A Society with Many More Seniors with Walkers than Youngsters in Strollers, Part III

GUESTS: Dr. John Rowe and Dr. James Jackson
VTR: 09/27/10

I’m Richard Heffner, your host on The Open Mind.

And this is another in a series of programs that relate to our quickly and dramatically aging society.

Now key to our conversation once again is the MacArthur Foundation’s “Research Network on an Aging Society”, which asks us to imagine a society with many more seniors with walkers than youngsters in strollers, when those over age sixty will clearly outnumber those under fifteen…and which asks us to consider realistically what Americans will have to do to accommodate these new demographic facts of life.

Well, here again today is the Chair of MacArthur’s Aging Society “Network”, Doctor John Rowe of Columbia University’s Mailman School of Public Health. Earlier, Dr. Rowe led Harvard’s program in academic geriatrics, was President and CEO of Mount Sinai Hospital and Medical School in New York, then served as President and CEO of Aetna, the health care organization.

With him today is another member of MacArthur’s Aging Society “Network” — James Jackson, Professor of Psychology, Health Behavior and Health Education at the School of Public Health at the University of Michigan. Dr. Jackson is also Director of Research at the University’s Institute for Social Research, where he studies immigration, race and ethnic relations, adult development and aging.
And Dr. Jackson I would begin today by asking what your areas of study have to do with and how they impact upon this question of aging.

JACKSON: One of the things that’s going to happen, Richard, in addition to the aging of society is that we’re becoming much more heterogeneous in two different ways.

As we become an aging society as you described earlier, the younger part of the population will become much more heterogeneous in terms of immigrants, race and ethnic background and so on.

But also, although not enjoying the longevity benefits as much as the non-Hispanic White population, both African Americans and Hispanic groups, there will be more represented among this aging populations as well.

HEFFNER: Well, let me understand … you’re not saying then that the aging population will be made up of one set, ethnically, or, or otherwise and the younger group … otherwise.

JACKSON: No, but … one of the things we have to remember is that the aging society that we’re talking about is actually already born and living. That is, people who are born this year … 60 years from now will be those sixty year olds that we’re talking about.

So that ethnic make up of the population today is going to be reflected in many ways in this older population in the aging society.

HEFFNER: And how will you describe it?

JACKSON: Well, we’re describe it as a much more diverse society.

We’re going to be much more diverse in all kinds of different kinds of ways. You know, ethnic and racial background is only one source of diversity that we can think about or should be thinking about.

But we are going to be an even more diverse society then than we are now.

ROWE: And isn’t there also going to be a, a period, James, where old people are going to be still mainly White and younger adults will maybe be half White and half minorities?

JACKSON: Well, as you well know, one of things that’s going to happen around mid-century is that because of immigration and the drop in fertility among the non-Hispanic White population … is that we’re going to have a population that’s going to be majority non-White, Hispanic by mid-century.

But the older population is going to reflect more what we see today, throughout the country and it will be predominantly non-Hispanic White.

HEFFNER: Is that an indication that there’ll be trouble?

JACKSON: Trouble? Well, that a … that’s a very, very good question. So one of the things that the network has addressed is given a younger population, which is more heavily Hispanic or African American, immigrant … will it be willing to support … in all kinds of ways an older non-Hispanic White population?

Two things to that. I think that the … I probably share the optimistic cup with, with Professor Rowe … but the fact is that, ahmm … the older individuals, because it’s going to be more heterogeneous will also be the parents and the grandparents of this younger population.

So I, I think, I think they will be willing to support this older population at that point.

ROWE: But I think … I think we have to … I think we have to start with a clear statement about the amount of support for older people that there is currently in our society.

Because there are a lot of nay-sayers and merchants of doom out there who say that the increased cost of Social Security and Medicare are causing a backlash amongst middle aged individuals and young adults. And that they’re not going to take it any more and they won’t pay for Social Security, they want to get rid of it, it’s unconstitutional … because it’s not in the Constitution … I heard that recently.

I’m not sure James Madison was thinking about Social Security at the time …

Every survey that I’ve seen and James is an expert on surveys … and he can comment on … every survey consistently shows in the United State and in Europe very strong support for Social Security amongst middle aged and younger adult people.

For a couple of very good reasons. One is they recognize that it’s a financial benefit for them because if it didn’t exist they would be supporting their parents to a greater extent.

And secondly they’ve been paying into the system and they are future beneficiaries of it.

So we have to start the conversation with recognition that there currently is not this warfare between the generations. The question is: will there be more tension and less support in the future? Would you agree with that?

JACKSON: I agree with that. As a matter of fact it would have to be an amazing change in terms of the support of the young for programs and policies to support the old over the next fifty years to have the kind of impact that you just described earlier.

