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Older Americans—A Diverse and Growing Population

Older AmericansA Diverse and Growing Population

Old age is the most unexpected of all the things that happen to a man.
Leon Trotsky, Russian communist revolutionary and Soviet politician


The United States is aging. During the twentieth century the country's older populationadults aged sixty-five and overincreased significantly. According to the U.S. Administration on Aging (AoA), in A Profile of Older Americans: 2006 (March 2007,, the number of older adults grew from 3.1 million in 1900 to 36.8 million in 2005 (the most recent year for which comprehensive data, as opposed to estimates or projections, are available). In the press release "Older Americans Month: May 2007" (March 1, 2007,, the U.S. Census Bureau reports that of an estimated U.S. population of 301.6 million people in 2007, 36.8 million, or 12.2%, were over the age of sixty-five. Between 2000 and 2050 the percent of the population over age sixty-five is expected to increase 147%, compared to just a 49% increase in the U.S. population as a whole.

By 2030 there will be 71.5 million people aged sixty-five and older, about twice the number in 2000, and by 2050 the ranks of older adults will increase to 86.7 million. (See Figure 1.1.) Wan He et al. of the Census Bureau note in 65 + in the United States: 2005 (December 2005, that in 2050, 20.6%one in five Americanswill be aged sixty-five and over. Even as the percentage of older adults approaches 13%, however, the United States is relatively young among developed countries. (See Table 1.1.) In 2006 older adults comprised at least 15% of the population of more than twenty such countries, including 20% in Japan, 19.7% in Italy, 19.4% in Germany, and 19% in Greece.

Fewer children per family and longer life spans have shifted the proportion of older adults in the population. The growth in the population segment of older adults in the United States, often called "the graying of America," is considered one of the most significant issues facing the country in the twenty-first century. The swelling population of people aged sixty-five and over affects every aspect of societychallenging policy makers, healthcare providers, employers, families, and others to meet the needs of older Americans.

Many of the findings and statistics cited in this chapter, as well as a number of the tables and figures presented, are drawn from Older Americans Update 2006: Key Indicators of Well-Being (May 2006,, a report prepared by the Federal Interagency Forum on Aging-Related Statistics. This forum consists of thirteen federal entitiesthe Census Bureau, AoA, Agency for Healthcare Research and Quality, Centers for Medicare and Medicaid Services, National Center for Health Statistics, National Institute on Aging, Office of the Assistant Secretary for Planning and Evaluation, Substance Abuse and Mental Health Services Administration, U.S. Bureau of Labor Statistics, Department of Veterans Affairs, Environmental Protection Agency, Office of Management and Budget, and Social Security Administrationthat are dedicated to encouraging cooperation and collaboration among federal agencies to improve the quality and utility of data on the aging population. Other data are drawn from the AoA's A Profile of Older Americans.

To understand the aging of the United States it is important to not only consider the current population of older adults but also to look at how the older population will fare over time. To anticipate the needs of this growing segment of society, policy makers, planners, and researchers rely on projections and population estimates. Population estimates and projections are made at different times and based on different assumptions. As a result, it is not surprising to find considerable variation in the statistics cited by different agencies and investigators. This chapter contains estimates and projections of demographic changes from several different sources, and as a result there is some variability in the data presented.


Unlike people, populations can age or become younger. There are key indicators of the age structure of a given population. Populations age or grow younger because of changes in fertility (birth rates expressed as the number of births per one thousand population per year) and/or mortality (death rates expressed as the number of deaths per one thousand population per year) or in response to migrationpeople entering or leaving the population.

The aging of the United States resulted from changes in fertility and mortality that occurred over the past century. Such shifts in birth and death rates are called demographic transitions. Generally, population aging is primarily a response to long-term declines in fertility, and declining fertility is the basic cause of the aging of the U.S. population. Reduced infant and child mortality, chiefly as a result of public health measures, fueled the decline in the fertility rate; that is, the increased survival of children prompted families to have fewer offspring. The birth of fewer babies resulted in fewer young people.

