I opened an email from Jim Oswald of Meals on Wheels about a week ago and read about the Thanksgiving Day plan to deliver 2,800 turkey dinners to homebound seniors in San Francisco and 1,400 meals to caretakers and family members, “bringing the total number of meals that may be delivered that day to 4,200.”
The message made me pause and reflect on what it would mean to be old, homebound and poor, reliant on state sponsored resources for food, health and companionship.
In less than 10 years I will be part of the elderly population. I’ve begun to pay avid attention to how older people cope, especially since I myself am a caretaker of an 86-year old mother, largely homebound, who looks especially fragile every passing day.
With advances in modern medicine, technology, nutrition and healthy living, more and more people are enjoying their eighth and ninth decades and even a full century of existence.
Steven P. Wallace, a professor at UCLA’s School of Public Health, has been deeply invested in studying the needs for the growing number of seniors. Presenting his findings at the Gerontological Society of America’s (GSA) Annual Scientific Conference in Austin this year, he said that the number of people, 65 and older, will double in America by 2040. The 2010 Census estimated that there were 40.2 million elderly in America, which is projected to grow to 81.2 million by 2040. Significantly, the fastest growth is among elders of color.
While increasing life span is evolutionary, it also presents a new set of challenges to confront.
Wallace presented a chart that showed many seniors having little economic bandwidth after paying rent. In 2015, one out of every two persons over the age of 65 spent more than one-third of their monthly income on rent and a good 23 percent experience a severe—over 50 percent—rent burden.
Policies like Supplemental Security Income, Social Security payments and Medicare were put in place to shield individuals from facing huge financial outlays in the twilight years of their lives. However, according to Amber Willink, a researcher from the Johns Hopkins Bloomberg School of Public Health, “one in five Medicare beneficiaries is under-insured,” and “beneficiaries are exposed to high out-of-pocket costs and premiums.”
The National Council on Aging found that over 25 million Americans aged 60 and over are economically insecure—living at or below 250 percent of the federal poverty level (FPL).
But FPL (one person, 2019)—set at $12,490—claims Wallace, is an insufficient measure of poverty and any analysis using FPL does not present an accurate portrayal of seniors in poverty. FPL does not reflect the variations in the cost of living of America’s counties and cities. Using a static figure as a benchmark for poverty doesn’t really make sense, Wallace emphasized.
Take for instance the contrast between the Housing and Urban Development (HUD) fair market rent for a single bedroom apartment in San Francisco estimated at $2,255 per month and a similar housing unit in Brownsville, Texas, which rents for $563 per month. The elderly in The City pay out four times what Brownsville residents spend on rent.
Further, the annual basic cost of living for a single older adult living in San Francisco county was $2,624 per month in 2015, about 28 percent higher than the California average, with rent accounting for 60 percent of the expenses, according to Wallace’s analysis.
A better alternative, according to Wallace, is the Elder Index, which is calculated at the county level using an array of costs, including housing, medical care, food—adjusted for regional differences, transportation, as well as “other costs” determined at 20 percent of the costs previously stated for a homeowner without a mortgage.
A recent study by Jan Mutchler, Yang Li and Nidya Roldán from the University of Massachusetts Boston bolstered Wallace’s findings, concluding that based on the 2019 Elder Index, half of older adults living alone, and 23 percent of older adults living in two-elder households, lack the financial resources required to pay for basic needs.
In Wallace’s opinion the solutions are multi-fold. He recommends helping the elderly improve their income by modernizing SSI, raising benefit levels, protecting and improving Social Security and making pension savings available to all workers through programs such as CalSavers, recently implemented in California. He also advocates for reducing the need for income by expanding Medicare benefits and housing assistance and creating a universal program to cover long-term services and support.
Oswald’s email outlined the landscape of elders living in poverty in San Francisco in the context of meals delivered. In 2018, Meals on Wheels delivered 2.1 million meals to 4,700 seniors in The City, many of whom are homebound, 68 percent who live alone and 74 percent who live on less than $900 a month.
All these numbers present a precarious picture of aging in The City and it’s only going to get worse as the numbers of elderly keep increasing. Meals on Wheels pointed out that three out of 10 San Francisco residents will turn 60 or older by 2030.
It’s clear that our existing old age policies are inadequate and insufficient. Old age should not be beset by financial complications. The elderly and infirm are vulnerable, but the elderly, infirm, lonely and poor carry a weight that’s hard to fathom in these modern times.
This article was written with the support of a journalism fellowship from The Gerontological Society of America, Journalists Network on Generations and the Silver Century Foundation.
Jaya Padmanabhan can be reached at firstname.lastname@example.org. Twitter: @jayapadmanabhan. In Brown Type covers immigrant issues in San Francisco. She is a guest columnist and her point of view is not necessarily that of The Examiner.