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FOREWORD

For the first time in our history a President of the United States has sent to the Congress a special message on the needs and interests of the elderly.

This message reflects the concern of the President, the concern of this special committee, and the growing concern and interest of the Nation in a part of our population long disadvantaged.

The White House Conference of 1961, the past work of this committee, the work of the President's Council on Aging and of the Special Staff on Aging (now the Office of Aging) of the Department of Health, Education, and Welfare have developed a great body of information on the problems of older people and the contributions older people can make to our society.

To this background of effort and information, the President's message has now added coordination and a sense of urgency. It has lifted the hearts of the elderly throughout the Nation, for the President has seen clearly, and has been able to make the country see, not only the problems which the elderly face but the resource of wisdom, experience, and seasoned judgment they can offer.

The heart of any program designed to provide services to older people, to offer opportunities to them, and to ask them for service, must be in their home community.

The President's message recognizes this central position and responsibility of States and communities, local agencies, and institutions, in the planning and administering of programs.

The President and this committee recognize also that States and localities vary greatly in their capacities and resources. Because the need is so extensive and in many ways complex, there is a Federal responsibility to assist States and the communities in their efforts. The program for senior citizens submitted to the Congress by the President involves some 36 legislative and administrative proposals. I believe that the President's message and the compilation of background fact sheets with respect to this program will be of assistance to all concerned with the well-being of the senior citizens of this Nation.

The compilation of this material is designed solely to be of assistance in making a determination for legislative purposes, and is not to be construed as endorsing in whole or in part any of the recommendations. GEORGE A. SMATHERS,

Chairman, Special Committee on Aging.

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FEBRUARY 21, 1963.-Referred to the Committee of the Whole House on the State of the Union and ordered to be printed

To the Congress of the United States:

On the basis of his study of the world's great civilizations, the historian Toynbee concluded that a society's quality and durability can best be measured "by the respect and care given its elderly citizens." Never before in our history have we ever had so many "senior citizens." There are present today in our population 17 million people aged 65 years or over, nearly one-tenth of our population-and their number increases by 1,000 every day. By 1980, they will number nearly 25 million. Today there are already 25 million people aged 60 and over, nearly 6 million aged 75 and over, and more than 10,000 over the age of 100.

These figures reflect a profound change in the composition of our population. In 1900, average life expectancy at birth was 49 years, Today more than 7 out of 10 newborn babies can expect to reach age 65. Life expectancy at birth now averages 70 years. Women 65 years old can now expect to live 16 more years, and men 65 years old can expect to live 13 additional years. While our population has increased 21⁄2 times since 1900, the number of those aged 65 and over has increased almost sixfold.

This increase in the lifespan and in the number of our senior citizens presents this Nation with increased opportunities: the opportunity to draw upon their skill and sagacity and the opportunity to provide the respect and recognition they have earned. It is not enough for a great

nation merely to have added new years to life-our objective must also be to add new life to those years.

In the last three decades, this Nation has made considerable progress in assuring our older citizens the security and dignity a lifetime of labor deserves. But "the last of life, for which the first was made ***" is still not a "golden age" for all our citizens. Too often, these years are filled with anxiety, illness, and even want. The basic statistics on income, housing, and health are both revealing and disturbing:

The average annual income received by aged couples is half that of younger two-person families. Almost half of those over 65 living alone receive $1,000 or less a year, and three-fourths receive less than $2,000 a year. About half the spending units headed by persons over 65 have liquid assets of less than $1,000. Two-fifths have a total net worth, including their home, of less than $5,000. The main source of income for the great majority of those above 65 is one or more public benefit programs. Seven out of ten-12.5 million persons-now receive social security insurance payments, averaging about $76 a month for a retired worker, $66 for a widow, and $129 for an aged worker and wife. One out of eight-2 million people are on public assistance, averaging about $60 per month per person, supplemented by medical care payments averaging about $15 a month.

