Are We Ready For A Massive Aging Population?

America's population is aging at a rapid rate: 20 percent of the country will be 65 or older by the year 2050. Guest host Celeste Headlee talks with experts about how the aging population will affect the American landscape.

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CELESTE HEADLEE, HOST:

This is TELL ME MORE from NPR News. I'm Celeste Headlee. Michel Martin is away. We turn now to the future of aging in America. By the year 2050, one in five Americans will be over the age of 65. That's according to the U.S. Census. And when we talk about getting older, most of us think about, what? Saving for retirement, Medicare, Social Security.

But there's also a bigger picture and a bigger question, and that's the fact that our aging population is going to change the American landscape from where people live and how they'll get around to how they'll paid for it all. And clearly this is something that many of you are thinking and worrying about.

We reached out to NPR listeners on Facebook and more than 500 of you wrote to us with your questions and concerns. So to help us make sense of it all we have Richard Florida with us. He's senior editor at The Atlantic magazine and cofounder of Atlantic Cities. That's a project that tracks how neighborhoods are changing. We also called Gretchen Alkema, she's the vice president of policy and communications at the SCAN Foundation, a nonprofit that focuses on healthcare issues for seniors. We should also mention the SCAN Foundation is a funder for NPR. Welcome to both of you.

GRETCHEN ALKEMA: Great to be here.

RICHARD FLORIDA: Thank you.

HEADLEE: Oh, yeah, it looks like we also have Julia Washington with us, one of our listeners who wrote in on Facebook. She works for the Stanislaus County Department of Aging and Veterans Services in Northern California. Julia, welcome to you too.

JULIA WASHINGTON: Thank you.

HEADLEE: Richard Florida, let's begin with you. We hear all the time that baby boomers are retiring - both aging and retiring - differently than the generation before them. What does that mean?

FLORIDA: Well, I think they are, and, you know, I mean, we know that the baby boomers have consistently had a really substantial - even in comparison to most any other generation - a substantial impact on our economy, our society, and our culture. And, of course, now with people taking better care of themselves, of course advances in medicine, but this whole kick about exercise. You know, my parent's generation surely didn't go jogging and go to the gym in their adult years. You know, they were content to sit and watch television.

They were fairly inactive. I think baby boomers are living healthier and they want to do two things. One, they want to find a vocation. And now, many do have to continue to work to just make ends meet, but those who can retire want to find another career. Something exciting to do that gives meaning and purpose in their lives. And the second big trend we're seeing - and it was just reported in a series of major media reports this past week - we're seeing many baby boomers not saying they want to stay out in a resort community or move to a, you know, a sunny area near a beach and a golf course. They want to move back to cities and they want to go to places where they can have thriving, exciting lives. So I think this is really changing what we thought of being a senior citizen and what we thought about as retirement.

HEADLEE: So Gretchen, what does this mean for the cities that are now going to see an influx of senior - I mean seniors? Your foundation works on issues like this, that are related to medical care and supportive services. What kind of new things will cities have to do?

ALKEMA: Now there's a lot of opportunity for cities to be welcoming and to a variety of different populations, including older adults. You know, things like ensuring that stoplights have the walk feature to them with the countdown. Having things where, you know, there's greater accessibility into stores and to communities. You know, a lot of times people think about, oh, my goodness, we have this huge demographic wave of folks and my gosh, what's going to happen, you know, a bit of the sky is falling. And I think ultimately it's a really great opportunity to integrate individuals, who have a tremendous life experience, into those communities and find really creative ways to incorporate their knowledge and their experience and their desire to be part of those communities.

HEADLEE: And Julia Washington, you actually wrote to us that helping to find affordable housing is one of the top requests you get. And that makes sense since many of these seniors, as Richard Florida was mentioning, are able to live independently whereas the generation before them didn't. What exactly are the challenges to getting all of these seniors housed?

