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I do not believe our elder citizens should be set apart from the rest of society either in our thinking or our public actions, for they are not made into something alien by reason of having reached age 65 or gone beyond that figure. Yet in this rough and ready industrial and urban social life we are now forced to live, age does become a major factor causing drastic changes that the individual in his private capacity cannot cope with successfully.
Our economy has become impersonal. Most people work for wages and most of them face a compulsory age retirement. Much of industry has raised an age barrier to employment as well. So that the older person is caught in a vise where retirement may be forced upon him whether he is economically and emotionally prepared to meet its obligations or not.
The very size of the problem forces public recognition of it. In 1900 we had less than 4 million persons 65 years or older; today we have 16 million, and this number will double to 32 million in the next life working span of 40 years. By the turn of the next century 1 out of every 10 persons will be over 65.
At the turn of this century a retiring person of 65 could expect to live on less than 3 years; today his average expectancy is 8 years. But the number reaching real old age, say 75 years or older, will triple by the end of the century. While there will be many among them needing health care and nursing attention, by and large these older people will be in reasonably good health and vigor. And among them women will outnumber men for each age group.
Only a handful of these older people are gainfully employed. Unless we change our present working practices substantially, proportionately fewer will have jobs in the future.
Despite the growing number who have some form of private pensions or retirement funds, over half of all retired persons are living on incomes of less than $1,000 a year. About the same proportion have assets of that amount, too. Yet they are potentially a major market for consumer goods as the University of Michigan income studies showed recently. For of all consumer units living in poverty or deprivation a sixth were households whose heads were aged 65 or older.
Such are the bare essential facts of the situation which caused the 1961 White House Conference on Aging to summarize that,
As people pass through their 60's, roles will change. Responsibilities of each person as worker, parent, or spouse will lessen, but those of citizen, friend, church or club member, and user of leisure time may be expanded if he has the desire and capacity and if society expects this to happen and provides opportunities.
A COORDINATED APPROACH
We in the labor movement, and my fellow members in the Brotherhood of Railroad Trainmen, are on record against creating any human scrap heap of older people. We emphatically endorse the conclusion of the President's Conference. We urge that machinery be established which will allow the transition from active working life to retirement status to go ahead without harmful consequences. For these older people are our fathers, mothers, near relatives, friends and ourselves in a few short years.
We are convinced that the White House Conference was right, and that Senator McNamara and Congressman Fogarty are on the right track when they offer legislation to set up a Federal Commission dealing with the many problems of aging in one place under sympathetic and understanding auspices.
We believe the argument advanced in favor of this centralized approach has much of merit in it. For the presently widespread responsibility for health, education, recreation, employment, occupational training and retraining, community service, leisure time activities, home ownership, family adjustment, income, and social security and other such endeavors makes impossible any coordinated or thorough attention being given them by any existing agency of the Government. There is a developing science of gerontology, a developing body of professional knowledge, a developing trained leadership in this important area which need to be gathered together in one place in order to achieve greatest good for the people who as they become older are the participants in these endeavors.
WHAT CAN BE DONE?
It may be premature to offer at this stage any comprehensive program which the Federal Commission should follow. But at the same time the facts developed in the extensive hearings of the Congress and built up in the reports and discussions of the White House Conference on Aging offer some guidelines for consideration. They seem to be compelling reasons for the establishment of a Federal Commission now.
Income is the first imperative problem needing public attention. For those receiving any form of public pension, or social security payments, it is essential that the Federal Government take cognizance of the fact that inflation over which no individual has any control is literally taking the bread out of the mouths of pensioned people. Since 1949, we are told that the purchasing power of the U.S. dollar has depreciated at a cumulative rate of 2 percent a year. The Senate committee report tells us that a man retiring in 1948 on a $100 a month pension is now realizing only $76 in its buying equivalent.
One of the earliest problems the Federal Commission should tackle is how to recast pensions and payments to the retired into purchasing power dollars which will insure their living standard despite inflationary changes in the economy.
Senators McNamara, Clark, and Randolph, aware of this problem, have suggested some ways of doing so through the issuance of purchasing power Federal bonds. This fruitful approach should be explored, along with others which may be developed.
