Back to Migration in Kentucky: Will the Circle Be Unbroken?By Graham D. Rowles and John F. Watkins
University of Kentucky
From Exploring the Frontier of the Future: How Kentucky Will Live, Learn and
Work
pp. 11-20, published 1996
Kentucky can be a wonderful place in which to grow old. For Arnold, a 67-year-old executive from Indianapolis and his wife (part of the small but significant stream of elderly migrants who have retired to Pulaski County on the shores of Lake Cumberland), our Commonwealth offers a temperate climate, natural scenic beauty, a slow pace of life, a low cost of living, and the chance to experience a genuine sense of rural community. For those with more urban tastes, like 73-year-old retired teacher Evelyn who moved to the state to be near her daughter, Lexington offers a range of upscale retirement community living options in an amenity-rich city well served by medical facilities and educational and cultural resources. There are opportunities to participate in the University of Kentucky’s Donovan Scholars program,(1) to enjoy the resources of the Center for Creative Living, to dine at a wide range of restaurants, and even to spend a day at the races.
But there is also another Kentucky, a place experienced by large numbers of our less affluent and less fortunate elders. For Leroy, an 86-year-old lifelong resident of Owsley County who has both mobility and self care limitations, there is the day-to-day struggle of living alone in a substandard dwelling without a telephone, without access to a vehicle and on an income below poverty. For 88- year-old Cicely, a widow living in poor quality housing in inner city Louisville, problems of inadequate resources are exacerbated by fears of crime and violence and by the even more invidious slights of neglect. This Kentucky is not such a good place in which to grow old.
In this chapter, we summarize trends in the growth of Kentucky’s elderly population and provide a description of the current status of this population with respect to an array of indices of life circumstances and well-being. We present the argument that circumstances for some of the Commonwealth’s elders are good and improving in comparison with their peers in the remainder of the nation. However, for others little has changed over the past few decades. There remains considerable regional variation in the status of our elderly population. Especially in the eastern portion of the state, there has been little improvement with respect to multiple indices of well-being. Indeed, with respect to selected indicators, the situation of some of our elders may actually be deteriorating.
Against this backdrop, we identify several recent trends, both national and local, that are likely to shape the future of Kentucky’s elderly population. Finally, we present a somewhat speculative look into the crystal ball to present an image of the future of aging in our state and what we can do to ensure that it is a bright one for all Kentuckians.
In 1930, the elderly population of Kentucky numbered just over 142,000, less than a third of today’s figure. During the early part of the century, the elderly nationwide accounted for a relatively small share of the total population; Kentucky was no exception with an elderly percentage of about 5.4 in 1930. The decades following 1930 signaled a period of rapid population growth for the elderly that continues today. By 1950, elders accounted for 8.0 percent of the state total (or about 235,000 persons aged 65 and over) and by 1970 these levels increased to 12.0 percent or 337,000 individuals (Figure 1). By 1990 there were 465,068 Kentucky residents 65 years of age or older, comprising 12.6 percent of the population of the Commonwealth. One in four Kentucky households contained one or more persons 65 or older and over 14 percent of Kentucky’s households contained two or more persons 65 or older.(2)
Figure 1: Changes in Kentucky's Elderly Population, 1930-1990
Several distinctive demographic processes underlie changes in Kentucky’s elderly population. First, there is the impact of previous fertility levels. This process is demonstrated by the rapid growth in size of the elderly population between 1930 and 1940. During this decade the elderly population increased by over 33 percent—an increase that has not been attained in any decade since that time. Such growth is a direct result of dramatic improvements in health and economies during the post-Civil War reconstruction era, which led to high fertility during the 1870s. Another example is the 21.5 percent increase in the size of the elderly population between 1970 and 1980, caused by a similar increase in fertility just after World War I.
