A Profile

of 

Older Americans: 2004 

Administration on Aging 

U.S. Department of Health and Human Services
Table of Contents 

Highlights.................................................................................................... 1

The Older Population..................................................................................... 2 

Future Growth............................................................................................. 3 

 Figure 1: Number of Persons 65+, 1900 - 2030 (numbers in millions) 

Marital Status.............................................................................................. 4 

 Figure 2: Marital Status of Persons 65+ - 2003 

Living Arrangements..................................................................................... 5 

 Figure 3: Living Arrangements of Persons 65+: 2002 

Racial and Ethnic Composition.......................................................................... 6 

Geographic Distribution.................................................................................. 6 

Figure 4: Persons 65+ as Percentage of Total Population by State: 2003 (US Map) 

Figure 5: Percentage Increase in Population 65+ by State: 2003 (US Map) 

Figure 6: The 65+ Population by State: 2003 (table) 

Income ..................................................................................................... 10 

 Figure 7: Percent Distribution by Income: 2003 

Poverty ..................................................................................................... 11 

Housing ................................................................................................... 11 

Employment .............................................................................................. 12 

Education ................................................................................................. 12 

Health and Health Care ................................................................................. 12

Disability and Activity Limitations .................................................................... 13 

 Figure 8: Percent with Disabilities, By Age: 1997 

Caregiving .................................................................................................... 14 

Special Topic: Health Insurance Coverage ...................................................... 15 

 Figure 9: Sources of Health Insurance Coverage: 2003 

Notes ....................................................................................................... 16 
Highlights *

• The older population (65+) numbered 35.9 million in 2003, an increase of 3.1 million or 9.5% 

since 1993. 

• The number of Americans aged 45-64 – who will reach 65 over the next two decades – increased 

by 39% during this decade. 

• About one in every eight, or 12.4 percent, of the population is an older American. 

• Over 2.0 million persons celebrated their 65th birthday in 2003. 

• Persons reaching age 65 have an average life expectancy of an additional 18.2 years (19.5 years 

for females and 16.6 years for males). 

• Older women outnumber older men at 21.0 million older women to 14.9 million older men. 

• In 2003, 17.6% of persons 65+ were minorities--8.2% were African-Americans,** 2.8% were 

Asian or Pacific Islander,** and less than 1% were American Indian or Native Alaskan.** 

Persons of Hispanic origin (who may be of any race) represented 5.7% of the older population. 

In addition, 0.5% of persons 65+ identified themselves as being of two or more races. 

• Older men were much more likely to be married than older women--71% of men vs. 41% of 

women (Figure 2). Almost half of all older women in 2003 were widows (43%). 

• About 31 percent (10.5 million) of noninstitutionalized older persons live alone (7.8 million 

women, 2.7 million men). 

• Half of older women age 75+ live alone. 

• About 416,000 grandparents aged 65 or more had the primary responsibility for their 

grandchildren who lived with them. 

• By the year 2030, the older population will more than double to 71.5 million. 

• The 85+ population is projected to increase from 4.7 million in 2003 to 9.6 million in 2030. 

• Members of minority groups are projected to represent 26.4 percent of the older population in 

2030, up from 16.4 percent in 2000. 

• The median income of older persons in 2003 was $20,363 for males and $11,845 for females. 

Median money income of all households headed by older people (after adjusting for inflation) 

rose by 0.4% from 2002 to 2003; however, this difference was not statistically significant. 

• For one-third of Americans over 65, Social Security benefits constitute 90% of their income. 

• About 3.6 million elderly persons (10.2%) were below the poverty level in 2003. This poverty 

rate was not statistically different from the poverty rate in 2002. Another 2.3 million or 6.7% of 

the elderly were classified as "near-poor" (income between the poverty level and 125% of this 

level). 

• About 11% (3.7 million) of older Medicare enrollees received personal care from a paid or unpaid 

source in 1999. 

