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Arizona Factbook on Aging, 2^nd Edition

Executive Summary 2002

This is an executive summary of the Arizona Factbook on Aging, 2^nd Edition, which reports on a variety of indicators that reflect the health and well being of people age 65 and older in the state.  

As the Baby Boom generation ages over the next 20 years the number of people age 65 and older will increase both in absolute terms and as a proportion of the population in general.  In 2025 the United States is projected to have approximately 80 percent more elderly than in 2000 but just 15 percent more working age adults and 15 percent more children.  One in five people in the United States will be 65 years old or older in 2025.  This group, while it is living longer and healthier lives, will require a disproportionate share of medical and social services.  On the other hand, they also command as many if not more financial resources than other age groups and will play a large role in shaping consumer products and services, such as recreation and travel.   

Demographics

According to the 2000 Census, Arizona is home to over five million people.  Of these, 667,839, or approximately 13 percent of the total state population, are 65 years of age or older.  This compares with 12.6 percent of the U.S. population.  Statistics for the 65 and older age group by race and ethnicity show that White, non-Hispanics make up 86.7 percent of the Arizona population. Approximately 20% of Arizona elderly live in rural settings. 

The most significant demographic trend in the aging of Arizona's population shows that since 1990, the number of people 65 years and older in Arizona has increased by almost 40 percent. 

Implications: The radical increase in the number of people 65 and over in Arizona presents unique challenges for planners and service providers. As the population ages and demand for services increases, access to resources will be more critical than ever to provide much needed services for this population. Community-based services will also be in great demand to prevent the elderly from becoming more isolated and more at-risk. 

Health

The social and behavioral aspects of an individual’s life can affect his or her health and well being. Findings from the 1999 Behavioral Risk Factor Survey report that persons over 65 years of age are less likely than other groups to report a high-risk behavior. 

Among people age 65 and older, heart disease and cancer are the leading causes of death.  Decreases in deaths attributable to heart disease, cancer, and stroke have been recorded in the period from 1989 to 1999.  However, deaths related to chronic obstructive pulmonary disease and pneumonia and influenza have increased in this time period. The Arizona Department of Health Services found that from 1989 to 1999, the mortality rate among elderly females increased by 5.5 percent compared with the elderly male morality rate, which decreased by 9.5 percent in this period. Data on limitations in physical activities showed that while 12.3 percent of men were unable to perform certain physical functions, more than 17 percent of women had the same physical limitations. Rural elderly showed a larger decrease in heart disease, cancer, chronic obstructive pulmonary disease, and stroke death rates than their urban counterparts. 

The most common causes of death are heart disease, cancer, stroke, chronic obstructive pulmonary disease, and pneumonia/influenza. These diseases are the dominant chronic issues with the major ethnic populations as well. While Arizona’s suicide rate is higher than the U.S. rate among all elderly age groups, suicide rates for Arizonans 65 years old and older have decreased in the 11 years between 1988 and 1998. Elderly white males were more likely to commit suicide than elderly white females. Among the four major ethnic groups in Arizona, suicide is highest among Hispanic elders followed by Black elders and American Indian elders. Suicide is practically non existent among Asian elderly. More suicides occur in urban than rural areas. 

Implications: Chronic health conditions can have a significant impact on physical and emotional well being. Long-term illness can also have high financial costs that make it more difficult for the elderly to access resources. The challenge for health care providers is to place more emphasis on the prevention of chronic illness and to create interventions that will maximize functioning for those who already experience chronic illness. With 20% of Arizona's elderly in rural settings and more than 13% from a variety of ethnic backgrounds, the challenge of service delivery to these populations will be extremely difficult. 

Health Care

The demands on the health care system in Arizona are greater than ever before and the growth in Medicare enrollment is a good indicator of the challenges to come. Medicare enrollment in Arizona has grown from 461,619 beneficiaries in 1988 to more than 650,000 in 1998. 

In 1999, people 65 years of age and older had four times the number of days of hospitalization (2 days) as did people under the age of 65 (0.4 days). The elderly also had more contact with doctors in 1999 than did younger people (7 contacts verses 4 contacts).   

According to AARP, Medicare spending per beneficiary is projected to increase, on average, by 5.3 percent per year between 2000 and 2010. In 2000 it is estimated that Medicare spent $5,490 per enrollee.  In Arizona, Medicare's expenditures were $4,464 per beneficiary.  While low-income families will spend less on health care costs than higher income families, they must spend a larger portion of their income on these expenses.  Families below the federal poverty level will spend approximately 33 percent of their income on health care compared to 8 percent for the wealthiest families. 

While Medicare beneficiaries age 65 and over spent about $2,430 (19 percent of their income) on out-of-pocket health care costs in 1999, when deductibles, coinsurance, and other fees for service are factored in, 54 percent of their income is used for health care costs. 

