In last week’s blog post, I wrote about 90-year-old oil tycoon T. Boone Pickens and his inspiring attitude about growing older, despite several recent health setbacks. In the article, Pickens suggests being “the eternal optimist who is excited to see what the next decade will bring.” He continues: “I remain excited every day, engaged and thrilled in the office and on the road. I thrive on that activity, and I’m going to stick to it, no matter the setback.”

>> Related: Positive Aging: Changing Your Mindset About Growing Older

Not to sound too cynical, but I can imagine some people might read Pickens’ article and think, “Well sure, it’s easy to be positive about aging when you’re a billionaire!”

It’s a fair point. There is no doubt that socioeconomics can impact your ability to age positively and ultimately access the care you need. And on top of that, it’s undeniable that we have a serious senior income disparity issue in this country.

Low-income seniors

While Social Security and Supplemental Security Income have helped reduce senior poverty rates, they haven’t solved the issue. Many still survive on limited fixed incomes and have little in the way of savings. In fact, as of 2016, half of the 49.3 million people age 65 and older have an annual income of less than $26,200, according to the U.S. Census Bureau.

A few startling statistics from a Kaiser Family Foundation analysis of the U.S. Census Bureau data:

  • Under the census’s Supplemental Poverty Measure(SPM), which accounts for both available financial resources and liabilities, including taxes, the value of in-kind benefits like food stamps, out-of-pocket medical costs, and geographic differences in housing costs, 7.1 million Americans age 65 and older lived in poverty in 2016 (14.5 percent), as compared to 4.6 million (9.3 percent) under the official poverty measure.
  • Almost 21 million seniors had incomes below 200 percent of the poverty rate under the SPM in 2016 (42.4 percent), versus 15 million (30.4 percent) under the official measure.
  • Under both poverty measures, the poverty rate among people age 65 and older increased with age and was higher for women, African Americans, and Hispanics, and people in poorer health.
  • In California, Florida, Georgia, Hawaii, Indiana, Louisiana, New Jersey, New Mexico, Texas, Virginia, and Washington, D.D., by SPM standards, at least 15% of seniors lived in poverty in 2016.

The impact of senior poverty

So how do these poverty rates impact quality of life and ultimately expectancy among seniors? A study conducted by researchers at MIT and Stanford found that the richest 1 percent of men lives 14.6 years longer on average than the poorest 1 percent of men. Among women, the difference is an average of 10.1 years.

And this so-called “mortality gap” is widening, according to the study. Over the last 15 years, among the nation’s top 5 percent of income-earners, life expectancy increased by 2.34 years for men and 2.91 years for women. But for the bottom 5 percent, the increase in life expectancy was just 0.32 years for men and 0.04 years for women.

>> Related: The Unexpected Cost of Divorce in Retirement

Positive aging, regardless of wealth

While income is clearly one predictor of longevity, there are numerous other factors that come into play in determining both your quality and quantity of life, and which contribute to your ability to age positively.

Lifestyle

A Harvard School of Public Health study found that five basic healthy habits can extend a man’s life by 12 years and a woman’s by 14: eating a healthy diet, exercising regularly, maintaining a healthy body weight, drinking alcohol in moderation, and never smoking. Seniors who adhered to these five habits were 82 percent less likely to die of heart disease and 65 percent less likely to die from cancer.

Social interactions

Experts agree that having a strong social support network is beneficial for seniors’ health and can lead to happier, longer lives. While nearly 90 percent of seniors say they want to remain in their own home as they age, according to the Senate Aging Committee, 40 percent of seniors are impacted by the isolation that comes with living alone. The resulting feelings of loneliness increase their risk for depression, dementia, and premature death. Interestingly, a 2015 study out of the University of British Columbia found that having a higher income actually worsens the mortality risk of such social isolation.

Perceptions about aging

A Yale study, which looked at a sample consisting of 660 people age 50 and older, found that seniors with long-held positive self-perceptions about aging lived 7.5 years longer than people with less positive self-perceptions of aging. This advantage remained after age, gender, socioeconomic status, loneliness, and functional health were factored in.

Genetics

You can’t talk about longevity without considering the role of genetics. Scientists generally say that the heritability of age at death in adulthood is about 25 percent, looking at influences like biological processes related to aging at the cellular level and protective factors that can buffer against certain diseases. With recent advances in dissecting the human genome, we continue to gain a better understanding about how our genes impact who we are, including lifespan.

>> Related: 4 Ways to Pay for Long-Term Care Services

Cost of care versus access to care

There’s no denying that socioeconomic status has an impact on seniors’ ability to live a long and happy life. T. Boone Pickens is but one example of this phenomenon. But much of this “positive aging” topic really boils down to a combination of cost of care and access to care.

When Pickens experienced age-related health issues, he not only could afford to pay for the very best care, he also had the ability to obtain all of the services he required. Not every senior is this fortunate. Some may have the financial means to pay for care, but perhaps they live in an area where therapeutic or palliative care resources are unavailable, or maybe there are long waiting lists at the facilities that offer services. Other people may live in a place where specialists and senior services abound, but they lack the funds to pay for the care they need.

Both of these roadblocks are the reason I so strongly encourage seniors to begin planning for their latter retirement years early. And importantly, that planning process should not be limited to just determining how you will pay for care. An equally important aspect is to carefully consider where you will live and the availability of long-term care services, should you ever need them.

Whether you are among the 90 percent of seniors who hope to stay in your own home, or you plan to move to a senior living community, such as a continuing care retirement community (CCRC), it’s wise to educate yourself about your retirement living options today — considering the potential implications of each choice over time — and create a plan before a health crisis arises.

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