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Summer/Fall 2008 Vol. 8 No. 2

Table of Contents

Photo by Bachrach FROM THE PRESIDENT

Institute of Medicine

A National Conversation on an Aging Society

As we edge toward 2011 -- the year that the first baby boomers turn 65 -- our concept of "old age" is being upended. These boomers, on average, can expect to live to age 83, longer than any previous generation. Currently about 13 percent of the U.S. population is over 65; by 2030, one in five of us, or 71 million Americans, will be 65 or older -- and we will be a far more diverse society. This profound demographic transformation presents us with many choices and challenges about how our society will age.

Many Americans moving into the "new old age" may need to postpone retirement by necessity. Those approaching the previously routine retirement age of 65 have saved less for their later years, and Social Security can provide only a measure of economic security. The likelihood of staying in the workplace longer or even launching second (or third) careers late in life is high. We will face increasingly intense issues of training and retention, workplace health, safety and design, and age discrimination as growing numbers of older Americans elect to stay in the labor force.

A 2008 Institute of Medicine report, Retooling for an Aging America, featured in this issue of In Focus, highlights a health care work force that is insufficient in both numbers and skills to care for an aging population. Medicare, the federal program of health insurance for the elderly, now exceeds $400 billion in annual expenditures. The burden is projected only to grow as an older population ages -- by age 80, a person can expect to have two or more chronic illnesses.

On a macroeconomic level, the shifting demography will affect our economy as well. Sustained economic growth and security will pose both national and cross-national challenges as aging becomes a worldwide phenomenon in developed and developing countries. Those societies that make aging a source of productivity rather than a drag on growth will have a decided advantage in the decades ahead.

Our academies have embarked on a new initiative to stimulate a national conversation on the complex policy issues facing an aging society, building on our previous work related to the demography of aging, retirement policies, private wealth and income security, the labor force and future skills demands, the health of aging populations, cognitive research on the aging mind, racial and ethnic differences in health in later life, technologies for adaptive aging, and the biodemography of longevity. An integrated, evidence-based approach to our rapidly aging world can help redefine "old age" as a time for creative engagement, health, and prosperity.

    Institute of Medicine

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Copyright 2008 by the National Academy of Sciences