Monday, February 26, 2007

Sick sense: I see old people

I see them migrating when they know they are going to need a lot of health care.

This report in the NYTimes of a surprising demographic trend of the elderly returning north after a decade or so of retirement in the warmth and lower CoL of the sunbelt tries various explanations for the trend.
For the first time since the Depression, more Americans ages 75 and older have been leaving the South than moving there, according to a New York Times analysis of Census Bureau data.
The reversal appears to be driven in part by older people who retired to the South in their 60s, but decided to return home to their children and grandchildren in the Northeast, Midwest and West after losing spouses or becoming less mobile.
...

William H. Frey, a demographer at the Brookings Institution, said, “The South, and Florida especially, has been a magnet for yuppie elderly: younger seniors with spouse present and in good health.
“These are a catch for communities that receive them, because they have ample disposable incomes and make few demands on public services,” he continued. “The older senior population, especially after 80, are more likely to be widowed, less well off and more in need of social and economic support.”
“Many northern states seem to have better senior services than Florida,” Dr. Frey added.

...
Mildred Morrison, administrator for the Area Agency on Aging of Allegheny, Pa., which includes Pittsburgh, described return migration as part of a natural progression. “They usually leave after retirement to a warmer climate, and return in good physical health, but maybe on the cusp of declining health, 10 years or so later,” Ms. Morrison said, mostly to “reconnect with family.”
...
Calvin Beale, senior demographer of the Economic Research Service at the federal Department of Agriculture, said: “After age 75, as health diminishes and/or widowhood occurs, there is some measure of return flow back to areas of origin, or wherever a caretaker-minded son or daughter lives. And this means a net outflow from the South.”

Most of the article is presentation of telling anecdotes that illustrate the "natural pattern of aging" where retirees return to family when they are no longer able to enjoy the idleness of their retirement. But I think Dr Frey has it right...its not just family but better medical infrastructure and support services that must have some appeal to a person sensing that sickness and age are getting the upper hand.

I found a very interesting web page put up by PBS as documentation of a Bill Moyers investigation of where the strain of mounting medical needs of an aging population will fall most heavily and where there is an adequate net to catch it. I colored in the map according to the listed data so you can get the tale that the data
tells. I will underscore one aspect of this map of which states have the highest and which the lowest portion of their citizens living with no health coverage at all: Look at the "rust belt" states where manufacturing and union labor were the economic and political giants for a few decades before and after WWII. There are exceptions like KS, NB, IN and NJ but I see a pattern that states once strongholds for organized labor STILL have the widest health coverage. Why would that be?

That Moyers report, the NYTimes article and dozens of such published sightings of icebergs bobbing dead ahead of our bow in the fog of politics ...all these would be worthy places to spend half a trillion dollars. Why is anyone anywhere silent about the upside down federal budget and mind boggling medieval priorities of the administration that proposes it?


Note: New York would also seem like an exception but its an interesting case. The rural and agricultural western counties of upstate NY had insurance enrollment rates similar to regions of appalachia where industrial base is slight and employer paid health coverage is not common. In the late nineties, the latest date for which comparable data were available from all states, NY numbers would reflect that low enrollment. But in strong divergence from the trends elsewhere, state and regional programs have sharply cut the numbers of uninsured in the last six years in western NY counties.

6 comments:

Gerry said...

Great post header, GS

GreenSmile said...

Maybe I should just save us all a lot of time: dash off a series of inspired titles and skip writing conent for the posts.? I DO like brevity inspite of my thoroughly exposed prolixity.

Gerry said...

Nah, content's important.

GreenSmile said...

if you insist, yer bearship.

GreenSmile said...

BTW, Gerry, please share that stunning idea about content with some of our TV network executives, if you'd be so kind..

Gerry said...

Ok, GS, next time I have a gaggle of TV network exec over for drinks on my yacht, I'll mention it to them...