In fact, young people and middle aged people are more supportive of older age programs than the older people themselves today.

HEFFNER: Explain that, please.

JACKSON: It, it, it really means if you take a look at how strongly supported are things like Medicare and Social Security and other kinds of programs … the young actually support this in greater proportions and more strongly than do the old themselves.

HEFFNER: You mean many …

ROWE: In surveys … in terms of

JACKSON: In surveys.

ROWE: …what proportion of a middle age population says they’re very supportive of Social Security … think it should be strengthened.

The survey shows it’s a couple percent higher than the proportion of older people (laugh) …

JACKSON: Older people.

ROWE: … who say “Let’s spend more on Society Security”.

HEFFNER: What do you see for the future, then, that is problematic. Again, I’m the guy who sees the glass half full … so I put my question that way.

JACKSON: Well, we have a, a difficulty … and I think Jack has discussed this before, which … you know we live in a kind of a age segregated society.

Ahh, even more than that, we have a society which has been dominated by a kind of a youthful perspective, irregardless of … bought into by both old and young.

That’s one of the kinds of orientations, set of values, and so on that’s going to have to change.

We’re going to have to have a more integrated society, by age … and we have a beginning of that. One of the things I think we tend to forget is that one of the benefits of an aging society is that young people will get to know their older grandparents in a way that they have never done before.

They will live longer and appear at a time when these youngsters are cognizant of them. And they will have more intimate and longer kinds of interactions.

I think this is a positive thing because older people do have a certain set of experiences and wisdom and other things.

The whole nature of the family is going to undergo change. In fact all institutions in the United States are undergo change. And how that change comes … change comes about, it’s a very important thing for us consider.

HEFFNER: Are you identifying in your work the, the changes that we will have to do, that we will have to accomplish in order to meet what the patterns are going to be in the future. Are you, are you … is your work reflective of that need?

JACKSON: Well, the demography is clear. So we start from that particular perspective, given the longevity benefits of medical technology changes and people are actually living longer.

So we know that’s going to happen. So our argument in the network is that we have to be involved with the introductions of public policies and other kinds of programs that will indeed be able to address that.

Our institutions are going to have to change. This is not a story about individual change or individual attitudes or orientations, but our very institutions will have to change. The family, government, other kinds of programs …

HEFFNER: Education …

ROWE: Education, urban design.

JACKSON: All this will have to be different as we have this ahmm aging society which is made up of … because of lowered fertility and increased longevity among the population.

HEFFNER: Change how? Let’s be specific.

JACKSON: Right. Well, one of the things we talked about is that we have to make sure that productive roles in society last longer than they, they do today.

Now whether that means a change with regard to what the retirement age is and so on, I think it’s not there. But we have to be able to provide productive opportunities for people at the upper end of the age course … ah, life course … whether that’s Experience Corps or other kinds of programs that we have or people engaging in paid work.

We have to remember that one of the benefits of the aging society, as people live longer in active and productive lives is that people may have two or three different types of careers, that they will be able to explore different aspects of what interests them, because they’re absolutely living longer and healthier lives.

ROWE: And I think, I think one way to look at this as … in our Network we have these discussions … is we, we talk about what would failure look like.

HEFFNER: What would failure look like?

ROWE: If we’re not a “go” …

HEFFNER: An interesting question.

ROWE: … to change our core institution … core institutions as changed … currently in our society were not designed to support a society with the age structure that we’re going to have.

And we believe that as we re-design work and education (laugh) in late life and so on … we should do it in an age-integrated way.

Failure would look like this … a persistent age-segregated society. Tension between the generations and, if we’re not careful, two Americas. The “haves” and the “have nots”.

The gap between the ‘haves” and the “have nots” seems to be enlarging. Now people say it’s okay because the absolute level that the “have nots” have is so much more than they used to have, in terms of housing and employment and access to health care now, etc., etc. that it’s not really the gap that matters, it’s do the people in the lower socio-economic strata have sufficient means.

HEFFNER: Do you … how do you answer that? How do you react to that?

ROWE: I believe that they have much more than they used to, but I believe that there is a point where the widening gap tears at the fabric of our society.

HEFFNER: Well, that’s what I was going to ask you, sir. Do you find that in your social science research … I keep asking myself “Where is the anger?”

Well, I find the answer now in this particular 2010 political season …

JACKSON: MmmHmm.

HEFFNER: … to some extent, but I do keep asking myself and I’ve asked myself this for some years … where is the anger, what have we done so well, perhaps, in our country that there isn’t the anger we find in other societies. At least it isn’t manifest.

