It’s no best-kept secret that the United States is a growing-older population, matching its compatriots among the established industrialized nations. But it was surprising to me that California, the Golden State of youth, energy and beauty, is on the same path. In fact, according to a Stanford researcher, in three decades the state’s population will be older than the country’s as a whole.
But it’s the projected age change in California’s residents over the next two decades that is so stunning. And, as the Center has reported, the consequences are huge – with potentially more economic and social impact than the recent financial crisis.
According to a new study by two USC demographers, the number of seniors in the state is projected to grow over the next 20 years at four times the pace of the past two decades.
By 2030, California will be home to 4 million more residents over 65, pushing the number of seniors to 18.5 percent of the state’s total population.
Think about it -- almost one of every five Californians will be a senior citizen. Right now, it’s closer to one of ten, with 11.4 percent of Californians in that age group.
So the boomers are finally coming of old age. This generation, who rebelled in the Sixties and Seventies, dropped back in for the Eighties, and have basically run the state and the country the past two decades, is about to matriculate into retirement. They’re almost certainly headed toward a life of higher health needs and costs.
This is trouble. Someone, after all, has to pay for the impacts that older boomer explosion will have on already expensive medical services.
Is that “someone” the young people in the workforce, who traditionally have provided the tax support for such programs as Medicare and Social Security? Well, the segment of the population under age 25, which grew more than 2 million in California from 1990-2010 – a relatively healthy pace -- will grow hardly at all in the next 20 years. And the next age cohort, 25-34, is expected to gain about 900,000 members over the next two decades – less than a quarter of the seniors’ growth.
It gets worse. Arguably the most important age category for California’s economic well-being is the 45-64 group that just follows the boomer generation. As the study’s authors point out, “This is the age range of maximum earnings and largest house purchases…” They make the money and pay the taxes. They’re the engines of the economy.
But over the next 20 years, the study projects, the growth rate of this group will dwindle precipitously, producing only one-fourth the population increase as the same age group did the previous two decades.
What the two researchers – John Pitkin and Dowell Myers, both of USC’S Population Dynamics Research Group -- have uncovered appears to be an almost perfect demographic storm – this huge cohort of elderly likely to consume enormous amounts of medical services; and a much-reduced-in-size cohort of working-age residents who will be hard-pressed to support them and their medical needs.
As if to emphasize this, the researchers calculated this set of alarming figures. In 1990, the ratio of seniors to the working age population was 21.6 to 100. In 2030, they project, that ratio will rise to 36. Where there were nearly five workers for every senior in the previous two decades, there will be fewer than three come 2030.
So who will pay for senior care? And will there be sufficient numbers of health professionals to treat the enormous wave of seniors?
No one has sure answers to these questions. But Julie Zissimopoulos, associate director for USC’S Schaeffer Center for Health Policy and Economics and a professor at its school of pharmacy, is convinced there exist in the current professional landscape ways to improve tomorrow’s health system for the expected senior deluge. “Pharmacists, nurse practitioners, physician assistants – they are all underutilized in our health system,” she said.
Pharmacists, for example, could be much more involved in an older patient’s experience, she said, since they dispense the hundreds of millions of dollars of medications seniors use.
“Typically, people 65 and older deal with two or more chronic conditions,” said Zissimopoulos. “Pharmacists can monitor drug use and adjust drug levels. They can lower costs and produce better outcomes.”
So there is hope that re-engineering health professionals’ scope of practice can alleviate some of the pressure boomer seniors will place on the system.
But for a state that has long and successfully branded itself as the land of youth and vigor, California is rapidly turning gray, and surprisingly – to me, at least -- is about to be confronted by the same aging issues as the rest of the country.