According to US Census projections, one in seven Southeastern Pennsylvania (SEPA) residents is age 65 or older. Nationwide estimates predict that by 2030, one in five adults will be over age 65.  Recently, much research has focused on the increased health care needs of an aging population, highlighting increases in chronic disease and routine care. However, the shifting health needs of an aging population reach beyond the clinical setting.  In addition to direct medical concerns, economic, social and mobility matters for SEPA residents 65+ are different from those of their younger counterparts.

This article examines utilization of programs and services by SEPA’s older adults.  The information is from PHMC’s 2006 Southeastern Pennsylvania Household Health Survey.

THE OLDER ADULT POPULATION IN SOUTHEASTERN PENNSYLVANIA

There are over 534,000 older adults (65+) in the SEPA region, with the greatest number of older residents (195,000) in Philadelphia.  The older population in SEPA is diverse in terms of employment, income and social factors.

· A disproportionate number of older adults are female; six out of ten persons 65 and older are women (60.0%) and four out of ten (40.0%) are male.

· Many of Southeastern Pennsylvania’s older adults (65+) are part of the workforce: 7.0% of older adults in SEPA are employed full time, and an additional 7.5% of older adults work part time.

· About 21,000 SEPA residents age 75 or older (about 7.6% of those in that age range) are working either full or part time.

· Nearly one out of ten persons 65 and older (9.8%) are considered low income, or have incomes that are  below the Federal Poverty Level.

ISOLATION AND NEEDS

With increasing age, the risk of social isolation for older adults often increases as well.  Some older adults may benefit from assistance from family, friends, and access to a wide range of services in their community.

· Overall, nearly one-third of older adults in the five-county area live alone (31.6% or approximately 170,000 persons).

· A greater percentage of SEPA residents age 75 and older live alone (38.1%) compared to older adults between 65 and 74 years of age (24.5%).

· One-fifth of older adults in SEPA who live alone (21.3%) see friends or relatives less than once a week.  This varies somewhat by county of residence.

· Nearly one in four (24.9%) older Philadelphians living alone see friends or relatives less than once a week.  In the suburban counties this ranges from 17.2% in Montgomery County to 20.1% in Bucks County.

· Shopping for groceries, preparing meals, and doing housework can become more challenging as individuals age and are considered examples of Instrumental Activities of Daily Living (IADL).  About one-quarter of older adults in SEPA (25.6% or approximately 130,000 persons) have one or more limitations related to these activities.

SENIOR CENTERS, FOOD PROGRAMS AND TRANSPORTATION PROGRAMS

In the past year, about 19% of older adults in SEPA have gone to a senior center or been involved in some other organized social program for older adults in the past year.   Nearly as many (18%) had not heard of any activities or senior centers.

· The use of senior centers and activities for older adults varied by age.  More than one in five SEPA residents over the age of 75 (21.4%) used these services, compared to 17.1% of area residents between the ages of 65 and 74.

· Approximately 34,000 older adults in the five county region (6.5%) participated in meal or food programs in the past year.  This pattern varied from a high of 8.8% in Philadelphia County participating in meal or food programs to a low of 4.8% in Delaware County.

· 8.9% of SEPA older adults (65+) had not heard of meal programs. 

About one out of seven older adults in the five-county area (13.5%) used some type of transportation service in the past year (including SEPTA discounts); this represents 72,000 older persons who used transportation services. However, many older adults are unaware of these services. 53,000 older adults in SEPA or 10% of the older adult population in the five counties had not heard of these transportation services and discounts.

There is a wide variation across the five counties in the percentage of older adults who have used any type of transportation service.  One out of five older adults in Philadelphia (20.0%) have used transportation services in the past year.  This percentage is higher than in the surrounding counties: Chester (10.5%), Montgomery (9.8%), Bucks (9.4%), and Delaware (9.1%).

Transportation difficulties can have serious implications for the health and healthcare of older adults.

· About 29,000 elderly SEPA residents (5.5%) have cancelled a doctor’s appointment or not scheduled one due to transportation problems.

· The percentage of older residents who had to cancel a doctor’s appointment due to a transportation problem was higher in Philadelphia (8.6%) compared to the suburban counties (7.0% in Delaware County, 3.4% in Bucks County, 2.7% in Chester County and 2.2% in Montgomery County).

SUMMARY

The older adult population in Southeastern Pennsylvania is diverse, with a wide range of strengths and needs.  As shown above, one-quarter of older residents of the five-county area have one or more limitations with activities like shopping, preparing meals and doing housework.  The needs of SEPA residents over 65 may be different from those faced by younger SEPA residents.  Programs that are tailored specifically for older adults in the region may meet some of these needs, but increased awareness of and access to these programs among older adults is key to increased utilization.

For information regarding PHMC’s Community Health Data Base’s 2006 Household Health Survey, or to learn more about older populations in the Southeastern Pennsylvania region, please contact Rose Malinowski Weingartner at rosemw@phmc.org.