Board
The Board of Governors of the Federal Reserve, also
called the Federal Reserve Board, publish the "Financial
Accounts of the United States" (Z.I) data quarterly
(about 10 weeks after the end of the quarter) on their
website. This data release presents the financial flows and
levels of sectors in the U.S. economy as well as selected
balance sheets, supplemental tables, and the Integrated
Macroeconomic Accounts (IMA).
The IMA relate production, income, saving, and capital
formation from the national income and product
accounts (NIPA) to changes in net worth from the
"Financial Accounts" on a sector-by-sector basis. The
IMA are published jointly by the Federal Reserve Board
and the Bureau of Economic Analysis and are based on
international guidelines and terminology as defined in the
System of National Accounts (SNA 2008).
Data shown for the most recent quarters are based on
preliminary and potentially incomplete information.
Nonetheless, when source data are revised or estimation
methods are improved, all data are subject to revision.
There is no specific revision schedule; rather, data are
revised on an ongoing basis. In each release of the
"Financial Accounts," major revisions are highlighted at
the beginning of the publication.
The data in the "Financial Accounts" come from a
large variety of sources and are subject to limitations
and uncertainty due to measurement errors, missing
information, and incompatibilities among data sources.
The size of this uncertainty cannot be quantified,
but its existence is acknowledged by the inclusion of
"statistical discrepancies" for various sectors and financial
instruments.
For more information, contact:
Federal Reserve Board of Governors
E-mail: rs-zl-staff@frb.gov
Website: http://www.federalreserve.gov/apps/fof/
Form 5500 Filings
Each year, most private pension and many private welfare
benefit plans satisfy their annual reporting requirement by
filing a Form 5500 Annual Return/Report regarding their
financial condition, investments, and operations with the
U.S. Department of Labor, Internal Revenue Service, and
the Pension Benefit Guaranty Corporation.
The pension research sample supports analysis of the plan,
participant, and financial characteristics of the private
pension plan universe and is used to produce the Private
Pension Plan Bulletin Abstract of Form 5500 Annual
Reports, an annual publication that summarizes data on
private pension plans.
For more information, contact:
Employee Benefits Security Administration
U.S. Department of Labor
Phone: 202-693-8410
Website: http://www.dol.gov/ebsa/publications/
form5500dataresearch.html
Health and Retirement Study
The Health and Retirement Study (HRS) is a national
panel study conducted by the University of Michigan's
Institute for Social Research under a cooperative
agreement with the National Institute on Aging (NIA).
In 1992, the study had an initial sample of over 12,600
people from the 19311941 birth cohort and their
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Data Sources
spouses. The HRS was joined in 1993 by a companion
study, Asset and Health Dynamics Among the Oldest Old
(AHEAD), with a sample of 8,222 respondents (who were
born before 1924 and were age 70 and over) and their
spouses. In 1998, these two data collection efforts were
combined into a single survey instrument and field period
and were expanded through the addition of baseline
interviews with two new birth cohorts: Children of the
Depression Age (1924-1930) and War Babies (1942-
1947). The HRS steady-state design calls for the addition
of a new 6-year cohort of Americans entering their 50s.
Thus, the Early Boomer birth cohort (1948-1953) was
added in 2004, the Mid-"Baby Boomer" birth cohort
(1954-1959) was added in 2010, and the Late "Baby
Boomers" (1960-1965) will be added in 2016. The 2010
wave also included an expansion of the minority sample
of Early and Mid-"Baby Boomers." Telephone follow-ups
are conducted every second year, with proxy interviews
after death. Beginning with the 2006 wave, one-half of the
sample goes through an enhanced face-to-face interview
that includes the collection of physical measures and
biomarker collection. The Aging, Demographics, and
Memory Study (ADAMS) and forthcoming Harmonized
Cognitive Assessment Protocol (HCAP) supplement the
HRS with data to support a population-based study of
dementia. A genome-wide scan on 2012 samples is still
being processed, after which approximately 19,000 HRS
participants will support genetic and genomic studies.
The combined studies, which are collectively called
the HRS, have become a steady state sample that is
representative of the entire U.S. population age 50 and
over (excluding people who resided in a nursing home or
other institutionalized setting at the time of sampling).
The HRS will follow respondents longitudinally until they
die (including following people who move into a nursing
home or other institutionalized setting).
The HRS is designed to explain the antecedents and
consequences of retirement; examine the relationship
between health, income, and wealth over time;
examine life cycle patterns of wealth accumulation and
consumption; monitor work disability; provide a rich
source of interdisciplinary data, including linkages with
administrative data; monitor transitions in physical,
functional, and cognitive health in advanced old age;
relate late-life changes in physical and cognitive health
to patterns of spending down assets and income flows;
relate changes in health to economic resources and
intergenerational transfers; and examine how the mix and
distribution of economic, family, and program resources
affect key outcomes, including retirement, spending down
assets, health declines, and institutionalization.
Race and Hispanic origin: Data from this survey are not
shown by race and Hispanic origin in this report.
For more information, contact:
Health and Retirement Study
E-mail: hrsquest@isr.umich.edu
Phone: 734-936-0314
Website: http://hrsonline.isr.umich.edu/
Intercensal Population Estimates: 2000 to
2010
Intercensal population estimates are produced for the years
between two decennial censuses when both the beginning
and ending populations are known. They are produced by
adjusting the existing time series of postcensal estimates
for the entire decade to smooth the transition from one
decennial census count to the next. They differ from the
annually released postcensal estimates in that they rely on
mathematical formulae that redistribute the difference
between the April 1 postcensal estimate and April 1 census
count for the end of the decade across the postcensal
estimates for that decade. For dates when both postcensal
and intercensal estimates are available, intercensal
estimates are preferred.
The 20002010 intercensal estimates reconcile the
postcensal estimates with the 2010 Census counts and
provide a consistent time series of population estimates
that reflect the 2010 Census results. The 2000-2010
intercensal estimates were produced for the nation, states,
and counties by demographic characteristics (age, sex, and
race and Hispanic origin).
For a more detailed discussion of the methods used to
create the intercensal estimates, see http://www.census.
gov/popest/data/intercensal/index.html.
For more information, contact:
Population Estimates Branch
Phone: 301-763-2385
Website: http://www.census.gov/popest/index.html
International Data Base
The U.S. Census Bureau produces the International Data
Base (IDE), which includes regularly updated population
estimates and projections for over 200 countries and areas.
The series of estimates and projections provide a consistent
set of demographic indicators, including population size
and growth, mortality, fertility, and net migration. The
IDE is accessible via the Internet at www.census.gov/
population/international/data/idb.
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For more information, contact:
Demographic and Economic Studies Branch
International Programs
Population Division
Phone: 301-763-1360
Website: http://www.census.gov/population/international/
data/
Master Beneficiary Record
The Social Security Administration maintains a record of
Social Security Title II benefits for each beneficiary and
applicant for benefits. The administrative database is for
each disabled insurance, retired worker insurance, survivor
insurance, and spouse insurance beneficiary. The system
of records is the Master Beneficiary Record (MBR). The
MBR extract file contains a record for every person who
has a record on the MBR. This general-purpose extract
file is comprised of 134 variables. The MBR extract is
produced semi-annually, and is used to support a variety
of research and statistical projects.
The data in Indicator 10 on Social Security beneficiaries
come from tabulations of the MBR data that are
published annually in the Statistical Supplement to the
Social Security Bulletin. The Supplement tables used in
Indicator 10 include 5A.1.2, 5A1.6, 5A5, 5A.6, 5A, and
6B5-1-
For more information, contact:
Email: statistics@ssa.gov
Website: https://www.socialsecurity.gov/policy/docs/
statcomps/supplement
Medicare Claims and Enrollment Data
The Medicare claims and enrollment data are captured
in the Chronic Condition Warehouse. The Centers for
Medicare & Medicaid Services (CMS) launched the
Chronic Condition Data Warehouse (CCW), a research
database, in response to the Medicare Modernization Act
of 2003 (MMA). Section 723 of the MMA outlines a
plan to improve the quality of care and reduce the cost of
care for chronically ill Medicare beneficiaries. In addition
to chronic conditions, the CCW supports health policy
analysis and other CMS initiatives.
The CCW data files were designed to facilitate research
across the continuum of care, using data files that
could be easily merged and analyzed by beneficiary.
Each beneficiary in the CCW is assigned a unique,
unidentifiable link key, which allows researchers to easily
merge data files and perform relevant analyses across
different claim types, enrollment files, Part D event data,
assessment data, and other CCW file types. CCW data
files are available upon request from CMS.
