This was considerably fewer, however, than the 1.5 million increase projected had disability rates not declined. Most older people describe themselves as socially active, which may enhance their physical and emotional health. But others report choices and behaviors, such as the failure to engage in physical activity or to keep up with vaccinations, that could interfere with health and independence. A large majority of older people report social contacts with friends, neighbors, and relatives or engaging in activities, such as going out to restaurants. From 1989 through 1995, the proportion of older people who were vaccinated against influenza and pneumonia increased, but reached the 60 percent coverage target set by Healthy People 2000 for only one group, non-Hispanic whites vaccinated against influenza.
Older people report being generally satisfied with health care quality and access.
Average costs have not risen steeply during the 1990s. The cost of health care and use of services is closely associated with age and institutional status, with higher expenditures incurred by the oldest Americans and those living in long-term care facilities. People age 85 and older are the most likely Americans to live in nursing homes. In 1997, only 11 people per 1,000 age 65 through 74 lived in a nursing home, compared with 192 people per 1,000 among those age 85 and older. About three-fourths of nursing home residents are women, roughly equal to their representation in the population age 85 and older.