Senior health care crisis looms; report ranks states

An aging nation that's living longer but with growing rates of obesity, diabetes and other chronic diseases points to an emerging health care crisis, says a report out Tuesday that analyzes seniors' health status state-by-state.

Just two years ago, the first Baby Boomers turned 65, setting into motion a "tremendous demographic shift in the U.S. population," said physician Rhonda Randall, a senior adviser to the not-for-profit United Health Foundation, which released America's Health Rankings Senior Report Tuesday.

The report focuses on 34 measures of senior health, including physical inactivity, obesity, self-reported health status, poverty, drug coverage, hospital re-admission rates and flu vaccinations. The data analyzed is from more than a dozen government agencies and private research groups.

As generations move into retirement, they become greater consumers of health care, Randall said. But those turning 65 today "are more likely to live longer than their parents and grandparents, and much more likely to live sicker for a longer period of time," she said.

Among signs of impending challenges the report cites:

• 1 in 8 Americans (13% or 40.3 million) are 65 or older, and that is projected to grow to 1 in 5 (19.3%, or 72.1) in 2030, the year all members of the Baby Boomer generation will have turned 65, according to Census data. By 2050, seniors will make up 25% of the population. Those 85 and older are projected to increase from 5.8 million in 2010 to 8.7 million in 2030.

• Nearly 8 in 10 seniors are living with at least one chronic health condition; 50% have two or more, the Centers for Disease Control and Prevention estimates. About 25% of older Americans are obese; 20% have been diagnosed with diabetes; more than 70% have heart disease; nearly 60% have arthritis, a leading cause of disability.

• Adults 65 and older spend nearly twice as much as those 45 to 64 on health care each year; they spend three to five times more than all adults younger than 65, according to CDC.

If not addressed, the increased burden of chronic disease will not only have severe economic consequences but affect older adults' overall well-being, Randall said. "This is a really important time in our nation's history for us to take a look at this demographic change and the health and behavior outcomes for this population. If we don't measure it, we won't know what to do about it."

The report offers "an important set of messages ... for personal focus, family and community focus, and a heads-up to the providers, and a real heads-up to policy makers," said Jennie Chin Hansen, CEO of the American Geriatrics Society and author of one of several commentaries in the report.

Some of the trends are "very cautionary," Hansen added. They highlight "that we really do have to be thoughtful, strategic and intentional if we are going to insure that people's health and well-being is going to be made better. There's stuff we know, but now there's stuff we have to do. "

Overall, Minnesota tops the list in senior health, followed by Vermont (2), New Hampshire (3), Massachusetts (4) and Iowa (5).

At the bottom: Mississippi (50), Oklahoma (49), Louisiana (48), West Virginia (47) and Arkansas (46).

Minnesota's top ranking reflects a combination of factors, including a large number of seniors who report being in very good or excellent health, high rates of creditable drug coverage, relatively high availability of home health care workers, as well as a low rate of seniors at risk of going hungry and a low rate of hospitalization for hip fractures, according to the study.

But it notes challenges for Minnesota, as well, including a high percentage of chronic drinking, a low percentage of senior residents with a dedicated health care provider, and low per-person expenditures by the state to assist older adults in poverty.

In bottom-ranked Mississippi, a high percentage of seniors live in poverty and are at risk of going hungry; there is a high rate of premature death; a low percentage of seniors report very good or excellent health and a low rate report annual dental visits. But Mississippi scored well for a low prevalence of chronic drinking and a high rate of flu vaccination.

The senior population in Mississippi is predicted to grow 46% between 2015 and 2030. In Minnesota, the population is expected to grow 54%. Arizona tops that category with an expected increase of 101%, followed by Nevada (89%), Florida (88%), Alaska (70%) and Texas (67%).

Among other trends noted in the report:

• Alaska (21%) has the lowest percentage of seniors with multiple chronic health conditions, followed by Wyoming (22%) and Montana (23%). The highest percentages are in Florida (44%), New Jersey (43%) and Delaware (40%).

• Nationally, 30% of seniors in fair or better health report doing no physical activity or exercise other than their regular job in the last 30 days. Inactivity levels range from a low of 20.5% of senior who report being inactive in Colorado and 21.3% in California to highs of 41.2% in West Virginia and 41.3% in Tennessee.

• Obesity rates among those ages 50 to 64 increased 8% from 1995 to 2010, suggesting that the next generation of seniors will experience higher rates of obesity compared with current seniors. Overall, 25% of adults ages 65 and older are considered obese. The prevalence varies from a low of 17% in Hawaii and 18% in Nevada to highs of 29% in Alaska and 30% in Michigan.

• An average of 9% of adults ages 65 and older live at or below recognized poverty thresholds, which is also associated with higher rates of chronic diseases and shorter life expectancy. Rates range from a low of 5% in Alaska and 6% in Utah to 12% in New Mexico and 14% in Mississippi.

How all 50 states ranked:

1. Minnesota

2. Vermont

3. New Hampshire

4. Massachusetts

5. Iowa

6. Hawaii

7. Connecticut

8. Colorado

9. Utah

10. Maryland

11. North Dakota

12. Delaware

13. Maine

14. Nebraska

15. Oregon

16. Washington

17. Pennsylvania

18. Kansas

19. South Dakota

20. Wisconsin

21. Virginia

22. Arizona

23. New York

24. Idaho

25. California

26. Michigan

27. New Jersey

28. Ohio

29. North Carolina

30. Florida

31. Rhode Island

32. Indiana

33. Missouri

34. Wyoming

35. Montana

36. South Carolina

37. Illinois

38. New Mexico

39. Texas

40. Alaska

41. Tennessee

42. Nevada

43. Georgia

44. Alabama

45. Kentucky

46. Arkansas

47. West Virginia

48. Louisiana

49. Oklahoma

50. Mississippi

Source: United Health Foundation