Tag Archives for Rhode Island's Office of Healthy Aging

New Census data reports the graying of U.S. population 

Published in RINewsToday on June 26, 2023

The nation’s population continues to gray and this is documented by a series of demographic profiles from the 2020 Census recently released. The release of this updated census data must be a wake-up call to Congress and federal and state officials who oversee aging programs and services.

According to Zoe Caplan, statistician demographer in the U.S. Census Bureau’s Sex and Age Statistics Branch, the U.S. population age 65 and over grew from 2010 to 2020 at the fastest rate since 1880 to 1890. The nation’s over-age-65 population grew nearly five times faster than the total population over the 100 years from 1920 to 2020, says Caplan in a May 25, 2023 posting on the agency’s website.

In her posting, Caplan says that in 2020, a whopping 1 in 6 people in the United States were age 65 and over. In 1920, this statistic was just 1 in 20. 

The 2020 Census reported that the older population increased by 50.9 million, from 4.9 million (or 4.7% of the total U.S. population) in 1920 to 55.8 million (16.8%) in 2020. This represents a growth rate of about 1,000%, almost five times that of the total population (about 200%).

Growth in older population spiked 2010-2020

According to Caplan, the older population has been growing for the past century but the decade before 2020 saw its fastest increase since 1880 to 1890. “From 2010 to 2020, the age 65 and over population experienced its largest-ever 10-year numeric gain — an increase of 15.5 million people. The next largest 10-year numeric increase, 5.7 million between 1980 and 1990, was less than half that size,” she says.

From 2010 to 2020, Caplan stated that the 65 and over population experienced the largest-ever percentage-point increase, from 13.0% to 16.8% of the total population. “Before 2010, it took 50 years (from 1960 to 2010)  for the nation’s older population’s share of the total population to grow by the same number of percentage points,” she said.

The 2020 Census Data reveals that while the nation’s population grew from 2010 to 2020, the size and rate varied by age groups for other age groups. The 65 to 74 age group was the largest of the older cohort groups, with 33.1 million people, representing over half of the age 65 and over population (or 1 in 10 Americans), she said.

“The 65 to 74 age group experienced the largest growth of any older age group the previous decade,” says Caplan, noting that its numbers grew by 11.4 million or (52.5%), increasing from 21.7 mil­lion in 2010 to 33.1 million in 2020.  

Caplan says that the 75-to-84 age group grew at about half that rate (25.1%) but is expected to pick up the pace in the next decade as baby boomers age into this group. Additionally, she noted that the 85-to-94 age group had a relatively slower growth (12.6%) than other older age groups, increasing from 5.1 million to 5.7 million.  The population 95 years and over also expe­rienced a large growth rate (48.6%), increasing from about 425,000 in 2010 to 631,000 in 2020, she added. 

The 2020 date also indicated that for those people age 70 and over, males experienced a larger percentage growth between 2010 and 2020 (42.2%) than females (29.5%). Meanwhile, the percentage of centenarians have grown 50% since 2010, the fastest recent census-to-census percent change for that age group.  

Finally, while the U.S. population age 65 and over population grew, the Census 2020 data indicated that the nation’s population remained relatively young when compared with other nations. Caplan noted that Japan has the largest percentage (28.5%) of older residents.  Many European countries, along with Canada and Hong Kong, have larger percentages of older residents than the United States, says Caplan, noting that the United States ranked 34th (16.8%) among these places.

Japan had the largest share (28.5%) of older residents. The United States ranked 34th (16.8%) among these places. Many European countries, along with Canada and Hong Kong, had higher shares of older residents than the United States, adds Caplan.

Nation’s median age creeps closer to Age 40

Just last week, the U.S. Census Bureau reported that the nation’s median age increased by 0.2 years to 38.9 years between 2021 and 2022.  Median age is the age at which half of the population is older and half of the population is younger.

“As the nation’s median age creeps closer to 40, you can really see how the aging of baby boomers, and now their children — sometimes called echo boomers — is impacting the median age. The eldest of the echo boomers have started to reach or exceed the nation’s median age of 38.9,” said Kristie Wilder, a demographer in the Census Bureau’s Population Division in a statement released on June 22, 2023.

“While natural change, nationally, has been positive, as there have been more births than deaths, birth rates have gradually declined over the past two decades. Without a rapidly growing young population, the U.S. median age will likely continue its slow but steady rise,” she says.

