The Blackwell Companion to Sociology (87 page)

economic structures impact the aging process. Third, social gerontologists have

shifted from a focus on old age as an isolated point or stage in life, to a life course perspective that emphasizes links across life stages. Finally, the discipline has moved away somewhat from a problem-based to a solution-based approach by

focusing on public policy and international comparisons that shed light on ways

to effect change.

We begin this chapter with an overview of the development of gerontological

theory. Next, we provide a primer on the demography of an aging population.

We then turn to issues of health and health care in old age. Finally, we explore the factors that shape economic security for the aged and their families. Along the

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way we pay careful attention to inequalities linked to race, class, and gender and to the policy initiatives that do ± and do not ± mitigate these sources of inequality.

Aging Theories

Social theories provide a framework or context to examine an issue such as

aging. The first aging theories found common ground in that they focused largely on the individual and what was normal aging. For example, disengagement

theory stated that it was normal and natural for an older person to withdraw

from society (Cumming and Henry, 1961). Activity theory, however, challenged

this assertion by claiming the reverse, that aging well entailed remaining active (Havighurst et al., 1968). Both micro-level theories nonetheless emphasized how

individuals age well rather than looking to external factors that impact the

process of aging.

Gradually, however, aging scholars began to ask how the elderly fit into the

larger social context (Quadagno, 1999). Age stratification theory, developed by

Matilda White Riley (1971), suggested that like class, race, and gender, age is a key source of social inequality, bias, and discrimination. These contextual theories pointed out the importance of age cohorts. People born around the same

time consequently experience similar events across their lives. For example,

those who became adults during the Second World War, many of whom were

able to rely on the GI Bill to obtain college degrees and buy their first homes, may have had more positive experiences than those who became adults during

the Great Depression. Similarly, life course theory, championed by Glen Elder

(1985), argued that to understand the diverse lifestyles of the aged, we must first understand the various paths and trajectories that people followed throughout

their lives. For example, women who have moved in and out of the labor force

because of child care and later parent care responsibilities tend to have very

different social and economic conditions in old age than women who have

prioritized their careers throughout their lives. Indeed, each cohort experiences the life course, and consequently old age, differently.

More recently, macro-level theories have employed political economy ideo-

logy by emphasizing how political and economic power differentially shapes the

material conditions of various groups of the elderly. One such theory is cumu-

lative disadvantage theory, which explains how one's place in the social structure throughout the life course, based upon gender, race, and class, defines experiences in old age. As you read this chapter, remember to think about the various

advantages and disadvantages, related to your income, health, race, and gender,

that are building across your life course. How will things look for you and for

your cohort as you approach old age?

Aging Populations

The United States, like most industrialized countries, is in the midst of unprecedented demographic changes; these countries are increasingly comprised of

Aging and Aging Policy in the USA

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growing numbers of older citizens. Even though they may not be warranted,

the sharp increase in older people raises many social, economic, and political

concerns.

A variety of indicators measure the changing age composition of a population.

One way to tell whether a country is aging is to examine the median age of the

population. In 1860, Americans' median age was under the age of 20, and by

1990, it was over 34 (Hobbs and Damon, 1996). A second way is to compute the

proportion of those aged 65 and over. In 1900, only 4 percent of the population

was aged 65 and over, by 1990, the proportion had reached 13 percent, and in

2030, the elderly may comprise 20 percent of the American population (US

Bureau of the Census, 1993). A third method emphasizes the proportion of the

oldest old, those aged 85 and over. In 1900, the oldest old comprised fewer than 0.1 percent of the population, but by 2030 this is estimated to increase to 8

percent (US Bureau of the Census, 1993). A final measure counts the number of

centenarians. Between 1980 and 1990 alone, the number of those aged 100 and

over grew from 14,000 to 28,000 (Hobbs and Damon, 1996).

The USA is not the only country experiencing an aging population. Currently,

the elderly comprise 20 percent of Sweden's population, and by 2020 they will

constitute between 20 and 25 percent of many European nations' populations. In

Japan, those aged 65 and older will have grown from 14 percent of the total

population in 1994 to over 25 percent in 2020. Less developed nations are also

aging; between 1993 and 1994 the proportion of elderly grew by 2.3 percent in

developed nations, compared to 3.2 percent in developing nations (Hobbs and

Damon, 1996).

Why Populations Age

How do we explain this dramatic jump in the aged population? Social

demographers emphasize three key factors: decreasing infant mortality rates,

decreasing fertility rates, and longer, healthier lives. Generally, people are

having fewer children, and those they do have are surviving and are increasingly likely to live longer. Thus, the old are making up a larger percentage of the

population.

One of the easiest ways to show the process by which populations age is with a

population pyramid that categorizes the population's distribution by age and

sex. Figure 26.1a characterizes a country with a young population. Typically

poor, agrarian, and lacking in public health care, less developed countries tend to have high fertility rates offset by high infant mortality and relatively low life expectancies (US Bureau of the Census, 1988). By contrast, figure 26.1b characterizes a country with a more middle-aged population. Societies that are

developing, industrializing, and improving public health tend toward declining

infant mortality rates, represented here through the squaring of the bottom part of the triangle. Finally, figure 26.1c characterizes a more developed nation with an older population. Like other developed nations, the USA is approaching this

rectangular shaped population pyramid due to an overall declining mortality

and a stabilized fertility rate.