As we head into the final stretch of the presidential campaign, one critical issue has largely been absent from the political discourse: the aging of the U.S. population and its implications for health care, housing and retirement security. As explained in a recent report by the Bipartisan Policy Center’s Senior Health and Housing Task Force, the United States is unprepared for the demographic transformation now underway.

Over the next decade, the number of Americans aged 65 and above will increase by 18 million. By 2030, more than one in five Americans will be a senior, a record high. Those aged 85 and above represent one of the nation’s fasting-growing demographic groups.

Maine is at the forefront of this aging trend. Mainers have a higher median age (43.5) than the residents of any other state. At 17 percent, the state is currently home to the second highest proportion of residents over age 65, right behind Florida. In the coming years, the senior population of Maine will grow significantly.

A key challenge is to ensure that Maine’s seniors have access to affordable housing. While most older adults in the state own their homes, incomes decline significantly as people age, a situation that will affect the thousands of seniors who still hold mortgages and pay property taxes. Without a significant increase in the supply of rental homes affordable to Maine’s lowest-income seniors, the current shortage of such homes will also widen as the older adult population expands and some senior homeowners “downsize” into rental housing.

National surveys show that an overwhelming majority of older adults will seek to “age in place” in their own homes and communities. Yet most homes lack the design features like “no-step” entrances, extra-wide hallways and doors and accessible switches and outlets that can help ensure safe and independent living by seniors.

In Maine, the housing stock is quite old: Approximately 31 percent of all housing units were built before 1950. As in most states, many communities in Maine lack support services such as transportation and easy access to health care that can enable aging in place. These challenges are compounded by Maine’s largely rural character.


As the Bipartisan Policy Center’s report points out, about 70 percent of those who reach age 65 will eventually need help with bathing, food preparation, dressing and medication management – assistance that is referred to as long-term services and supports. Medicare does not cover long-term services and supports, though they can be very expensive and impose a significant hardship on family caregivers. At the same time, more than two-thirds of Medicare fee-for-service beneficiaries suffer from multiple chronic conditions, accounting for 93 percent of Medicare spending.

In light of these facts, a key premise of the BPC’s report is that a far greater integration of the nation’s housing and health care systems is essential. The report makes a compelling case that more tightly linking health care with the home can help manage chronic disease, improve the physical and mental health of seniors and provide greater opportunities for older adults to age in place.

Better connecting housing with health care also has the potential to reduce overall health care costs. Vermont’s Support and Services at Home program, run by housing provider Cathedral Square, is demonstrating that combining supportive services for seniors with housing can slow the rate of growth of Medicare spending. Other supportive housing programs for seniors are also showing promising results.

Another key need is to reduce the number of falls by seniors. Falls are the leading cause of injury-related deaths among older adults, and most falls occur in the home.

Falls by older adults also account for over $30 billion in annual health care costs. A greater focus on fall prevention throughout the health care system, a key recommendation of the BPC report, holds great potential to help seniors remain at home and lead healthier lives while reducing costs.

On Friday, independent Maine U.S. Sen. Angus King and a group of national experts and local leaders will assemble at a public forum Friday, 9 a.m. to noon, at the DoubleTree Hotel in Portland to discuss how to better connect housing and health care to support our state’s seniors. With Maine’s senior population, already large, on the cusp of a major expansion, there are few issues as important for the future of our people and our state.

George J. Mitchell is a co-founder of the Bipartisan Policy Center and co-chair of its Housing Commission. He served as Democratic U.S. senator for Maine from 1980 to 1995 and as Senate majority leader from 1989 to 1995.

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