According to estimates presented in The World Factbook: United States (July 19, 2007,, the Central Intelligence Agency states that the total fertility rate in the United States in 2007 was nearly 2.1 children born per woman. This rate, which has not changed significantly

Total number 65 and over
Region or country Number Percent
Note: Table excludes countries and territories with less than 100,000 total population.
Japan 127,464 25,535 20.0
Italy 58,134 11,450 19.7
Germany 82,422 16,018 19.4
Greece 10,688 2,027 19.0
Spain 40,398 7,170 17.7
Sweden 9,017 1,588 17.6
Belgium 10,379 1,809 17.4
Bulgaria 7,385 1,279 17.3
Estonia 1,324 228 17.2
Portugal 10,606 1,822 17.2
Austria 8,193 1,401 17.1
Croatia 4,495 754 16.8
Georgia 4,661 768 16.5
France 60,876 9,998 16.4
Latvia 2,275 373 16.4
Ukraine 46,620 7,628 16.4
Finland 5,231 846 16.2
United Kingdom 60,609 9,564 15.8
Slovenia 2,010 315 15.7
Switzerland 7,524 1,171 15.6
Lithuania 3,586 554 15.5
Denmark 5,451 828 15.2
Hungary 9,981 1,518 15.2
Serbia 10,140 1,544 15.2
Belarus 9,766 1,462 15.0
Norway 4,611 683 14.8
Romania 22,304 3,275 14.7
Luxembourg 474 69 14.6
Czech Republic 10,235 1,481 14.5
Bosnia and Herzegovina 4,499 647 14.4
Netherlands 16,491 2,349 14.2
Russia 142,069 20,196 14.2
Malta 400 55 13.7
Montenegro 692 95 13.7
Canada 33,099 4,407 13.3
Poland 38,537 5,128 13.3
Uruguay 3,432 455 13.3
Australia 20,264 2,649 13.1
Hong Kong S.A.R. 6,940 890 12.8
Puerto Rico 3,928 504 12.8
United States 298,444 37,196 12.5
Slovakia 5,439 653 12.0
New Zealand 4,076 481 11.8
Iceland 299 35 11.7
Cyprus 784 91 11.6
Ireland 4,062 470 11.6
Virgin Islands (U.S.) 109 12 11.2
Armenia 2,976 332 11.1
Macedonia 2,051 225 11.0
Moldova 4,326 465 10.7
Argentina 39,922 4,244 10.6
Cuba 11,383 1,206 10.6
Martinique 436 46 10.6

since the mid-1980s, is sharply lower than the fertility rates between 1946 and 1964, following the end of World War II (19391945). Victorious U.S. soldiers returning home after the war were eager to start families, and this was facilitated by the relatively prosperous postwar economy.

Age-adjusted death rate
Rank* Cause of death Number Death rate 2004 2003 Percent change
Category not applicable.
*Rank based on number of deaths.
Notes: For certain causes of death such as unintentional injuries, homicides, suicides, and respiratory diseases, preliminary and final data differ because of the truncated nature of the preliminary file. Data are subject to sampling and/or random variation.
All causes 2,398,365 816.7 801.1 832.7 -3.8
1 Diseases of heart 654,092 222.7 217.5 232.3 -6.4
2 Malignant neoplasms 550,270 187.4 184.6 190.1 -2.9
3 Cerebrovascular diseases 150,147 51.1 50.0 53.5 -6.5
4 Chronic lower respiratory diseases 123,884 42.2 41.8 43.3 -3.5
5 Accidents (unintentional injuries) 108,694 37.0 36.6 37.3 -1.9
6 Diabetes mellitus 72,815 24.8 24.4 25.3 -3.6
7 Alzheimer's disease 65,829 22.4 21.7 21.4 1.4
8 Influenza and pneumonia 61,472 20.9 20.4 22.0 -7.3
9 Nephritis, nephrotic syndrome and nephrosis 42,762 14.6 14.3 14.4 -0.7
10 Septicemia 33,464 11.4 11.2 11.6 -3.4
11 Intentional self-harm (suicide) 31,647 10.8 10.7 10.8 -0.9
12 Chronic liver disease and cirrhosis 26,549 9.0 8.8 9.3 -5.4
13 Essential (primary) hypertension and hypertensive renal disease 22,953 7.8 7.6 7.4 2.7
14 Parkinson's disease 18,018 6.1 6.1 6.2 -1.6
15 Pneumonitis due to solids and liquids 16,959 5.8 5.6 5.9 -5.1
All other causes 418,810 142.6

During this period, which came to be known as the baby boom, U.S. fertility rates exploded, at one point approaching four children born per woman, according to Census Bureau statistics. Children born during the baby boom became known as baby boomers, and it is this huge cohort (a group of individuals that shares a common characteristic such as birth years and is studied over time) that is responsible for the tremendous increase projected in the number of people aged sixty-five and over, and especially aged sixty-five to seventy-four, after 2010. The older adult segment of the population is expected to swell between 2010 and 2030 as the baby boom cohort completes its transition from middle age to old age.

