Public Health Population Aging
by
Lynda Anderson
  • LAST REVIEWED: 05 May 2017
  • LAST MODIFIED: 29 September 2015
  • DOI: 10.1093/obo/9780199756797-0094

Introduction

The age of a population, or group of people, can change over time and become younger or older. “Population aging” refers to the process whereby older people account for a proportionally larger share of the total population. It is sometimes referred to as “demographic aging” or “global aging.” Increases in life expectancy are clearly a successful result of improvements in public health and medicine. This resultant aging of the population has profound effects on social, economic, health, and political systems that must adapt to the changing age structure. The increase in the numbers of older adults, often accompanied by a slowed growth in the number of children, will have dramatic consequences for public health, economic growth, housing, workforce, and social and health-care services. At the same time, it may inspire new policies and programs designed to promote health, independence, and well-being across the life cycle and to seize on other positive aspects of aging. Population aging is a global phenomenon. Analysis of the aging trends in the United States, for example, reveals changes in the proportion of the population over the age of sixty-five and the important growth within the older population. The proportion of adults aged sixty-five years or older stood at 4.1 percent in 1900, rose to 13.7 percent in 2012, and is projected to increase to 21 percent by the year 2040. The fastest-growing segment of the total population is people aged eighty years and over, with a growth rate twice that for those sixty-five years and older, and almost four times that for the total population. As of 2010, this group represents 10 percent of the older population and will more than triple by 2050.

General Overviews

It is critical to understand the attitudes toward an aging population. Attitudes about Aging: A Global Perspective (Pew Research Center 2014) highlights public perceptions about potential challenges posed by aging for the country and for the respondents personally. Several reports provide analysis of data trends and projections on demographics and other characteristics. World Population Ageing 2013 (UN Department of Economic and Social Affairs, Population Division 2013) includes information about demographic determinants, demographic profiles and characteristics of older populations, and intergenerational transfers and well-being in old age. Global Health and Aging (National Institute on Aging and World Health Organization 2011) provides a comprehensive examination of numerous population aging issues. Shades of Gray: A Cross-Country Study of Health and Well-Being of the Older Populations in SAGE Countries, 2007–2010 (He, et al. 2012) is a report that gives comparisons across six countries by using data from the World Health Organization’s (WHO) Study on global AGEing and adult health (SAGE). An Aging Nation: The Older Population in the United States; Current Population Reports (Ortman, et al. 2014) presents projections on how the age structure of the US population is expected to change over the coming decades. Finally, The Changing Demographic Profile of the United States (Shrestha and Heisler 2011) highlights the changing demographics in the United States and provides examples of how changes will affect the nation over time.

  • He, Wan, Mark N. Muenchrath, and Paul Kowal. 2012. Shades of gray: A cross-country study of health and well-being of the older populations in SAGE countries, 2007–2010. Washington, DC: US Census Bureau.

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    This report provides comparisons across six countries by using data from WHO’s SAGE. These overviews highlight characteristics of the “graying” populations in the six middle- and low-income SAGE participant countries.

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    • National Institute on Aging and World Health Organization. 2011. Global health and aging Publication 11-7737. Bethesda, MD: National Institute on Aging.

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      Examines, from a global perspective, a number of issues related to health and population aging, including aging demographics, trends, and projections; life expectancy and longevity; disability and dementia; data on aging and health; costs of aging and disability; health and work; the changing roles of the family; and long-term care.

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      • Ortman, Jennifer M., Victoria A. Velkoff, and Howard Hogan. 2014. An aging nation: The older population in the United States; Current population reports. Current Population Reports P25-1140. Washington, DC: US Census Bureau, Population Projections Branch.

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        The size and characteristics of the US older population is important for social and economic reasons both to the public and private sectors. This report presents projections on how the age structure of the US population is expected to change over the coming decades, focusing on the older population in terms of age, sex, race, and Hispanic origin.

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        • Pew Research Center. 2014. Attitudes about aging: A global perspective. Washington, DC: Pew Research Center.

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          This report highlights the findings from a Pew Research Center survey of twenty-one countries, conducted with 22,425 respondents, to assess public opinion on the challenges posed by aging for each country and for the respondents personally. Trends in the aging of the global population, the US population, and the populations in twenty-two other selected countries are also examined.

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          • Shrestha, Laura B., and Elayne J. Heisler. 2011. The changing demographic profile of the United States. Washington, DC: Congressional Research Service.

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            This report highlights changing US demographics and provides examples of how changes will affect the nation over time. Issues of work, retirement, and pensions; private wealth and income security; the federal budget and intergenerational equity; health, health care, and health spending; and the well-being of the aging population are examined.

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            • UN Department of Economic and Social Affairs, Population Division 2013. World population ageing 2013. New York; United Nations.

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              This comprehensive report, fourth in a series, provides descriptions of global trends in population aging. The report is organized into five major chapters, focusing on demographic determinants and speed of population aging, changing balance among aging groups, demographic profile of older populations, characteristics of older populations, and intergenerational transfers and well-being in old age.

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              Journals

              In order to stay current on aging and health, as well as on issues specific to population aging, articles from scientific journals are a critical resource. This section identifies select journals related to Gerontology, Population Aging, and Special Issues and Journal Supplements devoted to aging issues.

