The population of Americans aged 55 – 64 numbered 32.6 million in 2008. U.S. longevity statistics indicate that about 90% of those people will live to 65. Almost all of the survivors will become eligible for Medicare at that point. When they get there, unless unhealthy lifestyles are changed substantially, the incidence of hospitalizations, death and the costs of care in Medicare will rise, perhaps substantially. Table 1 shows that the 55 – 64 cohort smokes twice as frequently as does the 65+ age cohort and that the younger cohort is also more overweight/obese, has less adequate nutrition intake and a higher percentage of heavy drinkers.
As to smoking, this situation has been worsening for a decade. Table 2 shows that in the ten year period from 1999 to 2009, smoking among 55 – 64 year olds has declined significantly less than among the 65+ cohort.
Smoking costs the U.S. healthcare and economy system an estimated $150 billion per year. At least $20 billion of these expenditures are made by Medicare.
Whereas smoking has declined overall, obesity increased by 32% between 1998 and 2006 (which is responsible for 89% of the increased obesity costs in that period – a doubling to perhaps $147 billion per year). 8.5% of Medicare’s expenditures are for obesity. Most of the cost burden difference between obese and non-obese elders is for prescription drugs. Obesity is a major risk factor for hypertension, type 2 diabetes, coronary artery disease, stroke and much else. Prescription drugs for Medicare recipients are about $600 higher than for non-obese Medicare enrollees.
Table 3 shows that Floridians in the age cohorts 55 – 64 and 65+ are rather like the national cohorts. The 55 – 64 group in Florida smokes about twice as much as the 65+ group and is modestly higher in overweight/obesity, heavy drinking and lower fruit and vegetable intake. But in Florida, unlike the nation, the 55+ group is less likely than the 65+ group to have regular moderate-to-vigorous physical activity.
As to smoking in Florida, both the 55 – 64 group and the 65+ group increased in percentage tobacco use in the 2004 – 2009 time period.
Medicare, other public payers, physicians, hospitals, FQHCs, employers, insurers, non-profits and of course, the 55 – 64 year olds themselves, have a role to play in dealing with the issues of late career wellness and of family fitness. The ElderCare Companies are working in several states to be of assistance.
.jpg)
