By Rob Stein
Washington Post Staff Writer
Friday, April 20, 2007
As the first wave of baby boomers edges toward retirement, a growing body of evidence suggests that they may be the first generation to enter their golden years in worse health than their parents. While not definitive, the data sketch a startlingly different picture than the popular image of health-obsessed workout fanatics who know their antioxidants from their trans fats and look 10 years younger than their age.
Boomers are healthier in some important ways -- they are much less likely to smoke, for example -- but large surveys are consistently finding that they tend to describe themselves as less hale and hearty than their forebears did at the same age. They are more likely to report difficulty climbing stairs, getting up from a chair and doing other routine activities, as well as more chronic problems such as high cholesterol, blood pressure and diabetes.
"We're seeing some very powerful evidence all pointing to parallel findings," said Mark D. Hayward, a sociologist at the University of Texas at Austin. "The trend seems to be that people are not as healthy as they approach retirement as they were in older generations. It's very disturbing."
While cautioning that the data are just starting to emerge, researchers say the findings track with several unhealthy trends, notably the obesity epidemic. Two-thirds of Americans are overweight, and those extra pounds make joints wear out more quickly, boost cholesterol and blood pressure, and raise the risk of a host of debilitating health problems. And despite all those gym memberships, baby boomers tend to be less physically active than their parents and grandparents, their daily routines often dominated by desk jobs and the drive to and from work.
"A lot of what we visualize about the baby boomers are the people who went to college -- the highly educated group that gets all the attention. They're the cultural icon," said David R. Weir, an economist at the University of Michigan, noting that studies have shown that better-educated people tend to have more healthful lifestyles and better access to health care. "But not everyone went to college, and not everyone is engaging in these healthful activities."
Even those who try to take care of themselves are not always entirely successful. Take Larry Kirkland, a 57-year-old sculptor who lives in Northwest Washington. Kirkland walks and swims regularly to stay in shape, watches what he eats, and fights to keep his weight down. Ask him about his health, and Kirkland will tell you that it's good. Well, pretty good.
There's his blood pressure, which has been high for years. He takes medication to keep it under control. His cholesterol jumped, too, requiring another pill to keep that in check. Then his blood sugar started going up, prompting his doctor to remind him that he really should drop at least 10 pounds if he wants to avoid diabetes.
"There are the creeping aches and pains. I dislocated my shoulder once, and that continues to bug me. I have knees that decide to be wobbly on occasion. I know that as you get older things tend to begin to fall apart," Kirkland said, adding that he gets fever blisters and that his psoriasis flares up when he is stressed.
"I can get under quite a bit of pressure from my work," Kirkland said.
In fact, boomers tend to report more stress than earlier generations -- from their jobs, their commutes, taking care of their parents and their kids -- all of which can take a physical toll, which is compounded by having less support from extended families and communities, experts say.
"People are working two jobs. They are not sleeping as much. They're experiencing more job insecurity. They have less time to take care of themselves. They are more socially isolated," said Lisa Berkman of the Harvard School of Public Health. "This all could add up to a huge crisis and really calls for us to examine the things that perhaps we're not doing so well."
Some researchers are skeptical, saying that U.S. life expectancy has increased consistently for decades, accompanied by a steady drop in disability rates. Rising rates of chronic disease may simply mean that such illnesses are being diagnosed earlier, which could translate into longer lives and less disability because boomers are getting their heart disease and diabetes under control sooner.
"This doesn't cause me to despair," said Kenneth Manton, a demographer at Duke University. "You have to take this data in the context of other data, such as life expectancy."
Others agree that the data are unclear because the baby boomers are not yet old enough to report major health problems in significant numbers, but they added that the findings so far are ominous.
"We haven't seen any enormous effects yet," said David M. Cutler, an economist at Harvard. "But we may be starting to see some inklings of what's coming."
One of the most alarming red flags was thrown up by the federally funded Health and Retirement Study, which is tracking more than 20,000 U.S. adults as they move through middle age toward retirement.
When researchers examined the first wave of baby boomers to enter the study -- 5,030 adults born between 1948 and 1953 -- they were shocked to discover that they appeared to report poorer health than groups born between 1936 and 1941, and between 1942 and 1947.
The baby boomers were much less likely than their predecessors to describe their health as "excellent" or "very good," and were more likely to report having difficulty with routine activities, such as walking several blocks or lifting 10 pounds. They were also more likely to report pain, drinking and psychiatric problems, and chronic problems such as high blood pressure, high cholesterol and diabetes.
"It's not what I expected," said Beth J. Soldo of the Population Aging Research Center at the University of Pennsylvania, who led the analysis.
It is unclear whether boomers are really sicker or are simply more health-conscious by dint of being better educated and having better access to information. They may also have higher expectations, making them more likely to notice and complain about aches and pains that earlier generations would have accepted as just part of getting older.
"As they age, they may be less tolerant of the changes they see -- minor pains, less stamina, muscle loss and strength," Soldo said. "I don't just think they are crybabies or whiners. I think there is a changing definition of what good health means."
But self-reports of health tend to be powerful predictors of risk of death at any given age, Soldo and others say.
"We have been making progress with the elderly, who are doing better," said Dana Goldman, who studies health issues at the Rand Corp. "But while we've been patting our backs about the older people, the younger generation has been ignored. Disability is rising fastest among the youngest age groups."
The findings are consistent with a number of studies, including one last year that found American adults have poorer health than their British counterparts, and a preliminary analysis of data collected between 1972 and 2003 for the National Health Interview Survey, a nationally representative survey of more than 100,000 Americans.
"Overall it looks like there's been some recent declines in overall health among younger adults compared to the cohorts of previous decades," said Robert Hummer, a sociologist at the University of Texas, who conducted that analysis. "It's worrisome."
One of Hummer's colleagues produced similar findings in a survey of 2,500 adults between 1995 and 2001.
"It's pretty scary," said John Mirowsky, who conducted the survey. "Until now people have been living longer and living longer without the need for assistance -- they can dress themselves and take care of themselves. But it looks like we may be on the verge of a change where we'll have an increasing proportion of the elderly needing assistance, and possibly a decline in life expectancy."
If the findings are confirmed by further analysis, the trend could force policymakers to rethink a host of expectations and projections about the nation's overall medical bill and the future of Social Security and other retirement programs.
"If people are entering early old age in worse health, it doesn't bode well for society," said Richard M. Suzman of the National Institute on Aging. "It's quite worrying."