A far greater proportion of senior citizens live in inferior housing than is true of the houses occupied by younger citizens. According to the 1960 census, one-fourth of those aged 60 and over did not have households of their own but lived in the houses of relatives, in lodging houses, or in institutions. Of the remainder, over 30 percent lived in substandard housing which lacked a private bath, toilet, or running hot water or was otherwise dilapidated or deficient, and many others lived in housing unsuitable or unsafe for elderly people.

For roughly four-fifths of those older citizens not living on the farm, housing is a major expense, taking more than one-third of their income. About two-thirds of all those 65 and over own their own homes-but, while such homes are generally free from mortgage, their value is generally less than $10,000.

Our senior citizens are sick more frequently and for more prolonged periods than the rest of the population. Of every 100 persons age 65 or over, 80 suffer some kind of chronic ailment, 28 have heart disease or high blood pressure, 27 have arthritis or rheumatism, 10 have impaired vision, and 17 have hearing impairments. Sixteen are hospitalized one or more times annually. They require three times as many days of hospital care every year as persons under the age of 65. Yet only half of those age 65 and over have any kind of health insurance; only one-third of those with incomes under $2,000 a year have such insurance; only one-third of those age 75 and over have such insurance; and it has been estimated that 10 to 15 percent of the health costs of older people are reimbursed by insurance.

These and other sobering statistics make us realize that our remarkable scientific achievements prolonging the lifespan have not yet been translated into effective human achievements. Our urbanized and industrialized way of life has destroyed the useful and satisfying roles which the aged played in the rural and small-town family society of an earlier era. The skills and talents of our older people are now all too often discarded.

Place and participation, health and honor, cannot, of course, be legislated. But legislation and sensible, coordinated action can en

hance the opportunities for the aged. Isolation and misery can be prevented or reduced. We can provide the opportunity and the means for proper food, clothing, and housing, for productive employment or voluntary service, for protection against the devastating financial blows of sudden and catastrophic illness. Society, in short, can and must catch up with science.

All levels of government have the responsibility, in cooperation with private organizations and individuals, to act vigorously to improve the lot of our aged. Public efforts will have to be undertaken primarily by the local communities and by the States. But because these problems are nationwide, they call for Federal action as well.

RECENT FEDERAL ACTION

In approaching this task, it is important to recognize that we are not starting anew but building on a foundation already well laid over the last 30 years. Indeed, in the last 2 years alone, major strides have been made in improving Federal benefits and services for the aged:

1. The Social Security Amendments of 1961, which increased benefits by $900 million a year, substantially strengthened social insurance for retired and disabled workers and to widows, and enabled men to retire on social security at age 62. Legislation in 1961 also increased Federal support for old-age assistance, including medical vendor payments.

2. The Community Health Services and Facilities Act of 1961 authorized new programs for out-of-hospital community services for the chronically ill and the aged, and increased Federal grants for nursing home construction, health research facilities, and experimental hospital and medical care facilities. Such programs are now underway in 48 States.

3. The Public Welfare Amendments of 1962 authorized a substantial increase in Federal funds for old-age assistance, reemphasized restorative services to return individuals to self-support and self-care, and provided encouragement for employment by permitting States to allow old-age assistance recipients to keep up to $30 of his first $50 of monthly earnings without corresponding reductions in his public assistance payments.

4. The Housing Act of 1961 included provisions for the rapid expansion of housing for our elderly through public housing, direct loans, and FHA mortgage insurance. Commitments in 1961 and 1962 were made for more than 11⁄2 times the number of housing units for older citizens aided in the preceding 5 years.

5. The Senior Citizens Housing Act of 1962 provided low-interest long-term loans and loan insurance to enable rural residents over 62, on farms and in small towns, to obtain or rent new homes or modernize old ones.

6. The new Institute of Child Health and Human Development, which was authorized last year, is expanding programs of research on health problems of the aging.

7. Other new legislation added safeguards on the purchase of drugs which are so essential to older citizens-boosted railroad retirement and veterans' benefits-helped protect private pension funds against abuse and increased recreational opportunities for all.

8. By administrative action we have (a) increased the quality and quantity of food available to those on welfare and other low-income

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