JACKSON: Well, we have a, we have a hopeful society. You know we’re still a relatively young society, we’re not that old in comparison to some of the other societies that we’re involved with.

Immigration, we’re an immigrant country. And by that I mean that indeed our values and orientations are around that … so we’re always in some ways replenishing ourselves with people who have very positive attitudes, very strong work ethics and are willing to work hard.

So I think in some ways this is what keeps … you know … from having this kind of anger between the “haves” and the “have nots”.

HEFFNER: And the future?

JACKSON: I think in the future, I think Jack is absolutely correct. As we enter this aging society there is an issue with regard to the proportion of “have nots” may, indeed, reside in large numbers among the younger population.

One indeed could see anger and …there at that particular point in time. But again, being an optimist, I think to be kind of forewarned is to be forearmed …

HEFFNER: Will that split between “have” and “have not” be racial, ethic?

JACKSON: One of the things that I think … ahmm, ah … we need to be able to understand is that it’s not about race or ethnicity alone as, as the dimensions. Both social economic status differentials, as well as race and ethnicity, create some of the kind of dimensions of the “have” and the “have not” that we like to talk about. It’s not either one alone, it’s that plus geographical distributions, regional distributions and so on, all these play a role with regard to understanding the “have” and the “have nots” …

ROWE: But there are complicating factors, you know, so we, we start with the fact that our society is aging. And then we add on to it the fact that the difference between socio-economic groups seems to be widening. That’s an additional tension that we put on top of the aging society.

Then we add on top of that the fact that the birth rates are so much higher in the Hispanic population than the White population. The immigrant population is largely non-White … that there’s going to be a phase when the elders are more White and the younger individuals are not.

HEFFNER: You say “a phase”.

ROWE: A period of twenty, thirty years or so. We add that as a complicating factor … it’s a kind of cultural factor. So we know that middle aged White people support old White people. Are middle aged Latinos going to support old White people? Maybe. If we’re successful in our age integration of our society and re-engineering our, our institutions … yes.

If I were asked to, to find one factor which I think could have a very signficiant positive effect I would point to education. It’s very clear that education predicts life expectancy. Education predicts disability. People with less than a high school education are three times more likely to be disabled in their sixties and seventies than people with a college education.

And if we can enhance and strengthen education we will enhance socio-economic status of those individuals currently not getting enough education. They will then be able to participate more fully in an aging society. They won’t be disabled, they will live longer and so on.

So in many ways an aging society is about what happens early in life and are we giving educational opportunity to people of all races and ethnic backgrounds.

Do we have strategies to keep them in school … that’s really the question for me.

HEFFNER: Well, the question is to be put to you. Do we?

ROWE: Well, fix this, James.

JACKSON: Well, hold up for a moment … (laugh) So, I think Dr. Fried talked before about the fact that something like the Experience Corps …but remember, the older people of today who are involved with the Experience Corps are teaching the older people of tomorrow.

If we can improve and engage them more in education it will have a profound change with regard to their trajectories of life and that’s the kind of thing that Jack is talking about.

You know, getting people excited about reading. Getting them to stay in school longer. Getting them … because education is the most phenomenal thing in some ways in our society.

It is an amazing lever. It has amazing positive effects directly on health. It has positive effects with regard to involvement, productivity and so on.

HEFFNER: Professor Jackson, that leads me to the question of in your surveys, in your social research are you finding that we are a people … are dumbing down as so many critics of American life say?

JACKSON: Well, I don’t really think that’s the case.

HEFFNER: You don’t.

JACKSON: No. Education comes in many different forms and while we talk about formal education … in fact things like the Internet and other kinds of technology has really increased the access for all kinds of individuals to knowledge in a way that we couldn’t even imagine ten years ago.

HEFFNER: You use the word “access” …

JACKSON: Right.

HEFFNER: … and my question really had to do with use.

JACKSON: Right. Exactly. But people are using … now, maybe people don’t use the Internet for all the things that we’d probably like them to use it for, but indeed they are using it to become more knowledgable about issues and everything else.

ROWE: I can tell you as a physician that individuals’ sophistication and knowledge about medical issues is dramatically different (laugh) than it was 30 years ago.

HEFFNER: Enough to drive you crazy?

ROWE: Patients walk in the office (laugh) …

JACKSON: (Laugh)

ROWE: … they’ve got a stack of stuff they printed out and they, they know the website to go to, to figure out what this rash is that their children have or whether the medicine they’re taking is giving them a side effect.

I mean just think about the knowledge that people have and the access that they have now that they didn’t used to have. Regardless of how much education … now obviously well educated people are more likely …

JACKSON: Exactly right.

ROWE: … to access these things, but, but you don’t need a college degree to do this.