A second process involves the migration of a younger labor force. During the 1960s the Commonwealth’s elderly population growth slowed to about 15.4 percent over the decade. This slowing coincided, however, with a dramatic increase in the share of the total population defined as elderly, which grew from 9.6 percent in 1960 to just over 12 percent by 1970. These comparative changes were a consequence of Kentucky’s depressed coal economy during the 1960s, a decade marked by heavy out-migration of the labor force in pursuit of employment in other states and an aging-in-place of the older retired population. An upswing in economic conditions during the 1970s, plus a significant number of Baby Boomers entering the high mobility years of young adulthood, resulted in an influx of labor force migrants to the state, which caused a decline in the percent 65 and over, even though the elderly population was growing quite rapidly.
A third process—migration of the elderly—is evident in selected counties throughout the state. Areas such as Land Between the Lakes and, in more recent decades, Lake Cumberland have served as attractive retirement destinations for elderly residents from Kentucky and from several nearby states.(3) Migration of the elderly does not act in isolation but is associated with previous fertility and labor force migration.
It is with this context of multiple interacting demographic processes that we must interpret projections of future changes in Kentucky’s elderly population. A period of high fertility following World War II generated the Baby Boom population, the first members of which will be reaching age 65 in 2010 (Table 1). The outcome will be a 31.4 percent increase in the 65 and over population between 1990 and 2010.(4) Additional increase between 2010 and 2020 will reflect the influence of the main body of the baby boom birth cohort which will be reaching 65 during this decade. Thus, in the single decade between 2010 and 2020 the population 65 and over is projected to increase by an additional 29.6 percent (high growth series projection).
Table 1: Projected Growth in Kentucky's Elderly Population, 1990-2020
In addition to significant increase in the size of the general elderly population there is likely to be a continuation of change in the age composition of the elderly population, a trend that has become apparent in recent decades. With dramatic increase in life expectancy at birth (almost 30 years gained in this century—from 47.3 in 1900 to 75.5 in 1993), persons 75 and over have become an increasingly evident component of the elderly population (see Table 1). Indeed, the population 85 and over is the fastest growing segment of the population. Projections for Kentucky indicate that this age group will expand from 45,718 in 1990 (1.2 percent of the population) to 86,692 in 2010 (1.7 percent of the population), an increase of 89.6 percent over the two decade period.(5) In 1990, 9.8 percent of Kentucky’s elderly population was 85 or older. By 2010 this will increase to 14.2 percent.
Growth among Kentucky’s "old old" population (75 years and older) is not expected to progress uniformly across the state, and patterns of anticipated change are in some cases quite surprising. Three area development districts that have experienced the highest contemporary retirement in-migration, for example, include Purchase, Pennyrile, and Lake Cumberland, yet growth in the 75 and over populations of these ADDs is expected to slow by 2010 (Table 2). Similar magnitudes of slowing growth are also expected in Barren River and Kentuckiana. Conversely, dramatic acceleration of growth can be anticipated in the Appalachian ADDs of Big Sandy and FIVCO, and in Northern Kentucky.
Table 2: Population 75 and Over by Development District
Uncertainty in future migration trends will certainly alter current projections of our elderly population, and the relatively small size of the older elderly population will potentially cause forecasts of this segment to experience the greatest deviation from expected levels. Nevertheless, the statistics presented gain significance in that, regardless of the growth scenario used in the projections, there is no doubt that marked increases will occur in the 75 and over population size. These individuals, and especially those age 85 and over, are the most frail, the most dependent, and the most in need of services. The aging of Kentucky’s elderly population is therefore likely to create major concerns with respect to service provision and caregiving strategies. Such concerns will be amplified by the recognition that some areas in the state where the pace of growth will be high may be hardest pressed to provide assistance for their elders.
