1

1
Demographic Trends Making the Case for Health
System Reform in Pennsylvania
Secretary Nora Dowd Eisenhower Pennsylvania
Department of Aging
2
Global Demographic Trends

• By 2050, the global 65 age cohort will triple in
  size to 1.5 billion, or 16 of the total
• Simultaneous youth bulges in developing nations
  largest proportional youth populations in
  Pakistan, Afghanistan, Saudi Arabia, Yemen, and
  Iraq
• By 2015, a majority of the worlds population
  will live in cities

3
Implications of Global Demographics

• The industrialized world will face an
  unprecedented challenge related to the aging
  population

4
National Population Projections

• By 2030, the number of Americans aged 65 will
  more than double to 71 million, or 20 of the
  U.S. population
• In some states, 1/4 of the population will be
  aged 65

5

• Demographic Trends in Pennsylvania
• 2010 2020
• Significant increase in 60 80 year-old group
  (boomers)
• By 2020, the 60 population will be 1/3 larger
  than today 3.3 versus 2.5 million.
• Decrease in younger groups

6
Percent of Pennsylvania Population Under Age 18
Age 65 2000 - 2030
U.S. Census Bureau, Population Division, Interim
State Population Projections, 2005.
7
Percent of Older Population in Each Age Group in
PA
U.S. Census Bureau, Population Division, Interim
State Population Projections PA, 2005.
8
Projections of 60 age groups 2000-2030
9
Besides the Numbers Why the boomers are going
to change everything about aging as we know it
10

• Boomers Have Always Changed Everything
• Will continue to do so
• 60 aint what it used to be!
• A key theme
• Even more true over the next decade, as
  majority of boomers pass age 60
• Lifestage Matrix Marketing

11

• Boomer Values
• Boomers have a very different mindset value
  structure from seniors as we know them

12

• WWII/Post-War Values Mindset
• Dont make waves
• Fit in dont stand out
• No surprises!
• Follow the rules

13

• Boomer Values Mindset
• Do whats right (embrace causes)
• Do what feels good
• Challenge institutions authority
• Dont just follow the rules

14

• Why are they so different?
• Same country
• Same culture
• Not that far apart in time
• Because different cohorts have different defining
  moments

15
U.S. Cohorts 1930 - 2006
Birth Year
1920
1930
1940
1950
1960
1910
1970
1980
1990
Depression (1912 - 21)
Depression (1912 - 21)
13th Gen (1966 - 76
Gen X (1966 - 77)
WW II
(1922 - 27)
Post-War (1928 - 45)
Post-War (1928 - 45)
N-Gen (1978 - ?)
Boomer I (1946 - 54)
Boomer I (1946 - 54)
Boomer II (1955 - 65)
Boomer II (1955 - 65)
1930 1940 1950 1960
1970 1980 1990
Cohort Years (_at_ 18) Age in 2006
94- 85
84 - 79
78 - 61
60 - 51
50 - 40
39 29 19
28 - 18
US adult Pop.
4
6
21
14
14
22
16
Lifestage Analytic Matrix
N-Gen Gen-X Boomer II
Boomer I Post War W W
II Depression
Widowhood
LIFESTAGES
Retirement
Grandparent
Empty-Nesting
Divorce
Children
Marriage
College
Peak Disposable Income
Peak Income
Asset Depletion

Least Disposable Income
20 30 40 50 60 70 80
AGE
Source Defining Markets, Defining Moments,
Meredith Schewe
17
60 Age Cohorts 2006
Boomers
Post- War
WW II
Depression
AGE 60 65 70 75 80 85 90 95
18
60 Age Cohorts 2020
Leading-Edge Boomers
Trailing-Edge Boomers
Post- War

WW II
AGE 60 65 70 75 80 85 90 95
19
Conclusion You Cant Focus on an Age

• In constant flux
• Cohort Metabolism
• - New cohorts added at younger end of
  spectrum
• - Old cohorts depleted at older end

20
Making the Case for Health System Reform

• Demographic projections
• Lifestage Matrix Marketing concepts
• More informed health care planning

21
Large Increase in Frail Elderly

• 55 increase in 85 demographic happening NOW!
• Pressure on services
• Public Health
• Agriculture
• Parks Recreation Fish Game
• Housing
• Health Care
• Workforce
• Transportation
• Education

22
Short Term Good News

• Growth until 2010 (28 ) in the number of
  workers at maximum earnings ages (50 62)
• Implication strong income tax base until the
  boomers start to retire

23
Bad News Boomer Retirement

• Once boomers start to retire
• Income tax receipts down sharply
• Pressure on pension funds (public private)
• Fewer people in the workforce
• Smaller number of workers supporting much larger
  number of elders
• Major implications for health care housing
• Tax breaks for elderly will become very costly

24
Cost of Health Care for Older Adults

• The cost of health care for someone aged 65 is 3
  to 5 times greater than the cost for someone
  under age 65
• By 2030, the nations health care spending is
  projected to increase by 25

25
Shortage of Health Care Providers

• RN shortage to grow to 12 by 2010
• By 2020, a shortage of 1 million nurses,
  nationally
• Higher demand for doctors (per 1000 population)
• 2.8 in 2000 ? 3.1 in 2020
• Increased demand for pharmacists
• Expected shortfall of 157,000 by 2020

26
Health Care for Older Adults

• 80 of 65 have one chronic condition 50
  have two
• 32 of physician care hours on 65
• 39 by 2020
• 5 of seniors will experience macular
  degeneration
• 35 will fall break a bone
• Most likely to suffer from depression
• Rising incidence of HIV

27
Summary

• Information sounds challenging
• Huge Opportunity
• We know whats coming (not a surprise)
• Mandate to think ahead (for a change)
• Keep em healthy