              Gerontology

              There are numerous journals focusing on gerontology or aging studies. Given the number of journals on aging, only select examples are included here. The Gerontologist and the Journal of Applied Gerontology provide articles on a wide range of studies on applied gerontology. The Journals of Gerontology offer articles on a wide range of topics of interest to researchers. The Journal of Aging & Social Policy examines policymaking and political processes. The Journal of Aging and Health examines the relationship between health and gerontology. Finally, the Journal of Aging Research publishes studies and reviews on a various aging-related issues, including many special issues.

              Population Aging

              There are also a number of journals that provide articles on and critiques of methods related to population aging and demography. Journals focused on demographic topics include Demographic Research, Demography, Journal of Population Research, Population and Development Review, Population Studies: A Journal of Demography, and the Open Demography Journal. The Journal of Population Ageing contains articles on topics dealing specifically with population aging and economic and demographic problems.

              Special Issues and Journal Supplements

              Special issues, supplemental issues, or special series of journals allow guest editors to provide focused, in-depth exploration of topics or research areas of particular relevance or expanding evidence base within the scope of the journal in which they are published. They are organized by recognized experts in the topic area and include articles to provide important perspective to the readership. The following journals have included issues or series with a focus on aging issues. The American Journal of Public Health series on healthy aging (Northridge 2012) includes a set of articles on aging and the role of public health and health-care issues. A special issue of The Gerontologist (Pruchno 2012) focuses on articles characterizing the US baby boomer generation. A supplemental issue of Health Education & Behavior (Anderson and Prohaska 2014) includes articles that highlight key issues around the opportunities and challenges of fostering engagement and independence of an aging population. An ongoing series of special issues in Journal of Aging Research focuses on a diverse set of topics important to practitioners and researchers. A supplemental issue of Journal of Aging and Health (Tennstedt and Gee 2013) highlights findings from the Advanced Cognitive Training for Independent and Vital Elderly Study (ACTIVE). An interdisciplinary research forum in a supplemental issue of the Journals of Gerontology, Series B: Psychological Sciences and Social Sciences (Kasper and Freedman 2014) features studies drawing on round 1 data from the National Health and Aging Trends Study.

              • Anderson, Lynda A., Richard A. Goodman, Deborah Holtzman, Samuel F. Posner, and Mary E. Northridge. 2012. Aging in the United States: Opportunities and challenges for public health. American Journal of Public Health 102.3: 393–395.

                DOI: 10.2105/AJPH.2011.300617Save Citation »Export Citation »E-mail Citation »

                This editorial lays the foundation for the American Journal of Public Health series on healthy aging, designed to examine the roles of public health and the health-care system in supporting the growing demographic of the aging US population. The series of articles are published in subsequent journal issues.

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                • Anderson, Lynda A., and Thomas R. Prohaska, eds. 2014. Supplement issue: Fostering engagement and independence: Opportunities and challenges for an aging society. Health Education & Behavior 41.S1.

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                  This supplement issue includes twelve articles. The issue highlights the scope and potential of behavioral research and health education in contributing to the optimal health of older adults in the US.

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                  • Journal of Aging Research. 2011–2013.

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                    A series of seventeen special issues that cover a broad range of relevant aging issues such as mobility, behavioral factors of longevity, and successful aging. Several guest editors.

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                    • Kasper, Judith D., and Vicki A. Freedman, eds. 2014. Supplement: Findings from the 1st round of the National Health and Aging Trends Study (NHATS). Journals of Gerontology, Series B: Psychological Sciences and Social Sciences 69.S1.

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                      This supplement features studies that draw on round 1 data from the National Health and Aging Trends Study (NHATS), collectively addressing components and consequences of disability among older adults. Articles explore the role of the environment in daily functioning, care and unmet needs, adverse consequences, and caregiving by family members.

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                      • Northridge, Mary E., ed. 2012. Healthy aging series. American Journal of Public Health 102.3

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                        This series of articles on aging and the roles of public health and health care, continued in American Journal of Public Health 102.8, presents a lens for sharpening a collaborative focus on the aging population. Articles can be found by searching the journal for “CDC series on aging and the roles of public health.”

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                        • Pruchno, Rachel, ed. 2012. Special issue: Baby boomers. The Gerontologist 52.2.

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                          Includes twelve articles that provide a unique view of aging as it is being experienced by members of the baby boomer generation. The articles are peer reviewed and show the heterogeneity characterizing the US baby boomers, emphasizing the value of a life course perspective, with its focus on timing, agency, and interdependence for understanding baby boomer experiences.

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                          • Tennstedt, Sharon L., and Nancy S. Gee, eds. 2013. Supplement title: The ACTIVE study. Journal of Aging and Health 25.S8.

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                            This supplement includes a series of articles on the ACTIVE study, designed to compare three different types of cognitive training: one that focused on memory, one that targeted reasoning, and another that included training that exercised speed of processing. The study was conducted at six sites across the United States, and all the participants were healthy adults aged sixty-five or older. Researchers followed participants for ten years to evaluate the long-term effects of training.