WASHINGTON: Well, big challenge is the affordability of it. You know, we see so many folks who are retired. Maybe they retired because of a disability, maybe they retired too soon, who knows. Finding affordable housing in our areas is very difficult when your income is only $860 a month. So there's a lot of local subsidies but the waiting list for that can be anywhere from six months to two years. There's also the Section 8 option, but again, in our area, you know, that can be anywhere from five to eight years of a waiting list. Having facilities make accommodations. You know, are there elevators, are there stairs, you know, how many floors are there? Is a population that you're going to take in 60 and older, 55 and older, 65 and older? You know, these all come into play. In our area we do have about over 100 facilities in our county that make accommodations and are for older adults.

HEADLEE: I want to read something for you, especially you Richard. NPR listener, Charlotte Moore (ph) who's in her 70s, wrote this to us - quoting, my main concern is we need better city and community designs so that people can walk to shopping areas, libraries and other facilities. That's not something you really had to worry about if the seniors were retiring to a place like Leisure World right? They put everything right there for them.

FLORIDA: But it's actually better for seniors to live in cities, because it - you know, one of the things is, of course, people need access to great health care and big cities have great health care options. Two though, by being in a city where you can walk to the store, walk to the shop, walk to a senior center, walk to visit friends or your kids who might live there. It keeps the mind active. But her point is really well taken. Years and years ago when I lived in Pittsburgh, we were trying to make the case then that Pittsburgh needed bike lanes for students who are going to Carnegie Mellon and the University of Pittsburgh.

And the seniors were our most active group, because they said they wanted to keep the kids off the darn sidewalk and, you know, from mowing them down. So this idea of designing cities where it's safe to walk, with streetlights that have that countdown, as was mentioned, where bike lanes are protected, where you can get around and navigate easily, whether you're 13, or 14, or 15, or 21 and able-bodied, or 65, or 75. I think, you know, cities have made so much progress. I think of what Mike Bloomberg has done in New York, and other mayors have done, but we still a long way to go to really design a city that's good for people - not just good for cars and traffic.

HEADLEE: Well, I mean I've got to ask you Richard, 'cause you know I live in Maryland where they appear to not believe in sidewalks. It's expensive. It's expensive.

FLORIDA: What a disaster, you know, I mean - and can you believe we had this kind of mental collapse, if you will. It's like what drugs were we on that we developed cities and communities for cars and not human beings? It's like we had this giant mental stroke in the era after the war. We knew better years and years ago but I think we're getting back to a city and we know that what is the most - if you think all the healthcare remedies we have for senior citizens, for young people, to combat obesity, to combat, you know, diabetes, heart disease, Alzheimer's. The best therapy we have is walking. Twenty, thirty minutes an hour a day. Human beings were built to walk. So if we build pedestrian friendly cities they're great for seniors, they're great for kids, they're great for healthcare. And I know, that's why the person who wrote in, the listener, is so important. Our cities have to be designed for people and particularly for our aging populations.

HEADLEE: Cities designed for people, what is this revolutionary talk? If you're just joining us, we are talking about the rapidly increasing aging population in United States, with Gretchen Alkema of the nonprofit SCAN Foundation. Richard Florida, cofounder of the Atlantic Cities project, and Julia Washington of the Stanislaus County's Agency on Aging. Julia actually wrote in to us through NPR's Facebook page. And I wanted to ask you about that Julia, because you're actually in your 20s. Is it your job that is making you already think about these issues?

WASHINGTON: It absolutely is. You know, seeing people on a daily basis, the amount of medications they have to take, the lack of mobility they have, which is incredibly eye-opening. You know, both of my folks are in their 60s and, unfortunately, that wasn't enough to be an eye-opener. Seeing these people daily, you know, the ability to just get up and go out and get your mail, the ability to cook your own food, or even walk around the block.

