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Summary:
Individuals age 65 and older have experienced remarkable declines in mortality during the past 20 years. In 1980, 14.2% of newborns could expect to live to age 90; by 2003, this percentage increased nearly 50% to 20.9%. Average life expectancy went from 73.7 years in 1980 to 77.8 years in 2004 � about 30.5 years longer than the anticipated life expectancy for a baby born at the beginning of the 20th century. Between 1930 and 2003, the proportion of older Americans who lived to age 65 increased by more than 50%, the percentage to reach age 75 nearly tripled, and the fraction to reach age 85 increased nearly sixfold. Greater longevity is one factor contributing to the quickly growing share of elderly Americans. In 1950, persons age 65 and older made up 8.1% of the population. In 2000, they accounted for 12.4% of the population; by 2030, one in five Americans is projected to be a senior citizen. In 2004, a total of 1.8 million deaths of people age 65 and older was reported in the United States; one-third lost their life to a heart condition, one-fifth to cancer. Nevertheless, the number of deaths attributable to cardiovascular disease has fallen by nearly one-third since 1980. Moreover, the death rate for heart disease in 2004 was 41.6% lower than in 1980. Similarly, the death rate for stroke declined by 48.2% during the last quarter century. These declines are attributable to a number of factors, including medical advances that facilitate the diagnosis and treatment of these conditions, the introduction of new pharmaceuticals, and important changes in lifestyle behaviors, including less cigarette smoking and changes in diet. This significant decrease, however, has been partially offset by an increase in cases of some chronic conditions among older Americans. In particular, since 1980, the share of elderly deaths resulting from kidney disease, diabetes, Alzheimer's disease, atherosclerosis, and chronic liver disease more than quadrupled (from 5.0% to 20.1%), and death rates for chronic lower respiratory diseases increased by 120%. Increases in mortality attributable to chronic illness have not been evenly distributed. Even among the elderly, death rates vary by age. Moreover, significant racial and ethnic disparities are evident, reflecting different disease profiles for underlying populations, unequal access to health care, and other sociodemographic factors, such as income and education. Diabetes has been particularly deadly among blacks and Native Americans, heart disease has disproportionately affected white men, and Alzheimer's has been especially detrimental to white women. As the population of older Americans grows and the cost of medical care increases, the public policy interest in identifying the predominant causes of death among the elderly becomes more acute. Given the concentration of medical expenditures at the end of life, and the fact that Medicare covers more than 95% of all Americans age 65 and older, understanding trends in mortality may inform policy makers as they tackle the many challenges associated with financing and delivering care to the nation's rapidly growing cohort of older Americans.