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                            Textbooks

                            Albert and Freedman 2009 is an excellent textbook for undergraduate or graduate introductory courses in public health and aging. More recently, Prohaska, et al. 2012 is a comprehensive book that is highly readable and focuses on critical aspects of public health, introduces the reader to current aging-related challenges, provides direction for addressing those challenges, and offers a glimpse of things to come. Binstock and George 2011 is a major reference book that provides extensive reviews and critical evaluations of research on the social aspects of aging. Satariano 2006, titled Epidemiology of Aging, remains an outstanding volume providing an ecological perspective that is relevant and timely for public health audiences. Uhlenberg 2009 is the first book to provide a major compilation of relevant international perspectives on key topics relevant to population aging.

                            • Albert, Steven M., and Vicki A. Freedman. 2009. Public health and aging: Maximizing function and well-being. 2d ed. New York: Springer.

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                              The book provides an understanding of the physical-, mental-, and social-functioning domains that affect older persons and how these affect quality of life.

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                              • Binstock, Robert H., and Linda K. George, eds. 2011. Handbook of aging and the social sciences. 7th ed. Burlington, MA: Elsevier.

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                                This is a major reference book that includes extensive reviews and critical evaluations of research on the social aspects of aging and critical areas for future investigation.

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                                • Prohaska, Thomas R., Lynda A. Anderson, and Robert H. Binstock, eds. 2012. Public health for an aging society. Baltimore: Johns Hopkins University Press.

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                                  This important volume expands beyond the traditional scope and treatments of public health and aging by adopting a social-ecological perspective that incorporates individual, family, community, societal, and environmental concerns. Students and practitioners will find this to be an invaluable resource both in the workplace and classroom.

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                                  • Satariano, William. 2006. Epidemiology of aging: An ecological approach. Sudbury, MA: Jones & Bartlett.

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                                    This book covers the major topics in the epidemiology of aging. Applying an ecological model, the author highlights the determinants and consequences of the aging population and illustrates that all the topics are interrelated. The ecological model is quite relevant to public health research and practice.

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                                    • Uhlenberg, Peter, ed. 2009. International handbook of population aging. New York: Springer.

                                      DOI: 10.1007/978-1-4020-8356-3Save Citation »Export Citation »E-mail Citation »

                                      This volume is a major compilation devoted to population aging and is the first of its kind. It includes thirty-seven chapters that are devoted to topics ranging from questions about why populations age to thoughtful critiques of social implications. It offers multidisciplinary perspectives and is international in scope.

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                                      Health Demographics

                                      Seeman, et al. 2010, aimed at a public health audience, provides disability trends among older adults in the United States. Xu, et al. 2014 offers data on deaths and death rates as well as life expectancy estimates. Ward, et al. 2014 provides prevalence rates for single chronic conditions and multiple chronic conditions among the US adult population.

                                      • Seeman, Teresa E., Sharon S. Merkin, Eileen M. Crimmins, and Arun S. Karlamangla. 2010. Disability trends among older Americans: National Health and Nutrition Examination Surveys, 1988–1994 and 1999–2004. American Journal of Public Health 100.1: 100–107.

                                        DOI: 10.2105/AJPH.2008.157388Save Citation »Export Citation »E-mail Citation »

                                        Reports on trends in disability among older Americans by using data from the National Health and Nutrition Examination Surveys (1988–1994 and 1999–2004), examining time trends in basic activities of daily living, instrumental activities, mobility, and functional limitations for adults aged sixty years and older.

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                                        • Ward, Brian W., Jeannine S. Schiller, and Richard A. Goodman. 2014. Multiple chronic conditions among US adults: A 2012 update. Preventing Chronic Disease 11:130389.

                                          DOI: 10.5888/pcd11.130389Save Citation »Export Citation »E-mail Citation »

                                          Provides estimates of prevalence rates of single chronic conditions and multiple (more than two) chronic conditions (MCC) among the noninstitutionalized, civilian US adult population, by using data from the 2012 National Health Interview Survey (NHIS).

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                                          • Xu, Jiaquan Q., Kenneth D. Kochanek, Sherry L. Murphy, and Elizabeth Arias. 2014. Mortality in the United States, 2012. NCHS Data Brief 168. Hyattsville, MD: National Center for Health Statistics.

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                                            Presents 2012 US data on deaths and death rates among residents of the United States by such variables as sex, race and ethnicity, and cause of death. This report also includes life expectancy estimates.

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                                            Disability Demographics

                                            Freedman 2015 summarizes key research gaps in seven major areas for persons with disability. Freedman, et al. 2013 updates trends in activity limitations in the US population by using data from five US national surveys. Manton 2008 outlines numerous methodological approaches to describe the burden of disability. Trends in disability are not without controversy. Harwood, et al. 2004 provides information on the prevalence of disability, in order to estimate dependency in old age, and discusses the implications for family caregivers. Field and Jette 2007 provides recommendations by the Institute of Medicine to help persons living with disabilities lead independent and productive lives. Jacobzone, et al. 2000 demonstrates how different disability projections can affect the public costs associated with formal home and institutional care across countries.

