Aging refers to the process of getting older. People age at different rates and in different ways, influenced by cultural, social, biological, and economical factors. Race and ethnicity may also play a major role in how people experience aging. Since the beginning of the 20th century, improvements have been made in health care, nutrition, and public health. These improvements have greatly affected the longevity of different groups of people; however, not all groups of people have benefited equally. More often, the poor health status and life expectancies of minorities can be traced back to historical racial/ethnic discrimination and treatment of minority groups. This entry looks at the demographics of aging and discusses issues related to social support, health, and economic well-being—all with a focus on differences related to race and ethnicity.
Life expectancy is typically measured by averaging the number of years that people in a given population can expect to live. Data from the U.S. Census Bureau in 2003 indicate that the life expectancy at birth for all races was 77.5 years. However, there is a gap in life expectancies when accounting for race and gender. The life expectancy at birth for White males was 75.3 years and for White females was 80.5 years. Comparatively, the life expectancy for Black males was 69.0 years and for Black females was 76.1 years.
Three terms are commonly used to describe the old. Individuals between 65 and 75 years of age are referred to as the young old, individuals between 75 and 85 years of age are referred to as the old old, and individuals over 85 years of age are referred to as the oldest old. With people living longer than in previous times, the total amount and proportion of older people in the U.S. population is growing. For instance, the older population now constitutes approximately 12% of the total U.S. population. At the same time, the number of individuals living past 100 years of age, or centenarians, has increased during the past century as well.
A large birth rate between the years 1946 and 1964 produced more than 70 million people. Demographers label this cohort of births the “baby boom” population. The first wave of the baby boomers will turn 65 years of age in 2011. The mass amounts of people aging are expected to put a strain on society’s resources and institutions. Economic issues such as age of retirement, living arrangements, and costs of health care are of great and real concern because of the enormous pressures placed on government programs such as social security and Medicare benefits as means of support. Consequently, social institutions will also need to become flexible to meet the needs of a diverse population whose members might not have, or might never have had, equal treatment and resources in the society.
Reflecting the demographic changes of the U.S. population over the past decades, the older population will become more diverse. In 2003, the breakdown of the older (65+ years) U.S. population was as follows: non-Hispanic White, 82%; Black, 8%; Hispanic (of any race), 6%; Asian, 3%; and Native American, less than 1%. However, projections for 2050 indicate that the pattern is shifting. The Hispanic population is projected to grow the fastest, from just over 2 million in 2003 to 15 million in 2050, and to be larger than the older Black population by 2028. The diverse population of older people presents special issues and special needs.
Marital status and living arrangements can affect personal well-being both emotionally and economically. Older men are more likely than older women to be married. That is because women are more likely to be widows than men are to be widowers. On average, women live longer, so they spend more time alone as they get older, whereas men are likely to be married until they die.
The living arrangements of the elderly include living with a spouse, living with other relatives, living with nonrelatives (or in institutions such as nursing homes and hospitals), and living alone. Older men are more likely to live with a spouse than are older women. In contrast, as mentioned, older women are more likely to live alone.
Living arrangements of older people differ by race as well. For instance, Asian women are more likely than women of other races to live with relatives other than a spouse, whereas White and Black women are more likely to live alone. However, Black men are the most likely to live alone.
Living alone creates its own set of issues such as proper monitoring of health and depression. The living arrangements of the elderly are important factors because they are often linked to income, health status, and availability of caregivers. Also, people who live alone are more likely to be in poverty than are people who live with a spouse. Social networks, such as family and/or a spouse, provide the elderly with positive support both by encouraging healthy behaviors and by providing a safety net of individuals who can be counted on for any physical, emotional, and/or financial assistance. Stages of life, such as retirement and widowhood, can cause isolation and depression in the elderly.
Many families now live apart from one another, creating the issue of lack of immediate assistance for the elderly. With family members so far away, issues such as adequate housing and a safe environment become concerns. Not having these basic needs leaves a portion of the elderly vulnerable and isolated. Also, lack of economic resources or the perception thereof places a burden on the elderly and contributes to disparity in mortality of some groups.
Due to a cultural emphasis on independence, many elderly do not wish to burden family members. The caregiving issue has created a “sandwich generation”—a generation of people who are caring for their children and their aged parents at the same time. This puts quite a strain on the family, especially the women of the household, in that they are often the caretakers of elderly family members. Recent research has also begun to focus on the effects of kin support, in light of the national divorce trends.
There has been an “epidemiologic transition,” that is, a shift from infectious and acute diseases to chronic and degenerative diseases as reasons for mortality. Therefore, a cultural emphasis on preventing illness and maintaining health has emerged along with a “successful aging” approach. The top five causes of death for ages over 65 years are heart disease, cancer, stroke, emphysema, and pneumonia. These diseases are often referred to as “lifestyle” diseases, that is, diseases that trace to poor diet, obesity, lack of exercise, and/or cigarette smoking. These shifts in lifestyle account for much of the change in mortality rates over the past few decades.
The leading cause of death differs by group. Compared with Whites, Black Americans’ mortality rates are higher for stroke, heart disease, cancer, and HIV disease. Native Americans have the highest cancer mortality rate—approximately 40% higher than the rest of the population. Concurrently, Native Americans and Alaska Natives have considerably worse health outcomes—including higher infant mortality rates, more disease and disability, and shorter life expectancies—than much of the rest of the United States.
Healthy behaviors have a significant effect on one’s health status later in life. The risk factors that interfere with successful aging include smoking, alcohol abuse, depression, and lack of exercise. The top five sources of disability include diabetes, high blood pressure, heart disease, hearing impairment, and cataracts. Many elderly will move to nursing homes because of disability concerns as well as the need for assistance and management with activities of daily living such as bathing, dressing, and eating.
Minority and low socioeconomically disadvantaged groups are likely to experience health disparities, or a gap in the quality of health and health care, in comparison with wealthier and/or White groups. Negative social and environmental factors (e.g., poor housing/neighborhood), health-related behaviors (e.g., smoking, alcohol, poor eating habits/lack of nutrition), access to and use of health services (e.g., having health insurance/education on prevention), and quality of health care received further affect physical, cognitive, and emotional functioning later in life. Racial disparities that seem profound today can often be traced to a history of racial/ethnic discrimination in the United States.
Social security benefits are the largest source of income for the elderly and are received by most households. Other sources of income include earnings, asset income, and pensions. However, there is much inequality in income of the elderly. This can be attributed to employment patterns over the life course and is reflected in the differences in the sources of income for the elderly. For example, because Whites are more likely to have more assets and pensions, a smaller portion of their income derives from social security, whereas it accounts for the majority of minorities’ income. Those who spend their time in low-wage service sector jobs, agricultural, and domestic realms (mainly women and minorities) are often unable to save for retirement because the employers for whom they work rarely offered health or retirement benefits. Others who fall into this category are those who started saving too late and could not make up for earlier shortfalls and/or had their work histories interrupted by familial responsibilities.
Studying aging requires a multifaceted approach in that the social, cultural, and economic characteristics all play a part in how people experience aging. Furthermore, historical racial/ethnic discrimination also has a significant impact on how one experiences aging. Keeping up with changing demographics will be a challenge to the society. In particular, social institutions will require more diversity in the type of resources available for the aging U.S. population.
African Americans; Asian Americans; Familism; Family; Hispanics; Native Americans; Social Inequality; Social Support
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