The CCW claims data files have been streamlined to
include only those variables determined by CMS to be
of value and useful for research or analytic purposes. The
data files delivered from the CCW contain a subset of the
original source files. Variables used infrequently or not
applicable to a particular setting have been removed.
For more information, contact:
The Research Data Assistance Center
E-mail: resdac@umn.edu
Phone: 1-888-973-7322
Website: http://www.resdac.umn.edu
Chronic Conditions Data Warehouse
E-mail: CCWHelp@gdit.com
Phone: 1-866-766-1915
Website: https://www.ccwdata.org/web/guest/home
Medicare Current Beneficiary Survey
The Medicare Current Beneficiary Survey (MCBS) is
a continuous, multipurpose survey of a representative
sample of the Medicare population designed to help
the Centers for Medicare & Medicaid Services (CMS)
administer, monitor, and evaluate the Medicare program.
The MCBS collects information on health care use,
cost, and sources of payment; health insurance coverage;
household composition; sociodemographic characteristics;
health status and physical functioning; income and assets;
access to care; satisfaction with care; usual source of care;
and how beneficiaries get information about Medicare.
MCBS data enable CMS to determine sources of payment
for all medical services used by Medicare beneficiaries,
including copayments, deductibles, and non-covered
services; develop reliable and current information on the
use and cost of services not covered by Medicare (such
as long-term care); ascertain all types of health insurance
coverage and relate coverage to sources of payment; and
monitor the financial effects of changes in the Medicare
program. Additionally, the MCBS is the only source of
multidimensional person-based information about the
characteristics of the Medicare population and their access
to and satisfaction with Medicare services and information
about the Medicare program. The MCBS sample
consists of Medicare enrollees in the community and in
institutions.
The survey is conducted in three rounds each year, with
each round being about 4 months in length. The MCBS
has a multistage, stratified, random sample design and
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a rotating panel survey design. Each panel is followed
for 12 interviews. In-person interviews are conducted
using computer-assisted personal interviewing. A sample
of approximately 16,000 people are interviewed in each
round. However, because of the rotating panel design,
only 12,000 people receive all three interviews in a given
calendar year. Information collected in the survey is
combined with information from CMS administrative
data files.
The MCBS has two components: the Cost and Use file
and the Access to Care file. Medicare claims are linked
to survey-reported events to produce the Cost and Use
file, which provides complete expenditure and source-of-
payment data on all health care services, including those
not covered by Medicare. The Access to Care file contains
information on beneficiaries' access to health care,
satisfaction with care, and usual source of care. The sample
for this file represents the "always enrolled" population
those who participated in the Medicare program for the
entire year. In contrast, the Cost and Use file represents
the "ever enrolled" population, including those who
entered Medicare and those who died during the year.
Race and Hispanic origin: The MCBS defines race as
White, Black, Asian, Native Hawaiian or Pacific Islander,
American Indian or Alaska Native, or Other. People are
allowed to choose more than one category. There is a
separate question on whether the person is of Hispanic
or Latino origin. The "Other" category in Table 30c
consists of people who answered "No" to the Hispanic/
Latino question and who answered something other than
"White" or "Black" to the race question. People who
answer with more than one racial category are assigned to
the "Other" category.
For more information, contact:
MCBS Staff
Centers for Medicare & Medicare Services
E-mail: MCBS@cms.hhs.gov
Website: http://www.cms.hhs.gov/mcbs
The Research Data Assistance Center
E-mail: resdac@umn.edu
Phone: 1-888-973-7322
Website: http://www.resdac.umn.edu
Medical Expenditure Panel Survey
The Medical Expenditure Panel Survey (MEPS) is an
ongoing annual survey of the civilian noninstitutionalized
population that collects detailed information on health
care use and expenditures (including sources of payment),
health insurance, income, health status, access, and quality
of care. The MEPS, which began in 1996, is the third in
a series of national probability surveys conducted by the
Agency for Healthcare Research and Quality (AHRQ) on
the financing and use of medical care in the United States.
MEPS predecessor surveys are the National Medical Care
Expenditure Survey (NMCES) conducted in 1977 and the
National Medical Expenditure Survey (NMES) conducted
in 1987- Each of the three surveys (NMCES, NMES, and
MEPS) used multiple rounds of in-person data collection
to elicit expenditures and sources of payments for each
health care event experienced by household members
during the calendar year. The current MEPS Household
Component (HC) sample is drawn from respondents to
the National Health Interview Survey (NHIS) conducted
by the National Center for Health Statistics (NCHS). To
yield more complete information on health care spending
and payment sources, followback surveys of health
providers were conducted for a subsample of events in the
MEPS (and events in the MEPS predecessor surveys).
Since 1977, the structure of billing mechanism for
medical services has grown more complex as a result
of increasing penetration of managed care and health
maintenance organizations and various cost containment
reimbursement mechanisms instituted by Medicare,
Medicaid, and private insurers. As a result, there has
been substantial discussion about what constitutes an
appropriate measure of health care expenditures.60 Health
care expenditures presented in this report refer to what
is actually paid for health care services. More specifically,
expenditures are defined as the sum of direct payments
for care received, including out-of-pocket payments
for care received. This definition of expenditures differs
somewhat from what was used in the 1987 NMES, which
used charges (rather than payments) as the fundamental
expenditure construct. To improve comparability of
estimates between the 1987 NMES and the 1996 and
2001 MEPS, the 1987 data presented in this report were
adjusted using the method described by Zuvekas and
Cohen.58 Adjustments to the 1977 data were considered
unnecessary because virtually all of the discounting
for health care services occurred after 1977 (essentially
equating charges with payments in 1977).
A number of quality-related enhancements were made to
the MEPS beginning in 2000, including the fielding of an
annual adult self-administered questionnaire (SAQ). This
questionnaire contains items regarding patient satisfaction
and accountability measures from the Consumer
Assessment of Healthcare Providers and Systems
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(CAHPS*; previously known as the Consumer Assessment
of Health Plans), the SF-12 physical and mental health
assessment tool, EQ-5D EuroQol 5 dimensions with
visual scale (20002003), and several attitude items.
Starting in 2004, the K6 Kessler mental health distress
scale and the PH2 two-item depression scale were added
to the SAQ.
Race and Hispanic origin: Data from this survey are not
shown by race and Hispanic origin in this report.
For more information:
Agency for Healthcare Research and Quality
Website: http://meps.ahrq.gov/mepsweb
National Health and Aging Trends Study
and National Study of Caregiving
The National Health and Aging Trends Study (NHATS)
is a scientific study of how Americans function in later
life that is conducted by the Johns Hopkins University
Bloomberg School of Public Health, with data collection
by Westat and support from the National Institute on
Aging. The NHATS is intended to foster research that
will guide efforts to reduce disability, maximize health and
independent functioning, and enhance quality of life at
older ages.
Since 2011, the NHATS has been gathering information
on a nationally representative sample of Medicare
beneficiaries ages 65 and over through annual in-person
interviews. The interviews collect detailed information
on activities of daily life, living arrangements, economic
status and well-being, aspects of early life, and quality
of life. Among the specific content areas included are
the general and technological environment of the home,
health conditions, work status and participation in valued
activities, mobility and use of assistive devices, cognitive
functioning, and help provided with daily activities (self-
care, household, and medical). Study participants are
re-interviewed every year in order to compile a record of
change over time. The content and questions included
in the NHATS were developed by a multidisciplinary
team of researchers from the fields of demography,
geriatric medicine, epidemiology, health services research,
economics, and gerontology. As the population ages, the
NHATS will provide the basis for understanding trends
in late-life functioning, how these differ for various
population subgroups, and the economic and social
consequences of aging and disability for individuals,
families, and society.
The National Study of Caregiving (NSOC) is a national
study of people who help older family members and
friends with their daily activities and is conducted as a
supplement to the NHATS. NHATS respondents who
reported receiving assistance with household, mobility,
or self-care activities were asked to identify all persons
providing help with each activity. Caregivers were eligible
to participate in the NSOC if they were a family member
or an unpaid caregiver who was not a relative and helped
with any of the activities. NSOC participants took
part in telephone interviews and provided information
about the caregiving experience, caregiving support, and
demographic, socioeconomic, and family characteristics,
as well as type and amount of help provided and family
situation, positive and negative aspects of caregiving (i.e.,
gains from and burdens of caregiving activities), physical
and mental health (including symptoms and impairments
that limited participants' activities), participation in valued
activities and whether caregiving limited participation,
and subjective well-being. The NSOC was conducted in
2011 and 2015, concurrent with the "refreshing" of the
NHATS sample.