                                            • Field, Marilyn J., and Alan Jette, eds. 2007. The future of disability in America. Washington, DC: National Academies Press.

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                                              This report examines the developments since two previous Institute of Medicine reports on disability. Specifically, the authors examine disability policies and programs in the United States, raise questions about how individuals and society will cope with the challenges of disability, and make recommendations regarding actions essential to help people with disabilities lead independent and productive lives.

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                                              • Freedman, Vicki A. 2015. Research gaps in the demography of aging with disability. Disability and Health Journal 7.S1: S60–S63.

                                                DOI: 10.1016/j.dhjo.2013.04.009Save Citation »Export Citation »E-mail Citation »

                                                Provides a summary of research gaps, identified during a May 2012 conference, in seven major areas for persons with disabilities, ranging from the prevalence of adults aging with disabilities to the long-term consequences of developing disability before late life for subsequent health, functioning, and socioeconomic outcomes.

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                                                • Freedman, Vicki A., Brenda C. Spillman, Patti M. Andreski, et al. 2013. Trends in late-life activity limitations in the United States: An update from five national surveys. Demography 50.2: 661–671.

                                                  DOI: 10.1007/s13524-012-0167-zSave Citation »Export Citation »E-mail Citation »

                                                  Updated trends in activity limitations among the older US population by using data from five US national surveys, which are reported for three age groups: fifty to sixty-four, sixty-five to eighty-five, and eighty-five and older.

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                                                  • Harwood, Rowan H., Avan Aihie Sayer, and Miriam Hirschfeld. 2004. Current and future worldwide prevalence of dependency, its relationship to total population, and dependency ratios. Bulletin of the World Health Organization 82.4: 251–258.

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                                                    To estimate dependency, the authors examine the prevalence of levels of disability. They conclude that many countries will be affected by the increasing number of people who are dependent, and they examine the need to improve data on disability and the importance of caregivers.

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                                                    • Jacobzone, Stéphane, Emmanuelle Cambois, and Jean-Marie Robine. 2000. Is the health of older persons in OECD countries improving fast enough to compensate for population ageing? OECD Journal: Economic Studies 30:149–190.

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                                                      This paper compares two projections for the number of disabled older persons on the basis of disability rates, and the economic and social policy consequences for Organisation for Economic Co-operation and Development (OECD) countries. The projections demonstrate how they can have differing effects in terms of the public costs of formal home care and institutional care across countries.

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                                                      • Manton, Kenneth G. 2008. Recent declines in disability in the elderly U.S. population: Risk factors and future dynamics. Annual Review of Public Health 29:91–113.

                                                        DOI: 10.1146/annurev.publhealth.29.020907.090812Save Citation »Export Citation »E-mail Citation »

                                                        Provides an overview of chronic disability and changes in disability prevalence and also outlines numerous methodological approaches to describe the burden of disability. In addition, this article explores the risk factors, such as obesity trends and projected disability trends.

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                                                        Forecasts

                                                        Bongaarts 2006 reviews past population projections and compares different methodologies. Olshansky, et al. 2009 examines two sets of forecasts and demonstrates how slowing the aging process can influence future life expectancy and mortality. UN Department of Economic and Social Affairs 2012 provides global demographic estimates and projections for use by multiple groups.

                                                        • Bongaarts, John. 2006. How long will we live? Population and Development Review 32.4: 605–628.

                                                          DOI: 10.1111/j.1728-4457.2006.00144.xSave Citation »Export Citation »E-mail Citation »

                                                          This study examines issues related to life expectancy and the components influencing future trends in longevity. Reviews the controversy regarding future trends and examines past trends in the components of life expectancy at birth.

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                                                          • Olshansky, S. Jay, Dana P. Goldman, Yuhui Zheng, and John W. Rowe. 2009. Aging in America in the twenty-first century: Demographic forecasts from the McArthur Research Network on an Aging Society. Milbank Quarterly 87.4: 842–862.

                                                            DOI: 10.1111/j.1468-0009.2009.00581.xSave Citation »Export Citation »E-mail Citation »

                                                            The authors state that their findings are the first to document how slowing the manifestations of aging, reflected in intrinsic diseases and disorders, could affect life expectancy and mortality trends in the United States.

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                                                            • UN Department of Economic and Social Affairs. 2012. World population prospects: The 2012 revision. New York: UN Department of Economic and Social Affairs.

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                                                              This is the twenty-third round of the Population Division of the UN Department of Economic and Social Affairs, providing global demographic estimates and projections for use by multiple organizations and media.

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                                                              Social and Economic Issues

                                                              Several articles provide insights into social and economic implications, including access and use of technology. Angel and Settersten 2014 discusses current issues of the aging population and the social and economic implements. Christensen, et al. 2009 looks at life expectancy trends and discusses the implications when combined with data showing decreases in disability and better health in older adults. Goldman, et al. 2013 uses modeling to examine and compare “disease specific” and “delayed aging” scenarios relative to potential effects on longevity, disability, and costs of select US federal programs. Hayutin, et al. 2013 reports on trends in aging of the US labor force and explores what these changes mean for multiple sectors. Uhlenberg 2013 argues that societies should avoid viewing population as a challenge and should embrace the opportunities provided by an older population. Antonucci and Jackson 2009 provides an overview of health disparities in aging and describes policy implications and possible solutions. Manton, et al. 2007 presents information on the effects of disability declines and improved health on the growth of the US gross domestic product and national wealth. Finally, Colorafi 2014 provides a review of the literature examining the use of health information technology by older adults.

