National Aging Readiness

Policy Activity

As the U.S. population gets older and increasingly diverse, state leaders and stakeholders recognize the need to conduct systems-level, cross-sector planning.

Demographics

The older adult population is growing, increasingly diverse, largely living alone, and facing difficulties with self-care and living independently. Meeting their basic costs of living, particularly among those in poor health, is a significant challenge for many. These realities highlight the need to ensure our systems are prepared to support adults as they age.

Some new domain

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.

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.

Economic Security

Many older adults live in poverty and unable to afford the basic costs of living. The sources of income that older adults rely on change with age, but most adults age 65 or older rely primarily on a combination of retirement and/or Social Security. For older adults with limited incomes, Supplemental Security Income can be a crucial form of support but it is generally not sufficient to meet older adults’ basic needs. As a result of these economic challenges, older adults 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.

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. In addition, many older adults live in areas where the supply of health care providers is limited, thus limiting their access to care. 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.

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.

Dementia Challenge

Dementia is one of the most significant health challenges facing older adults and their loved ones. The rate of cognitive 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.

Mental Health

Older adults generally report very high levels of life satisfaction compared to 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. Suicide rates, particularly among older adult males, are a tragic indication of unmet behavioral health needs. As the population ages, there is a growing need for effective approaches to addressing the behavioral health needs of older adults.

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.ed for effective approaches to addressing the behavioral health needs of older adults.