"The issues surrounding the future of the health care labor force require that we move away from thinking about health care labor in terms of nurses or physicians or allied health professionals and that we begin thinking in terms of demographic changes and demands, appropriate levels of care, and appropriate venues for care," said Noreen Sugrue, senior research analyst at the Nursing Institute. "We need to think of health care labor as a team whose components must all be in sync if adequate care is to be delivered."
Panel members represent varying viewpoints from academia, the health care industry and the nonprofit sector. In addition to Martin, the members are: Edwin Artzt, chairman emeritus of Procter and Gamble; Paul Booth, assistant to the president of the American Federation of State, County, and Municipal Employees; Bill Bradley, former U.S. senator; Richard Corlin, president elect of the American Medical Association; Mary Kathryn James, president of the National Federation of Licensed Practical Nurses; Richard Kaplan, professor of law at the University of Illinois; Leslie Margolin, senior vice president for workforce development at Kaiser Permanente; Kweisi Mfume, executive director of the NAACP; Abner Mikva, professor of law at the University of Chicago; Len Nichols, principal research associate at the Urban Institute; Father Michael Place, executive director of the Catholic Health Association; Sara Rix, senior policy advisor at the American Association of Retired Persons; Jim Smith, senior economist at RAND; and Louis Sullivan, president of the Morehouse School of Medicine. Joan Shaver, dean of the UIC College of Nursing, is the convener.
Some of the statistics and trends the panel will consider include the following:
- Currently, more than 20 percent of people aged 70 and older have unmet health care needs.
In 1998, minorities made up 16 percent of the elderly population. By 2030, they are projected to be 25 percent of the elderly population.
- Four percent of persons aged 65 and older live in nursing homes, and the majority of those residents are women.
- While life expectancy at age 65 is higher for whites than for African-Americans, at age 85, it is slightly higher for African-Americans than for whites.
- The number of white non-Hispanic workers, as a proportion of all workers, is expected to decline from 75 percent (in 1998) to 64 percent in 2025.
- By 2025, Hispanics are projected to be 17 percent of the labor force, the second largest group. If there are not enough health care providers, then family members-historically, women-will fill the gaps. The increased responsibility may mean that these caregivers leave the work force, at a time when the nation will least be able to afford it, or that their productivity in the workplace decreases.
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Population estimates suggest that even as the number of elderly is increasing, the nation will experience increased fertility rates, producing more children. Those caught in the middle will be squeezed in terms of finances and other resources while caring for dependents at both ends of the life spectrum.
"The panel's work on these issues will be the first step in an important public dialogue leading to considered action to ensure that the health care needs of Americans are met in the first half of the 21st century," said Shaver.
The Nursing Institute-at the UIC College of Nursing, one of the top 10 nursing schools in the country-focuses on health care issues, including the labor force, health care delivery, practice and professional development.
With 25,000 students, the University of Illinois at Chicago is the largest and most diverse university in the Chicago area and is one of only 88 national Research I universities. Located just west of Chicago's Loop, UIC is a vital part of the educational, technological, and cultural fabric of the entire metropolitan region. It is one of the three main campuses of the University of Illinois, which is internationally renowned for scholarship and innovation.
About 33 million Americans are 65 or older. That's one in eight. But by the year 2020, the number rises to one in six. And by 2050, it grows to one in five -- or 20 percent. The Census report released Monday projected that the 65-plus age group will number 53 million by 2020 and 80 million by 2050.
Within that group, the fastest-growing segment of the U.S. population will be the "oldest old" -- people 85 and over -- whose numbers are expected to double to 7 million by 2020.
When the baby boom generation starts turning 65 in 2011, "It will have an explosive effect on all facets of society," said Richard Suzman, who heads the demography office in the government's National Institute on Aging.
"It's the equivalent of the waves of immigrants who came to the country, or the urbanization and industrialization of the country." Some 75 million people were born in the United States during the boom years, 1946 through 1964.
"These data are important because they confirm that states need to prepare their resources for an increasingly aged population," said Census analyst Kevin Kinsella.
"Some states 'age' because of in-migration of elderly, some because of out-migration of the young and some because of sustained low fertility, or some combination of these factors."
Pros and cons of aging
As baby boomers age, the effects will reach beyond retirement, health and long-term care, Suzman said, as working-age people increasingly face hard choices about educating their children, caring for their parents and saving for their own retirement.
On the positive side, Suzman said today's Americans are approaching their retirement years in better health and more prepared to cope with aging.
"We see signs that disability rates are dropping . . . I think there's hope that we can accelerate this process."
In recent years, workers have been retiring earlier, but Suzman said this is likely to change. As pensions that paid benefits at age 55 or 62 increasingly are replaced by plans to which individuals contribute, people have more incentive to stay on the job, he said.
Better overall health and the availability of procedures such as simplified cataract surgery and hip replacement reduces disability and permits more people to remain at work, Suzman said. "We are seeing more and more ability to influence health."
The health of boomers generally is better than that of their parents, most women have worked and generate their own Social Security and pension income, and education levels are higher, according to the Institute on Aging, which worked with the Census Bureau on the report.
More older women
Other findings of the report, "65+ in the United States," include:
The number of Americans age 100 and older has been climbing rapidly, reaching 49,894 by mid-1994.
- The elderly are more often women than men. There are 65 men for every 100 women over age 65. The ratio falls to 50 men for 100 women over age 80 and just 27 men for 100 women over age 100.
- The percentage of elderly living in poverty declined from 24.6 percent in 1970 to 12.9 percent in 1992.
- Among the 80 million elderly projected for 2050, 8.4 million will be black, 6.7 million will be of races other than white or black and 12.5 million will be Hispanic of any race.