Age alone is not an adequate indicator of health, well being, or dependency. Indeed the heightened attention during the 1970s given to the conditions and characteristics of the elderly did much to rectify the misleading stereotypes of growing old. How, then, can we more accurately describe our Commonwealth’s elderly population? What are their current life circumstances? How have these characteristics and circumstances changed during the past decade? And what changes can we anticipate in the future as this population increases in size? In this section we present a brief profile of the current status of Kentucky’s elderly population, employing several key indicators. (A more detailed profile is available in the recently published Kentucky Atlas of the Elderly. Unless otherwise indicated, all figures pertain to persons 65 or over.) The majority of Kentucky’s elders are female (60.4 percent, almost identical to the national figure of 59.8 percent). Most elderly Kentuckians are white (94.0 percent in comparison with a national figure of 89.3 percent). A very high proportion of Kentucky’s elders (44.5 percent) live in rural areas (defined as communities of 2,500 persons or less); this is almost twice the national percentage of 24.6 percent. A high proportion of Kentucky’s elders live alone (31.0 percent in comparison with a national figure of 28.8 percent). Living alone is even more prevalent among Kentuckians 75 and over (38.3 percent). This is consistent with national trends that show that propensity to live alone has increased over the past three decades and that propensity to live alone also increases with age.(6)
Turning to objective indicators of well-being, it is apparent that, in comparison with national statistics, Kentucky’s elders are subject to a litany of disadvantage. Many of Kentucky’s elders have limited education; 44.6 percent have less than a 9th-grade education in comparison with a national figure of 25.9 percent. Many continue to live on low incomes. In 1989, more than one in five Kentucky elders (20.6 percent) lived on an income below the poverty level, in comparison with a national figure of 12.8 percent. For those Kentuckians 75 and over this figure rises to one in four (25.3 percent). In comparison with national figures, Kentucky’s elders are also more likely to be without a telephone (5.3 percent versus 2.6 percent), to live in housing lacking complete plumbing (3.1 percent versus .98 percent) and to be without access to a vehicle (26.1 percent versus 22.3 percent). Compounding the effects of these objective disadvantages, Kentucky’s elders are far more likely to report mobility and/or self care limitations; 37.2 percent of Kentuckians 75 or over report such limitations, in comparison with a national figure of 30.5 percent.
Individual indices of disadvantage are, by themselves, distressing. However, their effects are magnified by the situation of multiple jeopardy in which many elderly Kentuckians find themselves. Far too many of Kentucky’s elders live under circumstances where they are alone, and survive on marginal incomes in inferior housing without access to a vehicle and with no telephone.
As was the case with patterns of elderly population growth (presented above), a state-level perspective paints a very generalized picture. Aggregate statistics obscure major variations among substate areas in terms of population characteristics and indices of life circumstances—variations between an optimistic extreme, with counties that are far better off than the national figure, and those areas where conditions are truly distressing. This variation is revealed in Table 3, which documents county extremes on a variety of indicators and provides a tally of the number of counties falling both below and above the national figure for each index. A clear pattern of regional disparity emerges when the indicators are considered in concert. Major contrasts are apparent between rural and urban areas, for example, with rural areas revealing considerable disadvantage on many indicators. In addition, there continues to be a striking contrast between eastern Kentucky (particularly the western fringe of the Appalachian coalfield) and the remainder of the state. The persistence of disadvantage in this region is revealed by clusters of counties including Breathitt, Clay, Cumberland, Jackson, Knott, Lee, Leslie, Magoffin, Menifee, Monroe, Morgan, Owsley, Perry, Wayne, and Wolfe, which record distressing figures on a variety of indices. Knott (2.1 percent) and Owsley (3.7 percent) have the lowest levels of employment among the elderly. Jackson (80.1 percent) and Leslie (78.3 percent) have the highest percentage of elderly residents who have completed less than nine years of school. Monroe (44.8 percent) and Wayne (43.8 percent) have the highest levels of poverty among the elderly in the state. Wolfe (46.2 percent) and Morgan (44.2 percent) have the highest percentages of elderly householders incurring housing costs greater than 25 percent of their income.
Table 3: Comparative Characteristics of Kentucky's Elderly, 1990
To what extent do the life circumstances of Kentucky’s elders as described represent patterns that have remained consistent over time? As we begin to look to the future, are there signs of hope that the disadvantage of our elders in comparison with those elsewhere in the nation is lessening? The answers to these questions are mixed. First, the good news. In common with national trends, the educational level of Kentucky’s elders has improved with each cohort. Improvement is also apparent since the time of the 1980 census in a number of indicators such as telephone ownership and access to transportation. Poverty levels are also dropping for some groups of elders, particularly males. However, in sharp contrast to these signs of hope are data revealing that for certain subgroups, particularly elderly women and especially the "old old," the situation continues to deteriorate and the gap between the most well-off and the least well off continues to widen.(7) Poverty among elderly women, for example, has increased during the 1980s despite the fall in general elderly poverty, and the increase is especially noteworthy among women age 75 and over. The percentage of persons age 75 and over living alone has moved upward almost 5.5 percentage points between 1980 and 1990, and this phenomenon also tends to be acutely associated with women.
