DR. SUE BOZINOVSKI, KEYNOTE FEB 24 2015
COLORADO WOMEN’S LEGISLATIVE BREAKFAST
Good morning. Thank you to the planning committee for inviting me here today to speak about AGING & THE SILVER TSUNAMI… a topic that I am very passionate about! For good reason… more people are becoming interested in it. Even a church in my community puts a sign up outside that says… “Aging… it’s better than the alternative!”
Before I begin I’d like you to know that my remarks will be available on the CO Women’s Legislative Breakfast website.
Over the past few decades, my colleagues and I have tried to educate as many people as possible about the implications of the Silver Tsunami. The “SILVER TSUNAMI” I am referring to is the TRULY UNPRECEDENTED NUMBER OF OLDER PEOPLE THERE WILL BE FROM NOW ON!
You may hear other terms also used such as “The Age Wave” or the “Graying of Society.” Whatever it is called, this phenomenon will affect almost every single aspect of our lives. The number of older people a society has… affects families, health care, housing, transportation, the economy, and many other realms. And while there will be some new problems that crop up, there will also be new societal benefits and opportunities.
The Silver Tsunami is partly the result of something very basic… industrialized countries have increasingly better food, medical care, shelter and other life necessities. More people are able to make it through childhood, and WAY more people therefore make it to old age.
For 99% of human history, the average life expectancy worldwide has been less than 18 years. A male child born today in the U.S. can expect to live, on average, 77.4 years; while a female child born today can expect to live 82.2 years.
So while one of the goals of modern medicine WAS to lengthen the human life, there are many implications of that… that were just not thought about carefully. For example, what will the QUALITY of our last years be? And… Will we have enough money if we live a really long life?
Now let’s talk about what population aging looks like for Colorado. We have always been considered a young state. According to Elizabeth Garner, State Demographer… between 2010 and 2030, Colorado will begin to look more like the rest of the country, in part because of our increased older population. In 1990, the median age here was almost 33 years of age. By 2040 it will be close to 40 years of age.
Between 2010 and 2030, Colorado’s 65 plus population will increase by 125% from 550,000 to 1.2 million. So in a 20-yr period, our older population will more than double. This trend will continue until the Baby Boomer generation has passed on. The coming older population will also be more racially and ethnically diverse.
Those age 80 (or 85) plus have been referred to as the OLD OLD or the frail elderly. While the rate of growth for the 65+ population will eventually taper off after 2030, we will see the 80+ population continue to grow steadily through 2040 and beyond. In Colorado, this OLD OLD group will grow from 163,000 in 2014 to over 500,000 in 2040. It is important to note that there are WAY more women than men in this group.
This very old age group is important to understand because many have exhausted any resources they may have had. Physical or mental health issues may surface causing mobility and functional difficulties. This group uses more services, has greater caregiving needs, and in fact, may need some type of long term care.
After World War II ended, having children was the thing to do in our country. The result: The Baby Boomers or the 77-78 million born from 1946 to 1964. This group is highly educated and affluent compared with past generations; and they say they want to continue contributing to their communities after they retire. This group will continue to request options and choices for Aging in Place.
But the Boomers have not saved enough for retirement. The first Boomers started hitting age 65 in 2011. According to the 2014 Retirement Confidence Survey by the Employee Benefits Research Group, 58% of workers age 45 and older report having total savings and investments of less than $25,000, not including the value of a primary residence or defined benefit plan.
In Colorado, 26% of the population is “Boomer.” There were over 1.3 million Boomers in 2010. They were 37% of our state’s labor force. And they are staying longer in the workforce; both because they want and need to. So while work participation rates for ages 65+ are increasing, the Boomers are going to “age out” of the workforce over the next 20 years.
Aging is definitely a women’s issue. The AARP Public Policy Institute identified the key issues faced by older women.
(1) The gender wage gap is still great and results in women having more economic difficulties than men in later life. In a new report out from the U.S. Bureau of Labor Statistics… in Colorado last year, “women earned 80.3 percent of what men did, and the gap is widening.” This gender wage gap is even wider for women of color.
(2) Women spend more time out of the workforce caring for family members. They typically spend 12 less years than men in the paid workforce. 67% of caregivers are women.
(3) Women are less likely to participate in pension plans because they worked for pay less and worked part time more often than employed men.
(4) Women typically spend more on medical care.
(5) Women aged 65 and older depend on Social Security for a larger share of their retirement income.
According to the National Women’s Law Center, for about 30 percent of female beneficiaries 65 and older, Social Security is virtually their only source of income. The average annual Social Security benefit for older women was about $13,500 in 2013.
(6) Women are more likely to enter a nursing home, a significant expense in retirement.
(7) Women are more likely to live in poverty in old age.