The decline in death rates, especially at the older ages, has also contributed to the increase in the number of older adults. Death rates of older adults began to decrease during the late 1960s and continued to decline through the early years of the twenty-first century. Advances in medical care have produced declining death rates for all three of the leading causes of death: heart disease, malignancies (cancer), and cerebrovascular diseases that cause strokes. (See Table 1.2.) The age-adjusted death rate in the United States reached an all-time low in 2004 of 801.1 deaths per 100,000 population, down from 832.7 deaths per 100,000 in 2003.

Projections of an increasing proportion of older adults from 2010 to 2030 are based on three assumptions: historic low fertility and the prospect of continuing low fertility until 2030, aging of the baby boom cohort, and continued declines in mortality at older ages and low mortality until 2030. Demographers (those who study population statistics) expect that when the entire baby boom generation has attained age sixty-five in 2030, the proportion of older people in the U.S. population will stabilize.


Forty is the old age of youth; fifty the youth of old age.
Victor Hugo, French poet, dramatist, and novelist

When does old age begin? The challenge of defining old age is reflected in the terminology used to describe adults aged fifty and older: for example, middle-aged, elder, elderly, older, aged, mature, or senior. The AARP (formerly the American Association of Retired People), a national advocacy organization for older adults, invites members to join its ranks at age fifty. Many retailers offer senior discounts to people aged fifty or fifty-five and older, and federal entitlement programs such as Social Security (a program that provides retirement income and health care for older adults) and Medicare (a medical insurance program for senior citizens and the disabled) extend benefits to people at age sixty-two, sixty-five, or sixty-seven. Despite the varying definitions of old age and the age at which one assumes "older adult" status, in this text, unless otherwise specified, the term older adults is used to refer to people aged sixty-five and older.

Gerontology, the field of study that considers the social, psychological, and biological aspects of aging, distinguishes among three groups of older adults: the young-old are considered to be those people aged sixty-five to seventy-four, the middle-old includes those aged seventy-five to eighty-four, and the oldest-old are people aged eighty-five and over. Figure 1.2 shows that the oldest segment of older adults, the oldest-old, grew from just over 100,000 in 1900 to 4.2 million in 2000 and is projected to steadily increase between 2010 and 2050.


In Health, United States, 2004 (2004,, the National Center for Health Statistics indicates that life expectancy (the anticipated average length of life) has increased dramatically since 1900, when the average age of death for men and women combined was 47.3 years. Most projections see life expectancy continuing to rise; according to the World Factbook: United States, the life expectancy of a baby born in the United States in 2007 was 80.9 years for females and 75.1 years for males.

Some researchers caution, however, that the historic trend of increasing longevity has ended, with life expectancy at birth beginning to decline by as much as five years as a direct result of the obesity epidemic in the United States. S. Jay Olshansky et al. suggest in "A Potential Decline in Life Expectancy in the United States in the 21st Century" (New England Journal of Medicine, March 17, 2005) that the methods used to establish life expectancy projections, which have long been based on historic trends, need to be reassessed in view of increasing obesity-related mortality.

Olshansky et al. base their projections on an analysis of body mass index (a number that shows body weight adjusted for height) and other factors that could potentially affect the health and well-being of the current generation of children and young adults, and they determine that obesity currently reduces life expectancy by approximately four to nine months. Olshansky et al. assert that unless steps are taken to curb excessive weight gain, younger Americans will likely face a greater risk of mortality throughout life than previous generations.

Global Life Expectancy

The more developed regions of the world have lower death rates than the less developed regions and, as such, have higher life expectancies. In Why Population Aging Matters: A Global Perspective (March 2007,, a report prepared by the U.S. Department of State, the U.S. Department of Health and Human Services, the National Institute on Aging, and the National Institutes of Health, it is observed that some nations more than doubled their life expectancy during the twentieth century. In 2006 life expectancy at birth in Japan was eighty-two years, and it was at least seventy-nine years in many developed countries. Many less developed countries have also seen a steady increase in life expectancy, except for countries in Latin America and Africa that have been hard hit by the human immunodeficiency virusacquired immunodeficiency syndrome epidemic. The sharpest increases have taken place in East Asia, where life expectancy at birth rose from less than forty-five years in 1950 to more than seventy-two years by 2006.

Even though the Department of Economic and Social Affairs, in World Population Prospects: The 2004 Revision (February 24, 2005,, predicts that the gap in life expectancy will narrow during the first half of the twenty-first century, the developed world will still be far ahead. From 2045 to 2050 the more developed regions will have a life expectancy of 82.1 years, compared to seventy-five years for less developed regions and 66.5 for the least developed.


