Health & Medicine

Aging in California: Who will support our seniors?

Winifred Hertzen raised her five kids in a world that seemed overrun by children: California of the 1950s and 1960s, during the height of the baby boom years. New suburbs seemed to pop up overnight to accommodate growing families. Businesses flourished. School districts added schools and more schools. The world seemed young and noisy, and filled with promise.

“So many of my friends back then had three, four or five kids,” said Hertzen, 89, a retired business manager and grandmother of nine who lives at Sacramento’s Eskaton Monroe Lodge. “Now I’m flabbergasted at the number of people I know who have no grandchildren at all and no great-grandchildren.”

The demographic change brought over the past two decades by smaller families with fewer kids has big implications for a rapidly aging society. Adults in their prime traditionally have supported their retired parents and grandparents – but what happens when there are far fewer working-age adults per older adult?

Along with the rest of the country, California is about to find out.

Studies are clear: The aging of the population will bring about a nationwide wave of lifestyle changes, shifts in real estate prices, huge pension payments for the elderly, increases in the cost of health care and heavy caregiving demands on a smaller number of younger family members. And the enormous burden of paying for all of it will be borne by a decreasing number of workers.

“It’s not like the easy days of the ’50s and ’60s,” said Dowell Myers, a University of Southern California demography professor. “The easy time is over. I just see it as reality. California can prosper, but you’ve got to make smart decisions today.”

In 1950 – in the early baby boom years, a decade after the Social Security system went into effect – there were more than seven working-age adults in California per senior citizen. By the time of the 2010 census, that number had dropped to 5.5.

By 2030, according to the latest projections from the state Department of Finance, the state will have about three working-age adults per senior citizen. Looked at another way: The number of older adults in California is projected to increase by 96 percent over the next two decades, while the number of working-age adults will increase by only 9 percent.

Nationally, that 2030 number – three workers per older adult – is projected to be the same, according to census figures.

The ratio is shrinking so quickly because people are living much longer. Life expectancy at birth for Californians is now about 81 years, compared to 72 years in 1970: The fastest-growing segment of the American population is the oldest of the old, people 80 and above.

The ratio also is shrinking because people are having fewer children. Californians gave birth to about 504,000 children in 2013, equivalent to 13.1 births per 1,000 residents. That’s the lowest birth rate in California since 1933, during the heart of the Great Depression.

By 2030, half of California's counties – 29 out of 58 – will have more senior citizens than children under 18, according to state projections. That was true of only nine counties in 2010.

“We should have started preparing in the 1990s for this, but we didn’t, because we were in the 1990s recession,” Myers said. “So there’s no advance preparation. The public-sector pension crisis today is one result of that. They kicked the can down the road.

“We’re just not ready. We’ve had a balanced system, and it will tip out of balance with so many people getting benefits.”

Savings an issue

One of the biggest concerns raised by the projections is how to pay for the financial support of retirees, especially given concerns over traditional sources of retirement income.

Social Security Administration projections suggest that the trust fund can pay full benefits through 2037, when the reserve is depleted. After that, taxes on the shrinking workforce can pay three-quarters of expected benefits. More than ever, retirees will need to rely on other sources or retirement income, such as pensions and retirement savings plans. But public-sector pensions are on shaky ground – and what happens if people haven’t saved enough?

In retirement, the state is sharply divided between haves and a growing number of have-nots. With a substantial service sector and agricultural workforce, only 40 percent of Californians are covered by any kind of retirement plan, according to Diane Oakley, executive director of the National Institute on Retirement Security. And the average Californian’s 401(k) account balance is $23,000, compared with the suggested average balance of at least $750,000 at age 65.

One way to remedy that shortage of retirement funds is California’s Secure Choice Retirement Savings Program: Signed into law in 2012, it will create individual retirement accounts that are automatically deducted from paychecks and pooled and administered by the state.

Even so, Oakley said: “One of the most important things you can do as you grow older is stay in the workforce.”

The oldest boomers, now age 68, didn’t get that message. Almost 90 percent of them are taking Social Security, although many work part time.

But workers a few years younger – who don’t yet qualify for Medicare; whose investments and housing equity took a huge hit during the recent recession – are delaying retirement. The average retirement age has risen to 62 from age 57 in 1991, according to a recent Gallup Poll, and most older workers today don’t expect to retire until they reach age 66.