Among old-age assistance receivers are many who can work and therebr stretch their pittance a mite further. Under Federal law, a report of such earnings results in a deduction, and this is an open invitation to concealment. For we are dealing here with desperation cases of poverty. We should encourage such working habits, instead of penalizing them. The White House Conference put a figure allowing $50 a month of earned income for a recipient of old-age assistance under Federal law. Such an allowance would do more than help poor people solve the problems of spreading their meager income in these days of inflation which is beyond their control. It would encourage them to participate in their community life. It would have a generally beneficial effect upon us all.
Housing, next to food is perhaps the greatest worry confronting our elder citizens. For rent is a heavy drain on income, and most of these people rent their shelter. How to meet the monthly rent, to avoid eviction by the police, to keep a decent home are constant worries.
Public housing authorities are one answer. These can be arranged and designed primarily to meet the needs of elderly people, and the few examples we have of such efforts point the way for the future. But they are altogether too few to be more than just that,
Public housing provided through Government capital investment, allowing low rentals in healthful surroundings is one important approach. But no single way will meet the needs of the elderly for proper housing. Many among them end their working careers with ownership or equity in homes on which they have lavished affectionate care over the years. The problem is how to make it possible for them to maintain their homes after their earning years are over.
Here, again, a Federal Commission on the problems of the aging would be of great value, for its studies would help solve the problem. One suggested approach is a differential tax levy for such elderly people living on limited income in modest homes, or partial exemption of realty taxes. Another is local provision for subsistence or partial subsistance projects on home property. But whatever the combination of methods found feasible, channeling them through an agency specifically designed to study and meet the housing needs of the aging population can result in time and money saved and better results achieved.
Employment is a main key to the happiness and well-being of our aging population, as it is to all the rest of us. Its income is the basis of our material circumstances. The skills we use in our callings and the job associations we experience in our daily working careers develop habits and social relationships of the utmost importance to our personal and community adjustment. To have all this suddenly wrenched away is to confront us with a major crisis from which some of us are never able to recover fully.
The industrial organization of society has established arbitrary cutoff dates for gainful workers in a wide variety of occupations. These are made even more effective in the same arbitrary manner because of the oversupply of workers eagerly awaiting job opportunities.
The White House Conference on Aging reported that there is no scientific evidence to warrant any compulsory retirement of workers due to chronological age alone. There is no reliable evidence that older workers are less productive as an age group, less reliable, more prone to absenteeism or accidents than are
younger workers. The Conference went on record urging the abandonment of any arbitrary upper age limit on hiring workers, and said that individuals should be employed, and I might add from experience should be retained in employment, on the basis of their personal qualifications and performance.
But it will take a great deal of education of management and much wider social acceptance of these truths before older workers can face the future secure in their jobs so long as they render satisfactory service. For the pressures have been too long in the other direction. Here, again, the work of a Federal Commission on problems of the aging would render a long-needed service.
In our mobile industrial society, where technology and automation destroy long-established occupations and create new jobs without regard to those who are directly involved, middle aged and older workers are apt to find themselves on the labor market several times before they fade out into retirement for age. As workers become older in years, new work opportunities become less and less a vailable to them. So that retraining, vocational counseling, and job placement become matters of growing importance to them. This entire field is one too new and as yet too fluid for a specific prescription to be offered. But it is properly the sphere of interest of a specially designed Federal Commission dealing with the problems confronting our aging population. The White House Conference thought so much of this idea that it recommended by an overwhelming vote of delegates that the President appoint a Permanent Committee on Employment of Older Workers which could spearhead this effort nationally and in local communities where jobs and job applicants are found.
There is yet another aspect of this problem of employment which should be brought to your attention. It has to do with the mobility of workers in an industrial society which is shifting from primary production on farms and in factories to services, and from one geographical location to another. Older workers have ties of family, custom, habit, and material possessions which make them less venturesome and less able to move to new locations where new opportunities may be found. Yet it is frequently in a new environment under new conditions that their working careers may be prolonged, their new start in life launched. How to enable workers to be as mobile as the occasion requires, yet not to make false moves wasteful and even disastrous to them, is the problem confronting us. How to adjust their retirement rights and other benefits to new jobs in new places is no easy matter. It will require the skill and experience of a well-organized Federal Commission to work out the ways of doing so. But without specific skilled attention directed toward these ends, we will continue to drift without aim or direction.
