Filed Under:Health Insurance, Ltci

Why should LTC needs forecasters hate these 5 states?

Mysterious numbers

The size of the
The size of the "oldest old" population is smaller than demographers were predicting it would be.

Even the components of long-term care (LTC) planning that ought to be easy to predict can be surprisingly difficult to pin down.

Everyone who has ever taken an introductory economics class knows that trying to predict where interest rates will go is a game for people who are comfortable with being wrong most of the time.

Guessing how likely buyers of private long-term care insurance (LTCI) are to develop limits on activities of daily living (ADLs) is difficult because of factors such as changes in diet, changes in medical care, and changes in culture. Will increased use of diet soda, whole wheat bread, ice lattes and gourmet cupcakes combine to jiggle the morbidity curve? Will researchers shock LTCI underwriters by finding a cheap, simple cure for Alzheimer’s – or come up with a way to prevent deaths from strokes that increases the risk of dementia?

In theory, one factor that ought to be reasonably easy to predict is the number of “oldest old" people – the number of U.S. residents ages 85 and older – who will be living in each state.

See also: DC: U.S. Death Rate Falls, Alzheimer's Hits Harder.

Estimating the future size of the oldest old population is important in community LTC needs planning, because oldest old people are much likely than younger people to suffer Alzheimer’s disease and other conditions that increase the likelihood that those people will need long-term care.

See also: Underwriting, frailty and older age applicants.

In 2010, for example, the share of U.S. residents who reported having difficulty with dressing or bathing was just 5.2 percent for those ages 65 to 84 but 31 percent for those ages 85 and older.

The accuracy of community LTC needs forecasts could affect individual consumers' LTC planning goals, by affecting the cost of LTC services. If the number of people who need care turns out to be much lower than expected, providers that increase the supply of beds to handle a non-existent rush crowd may have to cut prices to get customers in the door.

But a comparison of actual 2010 oldest old population numbers with past projections shows that government demographers have had a tough time projecting the size of the oldest old population.

Demographers consistently predicted that the United States would end up with more oldest old people than it actually had.

In 1996, for example, Census Bureau demographers used 1994 survey data to estimate that the United States was likely to have 5.969 million residents ages 85 and older in 2010, and that people in that age group would make up 2 percent of the population.

The number was 8.7 percent higher than the actual number -- 5.49 million. The prediction about the share of the population that would be in the oldest old age group was about 10 percent bigger than the actual share – 1.8 percent.

In 2005, Administration on Aging demographers used 2004 Census data to predict that the United States would have 5.67 million oldest old residents in 2010, and that those people would make up 2 percent of the population. This time, the projected oldest old population figure was still 3 percent higher than the actual figure.

Almost all of the errors went in one direction.

A comparison of the 2005 Administration on Aging forecasts and the actual 2010 survey figures shows that the share of the population in the 85-and-over age group was 6.7 percent higher than projected in Hawaii and 0.2 percent than projected in New Hampshire.

In every other state, the share of the population in the 85-and-over age group was smaller than projected.

In five states, the gap between the actual share of the population in the 85-and-over age group and the projected share was more than 15 percent.

It’s not immediately clear from census data why the actual size of the oldest old population has been so much lower than projected. But Fecilitie Bell and Michael Miller of the Social Security Administration have reported that improvement in female life expectancy slowed sharply from 1980 through 1999. The lack of improvement in women's life expectancy may have thrown off projections about the likelihood that older women would reach age 85.

Here’s a look at the five states where the demographers’ oldest old population crystal ball seems to have the hardest time coming up with a clear picture.

The current population figures are from a recent Census Bureau report based on 2010 survey data

The 2005 oldest old population projections for 2010 come from Aging on Administration projections based on Census Bureau data.

The figures on life expectancy at age 65 — and the number of healthy years a 65-year-old in a state can expect to enjoy — come from a U.S. Centers for Disease Control and Prevention (CDC) paper based on survey data collected from 2007 through 2009. 