According to He et al., in July 2003 there were 35.9 million people who were sixty-five and older. There were 18.3 million people in the young-old bracket (aged sixty-five to seventy-four), comprising 51% of the sixty-five and over population. Thirty-six percent of the older adult population was in the middle-old bracket (aged seventy-five to eighty-four). This group numbered 12.9 million. Thirteen percent (4.7 million) were the oldest-old (aged eighty-five and over).

By 2010 the number of young-old is projected to rise to more than twenty-one million, the middle-old will be nearing thirteen million, and the oldest-old will approach six million. (See Table 1.3.) Women are expected to outnumber men in all three age brackets. Table 1.3 shows how the projected distribution of older adults by genderthe number of males per one hundred femalesdeclines in 2010 from 86.3 in the young-old bracket to 73.3 in the middle-old and 45.4 among the oldest-old. Longer female life expectancy, combined with the fact that men often marry younger women, contributes to a higher proportion of older women living alonewidowed or unmarried.

The Oldest-Old

He et al. report that during the 1990s the oldest age group grew more rapidly than did the young-old and middle-old segments of the population. The eighty-five and older population grew from 3.1 million in 1990 to 4.2 million in 2000, an increase of 35%. In contrast, the middle-old increased by 23%, from 10.1 million in 1990 to 12.4 million in 2000, and the number of young-old rose less than 2%, from 18.1 million to 18.3 million.

According to the Census Bureau (, as of July 1, 2005, there were 5.1 million people aged eighty-five and older in the United States, and this group accounted for 14% of all older adults. He et al. note that by 2050 the eighty-five and over age group could number 20.9 million5% of the total U.S. population. The Older Americans Update 2006 notes that some researchers believe that death rates at older ages will decline more rapidly than is reflected in Census Bureau projections, which would result in even faster growth of this population segment.

The Census Bureau reports that among the oldest-old, women dramatically outnumber menthere are just forty-six men per one hundred women. Because it is anticipated that women will continue to live longer into the middle of the twenty-first century, they will comprise an even larger proportion of the older population and the overall U.S. population in the future.


According to Why Population Aging Matters, in 2005 adults aged eighty-five and older made up 7% of the world's over sixty-five population10% in developed countries and 5% in less developed countries. Over half of the world's oldest-old live in six countries: China, the United States, India, Japan, Germany, and Russia.

Furthermore, Why Population Aging Matters suggests that people aged eighty-five and over make up the fastest-growing population segment in the world. The eighty-five and older population is anticipated to grow by 151% between 2005 and 2030, compared to a 104% increase in the population aged sixty-five and older and a 21% increase in the population under age sixty-five.

Both sexes
Age group and year Number Percent of all ages Percent increase from 1995 Sex
Male Female Sex ratio*
*Males per 100 females
x=Not applicable
All ages
1995 262,820 x x 128,311 134,509 95.4
2000 274,634 x 4.5 134,181 140,453 95.5
2010 297,716 x 13.3 145,584 152,132 95.7
2030 346,899 x 32 169,950 176,949 96
2050 393,931 x 49.9 193,234 200,696 96.3
1995 21,138 8 x 10,045 11,093 90.6
2000 23,961 8.7 13.4 11,433 12,528 91.3
2010 35,283 11.9 66.9 16,921 18,362 92.2
2030 36,348 10.5 72 17,441 18,907 92.2
2050 42,368 10.8 100.4 20,403 21,965 92.9
1995 18,758 7.1 x 8,337 10,421 80
2000 18,136 6.6 -3.3 8,180 9,956 82.2
2010 21,058 7.1 12.3 9,753 11,305 86.3
2030 37,407 10.8 99.4 17,878 19,529 91.5
2050 34,732 8.8 85.2 16,699 18,033 92.6
1995 11,151 4.2 x 4,326 6,825 63.4
2000 12,316 4.5 10.4 4,938 7,378 66.9
2010 12,680 4.3 13.7 5,363 7,317 73.3
2030 23,517 6.8 110.9 10,818 12,699 85.2
2050 25,905 6.6 132.3 12,342 13,563 91
1995 3,634 1.4 x 1,015 2,619 38.8
2000 4,259 1.6 17.2 1,228 3,031 40.5
2010 5,670 1.9 56 1,771 3,899 45.4
2030 8,454 2.4 132.7 3,021 5,433 55.6
2050 18,224 4.6 401.5 7,036 11,188 62.9
1995 33,544 12.8 x 13,678 19,866 68.9
2000 34,710 12.6 3.5 14,346 20,364 70.4
2010 39,409 13.2 17.5 16,887 22,522 75
2030 69,379 20 106.8 31,718 37,661 84.2
2050 78,859 20 135.1 36,076 42,783 84.3