These things we see clients who just can't do that and that for me was just - it's sad, but then I realized, you know, I need to do something to make a change in my life so I'm not in this situation. I don't want to take medications if I can avoid it. You know, I don't want to not be able to get up and go get my mail. My mail is actually quite a distance from my apartment. I want to be able to still move, I want to be able to still be active, and when I have grandkids I want to be able to get on the floor and play with them. And that starts now. Being able to do that starts now.

HEADLEE: Well, let me then bring up a comment from another listener and direct this to you Gretchen. This listener wrote in to say most people don't want to be thought of as elderly but there are some tough conversations that have to be had. Taking the keys away from mom and dad. I wonder if the nation is prepared to have these conversations. What do you think?

ALKEMA: There's definitely an increasing hunger to figure out what do I do with mom and dad? How do I think about these things in my own family's life? And the reality is that aging is everybody's business. And this is a great opportunity now, you know, with the kind of moving cohort of boomers coming through the aging experience. Living it with their older family members, but also realizing wow, that clock is really coming closer to my own horizon. It's a time to have these conversations. And it's not about the death conversation. Let me tell you that, it's about the life conversation. Because ultimately people are going to be living considerably longer than they ever thought and will have needs during that period of time.

And one of the things that we did at the foundation is create a serious called "10 Things You Need to Know about Aging with Dignity and Independence." And part of that 10 thing series has the 10 conversations that speaks to, you know, what are the things that are important to me as I grow older? Where do I want to live? How do I want to be cared for in the event that that needs to be happen? And it starts to look down that trajectory of all of those conversations that we can be having with our families right now. Even if that time in life where we actually need to execute some of the decisions in those conversations are many, many years away.

HEADLEE: Well, then let me give to you Richard Florida - well, actually the multibillion-dollar question, right? Do we have the money to prepare for this? Are cities and towns even thinking about how to change their sidewalks, their stores, even their infrastructure, in order to be be able to prepare for all of these aging seniors?

FLORIDA: You know, I think everyone's hit on this. We tend to blame the individual - you eat too much, you smoke too much, you don't exercise enough. And, of course, people have to be - we have to be responsible, especially if we're adults. You know, a child is one thing. But I think it's our environment. You know, we've set up an environment where mom and dad or grandma and granddad have to drive. I mean, who in their right mind wants an 80 or 85-year-old, or a 16-year-old, driving long distances in a car. It's one of the most deadly things we do. We blame people for being inactive and say get on the treadmill. Why - you know, if we could make our communities more pedestrian friendly and cause people to go out. So I think it's an environmental, if you will, a land use, a city building issue. And the only way we're going to stop spending the billions is to stop treating the symptoms and treat the disease, which is that we've created an environment, a built environment, a cityscape, if you will, that conditions to people to sit on their duffs.

And I think we're finally - you know, what's so great about this conversation all of us are having today, is we're finally coming to that realization that we have to build cities for a more active and engaged population. And I'm not just talking physical activity, the mental engagement of walking around the city, of engaging others, talking to the postman or the shopkeeper, you know, keeps the mind sharp. We know that when people retire, when they're inactive, when they're mentally not engaged, that's when they start to slip. So I tend to think of this much more - less even as a health problem, or individual problem - and much more of a city building issue.

HEADLEE: Well, then let me go back to something you were saying, Julia, about thinking about aging now and preparing for that now other than say, salting money away for retirement. What exactly are you doing?

WASHINGTON: Well, I've definitely gotten back in to being more physically active. That was something I did when I was much younger and then, you know, life just happens, you work and you get consumed by that. And, you know, now I've made a conscious effort. Four days a week I get up early and I practice yoga or after work I go for a run and I have encouraged, you know, other folks to do that as well. And it's just little things, it's 10 minutes a day that I'm doing this to make that sort of change. And then also too, you know, it's eating healthier and making sure that I'm making those conscious decisions, like how is this going to affect my body in 25 year? Little things like that. It's baby steps, of course, getting there, because five years of being inactive is a lot to crack. But...

HEADLEE: ...Where would you like to retire, Julia?