At this point it is useful to begin considering some of the implications of the demographic projections presented earlier in this chapter with respect to the degree to which they are likely to result in, or be paralleled by, changes that will lead to improvement in the life circumstances of Kentucky’s elders. What will the next century, an era which some years ago the writer and scientist Isaac Asimov characterized as "the approaching age of age," hold for Kentucky’s elders? Allowing ourselves the luxury of speculation, it is helpful to consider some of the ways in which the experience of growing old is likely to change in the approaching age of age.
First, with increasing longevity, the pathways of aging are likely to become ever more diverse as the limits of physiological capability expand and the health status of the elderly continues to improve. There is likely to be an increased range between the most and the least capable during each phase of old age. Second, ever-increasing diversity within the elderly population will lead to entirely new definitions of what we mean by aging. That this process of redefinition and differentiation is already well underway is manifest in the introduction to our lexicon in recent decades of distinctions between the "young-old" (65-74), "old-old" (75+), "oldest-old" (85+) and even the "pre-old" (55-64). Third, old age will come to be associated with entirely new activities: starting a business, embarking on a second career, volunteerism, giving expression to talents that remained latent during a traditional working career, such as sculpture, painting, or even politics. Fourth, old age will come to be associated with new roles, some of which, such as becoming a caregiver for aging peers or assuming a greater role in the education of our youth, may become normative. As we evolve a new identity for aging, elders are likely to assume roles we have not even imagined. Indeed, we anticipate witnessing the emergence of an entirely new culture of aging and the aged; a culture forged to a large extent by the elderly themselves as they assume new roles in a postmodern society. Fifth, there will be continuing proliferation of innovative models of care for our oldest old, and for those who are less healthy and capable, as we harness the power of technology to design living environments in which even the most frail can continue to live with independence and dignity. It is quite conceivable that sophisticated robotics and benign monitoring systems will become key elements in the lives of the frail elderly. Finally, there are likely to be momentous social changes in the relationship of the elderly to the remainder of society. Not all of these changes will necessarily be positive. There is a danger that the separation and alienation of generations will be accentuated as increasing numbers of elders elect to reside in age-segregated environments—the Sun Cities, Leisure Worlds, and a plethora of smaller retirement communities that are springing up all over the nation, including in Kentucky. In Lexington alone there are three such communities: Richmond Place, Lafayette Place, and Mayfair Village. Alternatively, it is conceivable that our society will evolve in a manner that threatens the very integrity of the aging experience. As the debate over the intergenerational distribution and allocation of resources becomes more acrimonious, as we anguish over the use of life-extending technologies, as we consider the merits of assisted suicide, it is possible that there will emerge an entirely new and mean-spirited ethos of growing old. Will we evolve a new society in which, to paraphrase the now infamous words of former Colorado Governor Richard Lamb, the elderly will be encouraged, perhaps even obliged to get out of the way? In sum, in the years ahead there are likely to be many changes in the pathways by which we grow old. These pathways will be navigated by elderly of increasingly diverse characteristics and circumstances, and are likely to lead to an increasing diversity of accumulated personal life experience.
