The magazine of the UW School of Public Health

The Changing Expectations of Aging

A guest editorial by Denise Klein

It’s convenient to divide our aging population into cohorts and then speculate about how the behavior and values of one cohort are different from those of another. From there, we move on to tease out the implications of these differences in terms of needs, desires, and demands for goods and services.

In my field, which includes a part of public health—the part where we concern ourselves with prevention, diet, exercise, and encouraging healthy behaviors—we struggle with program design challenges in part because we want to serve multiple cohorts and serve them efficiently with limited dollars. Many of our customers and potential customers are older than 85. Many are still in their 60s. For both groups, staying healthy is not only a major preoccupation of many individuals, but also a concern of funders, planners, and organizers. We are anxious not to spend precious health care dollars undoing harm that people have done to themselves through inactivity or unhealthy behaviors.

There isn’t ever going to be a “dropping off a cliff” moment when all those turning 60 or 65 wake up and want something entirely new and different from what previous 60 or 65 year olds wanted. Nonetheless, all cultures constantly evolve, and each generation is shaped by birth rates and cohort size, immigration patterns, each generation’s own lived history, educational attainment, and changes in the economy … not to mention genetics and personality.

Here are a few observations about how Baby Boomers may be different from previous generations and how these differences are likely to affect their health, social service, and long-term care needs and expectations.

•   Boomers are less conservative about their finances (for better and worse) and more likely to spend money on services that will help them age well.

•   Shaped by a booming economy, many of these Boomers (despite lower savings rates) invested or have multiple pensions, so they may have quite a bit of disposable income.

•   Others, less financially well-off, will have needs similar to those of older generations as they age and will be in the market for subsidized services and housing.

•   Geared to a personal lifelong search for meaning and purpose beyond getting and spending, or perhaps motivated by the need for additional income, they may continue to work, postponing full-time retirement, for an indefinite period. They would like flexible schedules and interesting work opportunities, but they can be paid less or recruited as volunteers in some cases.

•   Although not as devout about voting and expressing opinions on public policy issues as the preceding generations of elders, Boomers can probably be organized and motivated to participate politically—especially those who did so in their youth (and then put aside their activism for a focus on career).

•  Boomers will not go gently into that good night. Their raging about aging predisposes them to exercise and watch what they eat so they can stave off the ravages of premature aging. This is a good thing and should lead to the realization of the promise of compression of morbidity—the phenomenon of remaining healthier for longer and experiencing a shorter period of disability near the end of our lives.

Most of my observations fall on the positive side of the ledger, reflecting a trait that I share with Boomers: a kind of unbridled optimism stemming perhaps from childhoods more financially and historically secure than those of our parents, as well as our young-adult ability to change what we wanted to change. We protested the Vietnam War, and it ended. We wanted to go to college and did so in unprecedented numbers. We got the jobs we aspired to, and many of us led organizations. What will we do with, to, and for ourselves and others in retirement? That’s the $64,000 question.

Denise Klein is executive director of Senior Services in Seattle, Washington.