WASHINGTON: You know, actually I wouldn't mind staying where I live now. My community that I live in is so good at focusing on seniors and how can we help them and what can we do to encourage them. We have so many resources. We have a senior information line that you can call and ask for help, how do I get connected to X, Y, and Z? We have a Healthy Aging Association that does exercise classes for folks that are 60 and older. You know, and they make those modifications if you have limited mobility. We have senior housing complexes that are affordable and some of them are located near a grocery store, near the library, so it allows that ability to walk to the grocery store or the library or even the healthy aging classes. As much as it may not necessarily be, it's hot here.

HEADLEE: You're speaking from Modesto, California, which is basically in the desert...

WASHINGTON: ...Right, from Modesto, California...

HEADLEE: ...Yeah.

WASHINGTON: Yeah, very hot here. But what we have in terms of resources - it's amazing - and it's a great place for folks to came and maybe spend their older years.

HEADLEE: All right, well, Gretchen you're also in California. Where would you think is a good place to retire?

ALKEMA: You know, I'm grateful to live in the city of Long Beach, which is also, you know, a really friendly community and has as different community pockets in the city of 500,000 people. You know, other cities I've thought about are places like New York. I mean, often times people say, oh, my goodness, why would you want to retire to New York, that's why everybody goes to Florida...

HEADLEE: ...It's very expensive...

ALKEMA: ...It's expensive, that's why people go to Florida. But I think the concept is living in very much the kind of segment that Richard spoke about, a walkable city, an accessible city, in terms of having groceries - all the community supports that you want, and I don't mean senior services, I mean grocery stores. You know, drugstores, theater arts, you know, things that are extremely stimulating to the mind and the spirit all being in one place. And having elevators, having those things that allow for accommodation in the event that, you know, physical impairment does come to pass. And I think there's ways in which we can look at our cities today to improve the walkability, to improve the flow of community life in them. And, yes, the suburban model of the 1950s probably doesn't bode well for us in the long run but this is the time to start thinking about changing those structures now. And, you know, there's definitely elements in the suburbs that are looking at how to make things more community friendly.

HEADLEE: Well, Richard, you're speaking us from Toronto, so that's kind of cheating. But in the minute that we have left, what city do you think would be good to retire in?

FLORIDA: Well, we spent a lot of the winter in South Beach. We also love California...

HEADLEE: ...South Beach, Florida

FLORIDA: ...And greater LA, because it's walkable. And I'm 55, I'll be 56, and a couple of years ago I got the wake up call as a writer with lower back pain and I immediately changed my life. I gave up - I drive occasionally but very occasionally. I brought a couple of bicycles, city bikes, and a road bike. I ride all the time, I lift weights, I walk everywhere, and I'll tell you, I mean, I'm in the best shape of my life...

HEADLEE: ...Yeah.

FLORIDA: ...And for the same reason that Julia said, I don't want to be infirmed...

HEADLEE: ...Yeah.

FLORIDA: ...And those little changes, riding a bike not taking a car, walking to the grocery store, and doing, you know, not heavy weight training but a little bit of weight training, watching what I eat, has made a world of difference...

HEADLEE: ...OK.

FLORIDA: ...But I think that living in an active city, and the other thing, just last, it's great to be in a place where all ages, not only ethnicities, get together. And in New York, in LA, a Chicago, a Toronto, that's where people can be together...

HEADLEE: ...Yeah.

FLORIDA: ...Across ages, I think that's fantastic.

HEADLEE: And Richard Florida, senior editor at The Atlantic magazine, cofounder of the Atlantic Cities project. Also Gretchen Alkema, vice president of policy and communications at the nonprofit SCAN Foundation. Julia Washington works for the Stanislaus County Department of Aging and Veterans Services. Thanks to all of you.

WASHINGTON: Thank you.

FLORIDA: Thank you, what a great segment...

ALKEMA: ...Thank you...

FLORIDA: ...What a great show.

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