Middle-aged Americans face significant health challenges, but on-the-ground programs offer key insights into how to curb the impact of chronic disease.
According to United Health Foundation’s America’s Health Rankings® Senior Report, obesity rates among today’s middle-aged population (50-64) are 25 percent higher when compared to the current senior population (65+) when they were that age. This increase is even more striking for diabetes, as rates for the current middle-aged population are 55 percent higher than rates for their senior counterparts 15 years ago.
This year’s report took an in-depth look at today’s 50-64 year old population and compared key health indicators to those of today’s seniors when they were this age in 1999. Along with higher rates of diabetes and obesity, the current middle-aged population also has lower rates of very good or excellent health status.
But the report did find a silver lining – the next wave of seniors smokes 50 percent less than today’s seniors did when they were middle-aged.
With baby boomers aging into their senior years, the 65+ population is projected to grow by almost 50 percent nationally by 2030. Geographically, states with the highest projected growth rates are generally clustered in the southwest, northwest, and southeast regions of the country. New York is projected to experience the lowest growth rate at 17 percent by 2030, while Alaska will likely see the greatest growth rate at 85 percent.
“The growth of the senior population, coupled with rising rates of preventable chronic conditions, is set to negatively impact the quality of life of seniors and place a tremendous strain on America’s health care system,” says Dr. Rhonda Randall, D.O., senior adviser to United Health Foundation, and Chief Medical Officer and Executive Vice President, UnitedHealthcare Retiree Solutions. “The United States already faces a shortage of primary care physicians and geriatricians, and we know that people with chronic conditions require more interactions with health care professionals.”
“Medicare spends over 30 percent of its annual budget on care associated with diabetes or obesity[i],[ii], and with these rates increasing among our senior population, spending will only rise over the next several years,” according to Ken Thorpe, Chairman of the Partnership to Fight Chronic Disease.
A recent MedPac analysis quantified the impact of today’s middle-aged population aging into Medicare, finding that spending is projected to grow at almost six percent per year on average from now through 2030.[iii]

Exploring Solutions to Managing Chronic Diseases

While chronic conditions can often lead to potentially serious complications, Dr. Randall notes that there are also several lessons to learn from programs that successfully manage these conditions for seniors.
Randall highlights recent success with the Diabetes Prevention Program, a joint pilot program with the Centers for Medicare & Medicaid Services and the Y-USA. The program aimed to prevent high-risk Medicare beneficiaries from fully developing type-2 diabetes and resulted in participants losing an average 5 percent of their body weight – significantly reducing their risk of future diabetes. Financially, the program saved Medicare $2,650 per enrollee.
“Understanding the public health programs that have the greatest impact on the health of people with chronic diseases can empower middle-aged Americans to prevent and take control of these conditions before they age into their senior years,” Dr. Randall adds.
UnitedHealth Group is taking steps to improve outcomes for seniors through HouseCalls, a program focused on delivering in-home clinical visits from health care practitioners to seniors. Practitioners provide medical examinations, medication reviews, lab tests, and screenings to seniors in their homes, and share the results with the senior’s primary care provider to promote coordinated care delivery. According to a 2015 Health Affairs study, Medicare Advantage beneficiaries enrolled in the program had up to 14 percent fewer hospital admissions compared to traditional fee-for-service beneficiaries over the same 12-month time period.[iv] The program also reduced the risk of nursing home admissions and increased the use of office-based physician care.
Thorpe notes that by improving care coordination and connecting patients with points of care through telemedicine and other technology regardless where they are, “the health care system can help people adopt healthy behaviors that dramatically reduce spending and improve productivity.”
By understanding the health challenges ahead and leveraging the insights offered by these innovative programs, America’s health care delivery system can be better prepared to care for the next generation of seniors.