Exploring the myths and realities of aging and health

Aging,  April-May, 1984  by C. Everett Koop

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At the turn on the century, the United States is slated to have some 50 million persons over the age of 65, or about 20 percent of the American population. That's twice the number of people over age 65 in the country right now. The impact upon all our services, but especially public health services, is going to be of considerable magnitude.

Today's "middle-aged" persons are already in a quandry over this dramatic shift of population toward the elderly. They know that decisions about the aged that are made and ratified today may determine how they themselves are cared for not too many years hence. Yet, they are not keen on putting forward positions, however reasonable, that might raise the hackles of their juniors or place an unfair burden on the young people of the nation. Therefore we need a good basis of common understanding between young people and middle-aged people if we are to avoid decades of deep division over the issue of aging and the position of the aged.

One of the most encouraging signs comes from a close look at the group over 65 that we consider the "aging" population. This group is more literate and better educated than any over-65 group in history. All signs indicate that by the year 2000, our population of persons over age 65 will be more self-sufficient and more reachable in terms of patient education than any previous group. On the Frontiers of Health

Today we are exhorting every American to take more personal responsibility for his or her health status. We're making some headway, but we'd like to be making more. And we will, as the years pass and the percentage grows of Americans who have the education and training to handle more personal health responsibility.

We are faced, however, with so many unknowns in the field of health for the aging that we must be careful not to generalize too quickly or too often. All our projections are based upon life as we've known it so far, not life as it will be in the future.

A quick look at the life expectancy statistics for this century gives us a good idea of the changing scene and the mushrooming problems. A baby born in 1900 could expect to live only a bit over 47 years, while a child born in 1982 could expect to almost reach 75. And those Americans who became 65 in 1982 could expect to live almost another 17 years on the average, with women living even longer.

There are many areas in which public health planners can proceed in an effort to protect and enhance the lives of older Americans. Over the past 15 years or so, for instance, there has been a virtual revolution in eye care and vision health among young adults and older working adults. As a result of this new concern with vision and the many effective ways to treat diseases of the eye today and the many ways we prevent eye disease and injury from occurring, it may be time to re-think many of our programs of vision health. We should soon be able to do much more with the same resources we now have.

Other areas of public health for the aging are just now capturing our attention. For example, one major problem among the elderly is uninary incontinence.