During the first half of the twenty-first century the United States will experience a centenarian boom. The chances of living to age one hundred have increased by 40% since 1900. The centenarian population more than doubled during the 1980s, and the Census Bureau estimates in "Older Americans Month" that the country had 79,682 centenarians in November 2006. Constance A. Krach and Victoria A. Velkoff, in Centenarians in the United States, 1990 (July 1999,, indicate that the United States will have 131,000 centenarians by 2010 and 834,000 by 2050, a phenomenal growth when compared to the 3,300 centenarians living in the United States in 1960. (Figure 1.3 shows the projected population distribution in 2025; Figure 1.4 and Figure 1.5 contain comparable data for 2050 and 2100, respectively.) Not surprisingly, most centenarians do not live long after age one hundred; He et al. note that 90% do not reach 105 years of age.

Racial and Ethnic Diversity

The older population is becoming more ethnically and racially diverse, although at a slower pace than the overall population of the United States. As Figure 1.6 shows, in 2004 approximately 82% of the older population comprised non-Hispanic whites, African-Americans made up around 8%, Hispanics accounted for approximately 6%, and Asians contributed about 3% of older adults. By 2050 the composition of the older population is projected to be more racially and ethnically diverse, with 61% being non-Hispanic white, 18% being Hispanic, 12% being African-American, and 8% being Asian. Even though the older population will increase among African-Americans, Asian-Americans, and Hispanics, the older Hispanic population will grow the most dramatically from 6% in 2004 to 17.5% in 2050. (See Table 1.4.) During this same period non-Hispanic whites will decline from 81.9% to 61.3%.

Marital Status

As in previous years, in 2005 older men were much more likely than women to be married. More than three-quarters (72%) of men aged sixty-four to seventy-five were married, compared to 42% of women in the same age group. (See Figure 1.7.) The proportion married decreases with advancing age. In 2004, 36.4% of women aged seventy-five to eighty-four and 15.1% of women aged eighty-five and over were married. Among men the proportion who were married decreased with advancing age but not as sharply. Even among the oldest-old most men (56.6%) were married. (See Table 1.5.)

As older women outnumber older men in all age groups, it is not surprising that there are more widows than widowers. In 2004 more than three times as many women as men aged sixty-five to seventy-four were widowed28% of women, compared to 7.5% of men. Even though the gap narrows in older age groups, there were still about twice as many women as men aged eighty-five and over who were widowed77.1% of women as opposed to 35.1% of men. A fairly small proportion of older adults were divorced, whereas an even smaller proportion had never married. (See Table 1.5.)

Foreign-Born Older Adults

In Foreign-Born Population of the United States: Current Population SurveyMarch 2004 (May 25, 2005,, the Census Bureau notes that in 2004 the nation's foreign-born population numbered 34.2 million, accounting for 12% of the population. This survey identified 3.7 million older adult U.S. residents as foreign born and indicated that the percentage of foreign-born older adults declines with age, from 3.5% in the sixty-five to sixty-nine age group to a scant 1.1% among older adults aged eighty-five and over. Among the foreign-born older population, somewhat more than 1.9 million people, or 50.1%, entered the United States before 1970. About 134,000, or 2.2%, arrived in 2000 or later.

The highest percentages of foreign-born older adults live in the West (19%) and Northeast (14%). (See Figure 1.8.) The Midwest is home to 4.9% of foreign-born older adults.


In A Profile of Older Americans, the AoA reports that in 2005 adults aged sixty-five and older accounted for 14% or more of the population in eight states. The proportion of the population aged sixty-five and over varied by state. In Florida the older adult population was 16.8%, followed by West Virginia with 15.3%, Pennsylvania with 15.2%, North Dakota and Iowa with 14.7% each, Maine with 14.6%, South Dakota with 14.2%, and Rhode Island with 13.9%. (See Figure 1.9.) In ten statesNevada (56.6%), Alaska (47.5%), Arizona (31.4%), New Mexico (26.5%), Utah (24.1%), Colorado (23.3%), Delaware (22.9%), Idaho (22.8%), Georgia (20.8%), and South Carolina (20.6%)the sixty-five and over population grew by 20% or more between 1995 and 2005. (See Figure 1.10.)

By 2010, 17.8% of Florida's population will be older adults, and by 2030 that percentage is projected to rise to 27.1%. Five other states in which the older population is predicted to exceed 25% by 2030 are Maine and Wyoming (26.5% each), New Mexico (26.4%), Montana (25.8%), and North Dakota (25.1%). (See Table 1.6.) In 2030 the states in which older adults will constitute the lowest percentage of the population are Utah (13.2%), Alaska (14.7%), Texas (15.6%), and Georgia (15.9%).

