Page 224 - Cultural Competence in Health Education

202 Cultural Competence in Health Education and Health Promotion

INTRODUCTION
In the last couple of decades, significant resources have been devoted to examining

the social, health, and economic impacts of what some have called the “ graying of
America. ” Despite increasing research on this topic, most people continue to view
aging as a mysterious and fearsome process, one that is enshrined in myths and stereo-
types extending from health to economics and, especially in the United States, an
almost universal fear of getting old. Regardless of how we define aging or when we

believe it to start, there is one truth we cannot escape: everyone is bound to experience
what Walt Whitman poetically romanticized as one of the four seasons in our lives.
This chapter presents an overview of the older population ’ s demographics, a brief
summary of the health status of its members, and a review of successful health inter-
vention programs focused on older adults.

DEMOGRAPHIC CHARACTERISTICS
OF OLDER AMERICANS

According to the Profile of Older Americans (Administration on Aging, 2005), some
36.8 million Americans, or approximately 14 percent of the total U.S. population,
are over the age of 65. This number represents a tenfold increase in this age group
since the 1900s (see Figure 11.1 ), and it makes individuals aged 65 and above one of
the fastest growing population segments in the United States. Population estimates
also predict that the number of people aged 65 and over will double in the next three
decades.
Current and future demographic changes in the older adult population require an
examination of the racial and ethnic composition of that population group. In 2000, a
majority of the individuals aged 65 years and over (84 percent) were non - Hispanic
whites (see Figure 11.2 ). Population estimates predict that by 2050 that trend will
continue, albeit at a smaller rate. The ethnic group with the smallest number of indi-
viduals in the 65 and older category is the American Indian and Alaska Native group.
As might be expected, the older adult population is not evenly distributed over
the fifty states. In 2000, the states of Florida, West Virginia, Pennsylvania, Iowa, and

North Dakota reported comparatively high proportions of older adults in their popu-
lations. In California, individuals aged 65 and over accounted for about 10 percent
of the total population (Wallace, Pourat, Enriquez - Haass, & Sripipatana, 2003).
One of the reasons for the large number of individuals in the age 65 and older
category is the increase in life expectancy for U.S. residents. For instance, a person
born in 2000 can expect to live an average of twenty - nine years longer than some-
one born in 1900. Better access to health care, advances in medical science, and
less dangerous occupations account for the increases in life expectancy. One thing
that has not changed much since the turn of the century, however, is the difference

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