Community well-being should factor in older adult population

Consider the Gallup-Healthways survey about community well-being.  Naples, Florida, is at the top. Really? Perhaps this caught your eye last week when you saw the Gallup survey about well-being.  For those who missed it, the survey ranked well-being of adults 18 and older in a community (town) by specific factors -- Purpose, Social, Financial, Community, and Physical.  At the highest level, Naples was followed by the town of Barnstable on Cape Cod. Consider that the attribute ‘Physical,’ for example, meant “Having good health and enough energy to get things done daily.” So look past the survey. These towns are comparatively wealthy by national measures -- the median income for a household in Naples is $66K and for those over age 75, it is $71K.  For Barnstable, median income is $62.1K – and note that 20% of the Barnstable population is 65+, higher than the 135 national percentage. In Naples, the median age is 60 and an eye-popping 42% of the population is aged 65+.

But is all going to be a state of well-being for older adults? Let’s think about Naples and Barnstable in another context. A few years ago, AARP published a census-based research report about the future of available caregivers for baby boomers – describing a Caregiver Support Ratio – the availability of people aged 46-64 to provide care for the population aged 80+.  They noted that this was particularly worrisome for the year 2026 and beyond -- when baby boomers age into their 80s. Examining this Caregiver Support Ratio (CSR) for the current US population aged 80+ by census counties, we posted a separate report listing the 100 counties that had the most notable problem in 2013 – the fewest people aged 46-64 in comparison to the population aged 80+. That analysis was titled Stranded by Geography -- guess which counties sorted as # 11 and # 17 of the top 100 – that is, the counties with the fewest available people aged 46-64 to care for the largest group of seniors?  Collier County, where Naples is and Barnstable County, where the town of Barnstable is located.

Now consider the census-derived paid caregiver population.  The availability of paid caregivers (paid Caregiver Support Ratio, or pCSR) – it is not good for either county.  Consider Collier County, home of Naples, where there are 470 census-identified individuals with the caregiver job code – in a population of 23,959 people aged 80+. That’s a pCSR of 46.7, the number of clients per available worker.  Can one worker handle 46.7 seniors in a geography of 2,305 square miles? And even for Barnstable County, the ratio is ‘better’ at 23.4 – but is it feasible in a county of 1,306 square miles?   Note that where you look for survey information, that is the survey information you will find.  These counties might be chock full of delighted and happy people – the Gallup-Healthways survey does not make it easy to figure out their actual ages. But the census does not lie – a large population of people on the far side of 80 has created worker shortages -- or job opportunities -- for the young and able-bodied.  Today, Collier County’s unemployment rate is apparently 4.5 and Barnstable’s is 3.5%.