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Then and Now: Changes in the Health of Young Seniors

Introduction

Seniors comprise a significant portion of the U.S. population, and the size of this group will only increase as baby boomers age. Analyzing the health of young seniors (aged 65 to 74) can yield important insights that policymakers, advocates, individuals and community members can use to set priorities and anticipate the needs of this growing population.
This analysis examines population demographics, behaviors and health outcomes as well as differences by gender to explore how the health of young seniors has changed between 2002 and 2017, the most recent year of data available. Data are for adults aged 65 to 74 and are from the Behavioral Risk Factor Surveillance System and the National Vital Statistics System. Population estimates are from the American Community Survey.

The young senior population is growing and becoming more racially and ethnically diverse

Since 2002, the young senior population has grown by more than 11 million individuals to nearly 30 million adults aged 65 to 74 in 2017. Seniors aged 65 to 74 account for 9.1 percent of the U.S. population, compared with 6.4 percent in 2002. This age group had a greater increase in size than seniors aged 75 and older, which grew by approximately 4 million individuals between 2002 and 2017.
The population of males aged 65 to 74 increased 66 percent, while the population of females aged 65 to 74 rose 58 percent. The population of young seniors now includes an estimated 13.9 million males and 15.8 million females.
The young senior population is more racially and ethnically diverse than in 2002, following a similar trend as the total U.S. population. Figure 2 displays the 15-year change in the proportion of seniors aged 65 to 74 by race. Between 2002 and 2017 the percentage of young seniors who are:
  • Asian or Pacific Islander (Asian/PI) increased 53 percent from 3.2 percent to 4.9 percent.
  • Hispanic increased 34 percent from 6.4 percent to 8.6 percent.
  • American Indian/Alaskan Native (AIAN) increased 40 percent from 0.5 percent to 0.7 percent.
  • Black increased 7 percent from 9.1 percent to 9.7 percent.
  • White decreased 6 percent from 80.8 percent to 76.2 percent.

Smoking has decreased, but excessive drinking and obesity have increased

Behaviors affect health and several leading causes of premature death are influenced by modifiable risk factors such as smoking, excessive alcohol use and obesity.

Smoking

Smoking damages nearly every organ in the body and is the leading cause of preventable death in the U.S. Community support, clinical intervention, clean air laws and cigarette taxes can help reduce smoking. The percentage of seniors aged 65 to 74 who report smoking at least 100 cigarettes in their lifetime and currently smoke every day or some days is 16 percent lower than it was in 2002, declining from 13.6 percent to 11.4 percent of young seniors (Figure 3). While the percentage has decreased, the estimated number of young seniors who smoke has increased from approximately 2.8 million to 3.3 million due to population growth.
Among females aged 65 to 74, smoking is significantly lower than in 2002, decreasing 22 percent from 13.4 percent to 10.4 percent in 2017. The change among males, however, is not significant.

Excessive Drinking

Excessive drinking is the percentage of adults aged 65 to 74 who report either binge drinking or chronic drinking. Seniors experience the highest alcohol-attributable death rate, and excessive alcohol use contributes to injuries, chronic diseases, dementia and mood disorders. Excessive drinking is 42 percent higher in 2017 than in 2002, increasing from 6.5 percent to 9.2 percent of seniors aged 65 to 74 (Figure 3). This represents an increase of more than 1.2 million young seniors reporting either binge or chronic drinking.
The prevalence of excessive drinking is higher among male and female seniors aged 65 to 74 than in 2002, increasing 29 percent among males and 53 percent among females. An estimated additional 776,700 male and 506,900 female seniors aged 65 to 74 reported excessive drinking in 2017.

Obesity

Obesity is the percentage of adults aged 65 to 74 with a body mass index of 30.0 or higher based on reported height and weight. Obesity contributes significantly to early death, diabetes, cognitive decline and certain cancers. Research suggests the relationship between obesity and mortality risk strengthens with age. Obesity among young seniors is 36 percent higher, increasing from 24.1 percent in 2002 to 32.7 percent in 2017(Figure 3). This represents an increase of more than 4.3 million seniors aged 65 to 74 who have obesity.
The prevalence of obesity is higher in males and females aged 65 to 74 in 2017, increasing 36 percent among males and 35 percent among females since 2002. This is an additional 2.3 million male and 2.0 million female seniors aged 65 to 74 that have obesity.

The prevalence of high health status has increased, but diabetes has also increased

Progress has been made in preventing early death among young seniors, and yet, concerning trends in suicide persists.

Early Death

Early death represents mortality from all causes in seniors aged 65 to 74. Fewer seniors are dying early than in 2002. The rate of early death is 22 percent lower, decreasing from 2,300 to 1,791 deaths per 100,000 seniors aged 65 to 74 years (Figure 4).
Early death occurs at a higher rate in males than females, though early death has decreased for males and females since 2002.

Suicide

Suicide is one indication of the burden of poor mental health among seniors. Despite a decrease over time in the overall death rate among seniors aged 65 to 74, death due to intentional self-harm per 100,000 adults aged 65 to 74 is 16 percent higher than it was in 2002 (Figure 4). The suicide rate among young seniors is 15.5 deaths per 100,000 adults aged 65 to 74,, compared with 13.4 deaths per 100,000 in 2002. The number of suicides increased from 2,460 to 4,614 over this time.
The suicide rate among females aged 65 to 74 is significantly higher than in 2002, increasing 51 percent from 4.1 to 6.2 deaths per 100,000. The increase among males, however, was not significant between these two periods.

The prevalence of high health status has also increased, but diabetes has increased

Despite a higher percentage of young seniors reporting their health is excellent or very good, the prevalence of diabetes has increased sharply since 2002.

High health status

Self-reported health status is an important indicator of overall health and a significant predictor of mortality. Health status is associated with mortality rates, making it a good predictor of future mortality rates and future use of health care. The percentage of seniors aged 65 to 74 who report their health is very good or excellent is 11 percent higher than in 2002, increasing from 39.1 percent to 43.4 percent (Figure 5). This equates to an estimated 5.0 million more young seniors reporting very good or excellent health.
Both males and females aged 65 to 74 report higher prevalences of high health status than in 2002, increasing 9 percent among males and 13 percent among females. An additional 2.5 million male and 2.4 million female seniors aged 65 to 74 reported having high health status in 2017.

Diabetes

Diabetes is the percentage of seniors aged 65 to 74 who report being told by a health professional that they have diabetes (excluding prediabetes and gestational diabetes). According to the National Center for Health Statistics, diabetes was the seventh leading cause of death among seniors in 2017, contributing significantly to deaths from heart disease and stroke. Diabetes can be managed through lifestyle modifications and clinical intervention. The prevalence of diabetes is 36 percent higher in young seniors than it was in 2002, increasing from 16.9 percent to 22.9 percent of young seniors (Figure 5). More than 6.8 million young seniors report having diabetes, an increase of over 3.3 million individuals since 2002.
Males and females report higher prevalence of diabetes than in 2002, increasing 33 percent among males and 30 percent among females. It is estimated that nearly 1.9 million more males and 1.5 million more females aged 65 to 74 reported having diabetes in 2017.

Conclusions

This analysis reveals how young seniors face different challenges than they did in 2002. There is progress in the prevalence of smoking and high health status and in the rates of early death among young seniors, and yet more work is needed to combat rising suicide rates and the increasing prevalences of excessive drinking, obesity and diabetes. Data in this analysis allow policymakers and health advocates to better understand the health of young seniors and to prioritize and anticipate the needs of this population.

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