Why has poor health become associated
with old age, and how are recent improvements
in health care changing that association?
Poor health has become associated with old age
because of the epidemiologic transition. The
epidemiologic transition is defined as a change
in the leading cause of death from infectious diseases
to chronic diseases. Recent improvements
in health care and prevention now mean that
most older people will remain in relatively good
health and that the years spent being disabled
are likely to be compressed into the final years
of life. This is termed the compression of morbidity
thesis.
How do people's lifestyles and social support
systems affect their health in old age?
Lifestyles have a large impact on health over the
life course. People who don't smoke and who
exercise, drink in moderation, and keep their
weight in the normal range are less likely to become
disabled than those who do not. The increasing
significance of healthy lifestyles means
that medicine is no longer the sole answer to
dealing with threats to health. Social support
systems also play a role in health outcomes.
Having a strong social support system improves
morale, reduces the risk of depression, and even
enhances recovery from surgery.
What is the best measure of an elderly person's
socioeconomic status, and how is
SES connected to a person's health? The
best measure of an elderly person's socioeconomic
status is education. People of higher SES
have better health in old age than people of lower
SES. One reason is that they have better access
to health care. People of lower SES are more
likely to have worked in stressful jobs where they
could be injured. People of higher SES also have
more resources that give them the opportunity to
engage in positive health practices.
How do gender, race, and ethnicity affect
an older person's health? Women have poorer
health and higher levels of disability than do men.
This is true not only for the United States but for
other countries as well. Both biological and behavioral
factors appear to account for the differences.
Older minorities have poorer health than
whites on several measures. As they age, they
are more likely to develop a serious illness and
more likely to rate their health as "poor."
How have changes in Medicare and
the health care industry affected older
Americans? Medicare is one of the fastest
growing federal programs. Costs will rise sixfold
as the baby boom generation approaches retirement
age. As political pressures increase to cut
Medicare expenditures, more elderly are likely
to be treated by physicians affiliated with health
maintenance organizations. The danger is that
efforts to save costs may reduce the quality of
care. And recently many HMOs have pulled
out of the Medicare program. One of the main
political issues for the future will be determining
how best to control the costs of Medicare while
maintaining quality health care for the aged.
