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Reframing Public Policy for Centenarians

The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.

By Richard T. Moore
March 13, 2021

Life expectancy in the United States and several other countries was another victim of the COVID-19 pandemic, according to a study by Andrasfay, Goldman and others published by the National Academy of Sciences on February 2, 2021. On average, we lost 1.3 years, but the impact on Blacks and Latinos was even more severe.

“COVID-19 has generated a huge mortality toll in the United States, with a disproportionate number of deaths occurring among the Black and Latino populations. Measures of life expectancy quantify these disparities in an easily interpretable way. We project that COVID-19 will reduce U.S. life expectancy in 2020 by 1.13 years. Estimated reductions for the Black and Latino populations are 3 to 4 times that for Whites,” the study reported.

This significant setback means it will take a bit longer to achieve predictions from the Centers for Disease Control and the Census Bureau on the growing population of centenarians. The CDC previously noted that, “The growth in the 100-plus age group is partly a result of better medical care and a combination of improved lifestyle factors. This cohort has expanded 44% since 2000.”

 The Census Bureau similarly explained that, “80% of centenarians are women. And in about 40 years, the number of people 100 and older will be six times as high as it is now.”

The aging population, predominantly women, and the growing numbers of Americans living to, and beyond, one hundred years, presents some important challenges for policymakers and public administration professionals. In a little more than a decade, older adults (those 65 or older) will outnumber children (those 18 or younger) in the population.

Barring some unexpected shift in savings and retirement financial planning, it is likely that many of those approaching their own centennial birthdays are likely to lack resources needed to live with dignity in their twilight years.

A recent study by researchers at Yale and the University of Alabama-Birmingham reported in the New York Times, revealed that, “College degrees and continuing education are correlated,” with longevity. The study noted that, “Having a degree doesn’t guarantee a longer life, but one’s longevity may be augmented by factors such as enlightened self-care, better medical attention and activity in later life.” Another study at Princeton found that, “Socio-economic differences can account for 80% of the differences,” in life expectancy between Black and white.

All of these studies suggest that policymakers and those who administer programs in a wide range of areas need to be looking to a future that may be different from the society that they currently attempt to manager. Clearly, this growing population will continue to value learning and health. Education and healthcare would do well to embrace the concepts of, “Age-friendly universities,” and, “Age-friendly health systems.”

Age-friendly universities (a model that includes community colleges) are a concept that has taken hold in just the past decade. They are defined by their adoption of ten “age-friendly” principles that include encouraging participation of older adults in all educational and research programs, promoting personal and career development for the second half of life and intergenerational learning to facilitate reciprocal sharing of expertise among learners of all ages.

Similarly, age-friendly health systems, as defined by the Institute for Healthcare Improvement (IHI), follow an essential set of evidence-based practices, cause no harm and align with what matters to older adults and their family caregivers.

Beyond education and health systems consistent with the needs and desires of older adults, other fields such as housing designed to complement the physical limitations of aging, transportation systems that are easily accessible for older adults and government agencies that welcome input and involvement from older adults in the civic life of the community, including remote participation, are also important areas for policy development.

There are some aspects of community life that may not be needed or that will need to change in dramatic ways. For example, senior centers will need to be intergenerational community centers. Nursing homes, if they exist at all, will have to become smaller communities that are more home-like compared to the large, sterile and impersonal environments we encounter today in long-term care. Finally, we should all embrace the Reframing Aging Initiative, a long-term social endeavor designed to improve the public’s understanding of what aging means and the many ways that older people contribute to society. Its sister project, Reframing Elder Abuse, aims to demonstrate how we can put elder abuse on the public agenda, generate a sense of collective responsibility and boost support for systemic solutions to address elder abuse.

Our goal in America should be to include older adults in work and community spheres, rather than marginalize and ignore them. Rather than thinking of old age as a period of dependence and decline, we should view those years as a period of opportunity and continued contribution. We need to embrace programs and policies that could address the demographics of the aging population.

Author: Richard T. Moore has served in both elective and appointive public office at local, state, and national levels of government. He served for nearly two decades each in the Massachusetts House and Senate, and was chosen as President of the National Conference of State Legislatures in 2010-2011 He is a past president of the Massachusetts Chapter of ASPA and served on the National ASPA Council. He is a member of Dignity Alliance Massachusetts advocating for older adults and people with disabilities. Email: [email protected].

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