Class 8, Part I Aging And Health Care

E S S A Y Q U E S T I O N There are a number of significant demographic trends (i.e., population shifts) extant in the U.S. which is altering the population mix in the U.S. Discuss 3 of these major trends; addressing 1 salient cause of and 1 major social consequence for each of these 3 trends.

Chapter 12 Aging and Inequality Based on Age

Chapter Outline The Social Significance of Age Age in Global Perspective Age and the Life Course in Contemporary Society Inequalities Related to Aging

Chapter Outline Living Arrangements for Older Adults Sociological Perspectives on Aging Death and Dying Aging in the Future

Chapter 18 Health, Health Care, and Disability

Chapter Outline Health in Global Perspective Health in the United States Health Care in the United States Sociological Perspectives on Health and Medicine

Chapter Outline Mental Illness Disability Health Care in the Future

Sharpening Your Focus How does functional age differ from chronological age? How does age determine a person’s roles and statuses in society? What actions can be taken to bring about a more equitable society for older people?

Age Chronological age is a person’s age based on date of birth. F unctional age includes observable individual attributes such as appearance, mobility, strength, coordination, and mental capacity.

How Much Do You Know About Aging and Age-Based Discrimination? True or False? After women reach menopause, they may enjoy sexual activity more than when they were younger.

Infancy and Childhood (Birth to 12 ) Children are among the most powerless and vulnerable people in society. Every day in the United States 1 out of every 5 infants are born into poverty. Over 3,000 children die from gunshot wounds every year. Every 11 seconds a child is reported abused or neglected.

How Much Do You Know About Aging and Age-Based Discrimination? True or False? Women in the United States have a longer life expectancy than do men Although gap is narrowing.

True In 2004, female life expectancy (at birth) was 80.4 years, as compared with 75.2 for males. These figures vary by race and ethnicity.

U.S. Age Pyramid by Age and Sex, 2000 (in millions)

Demographic Factors: Sex Chapter 18 Babies born in the U.S. in 2000: Life expectancy is 73.9 years for males and 79.4 years for females. Sociologist Ingrid Waldron notes that gender roles and gender socialization contribute to the difference in life expectancy: Men are more likely to work in dangerous occupations, more likely to engage in risky behavior, and are less likely to see a doctor.

Demographic Factors: Location, Chapter 18 People living where there are high levels of poverty and crime, or in remote rural areas have greater difficulty getting health care because most doctors prefer to locate their practice in a “safe” area. Although rural Americans make up 20% of the U.S. population, only 9% of the nation’s physicians practice in rural areas.

How Much Do You Know About Aging and Age-Based Discrimination? True or False? Most older persons are economically secure today as a result of Social Security, Medicare, and pensions.

False Although some older persons are economically secure, persons who rely solely on Social Security, Medicare, and/or pensions tend to live on low, fixed incomes that do not adequately meet their needs. A number live below the official poverty line.

Access to Health Care, Chapter 18 Access to quality health care is much greater for some people than for others. The factors that are involved vary not only for people within one nation but also across the nations of the world.

Demographic Factors: Age, Chapter 18 Rates of illness and death are highest among the old and the young. Mortality rates drop shortly after birth and begin to rise significantly during middle age. After age 65, rates of chronic diseases and mortality increase rapidly.

Percent of U.S. Population Without Health Insurance, 2002

Percentage of Persons Age 65+ Below Poverty Level

Aging and Politics Older people have actively protested changes in Social Security, Medicare, and other programs for senior citizens that they view as detrimental to their well-being.

2. The graying of America refers to: Americans living longer. Americans taking care of older adults. the vanishing of clear cut borders between what is old and what is not. longer life expectancy combined with an increase in birth rates.

Answer: a The graying of America refers to Americans living longer .

U.S. Population Growth, 1980–2000

% Distribution of U.S. Population by Age, 2000–2050 (projected)

3. The study of aging and older people is called: Sociology Geriatrics Gerontology Epidemiology

Answer: c The study of aging and older people is called gerontology .

Views of Aging in Preindustrial and Industrialized Societies In preindustrial societies, people of all ages are expected to share the work, and the contributions of older people are valued. In industrialized societies, older people are often expected to retire so that younger people may take their place.

Aging in Lower-income Nations In lower-income nations, older people may still perform useful economic functions such as gathering food or farming.

Age Stratification Inequalities, differences, segregation, or conflict between age groups.

Selected Life Expectancies by Race, Ethnicity, and Sex, 2000

% of Resident Population Age 65 and Older by State

Ageism Ageism is prejudice and discrimination against people on the basis of age, particularly against older persons. Ageism is rooted in the assumption that people become unattractive, unintelligent, asexual, unemployable, and mentally incompetent as they grow older.

Aging and Driving Although the vast majority of motor vehicle accidents are caused by younger drivers, when drivers in their 70s or 80s are involved in major accidents, widespread media coverage typically focuses on the driver’s age.

Elder Abuse As many as 1.6 million older people in the U.S. are victims of abuse each year. Physical abuse includes malnutrition, injuries and dislocations. Psychological abuse includes verbal assaults, threats, fear, and social isolation.

Elder Abuse Financial exploitation involves theft or misuse of the older person’s money or property. Medical abuse is when medicine is withheld or improperly administered. Neglect is not providing sufficient care.

