Spotlight on Older Women
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The majority of older people (aged 65 and above) in the United States are women, and many are active in the workforce. In 2013, nearly 14 percent of women aged 65 and older were in the labor force; among the youngest of this age group—those aged 65–74— more than one in five women (22.0 percent) were in the workforce. Slightly more than half of women aged 65 and older work part-time (51.4 percent).
- The median annual earnings of women aged 65 and older who work full-time, year-round in the United States are $37,000, slightly less than the earnings for all women aged 16 and older ($38,000). Women aged 75 and older who work full-time, year-round have median earnings that are $8,000 less than those aged 65–74 ($30,000 compared with $38,000).
- The gender earnings ratio between women and men aged 65 and older who work full-time, year-round is lower than the earnings ratio between all women and men. Older women earn 72.5 cents on the dollar compared with their male counterparts.
- Approximately 35.6 percent of employed women aged 65 and older work in managerial or professional occupations, a smaller percentage than their male counterparts (42.7 percent). Among all employed women and men aged 16 and older, the pattern differs: women are considerably more likely than men to work in professional or managerial occupations (39.9 percent compared with 33.0 percent).
- As with all employed women and men, older women and men tend to be concentrated in different jobs. Older women are substantially more likely than older men to work in service or in office and administrative support occupations; more than four in ten (45.9 percent) older women work in these occupations, compared with just one in five (19.6 percent) older men. Older women are much less likely than their male counterparts to work in management, business, and financial occupations (12.0 percent compared with 21.0 percent) and in construction or production occupations (5.8 percent compared with 24.9 percent). These general patterns hold true for all-age women and men as well, with slight differences (see Table 2.5).
IWPR calculations based on 2013 American Community Survey microdata.
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Older women (aged 65 and older) have lower socioeconomic status than older men due to multiple factors, including their more limited access to pensions and other sources of retirement income, lower lifetime earnings due to the gender wage gap (Hartmann and English 2009), and greater need for long-term care services at older ages (Kaiser Family Foundation 2013b).
- While younger women are much more likely than younger men to have a bachelor’s degree or higher, among older women and men the pattern differs: only 19.6 percent of women aged 65 and older have a bachelor’s degree or higher, compared with 29.9 percent of their male counterparts. Approximately 23.2 percent of women aged 65–74 have at least a bachelor’s degree, compared with 15.3 percent of women aged 75 and older (IWPR 2015a).
- Nearly all women and men aged 65 and older (99 percent) have health insurance coverage. One key source of coverage for older adults is Medicare, the federal health program that provides health insurance coverage to older Americans and younger adults with permanent disabilities (Kaiser Family Foundation 2013b and 2013c). Among women aged 65 and older with health insurance, the vast majority receive Medicare (97.6 percent). More than half (56 percent) of all Medicare recipients are women, and women are two-thirds of Medicare beneficiaries aged 85 and older (Kaiser Family Foundation 2013c).
- Among Medicare beneficiaries, older women have higher out-of-pocket annual expenses than older men, with the difference in expenses the largest among women and men aged 85 and older ($7,555 for women and $5,835 for men of this age range in 2009; Kaiser Family Foundation 2013c). These differences are due to women’s greater health care needs and use of long-term care services. On average, older women spend more than twice as much as older men for long-term services and supports (Kaiser Family Foundation 2013c).
- Older women (65 and older) are more likely to live in poverty than older men (11.3 percent compared with 7.4 percent; IWPR 2015a).
- Social Security provides an important economic base for older women that keeps many above poverty. In 2009, Social Security lifted more than 14 million women and men aged 65 and older above the poverty line; without Social Security’s programs, one-third of women in the United States aged 65–74 and half of women aged 75 and older would be poor (Hartmann, Hayes, and Drago 2011). Although Social Security’s benefits are relatively modest (the average monthly benefit for women aged 65 and older in the United States in 2013 was about $1,120; IWPR 2015d), Social Security’s programs provide more than three-fifths of total income for women aged 65 and older and more than half of all income for men of the same age range (Hartmann, Hayes, and Drago 2011). Social Security especially helps older women, whose longer life expectancy means that they often rely on the program for a longer period of time. In addition, older women are less likely to have income from their own pensions (either their own or a spouse’s or former spouse’s), and when they do have a pension plan they receive, on average, less than half as much as men (Hartmann, Hayes, and Drago 2011).
Data on poverty rates, educational attainment, and the percentage of older women and men with insurance coverage are based on IWPR analysis of 2013 American Community Survey microdata. Data on the average monthly amount of Social Security benefits for older women are based on IWPR calculations of data from the Social Security Administration.
As women age, they are more likely to experience chronic health conditions (Crescioni et al. 2010; Robinson 2007) and limitations in activities of daily living (Kaiser Family Foundation 2013b). Many older women do not have a spouse or relative who can provide the care they need, in part because women have a longer life expectancy than men (U.S. Census Bureau 2012), often marry men who are older than they are, and are less likely than men to remarry following divorce or spousal death (Livingston 2014). Older women’s lower likelihood of having a spouse, combined with their greater health care needs and larger share of the elderly population, means that they have higher average expenditures for home health care services and long-term care than men (Robinson 2007).
