America's elderly.
America's elderly.
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美国的老人。
DOI：
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发表时间：
1988
期刊：
影响因子：
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通讯作者：
E. Agree
中科院分区：
文献类型：
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作者：
B. Soldo;E. Agree
过去 20 年来，美国老年人口的增长速度是其他人口的两倍。随着大量婴儿潮群体步入中年并步入老年，这种增长预计将在下世纪初加速。如今，大约八分之一的美国人年龄在 65 岁或以上。到 2030 年，每 4 人中就有 1 人为老年人。所有年龄段的预期寿命，特别是高龄人群的预期寿命大幅提高，意味着不仅人口中老年人的比例会更高，而且85岁以上的“高龄老人”也会更多。到2050年，他们将占总人口的1/4以上。随着人们寿命的延长，许多人在退休后仍保持活跃和健康。然而，许多 80 多岁的人不得不应对影响他们进行日常活动能力的慢性残疾。现代医学在降低心脏病和中风等疾病的死亡率方面取得了巨大进展，但并没有消除这些疾病的所有影响。随着人口老龄化，医疗保健资金和可用性问题，特别是长期护理，变得越来越重要。与普遍看法相反，老年人并没有被家人遗弃到疗养院接受护理。绝大多数（-95%）居住在社区中。需要帮助的人通常会得到家人和朋友的帮助。这对联邦补贴产生了巨大的需求，以支持基于社区的长期护理服务。目前，1/4 的联邦预算用于老年人——1986 年为 2,700 亿美元。医疗补助和医疗保险是政府的成功案例之一，但这些计划却因其成功而受到威胁。经济学家估计，政府对老年人的支出是儿童的三倍，这就提出了“代际公平”的问题——如何平衡社会为已经缴费者提供的照顾量与为未来缴费者提供的照顾量。认为年轻人和老年人只是争夺固定资源的观点是误导性的。它忽视了代际之间的相互依存，以及生命历程各个阶段代际转移的负担和利益。
The older population in the US has grown twice as fast as the rest of the population in the last 20 years. This growth is expected to accelerate early in the next century as the large baby boom cohorts move through middle age and become elderly. Today, about 1 in 8 Americans is 65 years of age or older. By 2030, 1 out of every 4 persons will be in older person. Substantial improvements in life expectancy at all ages, particularly at extreme old age, mean that not only will there be a greater proportion of elderly in the population, but the more will be the "oldest-old," over 85. By 2050, they will be more than 1/4 of the population. As people live longer, many are active and healthy well past retirement. However, many individuals living into their 80s have to cope with chronic disabilities affecting their capacity to perform day-to-day activities. Modern medicine has made great inroads against mortality from such illnesses as heart disease and stroke, but has not eliminated all the effects of these diseases. As the population ages, the issues of health care funding and availability, particularly long-term care, increase in importance. Contrary to widespread belief, the elderly are not abandoned by their families to nursing home care. The vast majority--95%--live in the community. Those needing assistance generally receive help from family and friends. This has created a tremendous demand for federal subsidies to support community-based long-term care services. 1/4 of the federal budget is now spent on the elderly--$270 billion in 1986. Medicaid and Medicare are among the government's success stories, but these programs are threatened by their very success. Economists estimate that government expenditures are 3 times greater for the elderly than for children, raising the issue of "intergenerational equity"--how to balance the amount of care society provides to those who have already contributed with what is provided to those who will contribute in the future. The view that the young and old simply compete for fixed resources is misleading. It ignores the interdependence among generations, and the burdens and benefits of intergenerational transfers at all stages of the life course.