For more information, contact:
National Health and Aging Trends Study
E-mail: NHATSdata@westat.com
Website: http://www.nhats.org/
National Health Interview Survey
The National Health Interview Survey (NHIS) is the
principal source of information on the health of the
civilian noninstitutionalized population of the United
States. It is also one of the major data collection programs
of the National Center for Health Statistics (NCHS),
which is part of the Centers for Disease Control and
Prevention (CDC).
The main objective of the NHIS is to monitor the health
of the United States population through the collection and
analysis of data on a broad range of health topics. A major
strength of this survey is its ability to display these health
characteristics by many demographic and socioeconomic
characteristics.
The NHIS covers the civilian noninstitutionalized
population residing in the United States at the time of the
interview. Because of technical and logistical problems,
several segments of the population are not included in the
sample or in the estimates from the survey. Examples of
persons excluded are patients in long-term care facilities,
persons on active duty with the Armed Forces (though
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their dependents are included), persons incarcerated in
the prison system, and U.S. nationals living in foreign
countries.
Race and Hispanic origin: Starting with data year 1999,
race-specific estimates in the NHIS are tabulated according
to 1997 standards for federal data on race and ethnicity
and are not strictly comparable with estimates for earlier
years. In Older Americans 2016, the NHIS estimates
by race represent people who report one race, or if they
reported more than one race, identified one race as best
representing their race. See Health, United States, 2015,
Appendix II for details on race and ethnicity in the NHIS.
For more information, contact:
Division of Health Interview Statistics
E-mail: cdcinfo@cdc.gov
Phone: 1-800-232-4636
Website: http://www.cdc.gov/nchs/nhis.htm
National Health and Nutrition Examination
Survey
The National Health and Nutrition Examination Survey
(NHANES) is a program of studies designed to assess the
health and nutritional status of adults and children in the
United States. The survey is unique in that it combines
interviews and physical examinations. NHANES is
a major program of the National Center for Health
Statistics (NCHS). NCHS is part of the Centers for
Disease Control and Prevention (CDC) and is responsible
for producing vital and health statistics for the nation.
The NHANES program began in the early 1960s and
has been conducted as a series of surveys focusing on
different population groups and health topics. In 1999,
the survey became a continuous program with a changing
focus on a variety of health and nutrition measurements
to meet emerging needs. The survey examines a nationally
representative sample of about 5,000 persons each year.
These persons are located in counties across the country,
15 of which are visited each year.
The NHANES interview includes demographic,
socioeconomic, dietary, and health-related questions. The
examination component consists of medical, dental, and
physiological measurements, as well as laboratory tests
administered by highly trained medical personnel.
Race and Hispanic origin: Data from this survey are not
shown by race and Hispanic origin in this report.
For more information, contact:
Division of Health and Nutrition Examination Survey
E-mail: cdcinfo@cdc.gov
Phone: 1-800-232-4636
Website: http://www.cdc.gov/nchs/nhanes.htm
National Study of Long-Term Care
Providers
The 2014 National Study of Long-Term Care Providers
(NSLTCP) is designed to provide nationally representative
statistical information about the supply and use of long-
term care services in the United States. NSLTCP includes
five sectors: residential care communities, adult day
services centers, nursing homes, home health agencies,
and hospices. NSLTCP replaces three previous National
Center for Health Statistics (NCHS) surveys: the National
Nursing Home Survey, National Home and Hospice Care
Survey, and National Survey of Residential Care Facilities.
NSLTCP comprises two components: (1) primary
data collected by NCHS through surveys of residential
care communities and adult day services centers, and
(2) administrative data on nursing homes, home health
agencies, and hospices obtained from the Centers for
Medicare & Medicaid Services. Estimates in Older
Americans 2016 UK from the study's second wave and use
data from surveys about adult day services centers and
participants; residential care communities and residents
(fielded by NCHS between June 2014 and January 2015);
and administrative records obtained from CMS on home
health agencies and patients, hospices and patients, and
nursing homes and residents, which reflect these providers
and services users between 2013 and 2014.
Race and Hispanic origin: Data from this survey are not
shown by race and Hispanic origin in this report.
For more information, contact:
Long-Term Care Statistics Branch
E-mail: cdcinfo@cdc.gov
Phone: 1-800-232-4636
Website: http://www.cdc.gov/nchs/nsltcp.htm
National Vital Statistics System
The National Vital Statistics System (NVSS) collects and
publishes official national statistics on births, deaths, fetal
deaths, andprior to 1996marriages and divorces
occurring in the United States, based on U.S. Standard
Certificates.
NVSS collects and presents U.S. resident data for the
aggregate of 50 states, New York City, and Washington,
D.C., as well as for each individual state and D.C. and the
U.S. dependent areas of Puerto Rico, the Virgin Islands,
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Guam, American Samoa, and the Northern Marianas.
Vital events occurring in the United States to non-U.S.
residents and vital events occurring abroad to U.S.
residents are excluded.
By law, the registration of deaths is the responsibility
of the funeral director. The funeral director obtains
demographic data for the death certificate from an
informant. The physician in attendance at the death is
required to certify the cause of death. When a death is
from other than natural causes, a coroner or medical
examiner may be required to examine the body and
certify the cause of death. The National Center for Health
Statistics (NCHS) is responsible for compiling and
publishing annual national statistics on causes of death.
In carrying out this responsibility, NCHS adheres to
the World Health Organization (WHO) Nomenclature
Regulations. These regulations require (a) that cause of
death be coded in accordance with the applicable revision
of the International Classification of Diseases (ICD),
and (b) that underlying cause of death be selected in
accordance with international rules.
Race and Hispanic origin: Race and Hispanic origin are
reported separately on the death certificate. Therefore, data
by race shown in Indicator 15 (Life Expectancy) include
people of Hispanic or non-Hispanic origin. See Appendix
II of Health, United States 2015 for more information on
race in the mortality files of the NVSS.
For more information, contact:
Division of Vital Statistics
E-mail: cdcinfo@cdc.gov
Phone: 1-800-232-4636
Website: http://www.cdc.gov/nchs/nvss.htm
Population Projections
The 2014 National Population Projections provide
projections of the resident population and demographic
components of change (births, deaths, and international
migration) through 2060. Population projections are
available by age, sex, and race and Hispanic origin. Where
both estimates and projections are available for the same
time period, the Census Bureau recommends the use of
the population estimates. Below is a general description
of the methods used to produce the 2014 National
Population Projections.
The 2014 National Population Projections start with
the Vintage July 1, 2013, population estimates and are
developed using a cohort-component method. Many
of the characteristics of the U.S. resident population,
as measured by the 2010 Census, are preserved as
demographic patterns that work their way through the
projection period. The components of population change
(births, deaths, and international migration) are projected
for each birth cohort (persons born in a given year).
For each passing year, the Census Bureau advances the
population 1 year of age. The Census Bureau updates
the new age categories using survival rates and levels of
international migration projected for the passing year. A
new birth cohort is added to form the population under
1 year of age by applying projected age-specific fertility
rates to the female population age 14 to 54, and by
updating the new cohort for the effects of mortality and
international migration.
The assumptions for the components of change are based
on time series analysis. Because of limited information
about racial characteristics in the fertility and mortality
historical series, the assumptions were developed for
mutually exclusive and exhaustive groups. Five groups
were used for the fertility assumptions: native-born Asian/
Pacific Islander, all other native-born, foreign-born non-
Hispanic Asian/Pacific Islander, all other non-Hispanic
foreign-born, and foreign-born Hispanic. Three groups
were used for the mortality assumptions: non-Hispanic
White/Asian/Native Hawaiian/Pacific Islander, non-
Hispanic Black/American Indian/Alaska Native, and
Hispanic of any race. The resulting births and deaths were
then applied to the matching racial and ethnic categories
to project the population.
For more information, contact:
Population Evaluation
Analysis and Projections Branch
Phone: 301-763-2438
Website: https://www.census.gov/population/projections/
data/national/20l4.html
Postcensal Population Estimates
Each year, the United States Census Bureau produces
and publishes population estimates of the nation, states,
counties, state/county equivalents, and Puerto Rico.61
The Census Bureau estimates the resident population for
each year since the most recent decennial census by using
measures of population change. The resident population
includes all people currently residing in the United States.
The population estimates are used for federal funding
allocations, as controls for major surveys including the
Current Population Survey and the American Community
Survey, for community development, to aid business
planning, and as denominators for statistical rates.