- Among older women, as among all women, heart disease is the leading cause of death (American Heart Association 2013). The mortality rate from heart disease is 266.6 per 100,000 for women aged 65–74 and 879.8 per 100,000 for women aged 75–84. The rate for women aged 85 and older is 3,732.9 per 100,000 (Centers for Disease Control and Prevention 2015a).
- Women’s mortality rate from breast cancer also increases as they age. Women aged 55–64 have a breast cancer mortality rate of 44.1 per 100,000, compared with 68.4 per 100,000 for women aged 65–74, 104.4 per 100,000 for women aged 75–84, and 173.0 per 100,000 for women aged 85 and older (Centers for Disease Control and Prevention 2015a).
- In the United States overall, slightly less than half (47.8 percent) of older women—those aged 65 and older—report that they get at least 150 minutes of physical activity per week outside of their jobs, a similar proportion to women overall (48.2 percent) but a lower proportion than older men (55.1 percent). Older women in Oregon are the most likely to get this amount of exercise (62.2 percent), and older women in Mississippi are the least likely (30.8 percent).
- Women aged 65 and older are about as likely as women overall to report that they eat at least five servings of fruits or vegetables per day (20.4 percent of older women and 19.9 percent of all women say they eat this amount of fruits and vegetables). Older women are the most likely to say they eat five or more fruits or vegetables if they live in California (30.6 percent) or Oregon (27.6 percent) and least likely to do so if they live in Louisiana (9.8 percent) or Tennessee (10.2 percent).
- Older women in the United States also report having a higher average number of days of poor mental health per month than older men (2.7 compared with 2.0) but a lower number than women overall (4.3). Among older women, the average number of days of poor mental health per month is largest in Nevada (3.5) and West Virginia (3.3), and smallest in Minnesota (1.6) and South Dakota (1.7; Appendix Table B6.7).
- Six in ten women aged 65 and older (60.0 percent) are overweight or obese, compared with 72.1 percent of older men and 57.6 percent of women overall. Two-thirds of older women are overweight or obese in Louisiana (65.8 percent) and Michigan (65.5 percent), the states with the highest proportions. In Hawaii, the state with the smallest proportion, fewer than half of older women (44.4 percent) are overweight or obese (Appendix Table B6.11).
- One in five women aged 65 and older in the United States (19.8 percent) report having diabetes. Among older women, incidence of diabetes is highest in Mississippi (24.6 percent), South Carolina (23.9 percent), and Georgia (23.6 percent), and lowest in Colorado (14.2 percent) and in Montana and Vermont (14.8 percent each; Appendix Table B6.5).
- In the United States overall, older women report an average of 5.7 days per month on which their activities are limited by their health status, compared with 4.8 days for women aged 18 and older and 6.2 days for older men. Older women in North Dakota and Maine report having the smallest numbers of days of limited activities, and older women in West Virginia and Tennessee report having the most (Appendix Table B6.9).
Given older women’s lower socioeconomic status, tendency to experience more chronic health conditions than men, and greater longevity, the financing of their health care is an especially important issue. Medicare, the federal health program that provides health coverage to Americans aged 65 and older and younger adults with permanent disabilities, is a key source of health insurance for older women. More than half (56 percent) of all older Medicare recipients are women, and women constitute two-thirds of Medicare beneficiaries aged 85 and older (Kaiser 2013b). Medicare helps cover the costs of a range of basic medical care services, but the program has important gaps in coverage and charges relatively high cost-sharing that can result in higher out-of-pocket expenses for recipients (National Partnership for Women and Families 2012). Among Medicare beneficiaries, women have higher expenses than older men, with the difference in out-of-pocket expenses the largest among women and men aged 85 and older ($7,555 for women and $5,835 for men; Kaiser 2013b). The average out-of-pocket expenditures for older women who receive Medicare increase with age (Kaiser 2013b), which means that the highest expenditures come as some women’s financial resources are becoming more limited or depleted.
The Affordable Care Act includes some provisions that address the gaps in Medicare coverage. In addition to the ACA’s coverage of annual wellness visits and some preventive benefits that previously required co-pays—a financial barrier for many older women with low incomes and limited financial resources in retirement—the legislation begins to close a gap in coverage for prescription drugs that some individuals who use Medicare’s Part D drug benefit encounter and will fully close the gap by 2020 (National Partnership for Women and Families 2012). In addition, the ACA created the Center for Medicare and Medicaid Innovation to support the development and testing of new payment and service delivery models that improve the quality of care and lower costs. It also funds hospitals and community-based groups to provide transitional care services (from a hospital to home or another care facility) to high-risk beneficiaries to help make these transitions smoother and safer (National Partnership for Women and Families 2012). Since older women are more likely than older men to be Medicare recipients and to require transitional care services, these changes will especially benefit older women.
Data other than heart disease and breast cancer are based on IWPR analysis of Behavioral Risk Factor Surveillance System microdata (IWPR 2015b and 2015c). BRFSS data for the United States overall are for 2013; all other data are three-year averages (2011–2013). IWPR data not cited in the text are available at www.statusofwomendata.org.