“If people who live to age 60 are typically going to live to 95, we can’t expect them to be retired for 35 years,” said Ted C. Fishman, whose book, “Shock of Gray,” deals with global aging issues. “People deep down don’t want that.”

Slower drivers, fewer cars

Beyond the financial demands of huge numbers of retirees, the demographic shift to an aging population will alter the shape of the culture.

America’s baby boomers – 78 million strong, with almost 10 million in California alone – have dominated society at every age, with the youth culture of the ’60s giving way to the upwardly mobile strivers of the ’80s and ’90s, and now the retirement generation of the early 21st century. When the oldest surviving baby boomers hit age 85 in 2050, according to census projections, the retirement-age population will have almost doubled from 43 million in 2012 to 83.7 million.

In the next few years, said USC’s Myers, people will begin noticing a world reshaping itself to serve – and make money from – the needs of this aging populace.

Consider some of the lifestyle implications: Slower drivers on the road, but perhaps also fewer cars, as two-commuter households downsize to one car in retirement. Restaurants with menus geared to older tastes and, perhaps, earlier peak dining hours. People trying to downsize from big family homes in the suburbs to smaller, easier to maintain townhouses in walkable urban neighborhoods – and older homeowners having trouble selling their houses, the most valuable asset most people carry into retirement, because of a dearth of younger buyers.

A declining ratio of working-age adults to senior citizens is likely to slow down the Sacramento region’s economic growth, but will not be cataclysmic, said Jeff Michael, director of the Business Forecasting Center at the University of the Pacific.

“Long-run growth in the economy has averaged about 3.5 percent from World War II to the downturn,” he said. Largely because of an aging population, “a lot of economists expect that to be about 2.5 percent” going forward, he said.

As society feels pressure to devote more of its resources to caring for the elderly, Michael said, the losers could be children and young adults, who may not see as many resources devoted to their education.

Myers sees the same possibility – but he warns against cutting back on funds for education, saying that would work against the long-term interests of an aging population increasingly reliant on the work of younger taxpayers. Instead, he said, Californians would be smart to invest in home-grown workers and come to terms with the state’s growing diversity.

“We’re not preparing the younger generation well enough,” he said. “Schooling is how we have future workers and homebuyers. We really need these younger people. You’re educating a better taxpayer.

“The older white population controls the electorate. If they don’t see that they’re connected with the younger generation, there’s a problem.”

‘A lonely situation’

The graying of the population has implications for the health care industry as well. Taking care of seniors’ health care needs is expensive. Americans who retired at 65 last year will incur an average of $146,000 in out-of-pocket medical costs if they live to 85, according to the Health Care Cost Institute, a research group in Washington, D.C.

A larger burden will be placed on taxpayers. A single male earning a typical wage of roughly $41,000 and retiring at age 65 in 2030 will pay about $91,000 into the Medicare system during his lifetime – and receive about $300,000 in Medicare benefits before death, according to the Urban Institute.

To help them smooth over the rough patches of aging and illness, many people rely on family. Muriel Gragg is only 65, but because she’s disabled, she spent a decade in an assisted-living facility in Eureka. Two years ago, she moved to Sacramento’s Arden Arcade neighborhood to live with her oldest daughter.

It was a bumpy transition. For one thing, Gragg was used to independence. Besides, her daughter and her family are vegan, so Gragg had to drastically change her diet. But she found that her situation quickly improved. Her new doctors approved surgery for a new hip and left knee, and she lost almost 100 pounds.

“When I moved here, I was taking 17 medications,” said Gragg, who was a professional gospel singer for more than 20 years. “Now I take two.”

Had she stayed in Eureka, she said, “I’d probably be close to being on my deathbed, to tell you the truth.”

Other older adults find themselves alone, despite their efforts to surround themselves with other people.

Alberta Jordan was orphaned as a child. Growing up in Rhode Island, she lived with a foster family most of her childhood. She worked as a barber and a caterer and was briefly married but had no children. But she was close to her best friend’s family, and she moved to Sacramento from Southern California several years ago to be near them.

A few months ago, the friend’s son, whom Jordan thought of as her nephew, died. Now at 90, she often feels isolated in her downtown Sacramento apartment.

“It makes for a lonely situation,” said Jordan, who uses a wheelchair to get around.

An In-Home Supportive Services health aide comes to help Jordan five days a week. She occasionally goes to the Ethel M. Hart Senior Center to converse and learn. She takes comfort in writing and painting.

But, many days, she said, “It would be nice if I had someone to sit and visit and talk.”

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