The proportion of the population aged sixty-five and over also varies by county. He et al. report that in 2000 Charlotte County, Florida, had the highest proportion (34.7%) of older population in the United States, and McIntosh, North Dakota, was a close second with 34.2% of its population aged sixty-five and older. He et al. also observe that three out of four older adults lived in metropolitan areas in 2000.


The average person can get younger in the sense that he or she can have even more years to live as time goes on.
Warren Sanderson, "Forty May Be the New 30 as Scientists Redefine Age"

Race and Hispanic origin 2004 estimates 2050 projections
       Total 100.0 100.0
Non-Hispanic white alone 81.9 61.3
Black alone 8.4 12.0
Asian alone 2.9 7.8
All other races alone or in combination 1.2 2.7
Hispanic (of any race) 6.0 17.5
Selected characteristic 6574 7584 85 and over
Married 79.4 72.4 58.3
Widowed 7.5 18.8 35.1
Divorced 8.7 4.8 4.2
Never married 4.4 3.9 2.4
Married 56.6 36.4 15.1
Widowed 28.0 53.2 77.1
Divorced 11.7 7.0 3.2
Never married 3.7 3.5 4.6

In "Hope I Die before I Get Old: Mispredicting Happiness across the Adult Lifespan" (Journal of Happiness Studies, June 2006), Heather Pond Lacey, Dylan M. Smith, and Peter A. Ubel of the University of Michigan indicate that even though both young adults and older adults express the belief that happiness declines with advancing age, self-reports refute this belief.

Lacey, Smith, and Ubel asked more than five hundred study participants who were either between the ages of twenty-one and forty or older than sixty to rate their own happiness at their current age and predict their happiness at age thirty and seventy. The study participants were also asked to assess how happy they believe most people are at ages thirty and seventy.

Both younger and older adults said they thought that for the average person, happiness declines with age. Similarly, both age groups felt that older adults were less happy, and older adults themselves opined that they and others were happier when they were younger. Interestingly, only the older adults felt that their own personal happiness would decline with age. The younger adults felt that they themselves would be as happy at age seventy, but that others their age would likely see their happiness decline. Despite these beliefs, this study and others find that most people tend to become happier over time, based on their self-reports.

This study confirms a survey by the National Council on the Aging (NCOA), which published the results in "Nearly Half of Older Americans Say 'These Are Best Years of My Life,' National Survey Shows" (March 29, 2000, detail=43). The NCOA finds that the number of older Americans who agreed with the statement "these are the best years of my life" has risen over time from 32% in 1974, when the first study was conducted, to almost half (44%) in 2000. Furthermore, the NCOA notes that the vast majority of Americans of all ages (84%) said they would be happy to live to age ninety.

Other important survey findings reported by the NCOA include:

  • Most Americans favored spending morenot lessmoney on older people.
  • Older people were less worried about their health, their finances, and the threat of crime than they were twenty-five years ago.
  • For many respondents, old age begins with a decline in physical or mental ability, rather than with the arrival of a specific birthday.
  • Younger people tended to overstate the social isolation and financial problems of older people.

Positive Perceptions of Aging Influence Longevity

Becca R. Levy et al. find in "Longevity Increased by Positive Self-Perceptions of Aging" (Journal of Personality and Social Psychology, August 2002) that older people with more positive self-perceptions of aging lived 7.5 years longer than those with less positive self-perceptions of aging even after taking into account other factors, including age, gender, socioeconomic status, loneliness, and overall health. Analyzing data from the 660 participants aged fifty and older in the Ohio Longitudinal Study of Aging and Retirement, Levy et al. compared mortality rates with responses made twenty-three years earlier by the participants (338 men and 322 women). The responses included agreeing or disagreeing with statements such as "As you get older, you are less useful."

Levy et al. assert that "the effect of more positive self-perceptions of aging on survival is greater than the physiological measures of low systolic blood pressure and cholesterol, each of which is associated with a longer life span of 4 years or less.[It] is also greater than the independent contribution of lower body mass index, no history of smoking, and a tendency to exercise; each of these factors has been found to contribute between 1 and 3 years of added life." They conclude that negative self-perceptions can diminish life expectancy, whereas positive self-perceptions can prolong it.

Happiness in the Face of Trauma

In Americans 55and Older:A Changing Market (2001), Sharon Yntema characterizes older Americans as the happiest of any age group. In fact, the percentage of survey respondents that said they were "very happy" peaked in the sixty-five to seventy-four age group. Older Americans are also the most happily married. Seventy-two percent of couples aged sixty-five to seventy-four said their marriage was "very happy," compared to 61% of all couples.

