Health

Younger baby boomers report poorer overall health

Researchers wonder if those nearing retirement are expecting too much in the way of good health.

By Susan J. Landers — Posted March 26, 2007

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Could younger baby boomers be approaching retirement in poorer health than their immediate predecessors?

A new report by the National Bureau of Economic Research involving National Institute on Aging survey data leads to the conclusion that they are. The NBER is a nonprofit organization based in Cambridge, Mass.

According to this document, Americans in their early to mid-50s thought their health was worse, their pain was greater and their everyday physical tasks were more trouble to complete than had their older peers when they responded to the same questions at the same age. These findings add to a growing body of research -- some conflicting -- on boomers' health. This demographic group concerns many in the health care community because of fears that large numbers of older people in poor health will flood doctors' offices and overwhelm the system.

"There is a mix of evidence," said Richard Suzman, PhD, director of the NIA's behavioral and social research program, about what the future might hold. Some indicators point to a decline in disability among those age 65 and older since 1982, he said. "I think it's a balance of forces, and my prediction would be for [that] decline to continue. But we'll see."

Others, though, suggest that this trend may taper off or be reversed by increases in obesity and the major impact it has on heart disease and other ills, he added. The NBER report, "Cross-Cohort Differences in Health on the Verge of Retirement," offers evidence in support of this view. It was first released as a working paper in 2006 and is now slated for publication this year as a book chapter.

In it, researchers from the University of Pennsylvania in Philadelphia and Carleton University in Ottawa, Canada, compared the overall, self-reported health of people in three birth-year groups -- those born between 1936-41 (now ages 66 to 71), 1942-47 (now ages 60 to 65) and 1948-53 (now ages 54 to 59). These data came from the Health and Retirement Study, a nationwide, NIA-sponsored survey conducted since 1992 of more than 20,000 Americans older than 50.

How are they doing?

The report used respondents' answers to compare their assessments of health and well-being when they were all between 51 and 56.

Among the findings:

  • The two younger groups were less likely than the oldest group to have said their health was "excellent or very good" at 51 to 56 years.
  • The youngest group reported having more pain, chronic health conditions, drinking and psychiatric problems than did people at that age about a decade earlier.
  • Compared with the oldest group, the youngest group was more likely to have reported difficulty in walking, climbing steps, getting up from a chair, kneeling or crouching and doing other normal daily physical tasks.

The findings surprised the researchers, said Beth J. Soldo, PhD, director of the Population Aging Research Center at the University of Pennsylvania and a researcher on the study. "When I first saw the results coming in, I thought I had done something wrong."

Nonetheless, a study published three years ago in the journal Health Affairs reached similar conclusions, finding increasing disability levels among younger Americans, especially those ages 30 to 49. The new report confirms those findings, said Jay Bhattacharya, MD, PhD, assistant professor of medicine at Stanford University in Stanford, Calif. Dr. Bhattacharya was a co-author of the Health Affairs study.

"For the past 30 years, we have seen great reductions in disability prevalence among the elderly," he said. "These results and ours both suggest that these reductions may not continue in the future."

Although obesity could be the cause of some of the increased disability, "It seems a stretch to pin increasing psychiatric disease prevalence to obesity," Dr. Bhattacharya said. "Clearly something else is going on, and it will be interesting to find out what."

Dr. Soldo has a theory. The findings may result from unrealistically high hopes. "All of us boomers have been raised with the expectation that we are the best, our health is great. Look at the number who go to the gym and run marathons."

But although many might be in terrific health at mid-life, it's not likely that everyone in the cohorts studied is in optimal condition, Dr. Soldo said. She speculated that her findings may be because "people are increasingly intolerant of poor health."

Dr. Suzman went so far as to call the increased reporting of poor health "a possible decline in stoicism" or a "weakening of the stiff upper lip."

Dr. Soldo emphatically denied that the younger boomers were whiners. "I think it's rising expectations and the greater use of health care services. The more you see a physician, the more you are likely to find a problem of some sort."

But the increased prevalence of diabetes also could drive the findings with its implications for increases in cardiovascular and cerebrovascular disease, she said.

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ADDITIONAL INFORMATION

Getting sicker all the time

A 2006 report, "Cross-Cohort Differences in Health on the Verge of Retirement," found that baby boomers are in poorer health than their counterparts 12 years earlier. And in 2004, another study found substantial growth in reported rates of disability in populations younger than 50 but not among the elderly. Here are the explanations each offered:

2006 report

  • The act of seeking health care increases awareness of other health problems.
  • The barrage of advertisements for prescription medication increases disease or symptom awareness.
  • Changing notions of health in aging increase intolerance of minor pain, slight loss of stamina or even minute loss of muscle strength to the extent that younger people are less accepting of physiological changes.

2004 report

  • The recent rise in obesity levels represents one plausible reason why there might have been real deterioration in health.
  • Advances in medicine may have saved the lives of some who would have died in earlier years. This could lower the proportion of deceased but raise the proportion of people living with disability.
  • Trends in disability could reflect forces other than health, namely, changes in the economic incentives for disability insurance.

Sources: "Cross-Cohort Differences in Health on the Verge of Retirement," National Bureau of Economic Research Working Paper, 2006; "Trends: Are the Young Becoming More Disabled?" Health Affairs, January/February 2004

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External links

"Cross-Cohort Differences in Health on the Verge of Retirement," National Bureau of Economic Research working paper, December 2006 (link)

The Health and Retirement Study at the University of Michigan (link)

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