5. Alabama

 Alabama pier

 

Total Population: 4,779,736.

Number of people 65 years and over: 657,792.

Percentage of population 65 years and over: 13.8%.

Actual number of people 85 years and over: 75,684.

2005 projection for 2010 85+ population: 88,211.

Gap between projected 85+ population and actual 85+ population: 17%.

Actual percentage of population 85 years and over: 1.6%.

2005 projection of 2010 percentage of population 85 years and over: 1.9%.

Gap between projected and actual share of total 2010 population in the 85+ age group: 17%.

Life expectancy at age 65: 17.6.

Health years of life expectancy at age 65: 11.1.

4. New Mexico

 New Mexico flag

 

Total Population: 2,059,179.

Number of people 65 years and over: 272,255.

Percentage of population 65 years and over: 13.2%.

Actual number of people 85 years and over: 31,993.

2005 projection for 2010 85+ population: 38,326.

Gap between projected 85+ population and actual 85+ population: 17%.

Actual percentage of population 85 years and over: 1.6%.

2005 projection of 2010 percentage of population 85 years and over: 1.9%.

Gap between projected and actual share of total 2010 population in the 85+ age group: 17%.

Life expectancy at age 65: 19.6.

Health years of life expectancy at age 65: 13.9.

3. Florida

Florida palm trees

 

Total Population: 18,801,310.

Number of people 65 years and over: 3,259,602.

Percentage of population 65 years and over: 17.3%.

Actual number of people 85 years and over: 434,125.

2005 projection for 2010 85+ population: 537,846.

Gap between projected 85+ population and actual 85+ population: 19%.

Actual percentage of population 85 years and over: 2.3%.

2005 projection of 2010 percentage of population 85 years and over: 2.8%.

Gap between projected and actual share of total 2010 population in the 85+ age group: 18%.

Life expectancy at age 65: 20.4.

Health years of life expectancy at age 65: 15.4.

 

Photograph: AP photo: J. Pat Carter

2. Louisiana

 Mardi Gras 

Total Population: 4,533,372.

Number of people 65 years and over: 557,857.

Percentage of population 65 years and over: 13.8%.

Actual number of people 85 years and over: 65,686.

2005 projection for 2010 85+ population: 82,653.

Gap between projected 85+ population and actual 85+ population: 21%.

Actual percentage of population 85 years and over: 1.4%.

2005 projection of 2010 percentage of population 85 years and over: 1.8%.

Gap between projected and actual share of total 2010 population in the 85+ age group: 22%.

Life expectancy at age 65: 17.9.

Health years of life expectancy at age 65: 12.0.

 

Photograph: AP photo/Gerald Herbert

1. Wyoming

 Wyoming

 

Total Population: 563,626.

Number of people 65 years and over: 70,090.

Percentage of population 65 years and over: 12.4%.

Actual number of people 85 years and over: 8,602.

2005 projection for 2010 85+ population: 10,123.

Gap between projected 85+ population and actual 85+ population: 15%.

Actual percentage of population 85 years and over: 1.5%.

2005 projection of 2010 percentage of population 85 years and over: 1.9%.

Gap between projected and actual share of total 2010 population in the 85+ age group: 23%.

Life expectancy at age 65: 19.0.

Health years of life expectancy at age 65: 14.4.

United States

 U.S. map

Total Population: 308,745,538.

Number of people 65 years and over: 40,267,984.

Percentage of population 65 years and over: 13.0%.

Actual number of people 85 years and over: 5,493,433.

2005 projection for 2010 85+ population: 6,123,458.

Gap between projected 85+ population and actual 85+ population: 10%.

Percentage of population 85 years and over: 1.8%.

2005 projection of 2010 percentage of population 85 years and over: 2.0%.

Gap between projected and actual share of total 2010 population in the 85+ age group: 10%.

Life expectancy at age 65: 19.0.

Health years of life expectancy at age 65: 14.4.

 

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