In contrast to the happy marriages later in life, Yntema notes that those aged sixty-five to seventy-four suffered a high rate of traumatic events, including death, divorce, unemployment, hospitalization, and disability. Of people aged sixty-five to seventy-four, more than half (52%) had experienced at least one such traumatic event in the past five years, compared to 35% for all adults. Another 27% had experienced two or more such events, and 52% had experienced the death of one or more relatives in the past five years.

According to the NCOA, in "Survey Shows Older Americans More Worried about Personal Well-Being Than about Terrorists" (July 24, 2003, detail=378), in which people over the age of sixty were surveyed, 44% worried about physically caring for themselves and 42% worried about losing their memory. They also worried that their children and grandchildren will be exposed to drugs (63%) or have difficulties in becoming employed (54%).

The NCOA reports that those surveyed also said that "having something meaningful to do" (27%) or "having

2000 state 2000 percent 2000 rank 2010 state 2010 percent 2010 rank 2030 state 2030 percent 2030 rank
United States 12.4 (x) United States 13.0 (x) United States 19.7 (x)
Florida 17.6 1 Florida 17.8 1 Florida 27.1 1
Pennsylvania 15.6 2 West Virginia 16.0 2 Maine 26.5 2
West Virginia 15.3 3 Maine 15.6 3 Wyoming 26.5 3
Iowa 14.9 4 Pennsylvania 15.5 4 New Mexico 26.4 4
North Dakota 14.7 5 North Dakota 15.3 5 Montana 25.8 5
Rhode Island 14.5 6 Montana 15.0 6 North Dakota 25.1 6
Maine 14.4 7 Iowa 14.9 7 West Virginia 24.8 7
South Dakota 14.3 8 South Dakota 14.6 8 Vermont 24.4 8
Arkansas 14.0 9 Connecticut 14.4 9 Delaware 23.5 9
Connecticut 13.8 10 Arkansas 14.3 10 South Dakota 23.1 10
Nebraska 13.6 11 Vermont 14.3 11 Pennsylvania 22.6 11
Massachusetts 13.5 12 Hawaii 14.3 12 Iowa 22.4 12
Missouri 13.5 13 Delaware 14.1 13 Hawaii 22.3 13
Montana 13.4 14 Alabama 14.1 14 Arizona 22.1 14
Ohio 13.3 15 Rhode Island 14.1 15 South Carolina 22.0 15
Hawaii 13.3 16 New Mexico 14.1 16 Connecticut 21.5 16
Kansas 13.3 17 Wyoming 14.0 17 New Hampshire 21.4 17
New Jersey 13.2 18 Arizona 13.9 18 Rhode Island 21.4 18
Oklahoma 13.2 19 Missouri 13.9 19 Wisconsin 21.3 19
Wisconsin 13.1 20 Oklahoma 13.8 20 Alabama 21.3 20
Alabama 13.0 21 Nebraska 13.8 21 Massachusetts 20.9 21
Arizona 13.0 22 Ohio 13.7 22 Nebraska 20.6 22
Delaware 13.0 23 Massachusetts 13.7 23 Mississippi 20.5 23
New York 12.9 24 New Jersey 13.7 24 Ohio 20.4 24
Oregon 12.8 25 New York 13.6 25 Arkansas 20.3 25
Vermont 12.7 26 South Carolina 13.6 26 Missouri 20.2 26
Kentucky 12.5 27 Wisconsin 13.5 27 Kansas 20.2 27
Indiana 12.4 28 Kansas 13.4 28 New York 20.1 28
Tennessee 12.4 29 Tennessee 13.3 29 New Jersey 20.0 29
Michigan 12.3 30 Kentucky 13.1 30 Kentucky 19.8 30
District of Columbia 12.2 31 Oregon 13.0 31 Louisiana 19.7 31
South Carolina 12.1 32 Michigan 12.8 32 Michigan 19.5 32
Minnesota 12.1 33 Mississippi 12.8 33 Oklahoma 19.4 33
Illinois 12.1 34 Indiana 12.7 34 Tennessee 19.2 34
Mississippi 12.1 35 Louisiana 12.6 35 Minnesota 18.9 35
North Carolina 12.0 36 New Hampshire 12.6 36 Virginia 18.8 36
New Hampshire 12.0 37 North Carolina 12.4 37 Nevada 18.6 37
Wyoming 11.7 38 Virginia 12.4 38 Idaho 18.3 38
New Mexico 11.7 39 Illinois 12.4 39 Oregon 18.2 39
Louisiana 11.6 40 Minnesota 12.4 40 Washington 18.1 40
Maryland 11.3 41 Nevada 12.3 41 Indiana 18.1 41
Idaho 11.3 42 Washington 12.2 42 Illinois 18.0 42
Washington 11.2 43 Maryland 12.2 43 California 17.8 43
Virginia 11.2 44 Idaho 12.0 44 North Carolina 17.8 44
Nevada 11.0 45 California 11.5 45 Maryland 17.6 45
California 10.6 46 District of Columbia 11.5 46 Colorado 16.5 46
Texas 9.9 47 Colorado 10.7 47 Georgia 15.9 47
Colorado 9.7 48 Texas 10.5 48 Texas 15.6 48
Georgia 9.6 49 Georgia 10.2 49 Alaska 14.7 49
Utah 8.5 50 Utah 9.0 50 District of Columbia 13.4 50
Alaska 5.7 51 Alaska 8.1 51 Utah 13.2 51