According to the statement, a third (17) of the states in the country had a median age above 40.0 in 2022, led by Maine with the highest at 44.8, and New Hampshire at 43.3. Utah (31.9), the District of Columbia (34.8), and Texas (35.5) had the lowest median ages in the nation. Hawaii had the largest increase in median age among states, up 0.4 years to 40.7.

No states experienced a decrease in median age. Four states — Alabama (39.4), Maine (44.8), Tennessee (39.1), West Virginia (42.8), and the District of Columbia (34.8) — had no change in their median age from 2021 to 2022.

Can Rhode Island cope with a population growing older?  

“It is no secret that the Rhode Island population is growing older,” says Maureen Maigret, Chair of the Aging in Community Subcommittee of the Long-Term Care Coordinating Council, whose Subcommittee was charged with looking at Rhode Island’s older population, its demographics, services and programs to assist them to age in place in the community along with identifying gaps in services. “We issued a comprehensive report in 2016 showing that persons age 65 and over in Rhode Island would go from 14.4% of the state population in 2010 to 25% by 2040,” she said.  

According to Maigret, the US Census 2021 estimates shows the state’s 65 and over population is now at 18% and some its communities have already reached 20%. “Our older population is also becoming more diverse. White older adults went from 93.4% in 2010 to 86.4% in 2021 (RI Healthy Aging Data Report.) while Hispanic older adults increased from 3.8% to 6.5%. Our Subcommittee continues to work to implement recommendations we made in nine different areas important for aging in the community,” adds Maigret, noting that she has been working with advocates and legislative champions to implement and put them into law or practice.

“We have made some significant progress in expanding home care for those not impoverished enough to be on Medicaid, to expand respite services for caregivers and this year to fund the Office of Healthy Aging and Disability Resource Center. But we still have much more work to do,” says Maigret.

“I am especially concerned that studies show some 80% of persons age 65+ will not be able to afford two years of home care and many may need more than that. So that is something we need to address by changes in Medicaid and Medicare providing support for unpaid family caregivers who provide enormous amounts of long-term care to loved ones in need.  We also be providing more funding for local senior center programs that are shown to promote health and reduce social isolation with its negative health outcomes,” says Maigret.

Maigret says that funding for the Village Common of RI that, an organization that provides trained and vetted volunteers in local villages to provide supports such as transportation to medical appointments, grocery shopping, friendly visits, minor home tasks — all types of supports to help older adults remain in their own homes, should also be allocated. “More communities are interested in starting these types of volunteer programs of mutual support but funding is needed to support the infrastructure,” she advises.  

Maigret expresses concern that so many older Rhode Islanders are economically insecure. Twenty seven percent of older households are living on less than $25,000/year yet it costs an older Rhode Island couple in good health renting their home about $41,448 annually to meet basic living expenses (Elder Index).

“Economic insecurity is a special problem for older women who comprise 56% of the state’s 65 and over population and are more likely to live alone,” she says noting that their average Social Security checks amounts to $11,584 compared to $14,578 for men, and mean personal income for women is about $25,000 less than older males.

Maigret encourages state leaders to pay attention to these “age-related” demographics as they consider budget and policy priorities. And she would like to see each of the state’s communities assess their age-friendliness, like Newport, Cranston and Providence have done.” Other communities should follow Pawtucket’s lead of promoting fitness for older adults by creating  adult outdoor exercise area adjacent to its senior center or in local parks.

Addressing the State’s Shrinking Health Care Workforce

“The main focus in addressing issues related to meeting the needs of the state’s growing older population is to address the critical need for a robust healthcare workforce,” says John Gage, President & CEO of the Rhode Island Health Care Association.  “Reimbursement must support appropriate staffing levels at livable wages throughout the long-term care continuum – home care, assisted living residences and nursing facilities,” he says. 

“As the generations shift, there will be a greater need for long-term care supports and services with a shrinking workforce.  Sustainable funding is essential to the ability to provide this care, and it has never been more evident than today,” warns Gage.  “In the wake of the Covid-19 pandemic, current statistics from the U.S. Bureau of Labor Statistics indicate that Rhode Island’s nursing home workforce is down some 20% from pre-pandemic levels,” he says, stating a detailed analysis of the workforce for hospitals and nursing homes indicates that  nursing home RNs have declined by 16.5%, LPNs by 18.3% and CNAs by 25.4%.  It is estimated that, nationwide, recovery of the nursing home workforce will not occur until 2027 based on the small, incremental improvements quarter over quarter, adds Gage.

“Presently, 17% of our neighbors are aged 65 and older, and nearly a quarter (24%) are age 60 and above!  Recognizing this trend, we are actively engaged in anticipating and meeting the needs of our growing population of older adults in our state,” says Director Maria Cimini, of the Rhode Island’s Office of Healthy Aging.