*Principal sources of data for the Profile are the U.S. Bureau of the Census, the National Center on Health Statistics, 

and the Bureau of Labor Statistics. The Profile incorporates the latest data available but not all items are updated on 

an annual basis. 
The Older Population

The older population--persons 65 years or older--numbered 35.9 million in 2003 (the most recent year 

for which data are available). They represented 12.4% of the U.S. population, about one in every eight 

Americans. The number of older Americans increased by 3.1 million or 9.5% since 1993, compared to an 

increase of 13.3% for the under-65 population. However, the number of Americans aged 45-64 – who 

will reach 65 over the next two decades – increased by 39% during this period. 

In 2003, there were 21.0 million older women and 14.9 million older men, or a sex ratio of 140 women 

for every 100 men. The female to male sex ratio increases with age, ranging from 115 for the 65-69 age 

group to a high of 226 for persons 85 and over. 

Since 1900, the percentage of Americans 65+ has tripled (from 4.1% in 1900 to 12.4% in 2004), and the 

number has increased eleven times (from 3.1 million to 35.9 million). The older population itself is 

getting older. In 2003, the 65-74 age group (18.3 million) was eight times larger than in 1900, but the 75-

84 group (12.9 million) was 17 times larger and the 85+ group (4.7 million) was 38.5 times larger. 

In 2002, persons reaching age 65 had an average life expectancy of an additional 18.2 years (19.5 years 

for females and 16.6 years for males). 

A child born in 2002 could expect to live 77.3 years, about 30 years longer than a child born in 1900. 

Much of this increase occurred because of reduced death rates for children and young adults. However, 

the period of 1980-2002 also has seen reduced death rates for the population aged 65-84, especially for 

men – by 30.4% for men aged 65-74 and by 23.3% for men aged 75-84. Life expectancy at age 65 

increased by only 2.5 years between 1900 and 1960, but has increased by 3.9 years from 1960 to 2002. 

Over 2.0 million persons celebrated their 65th birthday in 2003. In the same year, about 1.8 million 

persons 65 or older died. Census estimates showed an annual net increase of over 317,000 in the number 

of persons 65 and over. 

There were 50,639 persons aged 100 or more in 2003 (0.17% of the total population). This is a 36% 

increase from the 1990 figure of 37,306. 

(Data for this section were compiled primarily from Internet releases of the U.S. Bureau of the Census 

and the National Center for Health Statistics). 

- 2-
Future Growth

The older population will continue to grow significantly in the future (see Figure 1). This growth slowed 

somewhat during the 1990's because of the relatively small number of babies born during the Great 

Depression of the 1930's. But the older population will burgeon between the years 2010 and 2030 when 

the "baby boom" generation reaches age 65. 

By 2030, there will be about 71.5 million older persons, more than twice their number in 2000. People 

65+ represented 12.4% of the population in the year 2000 but are expected to grow to be 20% of the 

population by 2030. The 85+ population is projected to increase from 4.6 million in 2002 to 9.6 million 

in 2030. 

Minority populations are projected to represent 26.4% of the elderly population in 2030, up from 17.6% 

in 2003. Between 2000 and 2030, the white** population 65+ is projected to increase by 77% compared 

with 223% for older minorities, including Hispanics (342%), African-Americans** (164%), American 

Indians, Eskimos, and Aleuts** (207%), and Asians and Pacific Islanders** (302%). 

Figure 1: Number of Persons 65+,

1900 - 2030 (numbers in millions)

3.1 4.9 9

16.7

25.7

31.2 35

40.2

54.6

71.5

0

10

20

30

40

50

60

70

80

1900 1920 1940 1960 1980 1990 2000 2010 2020 2030

Year (as of July 1)

Note: Increments in years are uneven. 

(Sources: Projections of the Population by Age are taken from the January 2004 Census Internet 

Release. Historical data are taken from "65+ in the United States," Current Population Reports, 

Special Studies, P23-190 Data for 2000 are from the 2000 Census and 2003 data are taken from the 

Census estimates for 2003.) 

- 3- 
Marital Status

In 2003, older men were much more likely to be married than older women--71% of men, 41% of women 

(Figure 2). Almost half of all older women in 2003 were widows (43%). There were over four times as 

many widows (8.2 million) as widowers (2.0 million). 

