Let's face it: Despite their Herculean efforts to cling to youth, even Baby Boomers realize when they look in the mirror that the times are definitely changing. Over the next two decades, the graying trend will only become more noticeable, as 78 million people—a quarter of the U.S. population—move into the 60-or-older category.
When that happens, how will this generation—which keeps rewriting age-old social rules—rewrite the book on old age?
The financial implications of this tidal wave of aging are staggering, says UAB marketing expert Robert Robicheaux, Ph.D. "The Baby Boomer generation has affected our society as they passed through each life-cycle stage. As young children, they spurred the fast-food franchise industry—Ray Kroc of McDonald's grew that firm to serve the Boomers as kids. Then Lee Iacocca launched the Ford Mustang when he realized the impact of Boomers on the auto market.
"They staggered the music industry and then the college and university business in the 1960s and 1970s. Subsequently, the rental housing markets were turned upside down in the 1970s and 1980s. Today, the Boomers are transforming the health-care business as well as the senior housing and entertainment markets."
As Robicheaux sees it, Boomer-inspired changes will cascade through society. "If Boomers significantly downsize their housing, relocate to more moderate climes, and experience all the health issues that are normal for seniors, they will transform those future markets greatly," he says. "And Alabama is positioned to benefit from these changes because we have available land at reasonable prices and a warm climate for year-round outdoor activities."
But global warming could put a dent in familiar patterns of retirement migration as the rest of the country heats up, says Steven Haeberle, Ph.D., chair of the Department of Government. Moreover, he says, you might expect to see a reversal of the flight from American cities that once led to an explosion in suburbs. "I think older people who aren't going to be raising kids will be more likely to be living in city centers, because of the accessibility of services and lack of perceived needs for yards," he says.
Engaging While Aging
Although they may be eager to take a break from raking, the Boomer passion for all sorts of activities will change the way older folks see themselves and the way society sees them, Robicheaux says. "As the Boomers affected the entertainment markets of the 1960s and 1970s, they will affect the next decade's entertainment business. Boomer lifestyles will differ from earlier seniors, for sure. On average, they will be more healthy, more active, and more engaged.
"They will volunteer, they will return to school for meaningful education, and they will travel. Las Vegas has already changed to reflect the evolving market, and the entertainment business will change, too. Boomers will spend lots of money on entertainment, but the industry will have to accommodate their wants and preferences."
Today's television commercials already reflect how business is changing, Robicheaux says. "There is and will continue to be a major emphasis by marketers on reformulating, resizing, and repackaging most of what is sold today. The changes will affect clothing, autos, furniture, packaged goods, restaurants and every other type of business. Simply put, marketers will have to focus on the 78 million Boomers or lose significant shares of their markets."
Robicheaux expects home-care services, restaurants, supermarkets, health spas, and physicians to be most affected by the growing market opportunities. But he predicts that "the clothing business will fare poorly." Why? Because "Boomers will find less need for anything other than comfortable and functional attire."
Geometry and Geriatrics
The aging of America will also shape domestic public policy, says geriatrician Richard Allman, M.D., director of UAB's Center for Aging. "Over the next several decades, we will see a shift from a 'population pyramid' with relatively small numbers of persons over the age of 85 to a 'population rectangle' with nearly equivalent numbers of older and younger people." This change will have a huge impact on every aspect of society, Allman says, but it will be especially resonant in the health-care fields.
For instance, a population with an increasing number of surviving elders has been forced to shift its attention from the emergency care that has been the system's specialty to long-term maintenance of patients with conditions such as heart disease or low vision.
The switch from acute to chronic disease models is "one of the most important realizations" in recent medical history, says Gerald Glandon, Ph.D., chair of UAB's Department of Health Services Administration. "For providers, this implied that we were not supposed to just treat and release patients but had to manage the disease process." And disease management, Glandon says, requires a greater number of specialists and a longer treatment horizon, in which "pre-hospital care and post-hospital care are as important as the hospitalization." Because the long-term approach is much more complex than previous models, there is a greater emphasis on tracking patient data and sharing that information among many different health-care providers, he adds.
Then there is another question: How will older people get access to care in the first place? "Getting more elderly patients to their physicians, therapists, and pharmacists becomes more difficult as their ability to walk and drive diminishes," Glandon notes.
Indeed, transit is set to become a hot-button issue, says Haeberle. Funding public transportation will become a priority, and the money for new transit options will come from funds now used to maintain and build highways, he speculates. "If there are fewer Boomers wanting to operate cars on the Interstates, then the need for highways and other kinds of roads goes down."
The Doctor Next Door
Unfortunately, as a society we have not done much yet to design buildings or other public places, roads, and our transportation systems with the aging population in mind," Allman says. "I'm confident that we will see road signs that are more easily readable and that are located where they will be more easily noticed. We already are seeing timers at busy intersections to make sure people know how long that they have before a light turns from green to red. However, I anticipate that we will see much more of this happening."
Another major trend Allman sees: the evolution of the nursing home. "The long-term care industry is working to build more ‘home-like' environments for older adults who are not able to live independently and who require skilled care from nurses and other health-care professionals," he says. "The future nursing homes, assisted living, and other senior housing options will provide options sensitive to older adults' preferences and needs. However, the question will be, ‘Who can afford these options?'"
Those who can may find they have surprisingly easy access to medical care, Glandon suggests. "As these living arrangements become more commonplace, I would think that providers would find setting up practice in that setting" to be very attractive, he says. "Being the generalist for a large number of elderly patients living in a group setting provides a ready practice for an internist or gerontologist starting a practice."
Students for the Second Time
UAB's highly ranked health-care schools expect to turn out a fair proportion of these new internists and gerontologists, but widespread changes in society will require universities to adapt as well. The most obvious consequence is that "all our faculty members will be getting older!" Allman notes. So will the student body. "We will see more older adults returning to the classroom for educational opportunities and training that will permit them to remain actively and productively involved in the workforce for a much longer time," Allman says. That will lead, he suspects, to "more frequent and intentional development" of programs that let younger students learn from their older classmates "and vice versa."
Allman predicts that the aging population will also affect the curricula at all UAB health schools. "There will be an increasing emphasis on making sure that students in all disciplines have basic competencies in gerontology," he says. "That will include greater attention to the diagnosis and management of the special problems of older adults. There will be greater emphasis on interdisciplinary and team approaches to care within our health care system, and we will be developing and implementing new technologies and information systems that will enable us to provide better care to all patients, but especially our older adults."
So after they have successfully remodeled restaurants, roadways, and retirement homes to suit their needs, Baby Boomers will be back in a familiar place: the center of attention.