As we contemplate this diversity, it is important to remember the human face of growing old. We strongly believe that success in facing the diversity of the new aging will be conditioned by the degree to which we are able to satisfactorily resolve many of the dilemmas that confront us as we deal with those of our elders who are frail and vulnerable. We are thinking of more than 45,000 Kentuckians over 85 years of age who are alive today, and more than 86,000 who are projected to be living in the Commonwealth less than 15 years from now. We are thinking of people like Leroy and Cicely who currently survive despite less-than-ideal circumstances. While many of these people remain active and engaged in life, a large number do not. As we have documented, far too many Kentuckians still live in poverty, in inferior housing, with limited access to transportation, and in geographical isolation from much-needed services. Thus, it is especially important to consider what the trends that have been speculated upon will mean for the future of Kentucky’s elders. Perhaps, even more important, what will we do as Kentuckians to ensure that the changes which are most assuredly coming are harnessed as an opportunity to improve the life circumstances of those of our elders, particularly in certain parts of the state, who are growing old under conditions of severe hardship.
Short of Draconian intervention through euthanasia, we cannot change the basic demographics of aging (for those who will be old have already been born). However, we can change our responses to them. We can create a Kentucky in which no elder remains poor, lives in inferior housing or is denied access to services he or she needs. We conclude this chapter by suggesting several broad directions in which we might progress in Kentucky, with respect to how we might live with an aging population and how we as individuals might live with our own aging.
Assisted living and continuum of care alternatives. The aging process is not clearly marked by discrete and sudden changes. We evolve over time with regard to such factors as physical and emotional strength, and sensory acuity. Because of these gradual and ongoing transitions, we have ever-changing needs from our immediate living environment. Unfortunately, too few homes, either family or institutional, allow the flexibility to meet the changing needs of the elderly. Consequently, recognizing the trend toward ever-increasing diversity in the elderly population, it will be important to progress toward a situation where in every part of the Commonwealth there exist a wide array of living and support options for the elderly (assisted living options, family care homes, a variety of home care options, etc.). Each of these options should be integrated within a comprehensive system of linked residential options that afford the opportunity to move freely from less to more supportive options (and back again) as individual circumstances change. Currently, there exist a plethora of innovative residential options that might become part of such a continuum but, especially in many rural parts of the state, real choices are limited for our elders because many of these options are unavailable in individual localities.(8)
Innovative technologies and design solutions. Given that the preference of the elderly to age in place is likely to continue into the new century, a major priority should be placed on embracing innovative technologies and design solutions that make it possible for elders to remain at home and able to live independently for as long as possible. Innovations in robotics (perhaps facilitated by expansion of the mission of the Center for Robotics at the University of Kentucky), advances in interior design, sophisticated landscape architecture, and even advances in the use of pharmaceuticals, may be employed to sustain independent living.
Overcoming barriers of distance. A major constraint on improving the life circumstances of elders in Kentucky is the barrier of distance and the remoteness of many elders from services that is a consequence of the rural character of much of the state. By embracing new forms of communication and communication technology, including distance learning, telemedicine, and other types of non-place-based services, it will be possible to effectively collapse space and enrich the lives of elders in even the most remote areas of the Commonwealth. Initiatives are already underway in these areas through the Center for Rural Health at the University of Kentucky. We can anticipate that continued expansion of such telecommunication options will become a major feature of service restructuring during the next century.
Expansion of selected services. While the introduction of new technologies will clearly become a major feature of service and care for the frail elderly, it is also important to recognize the role of more traditional programs. There is a need for the expansion of rural transportation services, financial planning services, and home care programs. In addition, we can anticipate the further growth of new services and programs which in recent years have become important features of the social service landscape. Such programs include community-based social support and respite care programs. We can also anticipate continuing expansion of adult day care (a service in which the state has played a pioneering role over the past decade) and growth in the importance of eldercare programs providing information and assistance to family members caring for a frail elderly relative. These programs might even involve the creation of care service banks through which individuals can gain credit for providing care for an elder in their neighborhood that can be used in a different part of the state to purchase similar care for their own relative living in that part of the state.
Seeking and encouraging new roles. Finally, perhaps the most important direction we can take is to invest in the support of elders as they create new roles for themselves as with increasing numbers they begin to evolve a very different culture of aging than currently exists. Obviously, we cannot predict the directions that this evolutionary process will take—whether it will involve greater emphasis on volunteerism, the assumption of enhanced family and community caregiving roles, the evolution of a leisure lifestyle separated from the remainder of society, or the assumption of politically powerful roles in mainstream society. What we do know is that the demographics of an increasingly aged Commonwealth will inevitably lead to emergence of new roles for elders. Moreover, building on the power of numbers, it is likely that future generations of elders will be less tolerant of the life-circumstance inequities we have described.