Divorced and separated (including married/spouse absent) older persons represented only 10.7% of all 

older persons in 2003. However, this percentage has increased since 1980, when approximately 5.3% of 

the older population were divorced or separated/spouse absent. 

Figure 2: Marital Status of Persons 65+ - 2003

44%

11%

4%

41%

71%

10%

4%

14%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Married Widowed Divorced or

Separated/

Spouse

Absent

Single

(never

married)

Women Men

 (Based on Internet releases of data from the 2003 Current Population Survey of the U.S. Bureau of 

the Census) 

- 4 - 
Living Arrangements

Over half (53.9%) the older noninstitutionalized persons lived with their spouse in 2003. Approximately

10.3 million or 71.2% of older men, and 8.1 million or 41.1% of older women, lived with their spouse 

(Figure 3). The proportion living with their spouse decreased with age, especially for women. Only 28.7% 

of women 75+ years old lived with a spouse. 

About 30.8% (10.5 million) of all noninstitutionalized older persons in 2003 lived alone (7.8 million 

women, 2.7 million men). They represented 39.7 of older women and 18.8% of older men. The proportion 

living alone increases with advanced age. Among women aged 75 and over, for example, half (49.8%) 

lived alone. 

About 643,000 grandparents aged 65 or over maintained households in which grandchildren were present 

in 2003. (Another 215,000 elderly were spouses of such people.) In addition, 453,000 grandparents over 

65 years lived in parent- maintained households in which their grandchildren were present. About 

416,000 grandparents over 65 years old were the persons with primary responsibility for their 

grandchildren who lived with them. 

While a relatively small number (1.56 million) and percentage (4.5%) of the 65+ population lived in 

nursing homes in 2000, the percentage increases dramatically with age, ranging from 1.1% for persons 

65-74 years to 4.7% for persons 75-84 years and 18.2% for persons 85+. In addition, approximately 5%

of the elderly lived in self-described senior housing of various types, many of which have supportive 

services available to their residents. 

Figure 3: Living Arrangements of Persons 65+: 2003 

Men

71%

19%

10%

living with spouse

living alone 

Other

Women

41%

40%

19%

living with spouse

living alone

Other

(Based on data from U.S. Bureau of the Census including the 2003 Current Population Survey and the 

2003 American Community Survey. See: March 2003 Current Population Survey Internet releases. 

See also: "America’s Families and Living Arrangements; Population Characteristics: June, 2001,

Current Population Reports, P20-537” and “The 65 Years and Over Population: 2000, Census 2000 

Brief, October, 2001” as well as other Census 2000 data and unpublished data from the Centers for 

Medicare and Medicaid Services.) 

- 5 - 
Racial and Ethnic Composition

In 2003, 17.6% of persons 65+ were minorities--8.2% were African-Americans,** 2.8% were Asian or 

Pacific Islander,** and less than 1% were American Indian or Native Alaskan.** Persons of Hispanic 

origin (who may be of any race) represented 5.7% of the older population. In addition, 0.5% of persons 

65+ identified themselves as being of two or more races. 

Only 6.8% of minority race and Hispanic populations were 65+ in 2003 (8.3% of African-Americans,** 

8.4% of Asians and Pacific Islanders,** 6.9% of American Indians and Native Alaskans,** 5.2% of 

Hispanics), compared with 15.1% of whites.** 

(Data for this section were compiled from Internet releases of the Census 2003 Estimates).

Geographic Distribution

The proportion of the older persons in the population varies considerably by state with some states 

experiencing much greater growth in their older populations (Figures 4 and 5). In 2003, about half (52%) 

of persons 65+ lived in nine states. California had over 3.8 million; Florida 2.9 million; New York 2.5 

million; Texas 2.2 million; and Pennsylvania 1.9 million. Ohio, Illinois, Michigan, and New Jersey each 

had well over 1 million (Figure 6). 