                                                              • Angel, Jacqueline L., and Richard A. Settersten Jr. 2014. The new realities of aging: Social and economic contexts. In New directions in the sociology of aging. Edited by Linda J. Waite and Thomas J. Plewes, 95–119. Washington, DC: National Academies Press.

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                                                                This chapter describes early-21st-century realities of the aging population and their social and economic contexts, including factors that have contributed to these new realities and their outcomes and implications. Issues discussed include the changing life course; shifts in education, work, and retirement; diversity of family and social relationships; personal and public economies; and aging policies and programs.

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                                                                • Antonucci, Toni C., and James S. Jackson, eds. 2009. Life-course perspectives on late life health inequities. Annual Review of Gerontology and Geriatrics 29. New York: Springer.

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                                                                  This volume includes an overview of health disparities in aging populations and of morbidities in general as well as specific morbidities, with particular focus on influences on cognition and functional abilities. Also addresses broad policy issues.

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                                                                  • Christensen, Kaare, Gabriele Doblhammer, Rolf Rau, and James W. Vaupel. 2009. Ageing populations: The challenges ahead. Lancet 3.374: 1196–1208.

                                                                    DOI: 10.1016/S0140-6736(09)61460-4Save Citation »Export Citation »E-mail Citation »

                                                                    The article discusses the effect of increases in life expectancy in developed countries over the past two centuries and the implications if it continues through the 21st century. These findings, combined with research suggesting that aging processes are modifiable and that people are living longer without severe disability, are important considerations in meeting the challenges of aging populations.

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                                                                    • Colorafi, Karen Jiggins. 2014. Computer use by older adults: A review of the literature. Journal of Gerontological & Geriatric Research 3.4: 164.

                                                                      DOI: 10.4172/2167-7182.1000164Save Citation »Export Citation »E-mail Citation »

                                                                      This literature review examined the use of health information technology by older adults and the state of the science in this area, through analysis of fourteen peer-reviewed studies in English-language journals between 2007 and 2013, focusing on the computer/Internet usage patterns of US adults aged over 65.

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                                                                      • Goldman, Dana P., David Cutler, John W. Rowe, et al. 2013. Substantial health and economic returns from delayed aging may warrant a new focus for medical research. Health Affairs 32.10: 1698–1705.

                                                                        DOI: 10.1377/hlthaff.2013.0052Save Citation »Export Citation »E-mail Citation »

                                                                        Using the Future Elderly Model, a microsimulation of the future health and spending of older Americans, this study compares optimistic “disease specific” scenarios with a hypothetical “delayed aging” scenario in terms of potential impact on longevity, disability, and major US federal program costs.

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                                                                        • Hayutin, Adele, Michaela Beals, and Elizabeth Borges. 2013. The aging US workforce: A chartbook of demographic shifts. Stanford, CA: Stanford Center on Longevity.

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                                                                          Examines trends in the aging of the US labor force and explores what these changes mean for employers, workers, and policymakers. Issues include population age and labor force shifts, industry and occupation age structures, job tenure and employment issues, age-related work preferences, compensation, and job types.

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                                                                          • Manton, Kenneth G., Gene R. Lowrimore, Arthur D. Ullian, XiLiang Gu, and H. Dennis Tolley. 2007. Labor force participation and human capital increases in an aging population and implications for U.S. research investment. Proceedings of the National Academy of Sciences of the United States of America 104.26: 10802–10807.

                                                                            DOI: 10.1073/pnas.0704185104Save Citation »Export Citation »E-mail Citation »

                                                                            This article examines declining how disability and improved health may increase human capital at later ages and stimulate the growth of the gross domestic product and national wealth in the United States.

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                                                                            • Uhlenberg, Peter. 2013. Demography is not destiny: The challenges and opportunities of global population aging. Generations 37.1: 12–18.

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                                                                              Given the changing demographics, the author argues that viewing population aging as a challenge should be avoided and that societies need to take advantage of opportunities provided by an older population.

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                                                                              Data Sources

                                                                              Numerous sources of data important to monitoring and understanding population aging are available. Data sources include surveys and collections of specific types of data and indicators, and they often provide linkages to other sources. This first set of sources focuses on data repositories that include indicators and data for chronic conditions, demographics, and mortality. The Healthy Aging Data Portfolio and Chronic Disease Indicators websites offer data from US surveys and surveillance systems that are important to practice. The Patient-Reported Outcomes Measurement Information System includes a set of interactive tools to reliably and validly measure patient-reported outcomes about different aspects of health-related quality of life, available for use across a wide variety of chronic diseases and conditions and in the general population. The Human Mortality Database provides detailed mortality and population for thirty-seven countries or areas. Although not specific to population aging, several other data sources provide important data on health and disability. The Ongoing Federal Data Resources Relevant to the Study of the Aging includes US federally sponsored surveys relevant to the aging population. DataFinder provides a portal to US and international data. The Publically Available Databases for Aging-Related Secondary Analyses in the Behavioral and Social Sciences provides links to a broad set of publicly available data collections to promote understanding of aging populations in the United States and throughout the world. The National Archive of Computerized Data on Aging preserves important data relevant to studying aging of the population. Demographic data from international sources are also available, including the European Data Center for Work and Welfare website, which has links to national data archives, national statistical offices, and numerous sources of national survey data.