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Overall, the estimate time series from 2000 to 2010 was
very accurate, even accounting for 10 years of population
change. The average absolute difference between the final
total resident population estimates and 2010 Census
counts was only about 3-1 percent across all counties.62
The population estimate at any given time point starts
with a population base (the last decennial census or the
previous point in the time series), adds births, subtracts
deaths, and adds net migration (both international and
domestic).63 The individual methods used by the Census
Bureau account for additional factors such as input data
availability and the requirement that all estimates be
consistent by geography, age, sex, and race and Hispanic
origin.
The Census Bureau produces these estimates using a "top-
down" approach. It first estimates the national population
and the populations of states and counties. All of these
follow a cohort component method. One key principle
used by the Census Bureau is that all estimates produced
must be consistent across geography and demographic
characteristics. To accomplish this, the Census Bureau
controls the estimates of the smaller geographic areas so
that they sum to the totals produced at higher levels.
For more information contact:
Population Estimates Branch
Phone: 301-763-2385
Website: http://www.census.gov/popest/methodology/
index.html
Supplemental Poverty Measure
Concerns about the adequacy of the official measure of
poverty culminated in a congressional appropriation in
1990 for an independent scientific study of the concepts,
measurement methods, and information needed for a
poverty measure. In response, the National Academy
of Sciences (NAS) established the Panel on Poverty and
Family Assistance, which released its report in the spring
of!995.64
In 2010, an interagency technical working group,
which included representatives from the Bureau of
Labor Statistics (BLS), the U.S. Census Bureau, the
Economics and Statistics Administration, the Council
of Economic Advisers, the U.S. Department of Health
and Human Services, and the Office of Management
and Budget, issued a series of suggestions to the Census
Bureau and the BLS on how to develop the Supplemental
Poverty Measure (SPM). Their suggestions drew on
the recommendations of the 1995 NAS report and the
extensive research on poverty measurement conducted
after the report's publication.65
Since 2011, the Census Bureau has published poverty
estimates using the new measure based on these
suggestions.66 The SPM serves as an additional indicator of
economic well-being and provides a deeper understanding
of economic conditions and policy effects. The SPM
creates a more complex statistical picture incorporating
additional items such as tax payments, work expenses, and
medical out-of-pocket expenditures in its family resource
estimates. The resource estimates also take into account
the value of noncash benefits, including nutritional,
energy, and housing assistance. Thresholds used in the new
measure are derived by staff at the BLS from Consumer
Expenditure Survey expenditure data on basic necessities
(food, shelter, clothing, and utilities) and are adjusted for
geographic differences in the cost of housing.
In addition to the annual report, the Census Bureau
makes available a research data file that enables analysts to
create their own SPM estimates and cross tabulations.67
For more information, contact:
Dr. Trudi J. Renwick
U.S. Census Bureau
E-mail: trudi.j.renwick@census.gov
Phone: 301-763-5133
Website: http://www.census.gov/hhes/povmeas/
methodology/supplemental/overview.html
Survey of Consumer Finances
The Survey of Consumer Finances (SCF) is a triennial,
cross-sectional, national survey of noninstitutionalized
Americans conducted by the Federal Reserve Board with
the cooperation of the Statistics of Income Division of the
Internal Revenue Service. It includes data on household
assets and debts, use of financial services, income,
demographics, and labor force participation.
The survey is considered one of the best sources for
wealth measurement because of its detailed treatment
of assets and debts, and because it oversamples wealthy
households.68'69 The data for the panels of the SCF used
in this study were collected by the National Opinion
Research Center at the University of Chicago. The
SCF uses a dual-frame sample consisting of both a
standard random sample and a special over-sample of
wealthier households in order to correct for the under-
representation of high-income families in the survey.
It uses multiple imputation techniques to deal with
missing data, which results in the creation of five data
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sets called "implicates." There are five implicates for every
record. In the SCF, a household unit is divided into
a "primary economic unit" (PEU)the familyand
everyone else in the household. The PEU is intended to
be the economically dominant single person or couple
(whether married or living together as partners) and
all other persons in the household who are financially
interdependent with the economically dominant person or
couple.70 The Indicator 11 data represent the PEU, which
are referred to as households in the chart and discussion.
Race and Hispanic origin: Data in this report for the head
of the primary economic unit are shown for White and
Black. Data are not shown by Hispanic origin.
For more information, contact:
Chris Angelov
E-mail: chris.angelov@ssa.gov
Phone:202-755-3114
VA Enrollee Health Care Projection Model
The Veterans Administration (VA) uses the VA Enrollee
Health Care Projection Model (Model) to project
enrollment and utilization of the enrolled veteran
population for 20 years into the future for more than
90 categories of health care services. First, the VA uses the
Model to determine how many veterans will be enrolled
each year and their age, priority, and geographic location.
Next, the VA uses the Model to project the total health
care services needed by those enrollees and then estimates
the portion of that care that those enrollees will demand
from the VA.
The Model accounts for the unique demographic
characteristics of the enrolled veteran population,
including Operation Enduring Freedom/Operation Iraqi
Freedom/Operation New Dawn (OEF/OIF/OND) and
other enrollee cohorts, as well as other factors that impact
a veteran's decision to enroll in the VA and use VA health
care services:
Enrollee age, gender, income, travel distance to VA
facilities, and geographic migration patterns
Significant morbidity of the enrolled veteran
population, particularly for mental health services
Economic conditions, including changes in local
unemployment rates and home values (as a proxy for
asset values) and the long-term downward trend in
labor force participation, particularly for high school-
educated males
Enrollee transition between enrollment priorities as a
result of movement into service-connected priorities or
changes in income
Enrollee reliance on VA health care versus the other
health care options available to them, i.e., Medicare,
Medicaid, TRICARE, and commercial insurance
Unique health care utilization patterns of OEF/OIF/
OND, female, and new enrollees, and other enrollee
cohorts with unique utilization patterns for particular
services
New policies, regulations, and legislation, such as the
implementation of the Medicare drug benefit
VA health care initiatives, such as the mental health
capacity improvement initiative
A continually evolving VA health care system, i.e.,
quality and efficiency initiatives
Changes in health care practice and technology such as
new diagnostics, drugs, and treatments
For more information, contact:
Carolyn Stoesen
Veterans Health Administration
Office of Policy and Planning
E-mail: carolyn.stoesen@va.gov
Phone:202-461-7151
Website: http://www.va.gov/HEALTHPOLICY
PLANNING/planning.asp
Veteran Population Estimates and
Projections
The VA Office of the Chief Actuary (OACT) provided
veteran population projection by key demographic
characteristics such as age and gender as well as geographic
areas. VetPop20l4 was last updated using Census 2000
data, VA administrative data, and Department of Defense
data. VetPop2016 will be released in Winter 2017-
Race and Hispanic origin: Data from this model are not
shown by race and Hispanic origin in this report.
For more information, contact:
The National Center for Veterans Analysis and Statistics
E-mail: VANCVAS@va.gov
Website: http://va.gov/vetdata/veteran_population.asp
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ossary
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Glossary
Activities of daily living (ADLs): Activities of daily living
(ADLs) are basic activities that support survival, including
eating, bathing, and toileting. See Instrumental activities of
daily living (lADLs).
In the Medicare Current Beneficiary Survey, ADL
disabilities are measured as difficulty performing (or
inability to perform because of a health reason) one or
more of the following activities: eating, getting in/out of
chairs, walking, dressing, bathing, or toileting.
Asset income: Asset income includes money income
reported in the Current Population Survey from interest
(on savings or bonds), dividends, income from estates
or trusts, and net rental income. Capital gains are not
included.
Auxiliary benefits: These benefits provide wives of
dependents with half of their husband's basic benefit and
surviving widows with their husband's full basic benefit.
Divorced women can receive auxiliary spouse/widow
benefits based on a marriage of at least 10 years' duration.
Body mass index (BMI): This is a measure of body
weight adjusted for height that correlates with body
fat. A tool for indicating weight status in adults, BMI
is generally computed using metric units and is defined
as weight divided by height2 or kilograms/meters2. The
categories used in this report are consistent with those set
by the World Health Organization. For adults 20 years
of age and over, underweight is defined as having a BMI
less than 18.5; healthy weight is defined as having a BMI
of at least 18.5 and less than 25; overweight is defined as
having a BMI equal to 25 or greater; and obese is defined
as having a BMI equal to 30 or greater. To calculate your
own body mass index, go to http://www.nhlbi.nih.gov/
health/educational/lose_wt/BMI/bmicalc.htm. For more
information about BMI, see "Clinical guidelines on the
identification, evaluation, and treatment of overweight
and obesity in adults."71
Cause of death: For the purpose of national mortality
statistics, every death is attributed to one underlying
condition, based on information reported on the death
certificate and using the international rules for selecting
the underlying cause of death from the conditions stated
on the death certificate. In addition to the underlying
cause, all other conditions reported on the death certificate
are captured and coded and are referred to as multiple
causes of death. Cause of death is coded according to the
appropriate revision of the International Classification of
Diseases (ICD). Effective with deaths occurring in 1999,
the United States began using the Tenth Revision of the
ICD (ICD-10).72
Civilian noninstitutionalized population: See
Population.