Person 65+ constituted approximately 14% or more of the total population in 9 states in 2003 (Figure 6): 

Florida (17.0%); Pennsylvania (15.4%); West Virginia (15.3%); North Dakota (14.8%); Iowa (14.7%); 

Maine (14.4); South Dakota (14.3); Rhode Island (14.0%); and Arkansas (13.9%). In nine states, the 65+ 

population increased by 20% or more between 1993 and 2003 (Figure 6): Nevada (60.5%); Alaska 

(50.3%); Arizona (32.4%); New Mexico (27.1%); Colorado (22.8%); Utah (22.5%); Delaware 

(22.4%); Hawaii (20.9%); and Idaho (20.6%). The ten jurisdictions with the highest poverty rates for 

elderly over the period 2001-2003 were Mississippi (17.1%); the District of Columbia (16.0%); Arkansas 

(15.7%); Texas (15.1%); South Carolina (14.6%); North Carolina (13.7%); Massachusetts (13.0%); 

Tennessee (12.8%); Alabama (12.6%); and New York (12.6%). 

Most persons 65+ lived in metropolitan areas in 2003 (77.4%). About 50% of older persons lived in the 

suburbs, 27.2% lived in central cities, and 22.6% lived in nonmetropolitan areas. 

The elderly are less likely to change residence than other age groups. In the five year period from 1995 to 

2000, 22.8% of older persons had moved (compared to 47.7% of persons under 65). Most older movers 

(59.7%) stayed in the same county while only 18.8% (of the movers) moved to another state. The 85+ 

segment of the older population had a much high rate of moving. During this period, 32.3% of the 85+ 

population moved, 61.1% of them within the same county. 

(Data for this section and for Figure 4 were compiled primarily from the Census Population Estimates 

for 2003 as well as other Internet releases of the U.S. Bureau of the Census including tables from the 

March 2003 Current Population Survey and “Internal Migration of the Older Population: 1995 to 

2000,” Census 2000 Special Report, CENSR-10, August 2003). 

- 6 - 
Figure 4: Persons 65+ as a Percentage of Total Population - 2003 

Percent 65+

by State

13.5% to 17.0% (12)

13.1% to 13.4% (6)

12.4% to 13.0% (10)

11.8% to 12.3% (11)

6.2% to 11.7% (12)

Based on Census 2003 Population Estimates from the U.S. Bureau of the Census 

- 7 - 
Figure 5: Percentage Increase in Population 65+ -- 1993 to 2003 

Percent Increase 1993-2003

65+ Population by State

19.9% to 60.5% (10)

13.2% to 19.8% (10)

6.1% to 13.1 (10)

0.3% to 6.0% (10)

-12.0% to 0.02% (11)

Based on Census 1993 and 2003 Population Estimates from the U.S. Bureau of the Census