                                                                              • Chronic Disease Indicators. Centers for Disease Control and Prevention.

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                                                                                Database of more than ninety indicators that allows states and territories and large metropolitan areas in the United States to uniformly define, collect, and report chronic disease data. In addition to providing specific indicator data, it will also include a new section on aging indicators, and it gives linkages to other data resources.

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                                                                                • DataFinder. Population Reference Bureau.

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                                                                                  Portal to US and international data. The site is searchable and allows for the creation of custom reports. The US data are from the US Census Bureau’s decennial census, the American Community Survey, and population estimates. The international data are from several Population Reference Bureau data sheets, and additional international indicators were compiled by staff, primarily through using national surveys.

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                                                                                  • European Data Center for Work and Welfare.

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                                                                                    This site provides information on and direct access to over five hundred data sources on work, care, and welfare, with data on a range of related fields.

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                                                                                    • Healthy Aging Data Portfolio. Centers for Disease Control and Prevention.

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                                                                                      The Healthy Aging Data Portfolio provides access to the array of Centers for Disease Control and Prevention data on key indicators of health and well-being, screenings and vaccinations, and mental health among older adults from various reports. It is searchable and allows for customized downloadable reports.

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                                                                                      • Human Mortality Database.

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                                                                                        This database contains original calculations of death rates and life tables for national populations (countries or areas), as well as the input data used in constructing the tables. The input data consist of death counts from vital statistics, plus census counts, birth counts, and population estimates from various sources.

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                                                                                        • National Archive of Computerized Data on Aging. University of Michigan.

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                                                                                          Provides archived data from studies in the following categories: demographic characteristics of older adults; social characteristics of older adults; economic characteristics of older adults; psychological characteristics, mental health, and well-being of older adults; physical health and functioning of older adults; and health-care needs, utilization, and financing for older adults.

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                                                                                          • Ongoing Federal Data Resources Relevant to the Study of the Aging. Federal Interagency Forum on Aging-Related Statistics.

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                                                                                            Select set of twenty-one ongoing federally sponsored surveys relevant to aging, with links to the websites. The listed surveys cover the range of concerns of the aging and are supported by a variety of federal agencies and departments.

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                                                                                            • Patient-Reported Outcomes Measurement System. National Institutes of Health.

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                                                                                              Database of measures available for use across a wide variety of chronic conditions, and of measures organized around physical, mental, and social dimensions of health. The Patient-Reported Outcomes Measurement System (PROMIS) also includes a set of tools to reliably and validly measure patient-reported outcomes about different aspects of health-related quality of life.

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                                                                                              • Publically Available Databases for Aging-Related Secondary Analyses in the Behavioral and Social Sciences. National Institute on Aging.

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                                                                                                Critical resource that provides overviews and links to a broad set of publicly available data collections supported in whole or in part by the Division of Behavioral and Social Research of the National Institute on Aging to promote understanding of aging populations both domestically and throughout the world.

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                                                                                                Data Reports

                                                                                                Several reports summarize aging-related statistics or provide “data for action” focusing on older adults. Researchers and practitioners will find Older Americans 2012: Key Indicators of Well-Being (Federal Interagency Forum on Aging-Related Statistics 2012) is a valuable document that helps paint a comprehensive picture of health and well-being among adults aged sixty-five years and older in the United States. Focusing on more select indicators of older adult health in the United States, The State of Aging and Health in America 2013 (Centers for Disease Control and Prevention 2013), Enhancing Use of Clinical Preventive Services Among Older Adults (Centers for Disease Control and Prevention 2011), and Promoting Preventive Services for Adults 50–64: Community and Clinical Partnership (Centers for Disease Control and Prevention 2009) are critical resources for practitioners and applied research because they provide a quick summary of major indicators and clinical preventive services. Profiles of Aging 2013 (UN Department of Economic and Social Affairs 2013) contains data on demographic, social, and economic characteristics of the older population at the national, regional, and world levels. AARP’s State Data Center provides state-level data on a variety of aging issues. From an international perspective, SCL/PRB Index of Well-Being in Older Populations: Final Report, Global Aging and Monitoring Project (Kaneda, et al. 2011) provides an index to measure well-being among older adults and allows cross-national comparisons.

                                                                                                • Centers for Disease Control and Prevention. 2009. Promoting preventive services for adults 50–64: Community and clinical partnerships. Atlanta: Centers for Disease Control and Prevention.

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                                                                                                  This report highlights data and opportunities to broaden the use of clinical preventive services among adults aged fifty to sixty-four years in the United States. It delineates science-based strategies and highlights “calls to action” that build on linkages between clinical and community efforts to facilitate the delivery of multiple preventive services

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                                                                                                  • Centers for Disease Control and Prevention. 2011. Enhancing use of clinical preventive services among older adults: Closing the gap. Washington, DC: AARP.