Civilian population: See Population.
Crowded housing: Crowded housing is defined as
households that have more than one person per room.
Death rate: The death rate is calculated by dividing the
number of deaths in a population in a year by the midyear
resident population. For census years, rates are based on
unrounded census counts of the resident population as of
April 1. Death rates are expressed as the number of deaths
per 100,000 people. The rate may be restricted to deaths
in specific age, race, sex, or geographic groups or from
specific causes of death (specific rate), or it may be related
to the entire population (crude rate).
Defined benefit plan: A plan that promises a specified
monthly benefit at retirement. The plan may state this
promised benefit as an exact dollar amount, such as $100
per month at retirement. Or, more often, it may calculate
a benefit through a plan formula that considers such
factors as salary and service (e.g., 1 percent of average
salary for the last 5 years of employment for every year of
service with an employer).
Defined contribution plan: A plan that does not promise
a specific benefit amount at retirement. Instead, employers
and/or employees contribute money to each employee's
individual account in the plan. In many cases, employees
are responsible for choosing how these contributions are
invested and deciding how much to contribute from their
paychecks through pretax deductions. Employers may
add to employees' accounts, in some cases, by matching
a certain percentage of the employee's contributions. The
value of an employee's account depends on how much is
contributed and how well the investments perform.
Dental services: In the Medicare Current Beneficiary
Survey (Indicators 30 and 34), the Medical Expenditure
Panel Survey (MEPS), and the data used from the MEPS
predecessor surveys used in this report (Indicator 33)
this category covers expenses for any type of dental care
provider, including general dentists, dental hygienists,
dental technicians, dental surgeons, orthodontists,
endodontists, and periodontists. In Indicator 30, dental
services are included as part of the "Other" category; in
Indicator 34, dental services are included as a separate
category.
Disability rating: Ratings reflect the severity of the
disability and how much the impairment impacts the
ability to work.
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Glossary
Earnings: Earnings are considered money income
reported in the Current Population Survey from wages or
salaries and net income from self-employment (farm and
nonfarm).
Emergency room services: In the Medical Expenditure
Panel Survey (MEPS) and the data used from the MEPS
predecessor surveys used in this report (Indicator 33), this
category includes expenses for visits to medical providers
seen in emergency rooms (except visits resulting in a
hospital admission). These expenses include payments
for services covered under the basic facility charge and
those for separately billed physician services. In the
Medicare Current Beneficiary Survey (Indicators 30 and
34) emergency room services are included as a hospital
outpatient service unless they are incurred immediately
prior to a hospital stay, in which case they are included as
a hospital inpatient service.
Fee-for-service: This is the method of reimbursing health
care providers on the basis of a fee for each health service
provided to the insured person.
Full Retirement Age (FRA): The age when benefits are
not reduced for early retirement. Benefits are increased by
about 8 percent a year until age 70 for delayed retirement.
Early Retirement Age (ERA) for retired workers begins
at age 62 with a 25 percent reduced level from benefits
at Full Retirement Age (FRA), age 66 in 2014. Initial
benefits at age 62 increase approximately 75 percent
for a delay from ERA to age 70. The FRA was age 65
until 1937 and increased at 2 months per year for each
birth year after 1937 until 1943- Please note that the
percentages are not the probabilities of claiming at an
age because different birth year cohorts are in each age
group in a given year and somewhat vary in the size of the
eligible population.
Group quarters: A group quarters is a place where people
live or stay in a group living arrangement that is owned or
managed by an entity or organization providing housing
and/or services for the residents. This is not a typical
household-type living arrangement. These services may
include custodial or medical care as well as other types of
assistance, and residency is commonly restricted to those
receiving these services. People living in group quarters
are usually not related to each other. The group quarters
definitions used in the 2010 Census are available in
Appendix B at: http://www.census.gov/prod/cen2010/
doc/sfl.pdf.
Head of household: The Survey of Consumer Finances
(SCF) estimates wealth for the "Primary Economic Unit,"
which is similar to the Census Bureau's Household.
The "Primary Economic Unit" is the economically
dominant single person or couple (whether married or
living together as partners) and all other persons in the
household who are financially interdependent with the
economically dominant person or couple. If a couple is
economically dominant in the PEU, the head is the male
in a mixed sex couple or the older person in a same-sex
couple. If a single person is economically dominant, that
person is designated as the family head in this report.
Health care expenditures: In the Consumer Expenditure
Survey (Indicator 14), health care expenditures include
out-of-pocket expenditures for health insurance, medical
services, prescription drugs, and medical supplies. In the
Medicare Current Beneficiary Survey (Indicators 30 and
34), health care expenditures include all expenditures for
inpatient hospital, medical, nursing home, outpatient
(including emergency room visits), dental, prescription
drugs, home health care, and hospice services, including
both out-of-pocket expenditures and expenditures covered
by insurance. Personal spending for health insurance
premiums is excluded. In the Medical Expenditure
Panel Survey (MEPS) and the data used from the MEPS
predecessor surveys used in this report (Indicator 33),
health care expenditures refer to payments for health care
services provided during the year. (Data from the 1987
survey have been adjusted to permit comparability across
years; see Zuvekas and Cohen.58) Out-of-pocket health
care expenditures are the sum of payments paid to health
care providers by the person, or the person's family, for
health care services provided during the year. Health care
services include inpatient hospital, hospital emergency
room, and outpatient department care; dental services;
office-based medical provider services; prescription
drugs; home health care; and other medical equipment
and services. Personal spending for health insurance
premium(s) is excluded.
Health maintenance organization (HMO): An HMO
is a prepaid health plan delivering comprehensive care to
members through designated providers, having a fixed
monthly payment for health care services, and requiring
members to be in a plan for a specified period of time
(usually 1 year).
Health Eating Index-2010 (HEI-2010): A measure
of diet quality that assesses conformance to the Dietary
Guidelines for Americans. The primary use of the HEI is to
monitor the diet quality of the U.S. population. The HEI-
201031 has 12 components, nine of which are adequacy
components and three are moderation components.
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Glossary
Intakes equal to or better than the standards set for each
component are assigned a maximum score. For the nine
adequacy components (e.g., total fruit, total vegetable), no
intake gets zero and scores increase up to the maximum
as the intakes increase towards the standard. The three
moderation components (e.g., refined grains, sodium)
are scored in reverse; that is, excessively high intakes get
zeros and as intakes decrease toward the standard, scores
increase; higher scores reflect lower intakes because lower
intakes are more desirable. A higher score indicates a
higher quality diet that aligns with the 2010 Dietary
Guidelines for Americans. Scores are averaged across all
adults based on usual dietary intakes.
Hispanic origin: See specific data source descriptions.
Home health care/services/visits: Home health care is
care provided to individuals and families in their places
of residence for promoting, maintaining, or restoring
health or for minimizing the effects of disability and
illness, including terminal illness. In the Medicare Current
Beneficiary Survey and Medicare claims data (Indicators
29, 30, and 34), home health care refers to skilled
nursing care, physical therapy, speech language pathology
services, occupational therapy, and home health aide
services provided to homebound patients. In the Medical
Expenditure Panel Survey (Indicator 33), home health
care services are classified into the "Other health care"
category and are considered any paid formal care provided
by home health agencies and independent home health
providers. Services can include visits by professionals,
including nurses, doctors, social workers, and therapists,
as well as home health aides, homemaker services,
companion services, and home-based hospice care. Home
care provided free of charge (informal care by family
members) is not included.
Hospice care/services: Hospice care is a program of
palliative and supportive care services providing physical,
psychological, social, and spiritual care for dying persons,
their families, and other loved ones by a hospice program
or agency. Hospice services are available in home and
inpatient settings. In the Medicare Current Beneficiary
Survey (MCBS) (Indicators 30 and 34) hospice care
includes only those services provided as part of a Medicare
benefit. In Indicator 30, hospice services are part of the
"Other" category. In Indicator 34, hospice services are
a separate category. In the Medical Expenditure Panel
Survey (MEPS) (Indicator 33), hospice care provided in
the home (regardless of the source of payment) is included
in the "Other health care" category, while hospice care
provided in an institutional setting (e.g., nursing home) is
excluded from the MEPS universe.
