Panel, Conference Presentation
Age-Forward 2030: The Intersection of Housing and Health Care
Milken InstituteSusan Donley, Gretchen Alkema, Bechara Choucair, Tama Duffy Day, Christopher Herbert
- Society will face increasing demand for housing and health care solutions driven by an aging population, with the number of households headed by individuals over 80 projected to nearly double from approximately 7 million today to 16 or 17 million within the next 20 years.
- Over half of middle-income seniors are expected to be unable to afford housing or care, and about 5 million elderly households currently spend more than 50% of their income on housing, forcing trade-offs between food, health care, and rent.
- The Milken Institute's "Age Forward 2030" report designates housing, affordable housing, and integrated care as top priorities for local communities to enact by 2030, a goal reinforced by a California executive order issued in June for a statewide master plan due in October 2020.
- Health care delivery is predicted to shift toward home-based settings and retail locations, with mobile modular units deployed by the VA and models like Johns Hopkins' "Capable" system envisioned for widespread integration into all health systems.
- Homelessness is characterized by severe disparities, including a life expectancy 27 years shorter than housed individuals, a mortality rate three to four times higher, hospital stays two to three days longer, and care costs three to four times higher for those without housing.
- Social determinants of health are critical, with 68% of people having experienced at least one unmet social need and 76-some percent of older adults expressing a desire to age at home, though 80% currently live in single-family houses that may lack mobility accommodations.
- Geographic and demographic factors heavily influence outcomes, such as New Orleans' 25-year life expectancy variance between neighborhoods and rising homelessness rates among LGBTQ youth aged 15 to 20 in the D.C. area.
- Financial instability is prevalent, with typical renters holding only a few thousand dollars in net wealth compared to homeowners' $100,000 to $200,000, while 1% of older people opting for multi-generational co-housing would still result in a large-scale adoption.
- Community-level interventions include the "Mayors and CEOs for U.S. Housing Investment" coalition, composed of 24 bipartisan members, seeking to embed affordable housing in infrastructure bills and double veteran vouchers, exemplified by Oakland's successful housing of 515 homeless individuals in eight months.
- By 2030, communities are envisioned to support diverse housing types for a broad range of people, not just older adults, with an assessment of progress toward these visions scheduled for evaluation in 10 years.