HEFFNER: All right, then, then let me ask this question in terms of all your social research … you said before you belong with Jack in the glass is half full group … are there specific problems that you see indicated in your social research that we need to pay attention to now.

JACKSON: Well, one of the things that we’re very concerned about at the Institute for Social Research, for example, that relates to the Network, but is not directly a part of it … is understanding something about the relationship between health and retirement.

That is we have a long running study, been running since 1992, which is actually studying how those two things inter-relate.

Do people retire and drop out of the workforce because they become ill or disabled? Or by losing meaningful roles in terms of work people actually then become sicker.

This is a very, very important question to be able to answer. And we’re following these amazing cohorts of the American public to try to answer this particular question.

HEFFNER: What kinds of answers do you have thus far?

JACKSON: Well, thus far, it would, it would look like … and I hate to say this because people always say this about social research … both things are probably true.

So, what we’re trying to figure out though are what are the things that predict that early in life, so that we could predict who are the individuals who are going to become disabled or unable to work and what’s the meaning of that.

Again, so we could find the levers to intervene and to really try to make a difference. Remember intervening with, with, with ten year olds today can have meaningful benefits 50 years from now when they’re 60. That is we can actually change the directories of life, means that we can have a very positive effect upon what’s going.

You know if, if we look at the, the average life expectancy in the United States there are large differences between individuals who are African American background, for example, and non-Hispanic White backgrounds …somewhere in the order between six to eight years in life expectancy.

If we could just bring up the life expectancy numbers among the African American population to those of the non-Hispanic White population right there we would improve the life expectancy for the country as a whole.

HEFFNER: And give us more problems about the aging.

JACKSON: Well, no … that’s a very interesting question. But, indeed, it would help address some of the questions with regard to the “haves” and “have nots” that we’ve been talking about before.

Remember younger African Americans or Hispanic individuals have the same kinds of investments in their parents and their grandparents and the same concerns about them as any other individuals within society.

So I think things that we could do to be beneficial to their parents in the same way that we do things for other parents would be a positive thing for the society.

HEFFNER: And you think you’re going to accomplish much along those lines?

ROWE: I think what we’re going to do, and we have this very generous support from the MacArthur Foundation, for which we’re very grateful, is we’re going to be able to develop policy options … strategies that we can present the policy makers … we are not policy makers, nor are we politicians, but, but we will be able to make the case for the need for changing these core institutions and be able to lay out some various strategies for the policy makers to debate and hopefully, to act upon.

HEFFNER: You mean to say you gentlemen and your colleagues in the Network, are not going to take positions on the various options that you present to the rest of us in American society?

ROWE: I think what we will do is take positions on the goals … we need an age integrated society … we need to re-structure the core institutions and then offer the “pros” and “cons” of different strategies to get there.

JACKSON: That is … likely outcomes … if one takes this particular strategy, one winds up … likely to wind up with this one versus the other and so on.

HEFFNER: You mean the alternatives are going to be so grim … the alternatives to the programs that you think should be adopted … are going to be so grim.

ROWE: We haven’t completed the analyses yet, but I … failure is really ugly. Failure is going to be ugly.

HEFFNER: Well you said that before and I, I wanted to egg both of you on to say what you mean by that. How ugly? How is it going to be ugly? In the minute we have left.

ROWE: I, I don’t think it’s going … it would look or feel like the America that we want to live in. I think it would be a less productive society because we would not take advantage of the productivity inherent in the older population. There would be more strife and tension and it might get aggravated across age, as well as SES … as well as racial lines. And if we move forward now with some of these strategies we’ve begun to articulate … we can mitigate much of that.

HEFFNER: Do you see signs of the ugliness?

JACKSON: Well just think about it for a moment. We’re going to have people who are living longer, who are in better health and able to do things. These individuals will want to do those things. And are we going to have a society which is so age segregated that it won’t allow for these kinds of productive roles? You talk about resentment … we’re going to have a growing population that is able, that’s capable and can do things that if we … we should allow them to be able to do it.

HEFFNER: Dr. Jackson …

JACKSON: Yes.

HEFFNER: Dr. Rowe … from your lips to God’s ears …

JACKSON: (Laughter)

HEFFNER: Thank you very much for joining me today on The Open Mind.

ROWE: Thank you, Dick.

JACKSON: It was our pleasure, thank you.

HEFFNER: And thanks, too, to you in the audience. I hope you join us again next time. Meanwhile, as an old friend used to say, “Good night and good luck.”

And do visit the Open Mind website at www.theopenmind.tv

N.B. Every effort has been made to ensure the accuracy of this transcript. It may not, however, be a verbatim copy of the program.