“At numerous State and non-profit spaces, we are present to ensure that the needs of older adults are central to discussions surrounding  health care, housing, transportation, education, accessible communities, and caregiving,” she adds.

“We embrace the opportunity presented by the recently passed Legislative Commission to Study the Services and Programs for Older Adults to collaborate with Rhode Islanders working with seniors. Together, we will share our experience with aging populations, promote valuable resources, and identify what we all need to make RI a great place to grow up and grow old,” says Cimini.

For a copy of the 2020 Census Brief, “The Older Population: 2020,” go to https://www2.census.gov/library/publications/decennial/2020/census-briefs/c2020br-07.pdf.

For a copy of the LTCCC’s Aging in Community Subcommittee June 2016 Report, “Aging in Community” go to  https://www.rilegislature.gov/Reports/AiC%20Full%20Final%20Report%206.13.16.pdf.

For a copy of the LTCCC’s Aging Community Subcommittee December 2016 Strategic Plan, “Aging in Community, go to https://www.rilegislature.gov/Reports/Building%20an%20Age-Friendly%20Community.pdf.

For a copy of Rhode Island Healthy Aging Data 2020 Report, go to

Home

Calls for Rhode Island to become more “Age Friendly”

Published in Pawtucket Times on January 24, 2022

On Aug. 3, 2020, The Decade of Healthy Aging 2020-2030 proposal was endorsed by the 73rd World Health Assembly. It was presented to the U.N. General Assembly Dec. 14, 2020, (Resolution 75/131), leading to the proclamation of a U.N. Decade of Healthy Aging (2021-2030).

The four-page Resolution expressed concern that, despite the predictability of population aging and its accelerating pace, the world is not sufficiently prepared to respond to the rights and needs of older people. It acknowledges that the aging of the population impacts our health systems but also many other aspects of society, including labor and financial markets and the demand for goods and services, such as education, housing, long-term care, social protection and information. It thus requires a total whole-of-society approach to make changes.

The passed Resolution called on the World Health Organization (WHO) to lead the implementation of the decade, in collaboration with the other U.N. organizations. Governments, international and regional organizations, civil society, the private sector, academia and the media are urged to actively support the decade’s goals.

According to WHO,  the world’s population is aging at a swifter pace than any time in the past and this will have an impact on all aspects of society.  There are more than 1 billion people aged 60 years or older, most of these individuals living in low- and middle-income countries. “Many do not have access to even the basic resources necessary for a life of meaning and of dignity. Many others confront multiple barriers that prevent their full participation in society,” says WHO.  

In a December 14, 2020, statement announcing the passage of Resolution 75/131, Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, stated that it “sends a clear signal that it is only by working as one, within the United Nations system and with governments, civil society and the private sector that we will be able to not only add years to life, but also life to years.”

“By adopting a U.N.-wide approach in support of healthy aging, we will be able to galvanize international action to improve the lives of older people, their families and communities, both during the COVID-19 pandemic and beyond,” Dr Etienne Krug, Director of the Department of Social Determinants of Health at added World Health Organization (WHO).

The WHO says that the ongoing COVID-19 pandemic highlights the seriousness of existing gaps in policies, systems and services and a decade of concerted global action is urgently needed to ensure that older people can fulfil their potential in dignity and equality and in a healthy environment.  

WHO’s worldwide initiatives would seek to change “how we think, feel and act toward age and aging; facilitate the ability of older people to participate in and contribute to their communities and society; deliver integrated care and primary health services that are responsive to the needs of the individual; and provide access to long-term care for older people who need it.” 

Healthy Aging Baseline Data Released

Just days ago, WHO released, “Decade of Healthy Ageing: Baseline Report,” in all official U.N. languages, to support member states, academia, civil society, U.N. partners and others to aid in evidence-based decision making on the policies, programmes and services needed to support all people, in particular older persons, to live long and healthy lives.

The Baseline report, released January 20, 2021, brings together data available for measuring healthy aging, defined by WHO as “the process of developing and maintaining the functional ability that enables well-being in older age.”

According to WHO, optimizing “functional ability” is the goal of the Decade of Healthy Aging, which began in 2021 and addresses five interrelated abilities that all older people should enjoy:  the ability to meet basic needs; to continue to learn and make decisions; to be mobile; to build and maintain relationships; and to contribute to society. The report also takes a look at people’s capacities (including physical and mental) and the environments (spanning attitudes, services, natural and built) in which people live, which contribute to functional ability.

