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National Healthcare Disparities Report, 2004

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The elderly (age 65 and over) numbered 35.6 million in 2002, an increase of 3.3 million, or 10.2%, since 1992. About 1 in every 8 Americans is in this age group. By the year 2030, the elderly population will more than double to 71.5 million. Older women outnumber older men (20.8 million vs. 14.8 million). Members of minority groups are projected to represent 26.4% of the elderly in 2030, up from 16.4% in 2000. About 3.6 million elderly lived below the poverty level in 2002, corresponding to a poverty rate of 10.4%. Another 2.2 million or 6.4% of the elderly were classified as near poor (income between the poverty level and 125% of this level)67.

On average, 65-year-olds can expect, to live an additional 18.1 years. In 2003, 38.6% of noninstitutionalized older persons assessed their health as excellent or very good compared with 66.6% of persons ages 18-64, and older blacks and Hispanics were less likely to rate their health as excellent or good than older whites. Most older people have at least one chronic condition. In 1997, more than half of the elderly reported a disability and over a third reported a severe disability67.

The Medicare program provides core health insurance to nearly all elderly Americans and reduces many financial barriers to acute and post-acute care services faced by the elderly. The Medicare Prescription Drug Improvement and Modernization Act of 2003 added important new prescription drug and preventive benefits to Medicare and provides extra financial help to people with low incomes. Consequently, differences in access to and quality of health care tend to be smaller among Medicare beneficiaries than among younger populations. However, racial, ethnic, and socioeconomic differences are still observed among the elderly.

Surveys of the general population often do not include enough elderly to examine racial, ethnic, or SES differences in health care. Consequently, this report relies upon data from the Medicare Current Beneficiary Survey to examine disparities in access to and quality of care.

Many measures of relevance to the elderly are tracked in the NHDR. Findings presented here seek to highlight conditions and topics of particular importance to quality of and access to health care among elderly Americans including:

  • Cancer
  • Vaccinations
  • Usual source of care
  • Patient perceptions of need



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