- 8 - 
Figure 6: The 65+ Population by State 2003 

Numbers 

Number of 

Persons 

Percent of 

All Ages 

Increase from 

1993 to 2003 

Percent Below Poverty 

2001-2003 

 US Total (50 States + DC) 35,919,174 12.4% 9.5% 10.3% 

 Alabama 592,181 13.2% 8.6% 12.6% 

 Alaska 40,598 6.3% 50.3% 7.9% 

 Arizona 714,467 12.8% 32.4% 6.5% 

 Arkansas 377,682 13.9% 5.4% 15.7% 

 California 3,764,870 10.6% 12.8% 8.6% 

 Colorado 441,371 9.7% 22.8% 9.0% 

 Connecticut 470,689 13.5% 2.2% 6.2% 

 Delaware 106,896 13.1% 22.4% 5.6% 

 District of Columbia 67,845 12.0% -11.9% 16.0% 

 Florida 2,897,383 17.0% 14.3% 10.2% 

 Georgia 826,506 9.5% 18.7% 12.4% 

 Hawaii 169,346 13.5% 20.9% 8.8% 

 Idaho 155,652 11.4% 20.6% 5.4% 

 Illinois 1,507,377 11.9% 1.8% 8.2% 

 Indiana 763,059 12.3% 5.3% 8.0% 

 Iowa 433,618 14.7% 0.1% 8.7% 

 Kansas 353,585 13.0% 0.5% 8.6% 

 Kentucky 512,381 12.4% 6.4% 10.3% 

 Louisiana 524,348 11.7% 7.8% 12.4% 

 Maine 188,385 14.4% 10.6% 10.5% 

 Maryland 624,980 11.3% 13.2% 9.9% 

 Massachusetts 856,982 13.3% 0.9% 13.0% 

 Michigan 1,236,501 12.3% 5.4% 9.0% 

 Minnesota 609,396 12.0% 7.6% 9.1% 

 Mississippi 349,407 12.1% 6.1% 17.1% 

 Missouri 759,980 13.3% 3.0% 8.0% 

 Montana 125,160 13.6% 12.2% 10.8% 

 Nebraska 232,387 13.4% 2.3% 10.0% 

 Nevada 250,787 11.2% 60.5% 8.2% 

 New Hampshire 154,174 12.0% 15.9% 7.0% 

 New Jersey 1,123,842 13.0% 4.8% 9.3% 

 New Mexico 225,266 12.0% 27.1% 12.2% 

 New York 2,488,959 13.0% 3.9% 12.6% 

 North Carolina 1,016,214 12.1% 17.0% 13.7% 

 North Dakota 93,837 14.8% 0.8% 10.5% 

 Ohio 1,516,771 13.3% 3.0% 7.7% 

 Oklahoma 461,133 13.1% 5.3% 11.8% 

 Oregon 453,568 12.7% 9.0% 6.4% 

 Pennsylvania 1,901,764 15.4% 0.4% 9.0% 

 Rhode Island 150,797 14.0% -2.3% 11.4% 

 South Carolina 511,732 12.3% 19.9% 14.6% 

 South Dakota 109,040 14.3% 4.3% 10.9% 

 Tennessee 726,683 12.4% 12.3% 12.8% 

 Texas 2,175,256 9.8% 18.3% 15.1% 

 Utah 203,007 8.6% 22.5% 8.4% 

 Vermont 80,132 12.9% 16.1% 8.9% 

 Virginia 833,427 11.3% 17.2% 10.0% 

 Washington 690,583 11.3% 13.3% 8.3% 

 West Virginia 277,220 15.3% 0.4% 10.1% 

 Wisconsin 711,987 13.0% 5.5% 7.8% 

 Wyoming 59,963 12.0% 17.7% 7.7% 

Population data is from the Census Bureau Population Estimates and poverty data is from the Current Population 

Survey, 2001, 2002, and 2003 Annual Social and Economic Supplements. 

- 9 - 
Income

The median income of older persons in 2003 was $20,363 for males and $11,845 for females. Median 

money income of all households headed by older people rose by 0.4% from 2002 to 2003; however, this 

difference was not statistically significant. Households containing families headed by persons 65+ 

reported a median income in 2003 of $35,310 ($36,797 for non-Hispanic Whites, $28,407 for AfricanAmericans, $34,872 for Asians, and $25,355 for Hispanics). About one of every ten (9.9%) family

households with an elderly householder had incomes less than $15,000 and 50.4% had incomes of 

$35,000 or more (Figure 7). 

Figure 7: Percent Distribution by Income: 2003* 

Family Households 65+ Householder

18.0%

16.9%

15.6%

18.3%

6.0%

21.4%

3.9%

0.0% 5.0% 10.0% 15.0% 20.0% 25.0%

Under $10,000

$10,000 - $14,999

$15,000 - $24,999

$25,000 - $34,999

$35,000 - $49,999

$50,000 - $74,999

$75,000 and over

$35,310 median for 12.0 million family households 65+ 

Persons 65+ Reporting Income

22.0%

9.1%

7.3%

22.9%

10.4%

21.9%

6.4%

0% 5% 10% 15% 20% 25%

Under $5,000

$5,000 - $9,999

$10,000 - $14,999

$15,000 - $24,999

$25,000 - $34,999

$35,000 - $49,999

$50,000 and over

$14,664 median for 33.8 million persons 65+ reporting income 

- 10 - 
For all older persons reporting income in 2002 (33.8 million), 29.3% reported less than $10,000. Only 

26.8% reported $25,000 or more. The median income reported was $14,664. 

