Capitol Ideas

CSG Knowledge Center

Research Services

MLC Policy Resolutions

Stateline Midwest

States Perform



Legislators challenged to take on policies associated with aging population

by Tim Anderson ~ August 2017 ~ Stateline Midwest »
In a comprehensive speech on demographics that touched on trends ranging from the elderly to family formation, Linda Jacobsen ended her talk to the Midwest’s legislators with a policy message: Act now in order to meet the unavoidable health care and workforce challenges that lie ahead.
“The greatest opportunity is to invest today to increase the future productive capacity of our children, because that is the best way to help offset the costs of our aging population,” Jacobsen, vice president of U.S. programs for the nonpartisan Population Reference Bureau, said in July at the Midwestern Legislative Conference Annual Meeting.
Already today, about 15 percent of the nation’s population is 65 and older (Those rates are higher in five Midwestern states: Iowa, Michigan, Ohio, South Dakota and Wisconsin). That percentage will rise to 21 percent by 2030 and 24 percent by 2060.
But those population numbers tell only part of the story. More than one-third of people 65 and older have a disability, Jacobsen noted, and dementia (the most costly U.S. health condition) affects 1 in 4 people over the age of 80.
Who will care for all of these older individuals?
In the past, unpaid caregivers have played a huge part, but more and more older people are living alone — away from family members to care for them and in communities that may lack an adequate supply of health care workers or facilities.
The nation’s “elderly support ratio” (the number of people ages 18 to 64 per individuals 65 or older) has been dropping for more than a century, from 13.6:1 in 1900 to 4.1:1 in 2016. It will fall to 2.8:1 by 2030. States in the Midwest, then, will need to find ways of caring for the elderly with less manpower, thus Jacobsen’s focus on building up the productive capacity of younger people to care for the elderly (as nurses, doctors or home health care aides, for example) or to thrive in other vocations. Their success will help create the tax base for communities to provide more residential facilities and transportation services for the elderly.
But demographic challenges exist among the region’s younger population cohorts as well. In 2015, for example, the 11-state Midwest lost close to 78,000 college-educated adults to domestic migration (the movement of people within the United States), continuing a longtime trend often referred to as the “brain drain.” (North Dakota was the only state in this region with positive net domestic migration in 2015.)
“The Midwest has a great opportunity in that you have a lot of college graduates, and a lot of those with engineering degrees,” Jacobsen said. “The trick is to figure out how to make it attractive for those graduates to remain [here].”
She also encouraged lawmakers to focus on strategies that close ethnic and racial disparities. On measures such as low birthweights, poverty, access to health insurance and educational attainment, African Americans and Latinos fare worse than whites.
“They’re going to make up a larger concentration of state populations,” Jacobsen said.
Across all ethnic and racial groups, too, fewer children are living in two-parent families — 69 percent in 2016 vs. 85 percent in 1970.