By Obermiller, Phillip J.; Ludke, Robert L.
Aging Today , Vol. 33, No. 5
With its higher proportion of older residents, Appalachia may be America's "canary in the coal mine"- an early warning system heralding the problems and possibilities that can attend an older population.
The region has 420 counties in 13 states, which run along the spine of the Appalachian Mountains from Mississippi to New York. Residents ages 65 and older comprise more than 15 percent of Appalachian population, as compared to 13 percent in the United States, and are projected to approach 20 percent by 2025. Appalachian older-than-age-65 population is growing faster than in the United States or even in the 639 counties adjoining the region. The fastest growing segment of this population is men between ages 65 and 74, with a growth rate almost triple that of women of comparable age, which may be due to greater female than male migration from some Appalachian states, along with the national trend of significantly reduced death rates among men of this age group.
Youth Leaving, Elders Are Sicker
This does not mean Appalachians live longer than other Americans. In fact, mortality from all causes among persons ages 35 to 64 is higher in Appalachia than it is in the nation as a whole. As seen in Appalachian Health and WellBeing (see "For Further Reading" on page 14), residents of Appalachia suffer from significantly higher rates of chronic disease- coronary disease, diabetes and cancer- than the national average, which creates economic and social burdens on families, and places greater demands on an oftentimes difficult-toaccess healthcare system. Poor physical environments, adverse social and economic conditions and unhealthy behaviors- particularly when it comes to tobacco use and diet- may be contributing to these health disparities.
Contributing to the phenomenon of a large elder cohort in Appalachia is the constant flow of younger people out of the region. Streams of young immigrants into Appalachia are smaller than those exiting; this results in higher proportions of elders living at a distance from family support systems.
Disability also increases with age. Thus, there is greater demand for a range of long-term-care options. Given the relative scarcity of rural nursing and retirement facilities, some younger family members who migrated to cities outside the region are bringing their older family members into their homes or nearby facilities for care.
The geographic distribution of older Appalachians is changing, too. Like many Americans, older Appalachians are gravitating to the Sun Belt. Counties in the northern part of the region, especially in Pennsylvania and West Virginia, were home to many older Appalachians in 2000 when West Virginia had the second oldest state population after Florida. By 2010, southern Appalachian counties in Georgia, South Carolina, Tennessee and North Carolina were showing growth in this age cohort.
Some Appalachian counties in western North Carolina, eastern Tennessee and northeastern Georgia have become residential destinations for fairly well-todo retirees, resulting in a notable decline in poverty among Appalachians ages 65 and older. However, high poverty rates among elderly people living alone continue to be a particular problem across the Appalachian region.
A Mixed Blessing
The aging of Appalachia results in mixed social outcomes and opportunities. On the one hand, retirees ages 62 to 75 are the type of new residents communities seek to attract. Usually couples with reliable sources of income, they do not put undue demands on criminal justice systems or educational facilities, and are often willing to volunteer or otherwise engage in civic activities. Others seek part-time jobs, bringing experience to the workforce without the need for employer-provided health insurance. …