Functionalist Perspectives on Aging Focus on how older persons adjust to their changing roles in society. According to sociologist Talcott Parsons, the roles of older persons need to be redefined by society. He suggested that devaluing the contributions of older persons is dysfunctional; older persons often have knowledge and wisdom to share with younger people.

Disengagement Theory According to disengagement theory, older persons make a normal and healthy adjustment to aging when they detach from their social roles and prepare for their eventual death. Disengagement aids a gradual and orderly transfer of statuses and roles from one generation to the next; an abrupt change would result in chaos.

Symbolic Interactionist Perspectives Examine the connection between personal satisfaction in a person’s later years and a high level of activity. Activity theory states that people shift gears in late middle age and find substitutes for previous statuses, roles, and activities.

C ontinuity People constantly attempt to maintain their self-esteem and lifelong principles and practices and simply adjust to feedback from and needs of others as they grow older.

Role theory Asks: What roles are available for older people? Some theorists note that industrialized, urbanized societies do not have roles for older people.

Conflict Perspectives Draws attention to the diversity in the older population. Differences in social class, gender, and race/ethnicity divide older people just as they do everyone else. The conflict perspective adds to our understanding of aging by focusing on how capitalism devalues older people, especially women.

Conflict Perspectives Differences in class, gender, and race/ethnicity divide older people in the U.S. into the “haves” and the “have-nots.” Older African Americans are affected by poverty because of discrimination in the past and subtle forms of contemporary prejudice.

Death and Dying There are three frameworks for explaining how people cope with the process of dying: the stage-based approach the dying trajectory the task-based approach . The stage-based approach was popularized

Symbolic Interactionist Perspectives Oder people who invest their time and energy in volunteer work or in other enjoyable activities tend to be healthier, be happier, and live longer than those who disengage from society.

Stage-based Framework: Elisabeth Kübler-Ross Stages in the dying process: Denial and isolation (“Not me!”) Anger and resentment (“Why me?”) Bargaining and an attempt to postpone (“Yes me, but . . .) Depression and sense of loss Acceptance.

Dying Trajectory Framework Three phases: The acute phase, characterized by the expression of maximum anxiety or fear. The chronic phase, characterized by a decline in anxiety as the person confronts reality. The terminal phase, characterized by the dying person’s withdrawal from others.

U.S. Population Projections: 2005–2050 Jeffrey S. Passel and D’Vera Cohn Pew Research Center Monday, February 11, 2008 pewhispanic.org/files/reports/85.pdf -

Dependency Ratio The dependency ratio is a demographic and economic indicator that compares the size of non-working-age groups—children and the elderly—with that of the working-age population.6 A higher number of elderly or children relative to the number of workers translates into higher costs per worker to pay for all government programs, including those targeted at the young and old such as schools and Social Security. In 2005, there were 59 elderly people and children for every 100 Americans of working ages. In 2050, assuming current trends continue, that dependency ratio will rise to 72. The main reason for the increase is that the elderly population will grow more rapidly over the next four decades than the working-age population. Most of the increase in the number of elderly will occur by 2030 as the baby-boom generation enters the retirement years. The ratio of children to working-age people, on the other hand, will change little.

The elderly dependency ratio was 20 people ages 65 and over for every 100 people ages 18 to 64 in 2005. That ratio has risen slightly since 1960 (from 16 per 100) and will increase rapidly (to 32 per 100) until 2030, when the youngest of the baby boomers turns 66. The elderly dependency ratio will level off at 32 elderly per 100 people of working age through 2050.

A very different pattern emerges with regard to the child dependency ratio. It is projected to be stable in coming decades, at about 40 children for every 100 people of working age. The major driver of this ratio is not the level of immigration but the average number of children per woman, which is projected to change little in the future.

Working Ages. Turning to the impact of immigration on different age groups, the scenarios diverge markedly after 2030 for working-age adults. (Figure 24) The baseline projection is that the number of adults ages 18 to 64 will rise from 186 million in 2005 to 255 million in 2050. The working-age population, now 63% of the total, would decline to 58%.

People of color are more likely to have incomes below the poverty line. People with lower incomes: Receive less preventive care and less optimal management of chronic diseases. Are more likely to be employed in jobs that expose them to danger and illness. Are are more likely to live in areas that contain environmental hazards.

How Much Do You Know About Health, Illness, and Health Care? Chapter 18 True or False? Health care in most high-income, developed nations is organized on a fee-for-service basis as it is in the United States.

False The United States is one of only two high-income, developed nations that do not have a form of universal health coverage. In the United States, health care has traditionally been purchased by the patient. In most other high-income nations, health care is provided or purchased by the government.

Private Health Insurance is cited as the main reason for medical inflation and gives doctors and hospitals an incentive to increase costs. Public Health Insurance - projections call for Medicaid spending to double and Medicare spending to triple.

New technologies create options for people and for society, but options that alter human relationships. New technologies increase the cost of medical care. New technologies raise provocative questions about the very nature of life.

Refers to a reduced ability to perform tasks one would normally do at a given stage of life and that may result in stigmatization or discrimination against the person with disabilities.

Characteristic % With a disability 20.8 Severe 13.7 Not severe 7,0

Workers with a severe disability make 59% of what their co-workers without disabilities earn. Among Latinos/as with a severe disability, only 26% are employed; those who work earn 80% of what white persons with a severe disability earn.

Class 8, Part I Aging And Health Care