Sunday, October 29, 2023

Baby Boomers Turning 80: The Flip Side of the 2026 Enrollment Cliff (#medugrift)

While COVID eliminated hundreds of thousands of older Americans from the dependency rolls, higher education experts have not expressed the profound effect that the Baby Boomers reaching their 80s will have on state budgets. In 2026, the year we expect an enrollment cliff, the first Boomers will turn 80. Transfers of wealth will enrich the upper-middle class and the rich, but working-class folks will be further devastated. 

Some of this should not be surprising. US birth rates have been declining for more than six decades. And US inequality began widening about a decade later. 

It should also be unsurprising that younger adults have chosen to have fewer children. Non-immigrants have even fewer--below replacement level. We may not see a population decline soon, but it does change the composition of the US age pyramid (see images below).

This demographic phenomenon, of more older people and fewer young people to care for them, will strain state budgets that need more money for nursing homes and other forms of long-term care. It is taken for granted (from a medical perspective) that with aging in the US comes years of disease, advanced disability, and large medical costs with expensive pills, procedures, hospitalizations, and institutionalization becoming the norm. "Eds and meds" are major employers in most US cities. And ageism, ableism, and sedentary lifestyles make the situation worse. 

The CDC estimates that 80% of adults aged 75 and older have at least one chronic health condition, and 50% have at least two. Some of the most common chronic health conditions among older adults include heart disease, stroke, cancer, diabetes, and arthritis.

According to the Alzheimer's Association, dementia among people in the US over 75 years of age is relatively common. In fact, they estimate that 6.2 million Americans aged 65 and older are living with Alzheimer's dementia, which is the most common form of dementia. Additionally, they estimate that 700,000 Americans aged 65 and older are living with vascular dementia, which is the second most common form of dementia.The risk of developing dementia increases with age, and people over the age of 75 are at the highest risk.

There are a number of ways in which people over 75 in the US differ from elders in other countries. Some of the key differences include:

  • Health: Older adults in the US are more likely to have chronic health conditions and disabilities than older adults in other developed countries. For example, the US has the lowest life expectancy among wealthy countries, and the gap between the US and other countries widens as people get older.
  • Wealth: Older adults in the US are more likely to be living in poverty than older adults in other developed countries. For example, an estimated 6.2 million Americans aged 65 and older live below the poverty line.
  • Social support: Older adults in the US are less likely to have strong social support networks than older adults in other developed countries. For example, the US has a relatively high rate of social isolation among older adults.
  • Access to healthcare: Older adults in the US are more likely to have difficulty accessing affordable healthcare than older adults in other developed countries. For example, the US has a high rate of uninsured and underinsured older adults.

Robotics and other less human strategies to manage elders may reduce costs. However, unless there are dramatic cuts in the US healthcare system, K-12 education, and prisons, community colleges and non-flagship state universities are likely to face more austerity.  Suzanne Mettler described this budgetary strain in her 2014 book Degrees of Inequality.  It's almost ten years later and little has been done to prepare for this wave. 

States with large percentages of poor elderly may be harder hit.  This may include New Mexico (13.3%), Mississippi (12.4%), Louisiana: (12.4%), New York: (11.8%), Rhode Island: (11.2%), Texas: (11.1%), Florida: (10.6%), and California: (10.5%). 

Changing the inverting pyramid would have economic and political consequences. Forcing girls and women to have children may be more likely in 2023 than it was in 1973, but that's not likely to improve the human condition. Allowing more immigration does not appear politically feasible. And adding population to the US means more global environmental destruction--the ultimate rate limiting factor.



Related link:

"Let's all pretend we couldn't see it coming" (The US Working-Class Depression)

State Universities and the College Meltdown

Community Colleges at the Heart of College Meltdown