An open access publication of the American Academy of Arts & Sciences
Spring 2015

Individual & Social Strategies to Mitigate the Risks & Expand Opportunities of an Aging America

Julie M. Zissimopoulos, Dana P. Goldman, S. Jay Olshansky, John Rother, and John Wallis Rowe
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Increasing life expectancy offers the potential benefit of additional years of productivity and engagement to both individuals and society as a whole. However, it also carries substantial risks. For many, advanced age brings increased disease and disability (including cognitive impairment), financial insecurity, and social isolation. These risks are greatest for those with the least education and financial resources. An aging society must cope with increasing demands for high-quality geriatric care, mounting stresses on social insurance programs (such as Social Security and Medicare in the United States), and the increasing danger that the growing gap between the haves and have-nots will threaten societal cohesion. These risks can be mitigated or aggravated by the lifestyle and savings behavior of individuals, families, employers, and the government. We present policy options in the areas of education, work and retirement, financial security, health care, and social cohesion that can promote the benefits and reduce the risks of longer life.

JULIE M. ZISSIMOPOULOS is an Assistant Professor at the Sol Price School of Public Policy and the Associate Director of the Schaeffer Center for Health Policy and Economics at the University of Southern California. Her research has been published in such journals as The Journal of Economic Perspectives, Journal of Health Economics, Journal of Human Resources, and Demography.

DANA P. GOLDMAN is the Leonard D. Schaeffer Chair in Health Policy at the University of Southern California. He is also the Director of the Schaeffer Center for Health Policy and Economics. He serves as a health policy adviser to the Congressional Budget Office, and his research has appeared in the New England Journal of Medicine, JAMA: The Journal of the American Medical Association, Demography, Journal of the American Statistical Association, and Health Affairs.

S. JAY OLSHANSKY is Professor of Epidemiology at the School of Public Health, Division of Epidemiology and Biostatistics at the University of Illinois at Chicago. He has published articles in such journals as The New England Journal of Medicine, JAMA, Science, The Scientist, Scientific American, and Health Affairs.

JOHN ROTHER is President and CEO of the National Coalition on Health Care. Prior to joining the Coalition, he served as the Executive Vice President for Policy, Strategy, and International Affairs at the AARP. He was also Staff Director and Chief Counsel of the Senate Special Committee on Aging under the direction of Chairman John Heinz (R-PA) and Special Counsel for Labor and Health to Senator Jacob Javits (R-NY).

JOHN W. ROWE, a Fellow of the American Academy since 2005, is Professor at the Columbia University Mailman School of Public Health and Chair of the MacArthur Foundation Research Network on an Aging Society. He is the author of Successful Aging (with Robert L. Kahn, 1998) and was the Chair of the Institute of Medicine of the National Academies project the Future Health Care Workforce for Older Americans, which authored the report Retooling for an Aging America: Building the Health Care Workforce (2008).

The aging of America presents both opportunities and risks. The opportunities, which are often neglected,1 relate principally to the availability of large numbers of generally fit, experienced older persons who can make valuable economic and social contributions to society.2  Although increasing attention is being paid to the risks of an aging society and ways to protect against them, the United States has yet to actively adapt to either the risks or the opportunities. The focus of this essay is to illuminate the changing nature of both.

For individuals, the risks of a longer life include becoming ill or disabled and needing extensive acute and long-term care. The latter is particularly important, as long-term care can deplete the patient’s financial resources, leaving him or her dependent on public support. Other individual risks include isolation and disengagement: increasing numbers of older persons are living alone, with fraying connections to families. U.S. families themselves are undergoing major changes in structure and function that impede their capacity to serve as a safety net for elderly members. . . .

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  • 1One exception is John Wallis Rowe and Robert L. Kahn, Successful Aging (New York: Dell, 1998).
  • 2David Lowsky, S. Jay Olshansky, Jay Bhattacharya, and Dana P. Goldman, “Heterogeneity in Healthy Aging,” The Journals of Gerontology: Biological Sciences & Medical Sciences 69 (6) (2014): 640–649.