The National Women’s Law Center reports (in its manuscript INSECURE & UNEQUAL POVERTY AND INCOME AMONG WOMEN AND FAMILIES 2000-2013) “Among people 65 and older, more than twice as many women (nearly 2.9 million) as men (over 1.3 million) lived in poverty. One-quarter of poor women 65 and older lived in extreme poverty in 2013. The poverty rate for women 65 and older was 11.6 percent, 4.8 percentage points higher than the poverty rate for men 65 and older (6.8 percent).
19% percent of women 65 and older living alone lived in poverty, compared to 11.3 percent for men 65 and older living alone. Poverty rates were particularly high for black (20.4 percent), Native American (20.8 percent), Hispanic (23.0 percent), and foreign-born (17.2 percent) women 65 and older. Older women who live alone have the highest poverty rates of any group.
So what does this mean for the services older people need and want?
There is a vast array of senior services starting with recreation programs for active community members… to bathing, dressing and feeding for those who require 24-hour care in an institutional setting. The one uniting theme is that people ALWAYS want to retain as much independence as possible for as long as possible.
In 2010, National Research Center found that most seniors in Colorado gave the lowest ratings to Community Information about available programs and resources for older adults. They also gave low ratings to the legal and financial planning information available. Community Design and Land Use were rated next lowest including such things as ability to get around and transportation. This category also included the variety and affordability of housing.
Most advocates and providers would agree that the availability of free or low cost senior services has not kept pace with the demand and need. There are often waiting lists for many different senior services. That is why legislation such as House Bill 1100 (a bipartisan measure by Reps. Lebsock and Roupe and Sens. Crowder and Ulibarri) to add $4 million to the Older Coloradans Cash Fund makes great sense. The cost of most senior services is less if provided in the home as opposed to in an institutional setting.
So what else does all of this mean for the state’s budget?
On January 20th, Bob Semro with the Bell Policy Center gave a presentation to the CO House Committee on Public Health and Human Services. He cited Phyllis Resnick, the lead economist of the Colorado Futures Center. Ms. Resnick said, “the biggest pressure on the (Colorado) state budget over the long term is the aging population.”
Semro pointed out that 70% of people who reach age 65 will need long term care at some point. This often means nursing home or assisted living – some of the most costly types of elder care. Most of these programs are funded by Medicaid which includes federal and state funds. Women on average spend almost 4 years in LTC while men spend on average closer to 2 years. The average cost of a day in a nursing home in CO is $217 according to a Genworth 2014 Cost of Care survey. That translates to $79,000 a year.
When we look at a list of the categories Colorado Medicaid funds, the highest per person cost category was "adults 65 years of age and older" in FY 11-12. While people age 65+ represented 7% of the state's Medicaid clients, almost 26% of the budget was spent on them.
This picture would be incomplete if we did not talk about some of the social and economic contributions made by Colorado’s older population. Seniors do not just take from society. They also give a lot to society.
In 2010, National Research Center estimated the paid and unpaid contributions of the age 65 plus population over a one year period. Older Coloradans had $6.2 billion in paid and $7.5 billion in unpaid economic contributions, for a total of over $13 billion per year.
Demographer Garner repeatedly points out that having older people is an economic driver for Colorado. In 2010, the spending of people age 65+ supported approximately 137,000 jobs. Projections are that by 2030 the age 65+ group will support 346,000 Colorado jobs. There will especially be a greater demand for health care jobs to serve older Coloradans.
So in closing, what are some of things we MUST start doing now… in 2015?
1. We must acknowledge that the Silver Tsunami is an incredibly important issue that we must be concerned with.
2. We must understand that it will affect everyone and every facet of life.
3. We must realize Us is them... Base what we do and what policies we create on how we want to age ourselves. We need to ask ourselves how do we want OUR OWN late life to be lived?
4. We must recognize that what helps elders, helps society… and all families.
5. We must know that ongoing large scale planning processes and conversations are needed and must involve many diverse interests and parties.
House Bill 1033 (Rep. Primavera) would establish a planning group appointed by the governor to respond to this demographic shift. The bill calls for an independent task force to lead a statewide conversation. The group will have a broader mandate than simply just health care or just human services. This type of broad-based planning initiative makes a whole lot of sense right now.
6. We must find and use the many documented planning and conversation processes... And not put what we do on the shelf to gather cobwebs.
7. We must use the incredible data, reports, projections, that are now available that weren't in the past.
8. And finally, we must advocate for no intergenerational warfare. It is not an Us vs. Them situation. If we are lucky enough, everyone will experience a long life span. Let's embrace each other and appreciate what each generation brings to life and our communities!
*Special thanks to Elizabeth Garner, State Demographer; Eileen Doherty, Executive Director of the Colorado Gerontological Society, Rich Mauro, Senior Policy Analyst with Denver Regional Council of Governments (DRCOG), Kelli Fritts, AARP, and Robert Semro of the Bell Policy Center for assisting me with developing this keynote address.