One of the paradoxes of this presidential campaign is that while many of the candidates are in their eighth decade of life, fundamental issues associated with the aging of American society are still receiving relatively little attention from the public, the press and politicians themselves. In 2031, the oldest baby boomers will turn 85, entering the land of the “old old” and facing exponentially higher risk for dementia, serious physical disabilities and long-term dependency.
Like climate change, the aging of America demands serious reconsideration of the way we live. Confronting the issue and its many implications, from Medicare’s failure to cover long-term care to the ethics of physician-assisted dying, requires what seems to be the most difficult task for human beings — thinking about the future.
In November, the National Center for Health Statistics reported that the birthrate among women of childbearing age had dropped to a record low, continuing a sharp decline in births that began around the financial crisis of 2008. At the same time, The Journal of the American Medical Association reported an increased death rate in the 25- to 64-year-old age group, with the main causes thought to be opioid overdoses, alcoholism and suicide.
What these statistics mean is that if these trends continue (always an important caveat in demographic studies), there will be many fewer young and middle-aged people to care for the frailest of the old, whose death rate has not increased in recent years. The population of the prime caregiving age group, from 45 to 64, is expected to increase by only 1 percent before 2030, while the population over 80 will increase by 79 percent.