some good friends" (26%) would increase the future quality of their life. When queried about the most important things to do within a year of retirement, the respondents' top choices included volunteering (27%) and visiting family and friends (22%).


People of all ages hold beliefs and attitudes about aging and older adults. Even young children can distinguish age differences, and they display attitudes that appear to be characteristic of their generation. Because attitudes strongly influence behavior and because more Americans reach older ages than ever before, interaction with older people and deeply held beliefs about growing old are likely influenced by cultural and societal attitudes about aging and older adults. The availability, accessibility, adequacy, and acceptability of health care and other services intended to meet the needs of older people are similarly influenced by the attitudes of younger people. The prevailing attitudes and opinions of political leaders, decision makers, health and human services personnel, and taxpayers are particularly important in shaping policies, programs, services, and public sentiment.

In nonindustrialized countries older people are often held in high esteem. Older adults are respected because they often have endured and persevered in harsh living conditions and because they have accumulated wisdom and knowledge that younger generations need to survive and carry on the traditions of their culture. In many industrialized societies, including the United States, a person's worth may be measured in terms of income (the flow of money earned through employment, interest on investments, and other sources) and the amount of wealth accumulated. When older adults retire from full-time employment, they may lose status because they are no longer working, earning money, or "contributing" to society. When an individual's sense of self-worth and identity is closely bound to employment or occupation, retirement from the workforce can make him or her feel worthless.

Stereotypes Fuel Worries of Older Adults

Even though people of all ages worry about the future, for older adults, aging may signify a future threat to their health and well-being, diminished social status, a loss of power, and the possibility of loss of control over their lives. Researchers posit that social stereotypes, such as media portrayals of older adults as weak and helpless and of old age as a time of hardship, loss, and pain, have a powerful influence on attitudes and may be another source of worry for older adults. They contend that the image of a tragic old age can create worries about having a tragic old age. Worse still, the negative image of old age can become a self-fulfilling prophecy, thereby confirming negative stereotypes and promoting ageism (discrimination or unfair treatment based on age).

In view of the myriad difficulties and challenges facing older adults, including ill health, inadequate financial resources, and the loss of friends and loved ones, it seems natural to assume that advancing age will be associated with less overall happiness and more worry. However, several studies refute this premise. Researchers find less worry among older adults than anticipated, little decrease in life satisfaction across the life span, and a remarkable ability of older adults to adapt to their changing life conditions.

For example, Shimshon M. Neikrug of the College of Judea and Samaria, in "Worrying about a Frightening Old Age" (Aging and Mental Health, September 2003), finds that of the 761 older adults that he surveyed, more than half reported feeling that their lives were better now than when they were forty-five to forty-nine years old. Nearly three-quarters of those aged eighty and older felt their lives were the same or better than their lives twenty years prior. Neikrug finds far more sources of pleasure for older adults than sources of worry and concern. Worries about becoming a burden to others and about declining health predominated, and few older adults expressed concern about their own mortality. Even though worries did increase among the oldest-old, overall, older adults appear to be more resilient than previously believed, even in the face of illness and loss.

Baby Boomers Challenge Stereotypes

Since their inception baby boomers have left their mark on every U.S. institution. As teenagers and young adults, they created and championed a unique blend of music, pop culture, and political activism. They have witnessed remarkable technological and medical advancements in their lifetime and have come to expect, and even loudly demand, solutions to health and social problems.

As the baby boomers begin to join the ranks of older Americans, they are fomenting a cultural revolution. The almost eighty million boomers approaching age sixty-five are not content to be regarded as "old." Accustomed to freedom and independence, they want to be recognized and treated as individuals rather than as stereotypes. The aging boomers are healthier, better educated, and wealthier than any other older adult cohort in history. They are redefining old agereinventing retirement, continuing to pursue health, and challenging the public's perception of what it is to be old.

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