As the population ages over the next three decades, the proportion of Americans over age 65 will exceed 25 percent. This demographic change will have a dramatic impact on income support and retirement programs, health care utilization, family caregivers, and the demand for long-term care (LTC) services, supportive housing, and transportation. The impact will be particularly acute for the health, LTC, and social support systems designed to serve older persons. Although many older individuals will enjoy good health and lead active lives in the community, a significant number of older Americans will have chronic illnesses and disabilities that reduce their ability to live independently. Currently, older Americans represent only 13 percent of the U.S. population, yet they account for 36 percent of all hospital stays, 49 percent of all days in the hospital, and 50 percent of all physician hours. It is estimated that, as the population ages, older Americans will incur 50 percent of all medical care expenditures.
As myths of aging have been discredited and replaced with a new understanding of the aging process, many middle-aged and older Americans no longer believe that aging inevitably means being unhealthy and impaired. There is a recognition that the adoption of positive, healthy habits (e.g., regular exercise) and the cessation of negative habits (e.g., smoking) can help to ensure a healthy and independent old age. An "active aging" paradigm is being accepted and embraced by a larger proportion of older Americans than ever before, and the baby boom cohort is likely to take a much more active role in managing their health than are current cohorts. This situation provides a fertile ground for public health interventions to promote healthy aging.
Given the magnitude of growth in the number of older Americans projected over the next three decades, it will become increasingly important for the adult population to engage in health-promoting activities to both reduce preventable illness and prevent premature impairment. Many activities are being conducted that relate to health promotion and disease prevention interventions for older persons, and private and public organizations are learning much about the potential of public health strategies to promote "healthy aging." Examining more closely the research, evaluation activities, and targeted health promotion and disease prevention programs will help identify areas that can be strengthened as the government promotes models of healthy aging in the future.