For one-third of Americans over 65, Social Security benefits constitute 90% of their income. The major 

other sources of income as reported by the Social Security Administration for older persons in 2002 were 

income from assets (reported by 55%), private pensions (reported by 29%), government employee 

pensions (reported by 14%), and earnings (reported by 22%). 

(Based on data from Current Population Survey, Annual Social and Economic Supplement, "Income, 

Poverty, and health Insurance Coverage in the United States: 2003," P60-226, issued August, 2003, by 

the U.S. Bureau of the Census, related Census detailed tables on the Census Bureau web site, and from 

Fast Facts and Figures About Social Security, 2004, Social Security Administration)

Poverty

About 3.6 million elderly persons (10.2%) were below the poverty level in 2003. This poverty rate was 

not statistically different from the poverty rate in 2002. The historic lowest level of 9.7% was reached in 

1999. Another 2.3 million or 6.7% of the elderly were classified as "near-poor" (income between the 

poverty level and 125% of this level). 

One of every twelve (8.8%) elderly Whites** was poor in 2003, compared to 23.7% of elderly AfricanAmericans,** 14.3% of Asians,** and 19.5% of elderly Hispanics. Higher than average poverty rates for 

older persons were found among those who lived in central cities (13.1%), outside metropolitan areas (i.e. 

rural areas) (11.0%), and in the South (11.9%). 

Older women had a higher poverty rate (12.5%) than older men (7.3%) in 2003. Older persons living 

alone were much more likely to be poor (18.6%) than were older persons living with families (5.8%). 

The highest poverty rates (40.8%) were experienced by older Hispanic women who lived alone. 

Based on data from Current Population Survey, Annual Social and Economic Supplement, "Income, 

Poverty, and Health Insurance Coverage in the United States: 2003," P60-226, issued August, 2004, 

by the U.S. Bureau of the Census and related Census detailed tables on the Census Bureau web site 

Housing

Of the 21.6 million households headed by older persons in 2003, 80% were owners and 20% were renters. 

The median family income of older homeowners was $25,353. The median family income of older renters 

was $13,540. In 2003, 42% of older householders spent more than one-fourth of their income on housing 

costs - 35% for owners and 76% for renters - .as compared to 41% of all householders. 

For homes occupied by older householders in 2003, the median year of construction was 1965 (it was 

1971 for all householders) and 5.2% had physical problems. In 2003, the median value of homes owned 

by older persons was $122,790 (with a median purchase price of $32,905) compared to a median home 

value of $140,201 for all homeowners. About 72% of older homeowners in 2003 owned their homes free 

and clear. 

(Source: "American Housing Survey for the United States in 2003, Current Housing Reports" 

H150/03)

- 11 - 
Employment 

In 2003, 5.0 million (14.4 %) Americans age 65 and over were in the labor force (working or actively 

seeking work), including 3.3 million men (18.3%) and 2.1 million women (10.7%). They constituted 

3.4% of the U.S. labor force. About 3.6% were unemployed. Labor force participation of men 65+ 

decreased steadily from 2 of 3 in 1900 to 15.8% in 1985, and has stayed at 16%-18% since then. The 

participation rate for women 65+ rose slightly from 1 of 12 in 1900 to 10.8% in 1956, fell to 7.3% in 

1985, and has been around 8%-10% since 1988. 

(Source: Bureau of Labor Statistics web-site: http://www.bls.gov/cps/home.htm)

Education

The educational level of the older population is increasing. Between 1970 and 2003, the percentage who 

had completed high school rose from 28% to 71%. Over 17% in 2003 had a bachelor's degree or more. 

The percentage who had completed high school varied considerably by race and ethnic origin in 2003: 

76% of Whites**, 70% of Asians and Pacific Islanders, 52% of African-Americans, and 36% of 

Hispanics. The increase in educational levels is also evident within these groups. In 1970, only 30% of 

older Whites and 9% of older African-Americans were high school graduates. 

