2003 ANNUAL REPORT
Examining trends in the health of older adults
Population aging—the increase in the proportion of a population that is older—is occurring in rich and poor countries alike as fertility and mortality rates fall. A major question surrounding the increase in survival to older ages is whether the extra years of life are spent in good or bad health. The answer has important implications for policies that might encourage people to work longer and for programs to support older people who cannot care for themselves.
| Percent of older adults in Taiwan with at least one functional limitation, by age and education |
 |
| In Taiwan, there has been an increase in the proportion of older adults with difficulty either walking 200–300 meters or climbing stairs. The youngest and best-educated older adults tend to have the fewest limitations. |
Two recent studies examined this issue. Population Council president Linda G. Martin, Vicki A. Freedman of the Polisher Research Institute, and Robert F. Schoeni of the University of Michigan published a review of the evidence on older Americans in the Journal of the American Medical Association. In a Population Studies article, Council sociologist Zachary Zimmer, Martin, and the former director-general of Taiwan’s Bureau of Health Promotion, Ming-Cheng Chang, investigated the question for Taiwan, whose population is aging even more rapidly than those of Western countries.
The researchers found that over the last two decades older Americans’ functioning has generally improved, but older Taiwanese have not fared as well. In the United States, “the greatest improvements occurred in the ability to carry out such routine activities as household chores and shopping, while there was little change for such personal care activities as bathing,” notes Martin. Overall, the proportion of the population aged 70 and older in the United States who needed help with any activity declined between 1982 and 1996 from about 23 percent to 19 percent.
The Taiwan study looked at the ability of people 65 and older to walk 200 to 300 meters and climb stairs. Between 1993 and 1999, the proportion who had difficulty with these activities grew—from 26 to 36 percent. The researchers were not able to explain this change, but speculated that one factor may have been the 1995 introduction of universal health insurance, which increased access to care and may have especially benefited those in poorest health. “Previously people with severe limitations may have been more likely to die,” Zimmer explains.
In both populations, tomorrow’s elderly generally will have received more education and experienced greater prosperity throughout their lives than today’s elderly. So while the recent decline in functioning among Taiwan’s elderly is not positive, Zimmer notes, “Young people in Taiwan are likely to enter their senior years much healthier than did their elders.”
Zachary Zimmer is a research associate in the Policy Research Division. |  |
