National Aging Readiness
As America's population ages, we face unprecedented challenges and opportunities. Explore America's aging landscape through this interactive dashboard, filter demographics, analyze trends across life stages, and uncover insights that challenge assumptions about growing older in the United States.
Policy Activity
Policy leaders and stakeholders recognize the need to conduct systems-level, cross-sector planning to prepare for an aging population that is increasingly diverse. Multisector Plans for Aging (MPAs) are state-level policy efforts aimed at ensuring that the needs of older adults, people with disabilities, and caregivers are understood and reflected across all programs, policies, and services over the coming decade.
Multisector Aging Policy Activity
Source: https://multisectorplanforaging.org/
Each state’s MPA is based on its unique characteristics, history, politics, and existing aging and disability initiatives.
Some states have created a multisector plan for aging (MPA), a state-led, cross-agency, multi-year approach that state legislators can use to transform the infrastructure and coordination of services to better address the needs of older adults.
Source: multisectorplanforaging.org
Demographics
The older adult population is growing, increasingly diverse, largely living alone, and facing difficulties with self-care and living independently. These realities highlight the need to ensure our systems are prepared to support adults as they age.
In every state, at least 1 in 6 people is age 60 or older.
By 2030, older adults age 65 and older will outnumber children age 18 or younger for the first time in America’s history.
Source: United States Census Bureau, 2023 National Population Projections Tables: Main Series
Economic Security
Public benefits are an important source of income throughout the life span.. Most adults age 65 or older rely primarily on a combination of retirement and/or Social Security income. Older adults with limited incomes sometimes do not have enough money to buy food, pay their mortgage or rent, or maintain access to utilities. These realities highlight the unmet need for initiatives to support older adults who are economically insecure.
Public benefits include Supplemental Security Income (SSI); Supplemental Nutrition Assistance Program (SNAP) benefits; and public assistance income, including general assistance and Temporary Assistance for Needy Families (TANF). The share of adults with income from public benefits remains about the same across age groups, but there are significant shifts in the prevalence of other sources of income as we age.
Nearly half (47%) of adults age 65 or older rely on Social Security income exclusively, without other retirement income.
Source: United States Census Bureau, American Community Survey
Health Care Coverage & Access
Health care coverage affects access to and affordability of health care for everyone. The vast majority of people age 65 or older are covered by Medicare, but many also have additional sources of coverage, particularly Medicaid. Nearly half a million older adults nationwide remain uninsured, putting them at risk of avoidable health care delays and adverse health outcomes. Access to high-speed internet is an increasingly important means for older adults to connect to people, goods, and services, including telehealth options that may promote better access to health care, but for many internet access is limited. Racial discrimination generally and when seeking health care can also impede access to high quality health care and negatively impact health outcomes. These challenges with coverage, access, and disparate treatment based on race contribute to older adults’ difficulties with affording care and getting routine care.
While almost all adults age 65+ have Medicare, nearly half a million are uninsured. Uninsurance is even more common for adults age 50-64.
There are 59.2 million people age 65+ nationwide, 99.1% of whom are insured. That still leaves about half a million people age 65 or older who have no health insurance.
Health Status
The majority of older adults report that they are in good health and that their physical health and mental health are good on most days, but there are disparities by sex, race, ethnicity, income, and other demographic characteristics. Similarly, physical activity and chronic conditions vary widely among sub-populations of older adults. Targeted planning and programming to meet the needs of older adults and promote better and more equitable health outcomes are essential.
Older adults who are White or Asian are more likely to report their health status as good or better, compared to older adults of other races or ethnicities.
About 6% of adults age 60 or older report that they are in poor health, but poor health rates are higher among older adults who identify as Hispanic or Latino (9%), American Indian or Alaska Native (14%), mixed race (15%), or Native Hawaiian or other Pacific Islander (16%).
Source: Centers for Disease Control and Prevention (CDC), Behavioral Risk Factor Surveillance System
Health Care Costs
Older adults account for a disproportionate share of personal health care expenditures nationally. Most personal health care spending for older adults is paid by a combination of Medicare, Medicaid, and older adults directly out of pocket (OOP). Nursing home care and home health care account for a growing share of personal health care expenditures, including OOP spending, as we age. Medicaid is the largest payer for nursing home care. Medicaid spending on home health care has increased over time and is now nearly equal to that of Medicare.