(Source: Current Population Survey, Annual Social and Economic Supplement, 2003 and related 

tables on the Census Bureau web site)

Health and Health Care

In 2004 (January-June), 37.4% of noninstitutionalized older persons assessed their heath as excellent or 

very good (compared to 65.8% for persons aged 18-64). There was little difference between the sexes on 

this measure, but older African-Americans (57.7%)** and older Hispanics (60.1%) were less likely to rate 

their health as excellent or good than were older Whites (76.9%).***** Most older persons have at least 

one chronic condition and many have multiple conditions. Among the most frequently occurring 

conditions of elderly in 2000-2001 were: hypertension (49.2%), arthritic symptoms (36.1%), all types of 

heart disease (31.1%), any cancer (20.0), sinusitis (15.1%), and diabetes (15.0). 

Almost 70% reported in 2004that they received an influenza vaccination during the past 12 months and 

57% reported that they had ever received a pneumococcal vaccination. About 24% (of persons 60+) 

report height/weight combinations that place them among the obese. Over 26% of persons aged 65-74 

and 16% of persons 75+ report that they engage in regular leisure-time physical activity. Only 8% 

reported that they are current smokers and only 4% reported excessive alcohol consumption. Only 2.4% 

reported that they had experienced psychological distress during the past 30 days. 

In 2002, over 12.7 million persons aged 65 and older were discharged from short stay hospitals. This is a 

rate of 3,575 for every 10,000 persons aged 65+ which is more than three times the comparable rate for 

persons aged 45-64 (which was 1,159 per 10,000). The average length of stay for persons aged 65+ was 

5.8 days; the comparable rate for persons aged 45-64 was 5.0 days. The average length of stay for older 

people has decreased almost 5 days since 1980. Older persons averaged more office visits with doctors in 

2002 – 6.6 for those aged 65-74 and 7.2 for persons over 75 while persons aged 45-65 averaged only 3.7 

office visits during that year. Almost 96% of older persons reported that they did have a usual place to go 

- 12 - 
for medical care and only 2.5% said that they failed to obtain needed medical care during the previous 12

months due to financial barriers. 

In 2002, older consumers averaged $3,741 in out-of-pocket health care expenditures, an increase of 45% 

since 1992. In contrast, the total population spent considerably less, averaging $2,416 in out-of-pocket 

costs. Older Americans spent 12.7%of their total expenditures on health, more than twice the proportion 

spent by all consumers (5.9%). Health costs incurred on average by older consumers in 2002 consisted of 

$2,002 (53%) for insurance, $905 (24%) for drugs, $688 (18%) for medical services, and $146 (4%) for 

medical supplies. 

(Sources: Advanced Data From Vital and Health Statistics and other data releases from the National 

Center for Health Statistics web site; and the Bureau of Labor Statistics web site) 

Disability and Activity Limitations 

In 1997, more than half of the older population (54.5%) reported having at least one disability of some

type (physical or nonphysical). Some of these disabilities may be relatively minor but others cause 

people to require assistance to meet important personal needs. Over a third (37.7%) reported at least one 

severe disability. The percentages with disabilities increase sharply with age (Figure 8). Disability takes a 

much heavier toll on the very old. Almost three-fourths (73.6%) of those aged 80+ report at least one 

disability. Over half (57.6%) of those aged 80+ had one or more severe disabilities and 34.9% of the 80+ 

population reported needing assistance as a result of disability. There is a strong relationship between 

disability status and reported health status. Among those 65+ with a severe disability, 68.0% reported 

their health as fair or poor. Among the 65+ persons who reported no disability, only 10.5% reported their 

health as fair or poor. Presence of a severe disability is also associated with lower income levels and 

educational attainment. 

Figure 8: Percent With Disabilities, By Age: 1997 

Figure 8: Percent with Disabilities, by

Age

57.7

38

57.6

34.9

8.1

30.7

44.9

46.6

10.5

28.3

16.9

73.6

0

10

20

30

40

50

60

70

80

% with any

disability

% with

severe

disability

% need

assistance

65-69

70-74

75-79

80+

- 13 -
In another study which focused on the ability to perform specific activities of daily living (ADLs), 

over 27.3% of community-resident Medicare beneficiaries over age 65 in 1999 had difficulty in 

performing one or more ADLs and an additional 13.0% reported difficulties with instrumental activities 

of daily living (IADLs). By contrast, 93.3% of institutionalized Medicare beneficiaries had difficulties 

with one or more ADLs and 76.3% of them had difficulty with three or more ADLS. [ADLs include 

bathing, dressing, eating, and getting around the house. IADLs include preparing meals, shopping, 

managing money, using the telephone, doing housework, and taking medication]. Limitations on 

activities because of chronic conditions increase with age. Among those 65-74 years old, 19.9 percent 

had difficulties with ADLs. In contrast, over half (52.5%) of these 85 years and older had difficulties 

with ADLs. 