The 203-page baseline report, now available in Arabic, Chinese, English, French, Russian and Spanish, introduces the concepts of health aging and strategies for achieving the initiatives goals by 2030. It provides a first-time baseline (in 2020) for healthy aging worldwide and takes a look at what improvements that can be made by 2030.  It documents progress and scenarios for improvement. The report addresses how stakeholders can work together and impact the functional abilities of older people. Finally, it outlines next steps detailing opportunities that can increase collaboration and impact by 2023, the next reporting period.

Is Rhode Island Becoming Age Friendly?   

Maureen Maigret, policy consultant and chair of the Aging in Community Subcommittee of Rhode Island’s Long-Term Care Coordinating Council, says that many Rhode Island communities are involved to 1 degree or another in what we consider age-friendly activities. “The initiative is usually led by the local senior center and in some instances volunteer programs such as RSVP and AARP and The Village Common of RI,” she says.

According to Maigret, over the last five years the state’s Long-Term Care Coordinating Council Aging (LTCCC) in Community Subcommittee has adopted and continues to work to support WHO’s decadelong initiative, adding the domains of Food & Nutrition and Economic Security and Supports to Remain at Home.

Maigret noted that Newport was the first community to join the AARP age-friendly network; Cranston, Providence and Westerly following. The state’s Office of Healthy Aging has adopted its State Plan on Aging, calling for Rhode Island to become an age-friendly state.

Governor Dan McKee’s proposed budget for FY2023 includes an additional $200,000 for local senior programs increasing the total amount to $1 million. Maigret calls for adding an additional  $800,000 so each municipality would be allocated $10 per person aged 65 and over to support local senior programs. Advocates had promoted this since at least 2018 to make up for prior budget cuts and inflation, she says.

Don’t forget improving and expanding the state’s transportation options for older Rhode Islanders who have mobility needs and are no longer able to drive. “This could be accomplished by adding trip types to the state funded Elderly Transportation Program,” she says, noting that trips are now limited for trips to medical appointments, adult day care services, meal sites and Insight. Why not provide trips for older adults to access volunteer activities, she adds.

“We also need to adequately fund our subsidized home care programs by providing realistic reimbursement to address the huge workforce challenges we face,” warns Maigret, noting that seniors are waiting over two months to get service. “This is a travesty,” she says.

“It is tragic that the state’s Office of Healthy Aging is so under resourced in so many areas,” says Maigret, putting the spotlight on the lack of affordable home maintenance and chore services to keep people in their homes. “There is also a need to provide greater supports for our family caregivers who provide the vast majority of caregiving in our state and nation,” she adds. 

Getting Municipalities Involved

Maigret suggests that Rhode Island’s cities and towns review their community’s Comprehensive Plans to see how age-friendliness is addressed. “This is what Newport did. They can also form local Steering Committees to identify local needs and develop recommendations to address them both at the local and state level,” she says.

Governor Dan McKee can also issue an Executive Order directing all state departments and agencies to review programs and policies for age-friendliness and provide incentive funding for local communities to assess their communities. Several states have done this. NY, MA, CO, FL, MI, ME, CA, she says. 

While aging advocates pushed for McKee and lawmakers to allocate ARPA COVID-19 federal funds to make Rhode Island a more age friendly, it’s gotten little attention, says West Warwick resident Vin Marzullo. “Quite frankly its shocking — that there is yet an explicit acknowledgement that the aging community needs resources, support, more collaborative arrangements, to extend living in-place. There seems not to be any sensitivity to the fact that 90% of the COVID deaths were adults 60 and over – and 53% were in congregate care,” says Marzullo, a  well-known aging advocate who served as a federal civil rights and national service administrator.

“The ARPA funds were authorized to be used to ameliorate the impact on the populations, communities, sectors, etc. that were adversely impacted. Our older adults must be in the conversation and not neglected,” says Marzullo.

Maigret agrees. “It is tragic that neither the McKee-Matos’ “Rhode Island 2030 Plan” nor the Rhode Island Foundation report outlining the use of ARPA funds gave sufficient attention to the needs of our state’s older population, she says, warning that this population is increasing, and getting more economically insecure and diverse,” she says.

“When we look at the exceedingly high cost of residential institutional care,  much of which is paid for taxpayers through government programs, we can make a strong case that funding programs helping older persons remain healthy and living in their homes and communities are important investments,” says Maigret. 

To obtain a copy of WHO’s “Decade of Healthy Ageing: Baseline Report,” go to:

https://www.who.int/publications/i/item/9789240017900.