Hopefully, the outcome of reinforcing these and other strategies will be elevation of the life circumstances of all of Kentucky’s elders and a reduction of the disparity between those who are best and worst off. While change will be inevitable, the direction of this change is not predetermined. Rather it will depend on the will we have to create the kind of environment in which all Kentuckians can grow older with dignity, independence, and an appreciation of the interdependence that is necessary to maximize quality of their lives. In considering the implications of change for quality of life, it is important to emphasize that the indicators of life circumstance employed throughout this chapter do not necessarily translate directly into "quality of life" or imply any judgments on our part with respect to lifestyle. Quality of life involves far more than the measures we have discussed. For most elders it entails immersion within a supportive milieu of family, friends, and community, and a socio-cultural context that provides reinforcement for a preferred lifestyle, a sense of personal identity, and an historical involvement with place. Viewed from this perspective, it is not surprising that the research literature amply illustrates that objective disadvantage is not necessarily associated with low levels of "subjective" well-being or an inferior lifestyle among the elderly.(9) While we acknowledge that objective circumstances do not necessarily correspond with subjective well-being, adopting a relative deprivation perspective, we see no reason for this relationship to serve as a justification for inaction.
What kind of place are we creating for our elders? What kind of setting do we want to create for a generation that will have quite different backgrounds from the current generation? In a very real sense it is important to consider the ways in which the next generation of elders will be reformulating the experience of growing old in Kentucky. Growing old in Kentucky will be what we choose to make it. We have two choices. One is to perpetuate through inaction the status quo. The outcome of this strategy will be reinforcement of the fragmentation of Kentucky’s elderly population into an array of contrasting sub-populations that move progressively farther apart from each other in the Balkanization of the aging experience—ranging from a group of relatively affluent retiree immigrants whom we actively recruit and attract to selected amenity regions of the state, to a group of disadvantaged elders in some areas of the state whose status continues to decline as we make only token efforts to alleviate the abysmal circumstances under which they eke out an existence. While it is important to celebrate diversity, such diversity should be based on divergent chosen pathways rather than the constraints of disparate life circumstances imposed by an uncaring community. It is important to begin to accept responsibility for our own future so that by the time we reach retirement the dire circumstances of the Leroys and Cicelys of our Commonwealth will be but a memory.
To view a list of all chapters in this book, click here. To read the chapters in sequential order, please follow the arrows below.
Back to Migration in Kentucky: Will the Circle Be Unbroken?
Ahead to Families and Children: The Common Wealth of
Kentucky
The
Donovan Scholars program provides free educational opportunities for senior citizens. Return to text.Rowles
, G., Gallaher, C.., Watkins, J., Ilvento, T., and Danner, D. (1996). Kentucky atlas of the elderly (Occasional Publication Number 4). Lexington, KY: University of Kentucky, Sanders-Brown Center on Aging. Return to text.Rowles
, G., Watkins, J. (1993). Elderly migration and development in small communities. Growth and Change, 24, 509-538. Return to text.Price
, M., Sawyer, T. and Scobie, M. (1995). How many Kentuckians: Population forecasts 1990-2020. University of Louisville: Kentucky State Data Center. Return to text.Kentucky
State Data Center. Return to text.Kasper
, J.D. (1988). Aging alone: Profiles and projections. New York: The Commonwealth Fund Commission on Elderly People Living Alone. Return to text.Rowles
, G., Johansson, H. (1993). Persistent elderly poverty in rural Appalachia. Journal of Applied Gerontology 12, 349-367. Return to text.Golant
, S. (1992). Housing America’s elderly: Many possibilities, few choices. Newbury Park, CA: Sage. Return to text.Lee
, G., Lassey, M. (1980). Rural-urban differences among the elderly: Economic, social and subjective factors. Journal of Social Issues, 36, 62-74. Return to text.