It should be noted that (except where noted) the figures above are taken from surveys of the 

noninstitutionalized elderly. Although nursing homes are being increasingly used for short-stay postacute care, about 1.6 million elderly are in nursing homes (about half are age 85 and over). These 

individuals often have high needs for care with their ADLs and/or have severe cognitive impairment, due 

to Alzheimer's disease or other dementias. 

(Sources: Current Population Reports, "Americans with Disabilities, 1997" P70-73, February 2001 

and related Internet data; Internet releases of the Census Bureau and the National Center on Health 

Statistics)

Caregiving 

About 11% (3.7 million) of older Medicare enrollees received personal care from a paid or unpaid source 

in 1999. Almost all community resident older persons with chronic disabilities receive either informal 

care (from family or friends) or formal care (from service provider agencies). Over 90% of all these older 

persons with chronic disabilities received informal care and/or formal care; and about two thirds received 

only informal care. About 9 % of this chronically disabled group received only formal services. 

(Source: National Long Term Care Survey)

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Special Topic: Health Insurance Coverage 

In 2003, almost all (96%) non-institutionalized persons 65+ were covered by Medicare. Medicare 

covers mostly acute care services and requires beneficiaries to pay part of the cost, leaving about half of 

health spending to be covered by other sources. About 61% had some type of private health insurance. 

Over 6.4% had military-based health insurance and 9% of the non-institutionalized elderly were 

covered by Medicaid. Less than 1% did not have coverage of some kind. Over 87% of noninstitutionalized Medicare beneficiaries in 2002 had some type of supplementary coverage. However, 

among Medicare beneficiaries residing in nursing homes, almost 58% were covered by Medicaid in 2001.

Figure 9: 

Health Insurance Coverage of Persons 65+: 2003

99.2

61.0

35.2

96.2 96.0

6.4 0.8 9.2

28.7

0.0

20.0

40.0

60.0

80.0

100.0

120.0

All types coverage

Total private

--employment-based

--direct purchase

Total government

--Medicare

--Medicaid

--Military

Not covered

Note: Figure 9 data is for the non-institutionalized elderly. A person can be represented in more 

than one category. 

(Source: "Income, Poverty, and health Insurance Coverage in the United States: 2003," P60-226, 

issued August, 2003, based on data from Current Population Survey, Annual Social and Economic 

Supplement, Bureau of the Census. Medicare beneficiary data is from the Medicare Current 

Beneficiary Survey)

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Notes: 

*Principal sources of data for the Profile are the U.S. Bureau of the Census, the National Center on Health 

Statistics, and the Bureau of Labor Statistics. The Profile incorporates the latest data available but not all 

items are updated on an annual basis. 

**Excludes persons of Hispanic origin. 

***Calculated on the basis of the official poverty definitions for the years 2000-2002 

  Census 2000 figure 

** *** 2001 figure 

A Profile of Older Americans: 2004 was prepared by the Administration on Aging (AoA), U.S. 

Department of Health and Human Services. The annual Profile of Older Americans was originally 

developed and researched by Donald G. Fowles, AoA. Saadia Greenberg, AoA, developed the 2004 

edition. 

AoA serves as an advocate for the elderly within the federal government and is working to encourage and 

coordinate a responsive system of family and community based services throughout the nation. AoA 

helps states develop comprehensive service systems which are administer by 56 State and Territorial 

Units on Aging, 655 Area Agencies on Aging, 226 Native American and Hawaiian organizations, and 

more than 29,000 local service providers. 

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