Health, medical care, and institutional care are three related aspects of aging which combine to present our elderly citizens with their most pressing unsolved problems. The fear of failing health, mounting doctor bills, and hospitalization haunt the waking hours of altogether too many of our people. Especially so, when we know how to organize these services and provide for them through widespread low-cost social insurance on a prepayment plan whereby all of us can be assured proper care in our old age.
It is in the breakdown period of life that such costs and worries mount. Persons over 65 spend 21/2 times more time in hospitals than those below that age. Medical costs amount to twice as much. Yet the increased incidence of illness and debilities occur precisely during this period of life when economic circumstances are most limited.
Hence, it is essential that the forces of society be organized to cope with this combination of problems. The White House Conference offered ample evidence of the lack of private material resources in the hands of elderly people to defray the sudden or cumulative costs of health, medical care, and, in the extremity of even institutional care.
The Kerr-Mills laws is a recognition by the Federal Government of responsibility in this area. It may very well be that it does not go far enough to accomplish the purposes, and that the labor-endorsed King-Anderson bill is needed so that the broadly based funds of social security may be put behind the program of health care for the aged.
Education, recreation, community services combine to offer the elderly both meaning and purpose in their daily lives. There is growing need for education for aging, for acquiring those skills and habits of mind which take advantage of the leisure time available to the elderly in pursuits beneficial to their health and well-being and useful to them and their associates in community relationships.
The White House Conference stressed the wide variety of programs and events open to local communities along these lines. But a beneficial coordination and
assistance at the national level was noted, and considerable oportunity for finan. cial and other aid flowing from the Federal Government agencies into the localities where these programs are carried on. Here, again, the establishment of a national commission on the problems of the aging could serve well as the vehicle for such effort.
Science and research in the newly opened field of gerontology offers much hope for the future well-being of our aging population. The White House Conference recommended strongly that a National Institute of Gerontology be established in conjunction with our national health center. For the biological basis of aging and the debilitating diseases connected with age have been much neglected by science. Yet they are most promising areas of research and discovery which could result in prolonging life, making it less prone to disease and more likely to become a time of continued vigor of mind and body.
The application of the findings of such research would become a vital aspect of the work of the Federal Commission on Aging. For in the spread of scientific knowledge and the use of its findings the Commission would have a major responsibility.
Through the medium of this brief testimony on a very comprehensive subject, I as the president of the Brotherhood of Railroad Trainmen have sought to convey our feelings concerning the great importance of Federal legislation establishing an organization particularly designed to meet the needs of the aging.
We support the effort of such stanch defenders of our elderly citizens as Senator Pat McNamara and Congressman John Fogarty to establish a Federal Commission on Aging.
We believe the need is well documented in such a recital of problems as these able Members of Congress have given which cannot be handled adequately through the channels of any existing agency.
We submit that the comprehensive analysis and recommendations made by the White House Conference on Aging offers abundant proof of the need for this interdepartmental approach.
We respectfully request your early and favorable consideration of this legislation.
STATEMENT OF DR. HAYVIS WOOLF, DIRECTOR OF PUBLIC WELFARE, CRANSTON, R.I.,
CHAIRMAN OF THE NEW ENGLAND COUNCIL OF OPTOMETRISTS-VISION CARE OP THE AGING COMMITTEE, A DIRECTOR OF THE RHODE ISLAND OPTOMETRIC AssoCIATION
Mr. Chairman and members of the committee, my name is Hayvis Woolf. My residence is 575 Pontiac Avenue in Cranston R.I. I am a practicing optometrist at my Cranston address and also the only elected director of public welfare in a city in the State of Rhode Island. I am a graduate of the Massachusetts College of Optometry in the class of June 1939. I have served with the Army and the Army Air Forces on active duty for 5 years during World War II, starting as a private and being separated as a first lieutenant. I am a ready reservist at the present time, with the rank of major, as an optometrist in the Medical Service Corps of the Army, assigned to the 1032d USAR Providence School. My statement here today is as the chairman of the Committee on Vision Care of the Aging of the New England Council of Optometrists; as chiarman of the Committee on Housing for the Elderly, Rhode Island Division on Aging; as a director of the Rhode Island Optometric Association and as a director of public welfare of the city of Cranston, R.I., a city of 67,000 population.