Per capita personal health care spending increases with age, contributing to higher total health care spending as the population ages.
Older adults (65 and older) account for 17 percent of the population and 37 percent of personal health care (PHC) spending, the total amount spent to treat individuals with specific medical conditions. PHC spending on older adults was $1.2 trillion total and $22,356 per person in 2020.
Mental Health
Older adults generally report higher levels of life satisfaction compared than younger adults. Yet, there are multiple indications that many older adults face significant behavioral health challenges, including social isolation, stress, frequent mental distress, and diagnoses of depressive disorders. As the population ages, there is a growing need for effective approaches to addressing the behavioral health needs of older adults.
There are many different ways to measure life satisfaction. This simple measure asks "In general, how satisfied are you with your life?" It's a straightforward question that may mask complexities of responses as people age and experience different life events. Explore the data to see how life satisfaction compares with other measures of well-being.
Nearly one in four older adults report feeling socially isolated and one in five say they have been diagnosed with a depressive disorder at some point in their life.
Source: Centers for Disease Control and Prevention (CDC), Behavioral Risk Factor Surveillance System
Caregiving
Many older adults need assistance with everyday activities, such as dressing and bathing, or managing household tasks, such as cleaning and preparing meals. Paid caregivers can be hard to find and afford, so family and friends often step in to provide unpaid care—sometimes for extended periods—at the expense of their own financial, physical, and emotional well-being. As the older adult population continues to grow, these caregiving pressures will increase, putting older adults at greater risk of needing nursing home placement and placing their loved ones under greater stress.
The direct care workforce has limited capacity to meet older adults’ assistance needs.
Many caregivers for older adults are older adults themselves. Adults age 65 or older are about as likely as younger adults to provide care to a family member or friend with a health problem or disability (22% of older adults v. 20% of younger adults).
Source: Centers for Disease Control and Prevention (CDC), Behavioral Risk Factor Surveillance System
The Dementia Challenge
Dementia is one of the most significant health challenges facing older adults and their loved ones. The rate of cognitive difficulty, meaning difficulty remembering, concentrating or making decisions due to a physical, mental or emotional condition, rises from 9% among those age 65 or older to nearly 20% among those 80 or older. Most people with cognitive difficulty also have difficulty dressing, bathing, and doing errands alone, heightening risks for those living alone. Among people reporting confusion or memory loss that is happening more often or is getting worse in the past year, nearly half of them (45%) said they talked about their cognitive decline with a health care professional. About one in four say the cognitive decline has caused them to give up day-to-day household activities, work, and/or social activities. Dementia is a common reason for people to provide care to a family member or friend with a health problem. It is also a leading cause of death among older adults.
Cognitive difficulty becomes more common with age but the share of those with cognitive difficulty who live alone remains relatively constant. Living alone with cognitive difficulties can heighten the risks of isolation and adverse health outcomes.
Dementia is often accompanied by other challenges. About 10% of adults age 65 or older has a cognitive difficulty plus an ambulatory, hearing, and/or vision difficulty.
Source: United States Census Bureau, American Community Survey
Housing & Homelessness
More than half of older adults who rent their home are housing cost burdened, spending at least 30% of their income on housing. Access to affordable housing for older adults is not keeping pace with the growth of the older adult population. Rising housing costs and more limited affordable housing options put older adults at risk of homelessness.
Older adults who rent their home are more likely than homeowners to spend at least 30% of their income on housing. This housing cost burden is even more likely among Black or African American older adult renters.
People who spend at least 30% of their income on housing costs are considered housing cost burdened. In 2023, 57% of older adults (65+) who rented their homes were housing cost burdened, compared to 27% of older adults (65+) who owned their homes.
Source: United States Census Bureau, American Community Survey
Transportation
Older adults need affordable, accessible, and safe alternatives to driving, as many - particularly among those who live alone - do not have access to a vehicle. Lack of reliable transportation can keep older adults from medical appointments, meetings, work, and other things needed for daily living.
Public transportation and other alternatives to driving may be limited in many areas, posing challenges for older adults who don’t have access to a vehicle.
Nationally, 21% of adults age 65 or older who live alone do not have access to a vehicle." Add the source as follows "Source: United States Census Bureau, American Community Survey"
Source: United States Census Bureau, American Community Survey