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= Office of
: sé DEPARTMENT OF HEALTH & HUMAN SERVICES Human Development Services
“at Office of Assistant Secretary
Administration on Aging Washington DC 20201

 
   

  

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Joshua Lederberg, Ph.D. MAY - 8 1984
President

The Rockefeller University

1230 York Avenue

New York, New York 10021

Dear Dr. Lederberg:

Thank you for your letter and your enclosed remarks from the
convocation at Hahnemann University. I read both with much
appreciation for your knowledge and interest in aging.

Your request for information regarding the demographics of
aging, the health of older people and projections for the
future is most appropriate and relevant to your overall thesis
regarding the full impact of biotechnology on the human
condition. According to available data it is estimated that
the decade of the eighties will witness an increase in the
numbers of Americans 65 years and older from 25 million to 30
million people. This growth on the older population reflects a
trend occurring over the last 30 years and one that will
continue for the next 45 years. In absolute numbers there were
12 million Americans 65 and over in 1950, 25 million in 1980
and there will be 55 million in 2030. Even ‘nore startling are
the projections for the increase in the "old-old" population.
There are presently 8 million people over the age of 75 or
about 1/3 of the older population and 2 1/2 million people 85
years and older. By the year 2030 25% of all Americans will be
over 65.

Although the majority of people age 65 and over view their
health as good, compared to others of their own age, about
3.1/2 million older people living in the community need the
help of another person in carrying out everyday activities.
However, the rate of those needing help in at least one basic
physical activity is substantially higher among people in the
older age categories. For example about 20.6 per 1,000 people
45-64 years of age need help compared with the rate of 52.6 per
1,000 people 65-74 years, 114.0 per 1,000 people 75 to 84 years
and 348.4 per 1,000 people 85 years of age and over. These
data clearly indicate that the incidence of chronic or
disabling conditions rises sharply with age. Such conditions
include heart disease, cancer, stroke, diabetes, arthritis and
emphysema. These diseases account for 87% of all deaths for
those age 65 and over and for 81% of days of restricted
activity. Two chronic conditions cause almost half the
limitations: heart disease restricts about 25% of the elderly
and arthritis another 23%. Other limiting conditions include
orthopedic impairments (10%), visual impairments (10%) and
hypertension (98).

In 1980 at least 13 billion dollars was spent nationally by the
public sector on the provision of services related to long term
care through Medicaid, Medicare, social and nutrition service
programs authorized by the Older Americans Act, SSI, Title XX
and long term care programs operated by the Veterans
Administration. Nursing home care accounted for the largest
portion of Fiscal Year 1980 total expenditures (64%) and
Medicaid accounted for 92% of Fiscal Year 1980 total public
long term care related spending. Medicaid also accounted for
33% of the in-home services spending. Medicare was second in
terms of total spending with 7% of the total. Public
expenditures for long term care are only part of the total
costs. There are no exact data regarding private financing of
long term care but it is thought that perhaps as much as
another 30 to 40% of the personal health care expenditures for
older people are privately financed through insurance, out of
pocket and other resources.

There are currently no existing national data regarding the
costs of informal care of the elderly. However, through
information gathered from the 1979 Health Interview Survey and
other survey data it has been estimated that the value of
informal care currently being provided ranges from $7.2 billion
to $16 billion a year depending on the methodology used to
calculate the total costs of care.

I hope this information will be useful in your continuing
efforts to communicate to others the need for training and
research relevant to the problems of the aged population, and
indeed, the importance of such endeavors to all Americans.

Sincerely,

C. Y
fest: lilt j Aare y/
Lennie-Marie P. Tolliver, “PK-D.

Commissioner on Aging