Many people require some assistance with daily activities as a result of physical or mental impairments. These long-term care services consist of personal care, nursing and home health care, adult day care, habilitation and rehabilitation, case management, social services, and assistive technology.  Approximately 7 million people age 65 and older required long-term care services in 1997.  This is expected to increase to 10.8 million in 2030.   

Implications: Given the current set of political and financial constraints, neither Medicare nor the health care industry in Arizona will be able to meet the increasing demands for health care from the older population. More emphasis will need to be placed on less expensive community-based options for care. Without additional support from federal and state sources, seniors will be forced to shoulder more responsibility for the cost of health care. Unfortunately, given the current economic status of the elderly many will likely have to go without health care services. While it is possible to consider the implementation of a two-tier system of health care services, the complex nature of such an undertaken would likely not be feasible for many communities in the state. 

Economic Status

The economic status of older people has improved over the past few decades.  Between 1989 and 1997, median real income for people 65 years old and older increased by about 4.4 percent, the largest increase for any age group.  The number of older Arizonans in poverty decreased from approximately 10.4 percent in 1989 to 9.1 percent in 1999.  

Income for the elderly in the U.S. comes from a variety of sources including Social Security (38 percent), earnings (21 percent), pensions (19 percent) and other (3 percent). In 2000, labor force participation for men 65 years of age and over was 17.5 percent compared to 9.4 percent for women.   

In 2000, 91 percent of Arizona residents 65 or over received Social Security benefits. This compares with 86.4 percent of the U.S. population in that same age group. In Arizona, Social Security beneficiaries were 44 percent female and 56 percent male. The critical nature of the Social Security benefits is illustrated by data that shows even with the Social Security, 8 percent of elderly beneficiaries are still below the poverty line, and 40 percent of the beneficiaries would be considered "poor" without it.  

Implications: Many of the elderly in Arizona are in financial jeopardy. Were it not for public income assistance programs, almost one-half would live in poverty. Policy- makers and service providers should consider creating a safety net that has the necessary financial resources to allow seniors to access much needed health and personal care services. Public/private partnerships should be explored to determine how to provide resources that will maintain quality of life and keep older individuals out of poverty. 

Crime and Victimization

The National Elder Abuse Incidence Study estimates that over 550,000 persons aged 60 and over experienced abuse, neglect, and/or self-neglect in 1996.  Persons 80 years and older were the victims of abuse and neglect two to three times their proportion of the older population.  It is also believed that four times as many new incidents of abuse, neglect, and self-neglect went unreported as those that were reported and substantiated by the adult protective service agencies.   

In fiscal year 2000, 21.3 percent of allegations were for abuse, 72.1 percent for neglect, and 22.7 percent were for exploitation. According to the Administration on Aging, elderly abusers were family members 90 percent of the time, and two-thirds of those perpetrators were adult children or spouses of the victims.  

In terms of crime other than abuse, neglect, and exploitation, people who are 65 years old and older generally experience fewer crimes than people in other age categories do.  The elderly are about five times less likely to be robbed, twelve times less likely to be the victims of aggravated or simple assault, and about three times less likely to have their car or other property stolen.  Older adults experience violent crime at about a tenth the rate for persons younger than 65.

Implications: Clearly, the most dominant concerns relating to the elderly and victimization are related to abuse. In a large majority of cases, abuse by a relative. More effort is needed to better understand the factors that contribute to abuse of the elderly. Community resources are critical to assist families with the stress of eldercaregiving. Equally as important, the elderly need outreach and support services to keep them from becoming isolated, which increases the risk of victimization and abuse. 

Recreation and Leisure

According to the Travel Industry Association of America, mature travelers defined as aged 55 and older, are just as financially sound as other age groups and have the highest net worth of all age groups.  Older individuals have more time available for leisure activities and have more discretionary income since they no longer have the expense of setting up a household or raising children.  The mature traveler already accounts for one-third of the domestic travel market.  This market will increase over the next two decades as the Baby Boomers age and begin to retire.  Given these factors, travel and leisure activities have a prominent role in the lives of the elderly.   

Mature travelers are more likely to travel for pleasure and visit friends or relatives. They are also more apt to visit historical places or museums, attend a cultural event or festival, and gamble. 

Implications: Since many seniors today are healthier and more affluent than their predecessors, there is a significant demand for meaningful recreation and leisure activities. Opportunities for education, exercise, and socialization will be needed to satisfy the active lifestyle preferred by this generation of older persons. 

Summary

This factbook presents a unique look at what is the dichotomy of the aging population in Arizona. While many of the state’s elders are better off financially, many continue to live within the shadow of poverty. While the health status of our older residents continues to improve, a significant number suffer with acute and chronic diseases. The data contained with in these pages presents a profile of an older cohort that is more heterogeneous than ever before and which contains a unique set of needs that present complex challenges in the area of policy and program delivery for the elderly in Arizona.

 * References contained in this summary can be found in the complete Factbook document.