Hospital care: Hospital care in the Medical Expenditure
Panel Survey (Indicator 33) includes hospital inpatient
care and care provided in hospital outpatient departments
and emergency rooms. Care can be provided by physicians
or other health practitioners. Payments for hospital care
include payments billed directly by the hospital and those
billed separately by providers for services provided in the
hospital.
Hospital inpatient services: In the Medicare Current
Beneficiary Survey (Indicators 30 and 34) hospital
inpatient services include room and board and all hospital
diagnostic and laboratory expenses associated with the
basic facility charge, as well as emergency room expenses
incurred immediately prior to inpatient stays. Expenses
for hospital stays with the same admission and discharge
dates are included if the Medicare bill classified the
stay as an "inpatient" stay. Payments for separate billed
physician inpatient services are excluded. In the Medical
Expenditure Panel Survey (Indicator 33) these services
include room and board and all hospital diagnostic and
laboratory expenses associated with the basic facility
charge, payments for separately billed physician inpatient
services, and emergency room expenses incurred
immediately prior to inpatient stays. Expenses for reported
hospital stays with the same admission and discharge dates
are also included.
Hospital outpatient services: These services in the
Medicare Current Beneficiary Survey (Indicators 30 and
34) include visits to both physicians and other medical
providers seen in hospital outpatient departments or
emergency rooms (provided the emergency room visit
does not result in an inpatient hospital admission), as well
as diagnostic laboratory and radiology services. Payments
for these services include those covered under the basic
facility charge. Expenses for in-patient hospital stays with
the same admission and discharge dates and classified
on the Medicare bill as "outpatient" are also included.
Separately billed physician services are excluded.
Hospital stays: Hospital stays in the Medicare claims data
(Indicator 29) refers to admission to and discharge from a
short-stay acute care hospital.
Housing cost burden: In the American Housing Survey,
housing cost burden is defined as expenditures on housing
and utilities in excess of 30 percent of household reported
income.
Housing expenditures: In the Consumer Expenditure
Survey's Interview Survey, housing expenditures
include payments for mortgage interest; property taxes;
maintenance, repairs, insurance, and other expenses;
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Glossary
rent; rent as pay (reduced or free rent for a unit as a form
of pay); maintenance, insurance, and other expenses for
renters; and utilities.
Income: In the Current Population Survey, income
includes money income (prior to payments for personal
income taxes, Social Security, union dues, Medicare
deductions, etc.) from: (1) money wages or salary;
(2) net income from nonfarm self-employment; (3) net
income from farm self-employment; (4) Social Security
or Railroad Retirement; (5) Supplemental Security
Income; (6) public assistance or welfare payments;
(7) interest (on savings or bonds); (8) dividends, income
from estates or trusts, or net rental income; (9) veterans'
payment or unemployment and worker's compensation;
(10) private pensions or government employee pensions;
(11) distributions from retirement accounts; and
(12) alimony or child support, regular contributions from
people not living in the household, and other periodic
income. Certain money receipts such as capital gains are
not included.
In the Medicare Current Beneficiary Study, income is for
the sample person or the sample person and spouse if the
sample person was married at the time of the survey. All
sources of income from jobs, pensions, Social Security
benefits, Railroad Retirement and other retirement
income, Supplemental Security Income, interest,
dividends, and other income sources are included.
Income, household: Household income from the
Medical Expenditure Panel Survey (MEPS) and the
MEPS predecessor surveys used in this report was created
by summing personal income from each household
member to create family income. Family income was
then divided by the number of people that lived in the
household during the year to create per capita household
income. Potential income sources asked about in the
survey interviews include annual earnings from wages,
salaries, or withdrawals; Social Security and VA payments;
Supplemental Security Income and cash welfare payments
from public assistance; Temporary Assistance for Needy
Families, formerly known as Aid to Families with
Dependent Children; gains or losses from estates, trusts,
partnerships, C corporations, rent, and royalties; and a
small amount of other income. See Poverty Indicator 33:
Out-of-Pocket Health Care Expenditures.
Income fifths: A population can be divided into groups
with equal numbers of people based on the size of
their income to show how the population differs on a
characteristic at various income levels. Income fifths are
five groups of equal size, ordered from lowest to highest
income.
Inpatient hospital: See Hospital inpatient services.
Institutionalized population: See Population.
Institutions: For the 2010 Census, the Census Bureau
defined institutions as adult correctional facilities, juvenile
facilities, skilled-nursing facilities, and other institutional
facilities such as mental (psychiatric) hospitals and in-
patient hospice facilities. See Population.
Instrumental activities of daily living (lADLs): lADLs
are indicators of functional well-being that measure the
ability to perform more complex tasks than the related
activities of daily living (ADLs). See Activities of daily living
(ADLs).
In the Medicare Current Beneficiary Survey. lADLs are
measured as difficulty performing (or inability to perform
because of a health reason) one or more of the following
activities: heavy housework, light housework, preparing
meals, using a telephone, managing money, or shopping.
Only the questions on telephone use, shopping, and
managing money are asked of long-term care facility
residents.
Long-term care facility: In the Medicare Current
Beneficiary Survey (MCBS) (Indicators 22 and 36), a
residence (or unit) is considered a long-term care facility
if it is certified by Medicare or Medicaid; has three or
more beds, is licensed as a nursing home or other long-
term care facility, and provides at least one personal care
service; or provides 24-hour, 7-day-a-week supervision
by a non-family, paid caregiver. In the MCBS (Indicators
30 and 34), a long-term care facility excludes "short-term
institutions" (e.g., sub-acute care) stays. See Short-term
institution (Indicators 30 and 34), and Skilled nursing home
(Indicator 29).
Mammography: Mammography is an X-ray image of the
breast used to detect irregularities in breast tissue.
Mean: The mean is an average of n numbers computed by
adding the numbers and dividing by n.
Median: The median is a measure of central tendency, the
point on the scale that divides a group into two parts.
Medicaid: This nationwide health insurance program
is operated and administered by the states with Federal
financial participation. Within certain broad, federally
determined guidelines, states decide who is eligible; the
amount, duration, and scope of services covered; rates
of payment for providers; and methods of administering
the program. Medicaid pays for health care services,
community-based supports, and nursing home care for
certain low-income people. Medicaid does not cover
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Glossary
all low-income people in every state. The program was
authorized in 1965 by Title XIX of the Social Security Act.
Medicare: This nationwide program provides health
insurance to people age 65 and over, people entitled to
Social Security disability payments for 2 years or more,
and people with end-stage renal disease, regardless of
income. The program was enacted July 30, 1965, as
Title XVIII, Health Insurance for the Aged of the Social
Security Act, and became effective on July 1, 1966.
Medicare covers acute care services and post-acute
care settings such as rehabilitation and long-term care
hospitals, and generally does not cover nursing home care.
Prescription drug coverage began in 2006.
Medicare Advantage: See Medicare Pan C.
Medicare Part A: Medicare Part A (Hospital Insurance)
covers inpatient care in hospitals, critical access hospitals,
skilled nursing facilities, and other post-acute care settings
such as rehabilitation and long-term care hospitals. It also
covers hospice and some home health care.
Medicare Part B: Medicare Part B (Medical Insurance)
covers doctor's services, outpatient hospital care, and
durable medical equipment. It also covers some other
medical services that Medicare Part A does not cover, such
as physical and occupational therapy and some home
health care. Medicare Part B also pays for some supplies
when they are medically necessary.
Medicare Part C: With the passage of the Balanced
Budget Act of 1997, Medicare beneficiaries were given
the option to receive their Medicare benefits through
private health insurance plans instead of through the
original Medicare plan (Parts A and B). These plans were
known as "Medicare+Choice" or "Part C" plans. Pursuant
to the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003, the types of plans allowed to
contract with Medicare were expanded, and the Medicare
Choice program became known as "Medicare Advantage."
In addition to offering comparable coverage to Part A and
Part B, Medicare Advantage plans may also offer Part D
coverage.
Medicare Part D: Medicare Part D subsidizes the costs
of prescription drugs for Medicare beneficiaries. It was
enacted as part of the Medicare Prescription Drug,
Improvement, and Modernization Act of 2003 (MMA)
and went into effect on January 1, 2006. Beneficiaries can
obtain the Medicare drug benefit through two types of
private plans: beneficiaries can join a Prescription Drug
Plan (PDP) for drug coverage only or they can join a
Medicare Advantage plan (MA) that covers both medical
services and prescription drugs (MA-PD). Alternatively,
beneficiaries may receive drug coverage through a former
employer, in which case the former employer may qualify
for a retiree drug subsidy payment from Medicare.
