AMERICA'S OLD AGE CRISIS: Public Policy and the Two Worlds of Aging

A succinct, knowledgeable update on social care of the aging--with some major surprises and a number of thoughtful suggestions. In his research and planning for New York City's Human Resources Administration (he's Director of Family and Adult Services), Crystal found many commonly-held beliefs to be ""myths."" Extreme poverty is rare--most retirees retain their pre-retirement socioeconomic status. Poor health is also the exception, and medical care is widely available. Fewer than one percent of the elderly, however, receive financial support from their children. And--an all-round surprise--a relatively small number live in institutions. Crystal is not minimizing the problems of the elderly, however, just trying to identify them accurately. Saliently, the split is widening between ""two worlds of aging""--one poor, one comfortable. (Worst off are many of those over 75; single; with health problems and/or previously low incomes.) Our policies for helping those in need, meanwhile, are ""inequitable, inefficient, and ineffective."" Services are fragmented; the aged are isolated and denied a productive social role. Against this background, Crystal addresses the two major public-policy questions of providing care for the infirm aged and adopting a pension program that will assure everyone a minimum level of economic well-being. He also makes some proposals for immediate consideration. For example: ""Age-connected housing often leads to the emergence of mutual-help networks which maintain morale and help the aged to remain safely in the community."" (And, to criticism that this constitutes ""segregation"": ""The better-off aged can choose to buy into a retirement community; the poorer aged seldom have this choice."") Vital, persuasive data on the minority group that, as Crystal reminds us, we can all look forward to joining.