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                                                                                                    This report uses state and national self-reported survey data to highlight utilization of recommended clinical preventive services among adults aged sixty-five years and over, calling attention to critical gaps in use of these services. It also spotlights interventions that have successfully increased the use of clinical preventive services among older adults in diverse communities.

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                                                                                                    • Centers for Disease Control and Prevention. 2013. The state of aging & health in America 2013. Atlanta: Centers for Disease Control and Prevention.

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                                                                                                      The sixth volume in a series of data reports presenting snapshots of the health and aging landscape in the United States and other regions of the world. This volume, focused on the select indicators of older adult health in the United States, combines data presentations (including state and national report cards) with calls to action and public health interventions. This report also includes a spotlight on mobility.

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                                                                                                      • Federal Interagency Forum on Aging-Related Statistics. 2012. Older Americans 2012: Key indicators of well-being. Washington, DC: US Government Printing Office.

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                                                                                                        This document provides a comprehensive picture of the health and well-being of the US population aged sixty-five and over. Information is organized into five broad groups: population, economics, health status, health risks and behaviors, and health care. This is the sixth chartbook prepared by the Federal Interagency Forum on Aging-Related Statistics.

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                                                                                                        • Kaneda, Toshiko, Marlene Lee, and Kelvin Pollard. 2011. SCL/PRB Index of Well-Being in Older Populations: Final report, global aging and monitoring project. Washington, DC: Population Reference Bureau.

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                                                                                                          This report describes the SCL/PRB Index of Well-Being in Older Populations, developed by the Stanford Center on Longevity and the Population Reference Bureau. The index provides a summary measure of well-being for older adult populations and allows for cross-national comparisons. The report highlights twelve indicators of material, physical, social, and emotional well-being in the United States and eleven European countries.

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                                                                                                          • State Data Center. AARP Public Policy Institute.

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                                                                                                            This website includes numerous reports featuring state-level data on a variety of aging issues, including preventive care, long-term care, economic indicators, housing, and family caregiving. The site also includes links to state-specific data reports for each US state and select US territories.

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                                                                                                            • UN Department of Economic and Social Affairs. 2013. Profiles of aging 2013. New York: UN Department of Economic and Social Affairs.

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                                                                                                              This database from the United Nations contains the data on thirteen indicators, including demographic, social, and economic characteristics of the older population at the national, regional, and world levels. For the period from 1980 to 2013, data are available for 236 countries or areas. The database also includes projections to 2050.

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                                                                                                              Organizations

                                                                                                              Organizations are a good place to start when seeking information about aging in general and population aging issues in particular. The organizations can be grouped into two general categories: (1) aging organizations concerned with services, research, and dissemination of programs and information, and (2) international organizations concerned with global aging. Aging-related research and its dissemination are the cornerstone of population aging. The National Institute on Aging plays a key role in generating new research, evaluating existing data resources, stimulating new database development, and disseminating research findings. Other federal agencies, including the Administration for Community Living / Administration on Aging and the Centers for Disease Control and Prevention’s (CDC) Healthy Aging Program; professional societies and organizations concerned with aging, such as AARP, the American Society on Aging, the Gerontological Society of America, and the National Council on Aging’s Center for Healthy Aging; and networks of centers focused on aging, such as the CDC’s Healthy Aging Program, play critical roles in promoting the dissemination of research as well as linking aging and public health professionals. HelpAge International and the International Institute on Ageing provide important information on, and links to, what is occurring in aging around the world.

                                                                                                              Digital Media

                                                                                                              Digital media include media sources such as PowerPoint presentations and other forms of media such as links to audio, infographics, or videosrelated to aging. A select number are included here. The Federal Interagency Forum on Aging-Related Statistics provides a PowerPoint presentation set using charts from Older Americans 2012: Key Indicators of Well-Being. The Population Reference Bureau provides links to a large collection of multimedia data, programs and projects presentations related to aging (Multimedia: Aging). Finally, the National Institute on Aging provides a Media Resources page that links to numerous media on aging.

                                                                                                              Self-Management Support

                                                                                                              Barlow, et al. 2002 provides a historical perspective on self-management approaches. Chodosh, et al. 2005 is a meta-analysis of fifty-three randomized trials of self-management programs for chronic disease, with a finding of small but significant effects for different sets of clinical outcomes. Brady, et al. 2013 provides a more recent meta-analysis of studies on chronic disease self-management intervention, examining the program’s effects on health behaviors, physical and psychological health status, and health-care utilization. The most recognized and well-documented self-management program is the Stanford Chronic-Disease Self-Management Program (CDSMP). Lorig, et al. 1984 describes the initial study of the Arthritis Self-Management Program, documenting its feasibility and effect on reports of arthritis pain. Lorig, et al. 2001 reports the results of follow-up to a randomized trial of the CDSMP, documenting that participants at one and two years showed reductions in health distress, increased self-efficacy, and made fewer visits to emergency rooms at each follow-up period. Ory, et al. 2014 compares participants sixty-five years of age or older to middle-aged participants aged fifty to sixty-four to determine the long-term effectiveness CDSMP. The authors of Stellefson, et al. 2013 conducted a review of six databases to assess the effectiveness of web 2.0 CDSMP for older adults with chronic conditions. Jordan, et al. 2008 raises important concerns about the lack of coordination between self-management support initiatives and efforts to enhance the delivery of care in clinical settings, describing various aspects necessary to promote integrations.