Medigap: See Supplemental health insurance.
National population adjustment matrix: The national
population adjustment matrix adjusts the population to
account for net underenumeration. Details on this matrix
can be found on the U.S. Census Bureau website: https://
www.census.gov/population/www/censusdata/adjustment.
html.
Noninstitutional group quarters: For the 2010 Census,
the Census Bureau defined noninstitutional group
quarters as facilities that house those who are primarily
eligible, able, or likely to participate in the labor force
while resident. The noninstitutionalized population
lives in noninstitutional group quarters such as college/
university student housing, military quarters, and other
noninstitutional group quarters such as emergency
and transitional shelters for people experiencing
homelessness and group homes. For more information on
noninstitutional group quarters, please see Appendix B at
http://www.census.gov/prod/cen2010/doc/sfl.pdf.
Obesity: See Body mass index.
Office-based medical provider services: In the Medical
Expenditure Panel Survey (Indicator 33), this category
includes expenses for visits to physicians and other health
practitioners seen in office-based settings or clinics. "Other
health practitioner" includes audiologists, optometrists,
chiropractors, podiatrists, mental health professionals,
therapists, nurses, and physician's assistants, as well as
providers of diagnostic laboratory and radiology services.
Services provided in a hospital based setting, including
outpatient department services, are excluded.
Other health care: In the Medicare Current Beneficiary
Survey (Indicator 34), this category includes short-term
institution, hospice, and dental services. In the Medical
Expenditure Panel Survey (MEPS) (Indicator 33) other
health care includes home health services (formal care
provided by home health agencies and independent
home health providers) and other medical equipment
and services. The latter includes expenses for eyeglasses,
contact lenses, ambulance services, orthopedic items,
hearing devices, prostheses, bathroom aids, medical
equipment, disposable supplies, alterations/modifications,
and other miscellaneous items or services that were
obtained, purchased, or rented during the year.
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Glossary
Other income: Other income is total income minus
retirement benefits, earnings, asset income, and
public assistance. It includes, but is not limited to,
unemployment compensation, worker's compensation,
alimony, and child support.
Out-of-pocket health care spending: These are health
care expenditures that are not covered by insurance.
Outpatient hospital: See Hospital outpatient services.
Overweight: See Body mass index.
Pensions: Pensions include money income reported in
the Current Population Survey from Railroad Retirement,
company or union pensions (including profit sharing and
401 (k) payments), distributions from IRAs, distributions
from Keoghs, regular payments from annuities and paid-
up life insurance policies, Federal government pensions,
U.S. military pensions, and state or local government
pensions.
Physician/Medical services: In the Medicare Current
Beneficiary Survey (Indicator 34), this category includes
visits to a medical doctor, osteopathic doctor, and health
practitioner as well as diagnostic laboratory and radiology
services. Health practitioners include audiologists,
optometrists, chiropractors, podiatrists, mental health
professionals, therapists, nurses, paramedics, and
physician's assistants. Services provided in a hospital-based
setting, including outpatient department services, are
included.
Physician/Outpatient hospital: In the Medicare Current
Beneficiary Survey (Indicator 30), this term refers to
"physician/medical services" combined with "hospital
outpatient services."
Physician visits and consultations: In Medicare claims
data (Indicator 29), physician visits and consultations
include visits and consultations with primary care
physicians, specialists, and chiropractors in their offices,
hospitals (inpatient and outpatient), emergency rooms,
patient homes, and nursing homes.
Population: Data on populations in the United States
are often collected and published according to several
different definitions. Various statistical systems then use
the appropriate population for calculating rates.
Resident population: The resident population of the
United States includes people resident in the 50 states
and the District of Columbia. It excludes residents of
the Commonwealth of Puerto Rico and residents of
the outlying areas under United State sovereignty or
jurisdiction (principally American Samoa, Guam, Virgin
Islands of the United States, and the Commonwealth
of the Northern Mariana Islands). An area's resident
population consists of those persons "usually resident"
in that particular area (where they live and sleep most
of the time). The resident population includes people
living in housing units, nursing homes, and other types
of institutional settings. People whose usual residence is
outside of the United States, such as the U.S. military and
civilian personnel as well as private U.S. citizens living
overseas, are excluded from the resident population.
Resident noninstitutionalizedpopulation: The resident
noninstitutionalized population is the resident population
residing in noninstitutional group quarters. See also the
definitions of Resident population and Noninstitutional group
quarters.
Civilian population: The civilian population is the U.S.
resident population not in the active-duty Armed Forces.
Civilian noninstitutionalized population: This
population includes all U.S. civilians residing in
noninstitutional group quarters. See also the definition of
Noninstitutional group quarters.
Institutionalized population: For the 2010 Census, the
Census Bureau defined institutional group quarters as
facilities that house those who are primarily ineligible,
unable, or unlikely to participate in the labor force while
resident.
The institutionalized population is the population
residing in institutional group quarters such as adult
correctional facilities, juvenile facilities, skilled-nursing
facilities, and other institutional facilities such as mental
(psychiatric) hospitals and in-patient hospice facilities.
People living in noninstitutional group quarters are the
noninstitutionalized population. For more information on
institutional and noninstitutional group quarters, please
see Appendix B at http://www.census.gov/prod/cen2010/
doc/sfl.pdf.
Poverty: The official measure of poverty is computed
each year by the U.S. Census Bureau and is defined
as having income less than 100 percent of the poverty
threshold (i.e., $11,354 for one person age 65 and over
in 2014).73 Poverty thresholds are the dollar amounts
used to determine poverty status. Each family (including
single-person households) is assigned a poverty threshold
based upon the family's size and the ages of the family
members. All family members have the same poverty
status. Several of the indicators included in this report
include a poverty status measure. Poverty status (less than
100 percent of the poverty threshold) was computed for
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Glossary
"Indicator 7: Poverty," "Indicator 8: Income," "Indicator
28: Cigarette Smoking," "Indicator 32: Sources of Health
Insurance," and "Indicator 33: Out-of-Pocket Health
Care Expenditures" using the official U.S. Census Bureau
definition for the corresponding year. In addition, the
following income-to-poverty categories are used in this
report:
Indicator 8: Income: The income categories are derived
from the ratio of the family's money income (or an
unrelated individual's money income) to the poverty
threshold. Being in poverty is having income less than
100 percent of the threshold. Low income is income
between 100 percent and 199 percent of the poverty
threshold (i.e., between $11,354 and $22,707 for one
person age 65 and over in 2014). Middle income is
income between 200 percent and 399 percent of the
poverty threshold (i.e. between $22,708 and $45,415
for one person age 65 and over in 2014). High income
is income 400 percent or more of the poverty threshold.
Indicator 28: Cigarette Smoking: Below poverty is
defined as having income less than 100 percent of the
poverty threshold. Above poverty is grouped into two
categories: (1) income between 100 percent and 199
percent of the poverty threshold and (2) income equal
to or greater than 200 percent of the poverty threshold.
Indicator 32: Sources of Health Insurance: Below
poverty is defined as having income less than 100 percent
of the poverty threshold. Above poverty is grouped into
two categories: (1) income between 100 percent and
199 percent of the poverty threshold and (2) income equal
to or greater than 200 percent of the poverty threshold.
Indicator 33: Out-of-Pocket Health Care Expenditures:
Two income categories were used to examine out-of-
pocket health care expenditures using the Medical
Expenditure Panel Survey (MEPS) and MEPS predecessor
survey data. The categories were expressed in terms of
poverty status (i.e., the ratio of the family's income to
the Federal poverty thresholds for the corresponding
year), which controls for the size of the family and the
age of the head of the family. The income categories were
(1) poor and near poor and (2) other income. The poor
and near poor income category includes people in families
with income less than 100 percent of the poverty line,
including those whose losses exceeded their earnings,
resulting in negative income (i.e., the poor), as well as
people in families with income from 100 percent to less
than 125 percent of the poverty line (i.e., the near poor).
The other income category includes people in families
with income greater than or equal to 125 percent of the
poverty line. See Income, household.
Prescription drugs/medicines: In the Medicare
Current Beneficiary Survey (Indicators 30, 31, 34) and
in the Medical Expenditure Panel Survey (Indicator
33), prescription drugs are all prescription medications
(including refills), except those provided by the doctor or
practitioner as samples and those provided in an inpatient
setting.
Prevalence: Prevalence is the number of cases of a disease,
infected people, or people with some other attribute
present during a particular interval of time. It is often
expressed as a rate (e.g., the prevalence of diabetes per
1,000 people during a year).
