We’re Not Asking the Most Important Questions About Age
“By James Chappel
Mr. Chappel is the author of the forthcoming book “Golden Years: How Americans Invented and Reinvented Old Age.”
After President Biden delivers his third State of the Union address on Thursday, much of the analysis will focus on the apparent signs of the president’s age. How alert does he seem? How spry? Does he look up to the task of running for office, or of governing? Questions like these certainly matter, but they are not the only ones we should be asking about age and aging right now. They are not even the most important.
As a historian who studies aging in America, I see this presidential contest as an opportunity for us to change the national conversation on aging. Right now, the mainstream discussion has focused on the capacities of two individuals, presuming throughout that old age is a problem and that the natural signs of aging are deplorable weaknesses. The problem is not that such a conversation is ageist — although it often is — but that it threatens to once again become the only one we have about aging in this election cycle. It stands in the way of the conversation that matters more: How can we ensure that older Americans, many of whom are vulnerable and precarious, are able to live healthier, happier and more dignified lives?
In a way, the persistent debate about Mr. Biden’s age represents a mass delusion that we are still a nation of the young. We have always liked to think of ourselves as the prototypical country of youth: a nation of plucky strivers, distinguished from the old country by our restless, creative spirit. Such a nation, we might think, ought to be led by someone young, or at least young at heart. Maybe this was even true, once. But it’s not anymore.
The age of the American president has gone up and down over time, but the age of the American public has not: We get older as a nation every year. The 2020 census showed that, between 2010 and 2020, the number of people over 65 shot up from 40 million to 56 million; this population grew five times as fast as the overall population, in a decade when the size of the under-18 population actually shrunk. It’s worth noting that the older population is also growing more ethnically diverse every year, as those who arrived as young people in the wake of the 1965 immigration reform head into their golden years.
Our political discussion should reflect this reality. Mr. Biden recognizes this.
Another way to look at Biden’s Age
Median age in the United States
Pew Research Center, Census and U.N.
In his previous State of the Union address, Mr. Biden devoted a fair amount of attention to old-age politics: Social Security and Medicare, of course, but he also called for an expansion of in-home health care services for older people. It is easy to dismiss this as pandering to an interest group that tends to vote. But it’s more than that: Old-age policies affect everyone. Affordable home health care aides, for instance, would primarily benefit the millions of middle-aged people, mainly women, who are currently doing most of the nation’s elder care for free. So when Mr. Biden talks about old age policy, as he likely will, he is laying out his plan to address one of the most important long-term trends challenging the nation.
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Millions of older Americans rely on Social Security to stay out of poverty. The system, though, is set to become insolvent in about a decade — a looming disaster that is eminently solvable. (Passing the bill known as Social Security 2100, which has 183 co-sponsors in the House, into law would be a good start.) Even Social Security is little help for older Americans once they become disabled and need long-term care.
As the bitter experience of millions of families attests, the “system” for such care is in crisis. We need, therefore, a vast expansion in public support for home health care and for nursing home care, both of which are often paid for out of pocket. For both of these, too, we need better regulatory oversight and better labor protections for care workers. There is no avoiding the fact that long-term care will be a massive component of the 21st-century economy. We have a political decision to make: Will this remain in the shadows, with underpaid workers and poor conditions? Or will this become, as it ought to be, a glittering centerpiece of our new old country?
Politicians and the media used to recognize the centrality of old-age policy. When researching the history of old age politics, I was struck by how widespread and sophisticated the discussion has normally been. In the late 19th century, Americans advocated pensions for Civil War veterans; in the early 20th century, many argued that the formerly enslaved deserved pensions, too. Those discussions were alive to the ways that mass warfare and chattel slavery had marred the lives of older Americans, and how the state might help.
Between 1935 and 1975, old-age security was arguably, next to military might, the central preoccupation of American policy. The passage of the Social Security Act (1935) and the Medicare and Medicaid Act (1965) are just the two most famous examples. Every year, legislation streamed from Washington that addressed problems in housing, nutrition and care for older people. Some of it was good, some of it was bad, but together that flood of legislation created an admirable safety net for American seniors. And throughout, this safety net benefited Americans of all ages. One of the most important aims of Social Security, after all, was to free older people from dependence on their children.
Since 1975, that flood of legislation has slowed to a trickle and the national conversation about those issues has more or less ceased. It’s not that we’ve ceased talking about old age — we talk about it constantly, as we are now. But those conversations have focused on well-off older people, like Donald Trump and Mr. Biden, and on their place in culture, society and politics. From AARP to “The Golden Girls,” the American reckoning with age has been, by and large, a reckoning with age for the relatively privileged and able-bodied. The more important issues have been largely unaddressed.
The old-age lobby is not as powerful as many believe — even the mighty AARP has supported many failed initiatives, including an effort in 1988 to provide federally subsidized long-term care insurance. Social Security has not been meaningfully reformed in my lifetime; its last major change was voted into law in March 1983, a few weeks before I was born. There have been various efforts to reform a nursing home system that is, by all accounts, in disastrous shape, and to improve labor conditions for home health care workers. Those, too, have come to little, and many of the regulations that were passed have not been enforced.
Today, as we continue to have familiar discussions about old age and the so-called gerontocracy, older people are being buffeted by new challenges. Climate change, for instance: Older people are disproportionately affected by the storms, wildfires and electricity shortages that accompany our warming planet. The Covid-19 pandemic is another painful example. More than half of those killed by Covid-19 in the first three years of the pandemic were over the age of 75; three-quarters were over the age of 65. Nursing homes especially became death traps. More than one-fifth of Covid-19 deaths took place among residents or staff of nursing homes, a group that comprises less than one percent of the population.
There is a serious conversation to be had about aging. It’s about how we can, as a country, prepare for a century of pandemics, heat waves and hurricanes, and how we can provide humane care to millions of frail older people, many of them people of color who have suffered a lifetime of disenfranchisement. Every word that we use to analyze gaffes or provide armchair diagnoses is a word that is not being used on them. We can do better. More than ever before, demographically speaking, we are a nation of grown-ups. It’s time to start acting like “
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