For the past 13 months since I assumed the office of director of public welfare, I have become intensely interested in the problems of the elderly in my community, my State, and in the Nation. I first recalled the problems of elderly people from my own optometric practice who required special attention and special services for their particular-type problems. Then came the problems of the elderly people who are now participating under welfare programs such as old-age assistance, which is a Federal-State program. In the State of Rhode Island, welfare recipients are allowed in their budgets just $35 a month for rental of suitable or possibly unsuitable living quarters. Since, by the 1950 census, our average rental in my community was $50 a month, this presented an acute problem and made me realize that our elderly citizens were not receiving sufficient subsidies through the old-age program for suitable, comfortable, living quarters. Many of our aged citizens who are aflicted with heart trouble
ind arthritis are living in third-floor apartments and tenements, not being able co go out of doors because they cannot walk the stairs. Many were being housed with expenses exceeding their allotments for rent and fuel ; constantly juggling to pay all the bills. Then there is the percentage that can only afford dilapidated and substandard dwellings due to their low budgets. At that time I traveled to HHFA and the regional office of the U.S. Public Housing Authority in New York to seek information relative to the building of low-rent public housing in my city. I was amazed to learn the considerable facts, figures, and statistics that had been compiled relative to the apparent need for this type of low-rent housing for the elderly in Cranston.
I realized also that if such a situation existed in my city it must also exist in cities and towns throughout my State and throughout the United States. Upon further investigation and attendance at various conferences and meetings in several parts of the United States, I have found that the problems of the elderly are common problems that could be resolved by the proper channeling and the full cooperation of all agencies that deal specifically with the problems of the elderly.
In June 1961 I attended the followup of the White House Conference on Aging in Washington and discussed there with some of the State delegates assembled the need for a central agency that would develop programs that would be solely of benefit to the aging. With full reality that the Department of Health, Education, and Welfare does, at the present time, have a separate department to deal with the problems of the elderly, there seemed to be a little something lacking that could only be accomplished by a separate agency for the elderly. When I returned to Rhode Island I discussed this particular need with the administrator of our division on aging, Dr. Mary C. Mulvey, and we definitely concluded that more close cooperation was necessary between the Federal Government and State agencies dealing with the problems of the aged. With the present setup, housing for the elderly must come through one Federal agency; education for the elderly and old-age assistance must come through another agency. Federal grants for demonstration and research projects must come through still another agency.
In accordance with available statistics each State makes an annual appropriation to the agency caring for the aged program, only in the monetary amount that it feels is required for such a program. As can be seen from the facts assembled, other States feel that the program is more essential than others; thereby not allowing adequate funds to carry on the essentials of a wellrounded program.
In recent months I have turned my attention to my own profession and upon conferring with the chairman of the vision care of the aging committee of the American Optometric Association, Dr. Donald C. Exford, optometrist of Pittsfield, Mass., I found that my own conclusions and statistics were shared in great measure by other men in the profession. It has been found that many people in the ill and aged category have great difficulty in their latter years, to come to the office of the optometrist to have their eyes examined; some with arthritis, heart trouble, some with just failing sight that could be helped with optometric service. And so I thought that if there were some way in which we could bring our service to these senior citizens in their homes, in their place of living, where they could have their vision cared for so that they could enjoy the declining years of their lives, to see a newspaper or read a book or a magazine, to watch television or just to look out upon the adjoining scenes from an upstairs window. And so it is, that after 6 years of a mental dream, this project of bringing vision care to the elderly and the chronically ill has finally been put down in outline form. This plan will be presented to the U.S. Public Health Service for consideration for a grant as a demonstration project for our profession in the entire United States. Yes, a self-propelled mobile examination vehicle outfitted as an optometric office on wheels could be taken where necessary to care for the vision of our elderly. Under a commission of the aging, this particular idea could have been carried out in conjunction with a dental study in the Kansas City area which resulted in a project movie film, “The Vigil of Jenny Fay.” The two studies could have paralleled each other with resultant statistics and date of benefit to both professions. However, the coordination was not available due to the lack of one organization to care for all phases and problems of the elderly and aging.
To go back once more to the welfare office where daily we come in contact with elderly people receiving social security benefits who are not able to be covered by present-day medical care programs, creating for them great mental anguish.