Private supplemental health insurance: See Supplemental
health insurance.
Public assistance: Public assistance is money income
reported in the Current Population Survey from
Supplemental Security Income (payments made to
low-income people who are age 65 and over, blind, or
disabled) and public assistance or welfare payments, such
as Temporary Assistance for Needy Families and General
Assistance.
Quintiles: See Income fifths.
source
ions.
Race: See specific,
Rate: A rate is a measure of some event, disease, or
condition in relation to a unit of population, along with
some specification of time.
Reference population: The reference population is the
base population from which a sample is drawn at the time
of initial sampling. See Population.
Respondent-assessed health status: In the National
Health Interview Survey, respondent-assessed health status
is measured by asking the respondent, "Would you say
[your/subject name's] health is excellent, very good, good,
fair, or poor?" The respondent answers for all household
members including himself or herself.
Retiree Drug Subsidy: The Retiree Drug Subsidy is
designed to encourage employers to continue providing
retirees with prescription drug benefits. Under the
program, employers may receive a subsidy of up to 28
percent of the costs of providing the prescription drug
benefit.
Short-term institution: This category in the Medicare
Current Beneficiary Survey (Indicators 30 and 34)
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Glossary
includes skilled nursing facility stays and other short-term
(e.g., sub-acute care) facility stays (e.g., a rehabilitation
facility stay). Payments for these services include Medicare
and other payment sources. See Skilled nursing facility
(Indicator 29), Nursing facility (Indicator 36), and Long-
term care facility (Indicators 22, 30, 34, and 37).
Skilled nursing facility: A skilled nursing facility (SNF)
as defined by Medicare (Indicator 29) provides short-
term skilled nursing care on an inpatient basis, following
hospitalization. These facilities provide the most intensive
care available outside of inpatient acute hospital care. In
the Medicare Current Beneficiary Survey (Indicators 30
and 34) "skilled nursing facilities" are classified as a type
of "short-term institution." See Short-term institution
(Indicators 30 and 34), and Long-term care facility
(Indicators 22, 30, 34, and36).
Skilled nursing facility stays: Skilled nursing facility
stays in the Medicare claims data (Indicator 29) refers to
admission to and discharge from a skilled nursing facility,
regardless of the length of stay. See Skilled nursing facility
(Indicator 29).
Social Security benefits: Social Security benefits include
money income reported in the Current Population Survey
from Social Security old-age, disability, and survivors'
benefits.
Standard population: This is a population in which the
age and sex composition is known precisely, as a result of
a census. A standard population is used as a comparison
group in the procedure for standardizing mortality rates.
Supplemental health insurance: Supplemental
health insurance is designed to fill gaps in the original
Medicare plan coverage by paying some of the amounts
that Medicare does not pay for covered services and
may pay for certain services not covered by Medicare.
Private Medigap is supplemental insurance individuals
purchase themselves or through organizations such as
AARP or other professional organizations. Employer- or
union-sponsored supplemental insurance policies are
provided through a Medicare enrollee's former employer
or union. For dual-eligible beneficiaries, Medicaid acts
as a supplemental insurer to Medicare. Some Medicare
beneficiaries enroll in HMOs and other managed care
plans that provide many of the benefits of supplemental
insurance, such as low copayments and coverage of
services that Medicare does not cover.
Supplemental Poverty Measure: Since 2011, the
Census Bureau has published poverty estimates using
the Supplemental Poverty Measure (SPM). The SPM
creates a more complex statistical picture incorporating
additional items such as tax payments, work expenses, and
medical out-of-pocket expenditures in its family resource
estimates. The resource estimates also take into account
the value of noncash benefits including nutritional,
energy, and housing assistance. Thresholds used in the
new measure are derived from Consumer Expenditure
Survey expenditure data on basic necessities (food, shelter,
clothing, and utilities) and are adjusted for geographic
differences in the cost of housing.
TRICARE: TRICARE is the Department of Defense's
regionally managed health care program for active duty
and retired members of the uniformed services, their
families, and survivors.
TRICARE for Life: TRICARE for Life is TRICARE's
Medicare wraparound coverage (similar to traditional
Medigap coverage) for Medicare-eligible uniformed
services beneficiaries and their eligible family members
and survivors.
Veteran: Veterans include those who served on active
duty in the Army, Navy, Air Force, Marines, Coast Guard,
uniformed Public Health Service, or uniformed National
Oceanic and Atmospheric Administration; Reserve Force
and National Guard called to Federal active duty; and
those disabled while on active duty training. Excluded are
those dishonorably discharged and those whose only active
duty was for training or State National Guard service.
Veterans' health care: Health care services provided
by the Veterans Health Administration (Indicator 35)
includes preventive care, ambulatory diagnosis and
treatment, inpatient diagnosis and treatment, and
medications and supplies. This includes home- and
community-based services (e.g., home health care) and
long-term care institutional services (for those eligible to
receive these services).
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The Historical Experience of Three Cohorts of Older Americans: A Timeline of Selected Events 1923-2016
1923 Cohort
5 years old
1933 Cohort
1943 Cohort
Year
1923
1928
1933
1938
1943
1948
1953
1958
1963
1968
1973
1978
1983
1988
1993
1998
2003
2008
2013
Historical Events
Legislative Events
1929 - Stock market crashes
1941 - Pearl Harbor; United States enters WWII
1945 -Yalta Conference; Cold War begins;
1946 - Baby boom begins
1950 - United States enters Korean War
1955 - Nationwide polio vaccination program begins
1964 - United States enters Vietnam War; baby boom ends
1969 - First man on the moon
1980 - First AIDS case is reported to the Centers for
Disease Control and Prevention
1989 - Berlin Wall falls; 1990 - United States enters
Persian Gulf War
2001 - September 11: Terrorists attack United States; 2003 -
United States enters Iraq war; 2007 - Economic downturn
begins December 2007; 2008 - First Baby Boomers begin to
turn 62 years old and become eligible for Social Security
retired worker benefits; 2009 - Economic downturn ends
June 2009; 2010 - Offshore explosion on the Deepwater
Horizon drilling rig causes the largest oil spill in U.S. history
2011 - World population reaches 7 billion, 0.9 billion age 60
and over; United States formally ends the Iraq War
2012 - First Baby Boomers reach Social Security full-
retirement age; 2013 - Supreme Court rules Defense of
Marriage Act (DOMA) unconstitutional; Nobel Prize for
Medicine and Physiology honored research advancing
insights on diabetes and Alzheimer's disease
2014 - Cuba and the United States agree to resume full
diplomatic relations
1934 - Federal Housing Administration created by Congress
1935 - Social Security Act passed
1937 - U.S. Housing Act passed, establishing Public Housing
1956 - Women age 62-64 eligible for reduced Social
Security benefits; 1957 - Social Security Disability Insurance
implemented; 1959 - Section 202 of the Housing Act
established, providing assistance to older adults with low
income
1961 - Men age 62-64 eligible for reduced Social Security
benefits; 1962 - Self-Employed Individual Retirement Act
(Keogh Act) passed
1964 - Civil Rights Act passed
1965 - Medicare and Medicaid established; Older
Americans Act passed
1967 - Age Discrimination in Employment Act passed
1972 - Formula for Social Security cost-of-living
adjustment established; Social Security Supplemental
Security Income legislation passed; 1974 - Employee
Retirement Income Security Act (ERISA) passed; IRAs
established; 1975 -Age Discrimination Act passed
1978-401(k)s established
1983 - Social Security eligibility age increased for full
benefits; 1984-Widows entitled to pension benefits if
spouse was vested
1986 - Mandatory retirement eliminated for most workers
1987 - Reverse mortgage market created by the HUD
Home Equity Conversion Program
1990 -Americans with Disabilities Act passed
1996 -Veterans' Health Care Eligibility Reform Act passed,
creating access to community based long-term care for all
enrollees; 1997 - Balanced Budget Act passed changing
Medicare payment policies
2000 - Social Security earnings test eliminated for full
retirement age
2003 - Medicare Modernization Act passed, creating the
Medicare prescription drug benefit
2005 - Deficit Reduction Act passed realigning Medicaid
incentives to provide noninstitutionalized long-term care;
2006 - Pension Protection Act passed
2010 - Patient Protection and Affordable Care Act passed;
2014 - The Multiemployer Pension Reform Act of 2014
passed, enabling certain plans to apply to reduce pension
benefits; 2015 - The Medicare Access and CHIP
Reauthorization Act passed, reforming Medicare physician
reimbursement
2016 - Reauthorization of the Older Americans Act
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