Boomers aging “longer and better” ? Not so fast, not so good, and tell me your zip code

One of the key issues in approaching any data regarding average life expectancy (ALE) in the United States and the interpretation of that one number – the magic number we hear about – and hope that “it” keeps” increasing is being cautious and specific about exactly WHO benefits from the gains, and WHY, and WHERE.  Furthermore, when the gains in ALE takes place over a period of time – what is the gain?  Look at the figure below – it shows the life expectancy for U.S. residents at age 65, by sex and race, from 1999 through 2006.

And? Well, take a closer look. The data show gradual increases in the number of years from 2000 to 2006 for whites, blacks, men, and women, with the increases ranging from 0.7 years for white women to 1.1 years for black women; life expectancy at age 65 years increased by 0.9 year for the overall U.S. population. The gain over six years was “upward” but I am always amazed by the number of people who assume we are adding (or increasing) 5-10 years to ALE per decade – but that is not the case. I can almost sense the heavy disappointment in many aging baby boomers: “Wait, let me get this straight – ALE at 65 increased by o.9 ? Whooopeeddedo – big frickin deal. That’s it? In six years? – Yeah, but if that is the case, then by the time I hit 75, then….oh, I see…..”

Upward in gains – yes. But like a rocket and overnight express change in ALE ? – No.

QuickStats: Life Expectancy at Age 65 Years, by Sex and Race — United States, 2000–2006*

And then there is other dimension of living longer – Is is any better? Again, it depends. But do not think that the boomers are leading some sort of humongus transformation in quality of life issues into the aging years. Instead of some big paradigm shift in health and functioning, maybe it is more realistic to say there is an incremental and progressive (slow and sure) transition, but again nothing to put up on your Facebook page and shout to the world. 

+ HEALTH STATUS

Health and Functioning Among Baby Boomers Approaching 60 

The Journals of Gerontology Series B: Psychological Sciences and Social Sciences 2009 64B(3):369-377; doi:10.1093/geronb/gbn040

Linda G. Martin¹, Vicki A. Freedman², Robert F. Schoeni³ andPatricia M. Andreski³

Objective: To investigate whether the health and functioning of the Baby Boom generation are better or worse than those of previous cohorts in middle age.

Methods: Trend analysis of vital statistics and self-reports from the National Health Interview Survey for the 40–59 population. Specific outcomes (years of data): mortality (1982–2004); poor or fair health (1982–2006); nine conditions (1997–2006); physical functional limitations (1997–2006); and needing help with personal care, routine needs, or either (1997–2006).

Results: In 2005, the mortality rate of 59-year-olds, the leading edge of the Baby Boom, was 31% lower than that of 59-year-olds in 1982 (8.3 vs. 12.1 per 1,000). There was a similar proportional decline in poor/fair health, but the decline reversed in the last decade. From 1997 to 2006, the prevalence of reports of four conditions increased significantly, but this trend may reflect improvements in diagnosis and treatment. Functional limitations and need for help with routine needs were stable, but the need for help with personal care, while quite low, increase

Discussion: Trends varied by indicator, period, and age. It is surprising that, given the socioeconomic, medical, and public health advantages of Baby Boomers throughout their lives, they are not doing considerably better on all counts.

And finally, I hate to say  this, but I will: Tell me WHERE you live (your zip code, area code, etc. etc) and then I will tell you some more about how ALE will vary and how geography is (may- quite possibly be) destiny.

+ WHERE (Geography)

Although the average life span in the US continues to rise, gaps in life expectancy have changed little from 1982 to 2001. There is a wide gulf — as much as 33 years — between those who enjoy the best health and those who are most likely to suffer from illnesses, according to a new study published in PLoS Medicine. Researchers at Harvard University’s Initiative for Global Health and its School of Public Health divided the US into eight “Americas” based on factors including race, location, population density, income and homicide rates:

Asians, 10.4 million popuulation, $21,566 average income, life expectancy 84.9 years;
Northland low-income rural whites, 3.6 million population, $17,758 average income, life expectancy 79 years;
Middle Americans, 214 million population, $24,640 average income, life expectancy 77.9 years;
Low-income whites in Appalachia and Mississippi, 16.6 million population, $16,390 average income, life expectancy 75 years;
Western Native American, 1 million, $10,029 average income, life expectancy 72.7 years;
Black middle America, 23.4 million population, $15,412 average income, life expectancy 72.9 years;
Southern, rural, low-income black, 5.8 million population, $10,463 average income, life expectancy 71.2 years; and
High-risk urban black, 7.5 million population, $14,800 average income, life expectancy 71.1 years.

The primary cause of the disparities between racial and geographic groups is early death from chronic disease and injuries, an analysis of data from the Census Bureau and the National Center for Health Statistics showed.

Asian-American women living in Bergen County, NJ, enjoy the greatest life expectancy in the US, at 91 years. American Indians in South Dakota have the worst, at 58 years.

The differences were attributed to a combination of injuries and such preventable risk factors as smoking, alcohol, obesity, high blood pressure, elevated cholesterol, diet and physical inactivity — particularly among people from 15 years to 59 years of age. They were not due to income, insurance, infant mortality, AIDS or violence, said the study’s lead investigator, Christopher J.L. Murray, director of the Harvard Initiative for Global Health.

Bottom line: We have a long way to go in the domain of quality-of-life for aging Americans – and any time you hear or read about the ONE NUMBER – life expectancy in the US is………………..”_____”, you will say, Yes, however, it depends on……

thanks, Scott D. Wright