                                                                                                              • Barlow, Julie, Chris Wright, Janice Sheasby, Andy Turner, and Jenny Hainsworth. 2002. Self-management approaches for people with chronic conditions: A review. Patient Education and Counseling 48.2: 177–187.

                                                                                                                DOI: 10.1016/S0738-3991(02)00032-0Save Citation »Export Citation »E-mail Citation »

                                                                                                                This article provides an important review of self-management approaches, using a rather broad definition, and then characterizes the studies across a large number of dimensions.

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                                                                                                                • Brady, Teresa J., Louise Murphy, Benita J. O’Colmain, et al. 2013. A meta-analysis of health status, health behaviors, and health care utilization outcomes of the chronic disease self-management program. Preventing Chronic Disease 10:120112.

                                                                                                                  DOI: 10.5888/pcd10.120112Save Citation »Export Citation »E-mail Citation »

                                                                                                                  A meta-analysis of studies on chronic disease self-management intervention in English-speaking countries, designed to quantitatively summarize the results to determine the program’s effects on health behaviors, physical and psychological health status, and health-care utilization at four to six months and nine to twelve months after baseline.

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                                                                                                                  • Chodosh, Joshua, Sally C. Morton, Walter Mojica, et al. 2005. Meta-analysis: Chronic disease self-management programs for older adults. Annals of Internal Medicine 143.6: 427–438.

                                                                                                                    DOI: 10.7326/0003-4819-143-6-200509200-00007Save Citation »Export Citation »E-mail Citation »

                                                                                                                    A meta-analytic review of self-management programs to improve chronic disease management, which included fifty-three studies using randomized control designs. The authors reported the results across a number of chronic conditions and outcomes. Overall, they found small but significant effect sizes for various clinical outcomes.

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                                                                                                                    • Jordan, Joanne E., Andrew M. Briggs, Caroline A. Brand, and Richard Osborne. 2008. Enhancing patient engagement in chronic disease self-management support initiatives in Australia: The need for an integrated approach. Medical Journal of Australia 189.10: S9–S13.

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                                                                                                                      Raises concerns about the lack of coordination between self-management support initiatives and efforts to enhance the delivery of care in clinical settings. The authors provide a number of useful perspectives on how to coordinate and integrate these initiatives.

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                                                                                                                      • Lorig, Kate, Janette Laurin, and Halsted R. Holman. 1984. Arthritis self-management: A study of the effectiveness of patient education for the elderly. Gerontologist 24.5: 455–457.

                                                                                                                        DOI: 10.1093/geront/24.5.455Save Citation »Export Citation »E-mail Citation »

                                                                                                                        The initial study of the twelve-hour community-based, lay-led Arthritis Self-Management Program, demonstrating that among the study participants there were documented gains in knowledge and decreases in pain for twenty months, and in disability for eight months.

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                                                                                                                        • Lorig, Kate, Philip Ritter, Anita Stewart, et al. 2001. Chronic disease self-management program 2-year health status and health care utilization outcomes. Medical Care 39.11: 1217–1223.

                                                                                                                          DOI: 10.1097/00005650-200111000-00008Save Citation »Export Citation »E-mail Citation »

                                                                                                                          Provides the results of a follow-up study to a randomized trial of the CDSMP, documenting that at one- and two-year follow-ups, participants who could be contacted showed reductions in health distress and increased self-efficacy and made fewer visits to emergency rooms at each follow-up period.

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                                                                                                                          • Ory, Marcia G., Matthew Lee Smith, SangNam Ahn, Luohua Jiang, Kate Lorig, and Nancy Whitelaw. 2014. National study of chronic disease self-management: Age comparison of outcome findings. Health Education & Behavior 41.S1: 34S–42S.

                                                                                                                            DOI: 10.1177/1090198114543008Save Citation »Export Citation »E-mail Citation »

                                                                                                                            Baseline and twelve-month follow-up data from CDSMP participants were analyzed for participants sixty-five years of age or older and were compared to middle-aged participants aged fifty to sixty-four to determine the long-term effectiveness of the program.

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                                                                                                                            • Stellefson, Michael, Beth Chaney, Adam E. Barry, et al. 2013. Web 2.0 chronic disease self-management for older adults: A systematic review. Journal of Medical Internet Research 15.2: e35.

                                                                                                                              DOI: 10.2196/jmir.2439Save Citation »Export Citation »E-mail Citation »

                                                                                                                              A systematic literature search was conducted by using six health databases to review the planning, implementation, and overall effectiveness of web 2.0 self-management interventions for older adults with one or more chronic disease(s). The RE-AIM (Reach, Efficacy, Adoption, Implementation and Maintenance) model was used to organize findings and to compute a study quality score for the fifteen articles reviewed.

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