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Chart E.-Comparison of present and proposed social security with-

holding for income received from employment-primary benefit-

man only..

Table F.-Annual income, man only, age 65-

Chart G.-Comparison of present and proposed social security with-

holding for income received from employment-man and wife...

Table H.-Annual income, man and wife, age 65.

Some examples of effect of earnings from work on total income..

Swartz, Dr. Frederick, chairman, Committee on Aging of the Council on
Medical Services, American Medical Association, practicing physician..
Williams, Harold, executive director, advisory board on problems of older
workers, Commonwealth of Pennsylvania___

Winston, Dr. Ellen, director, Department of Welfare, North Carolina; past
president. American Public Welfare Association; past president, North
Carolina Health Council_----

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85

298

ADDITIONAL INFORMATION

Annual Report of the California Citizens' Advisory Committee on Aging,
1958.

110

Leaflet entitled, "Federal Legislative Objectives-1959," published by
the American Public Welfare Association_...

300

Memorandum from Robert H. MacRae, executive director, Welfare Coun-
cil of Metropolitan Chicago, entitled "Observations on Social Services
Needed by Older Persons"

282

News release by Assemblyman John E. Johnson, chairman, New York

State Joint Legislative Committee on Problems of the Aging-

Summary of health benefits under OASI proposed in the Forand bill,
H.R. 4700, introduced February 18, 1959__

TABLES AND CHARTS

187

Table 1.-Estimated number of persons aged 65 and over receiving money
income from specified sources, by sex, June 1958 (continental United
States, Alaska, Hawaii, Puerto Rico, and Virgin Islands) __.
Table 2.-Estimated population as of July 1, 1958, for use in computing
proportion of population receiving assistance (recipient rates) for June

13

1958

13

Table 3.-Public assistance in the United States, by month, March
1958-59
Table 4.-Old-age assistance: Recipients and payments to recipients, by
State, March 1959.

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16

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Chart 2-Life expectancy in United States_-

THE AGED AND THE AGING IN THE UNITED STATES

(Sec. I.-The Health of the Aged and Aging)

TUESDAY, JUNE 16, 1959

U.S. SENATE,

SUBCOMMITTEE ON PROBLEMS OF THE AGED AND AGING,
OF THE COMMITTEE ON LABOR AND PUBLIC WELFARE,

Washington, D.C. The subcommittee met at 9:30 a. m., pursuant to call, in room 4232, New Senate Office Building, Senator Pat McNamara ́ (chairman of the subcommittee) presiding.

Present: Senators McNamara (presiding), Clark, and Randolph. Subcommittee staff members present: Sidney Spector, staff director, and Dr. Harold Sheppard, research director.

Committee staff members present: Stewart E. McClure, chief clerk; Michael J. Bernstein, minority counsel; and Raymond D. Hurley, minority professional staff member.

Senator MCNAMARA. The hearing will be in order.

A profound, potentially explosive revolution has been taking place in this Nation in the last 25 years. This is the extraordinary shift in the age groups of our population, particularly among those over 65. In the first 57 years of the century, our total population has more than doubled, but the number 65 and over has multiplied more than five times. Today, there are about 1512 million Americans over 65. In 15 years just the day after tomorrow-there will be more than 20 million people in this age category. And the chances of a person 65 years old living to the age of 85 have increased by 41 percent in this past half century.

The necessary adjustments that individuals and society must make to this major social change constitute a great challenge to our Nation today. We are living in a time of such international tension that the fate of the free world rests in great measure on the productive capacity of our country. It would seem essential to our survival that we make full use of the assets and contributions of all our citizens to meet the needs of our times.

Yet there is vast waste of wisdom, experience, and human resources in the compulsory retirement of our older citizens; in the depressed housing so many of them must accept; in the less than subsistence income they receive. It seems to me that as a Nation we are doing very little to develop effective public health programs which protect and promote irreplaceable skills and abilities.

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Under Senate Resolution 65, the Committee on Labor and Public Welfare, chaired by Senator Lister Hill, was authorized to create this Subcommittee on Problems of the Aged and the Aging. The subcommittee was requested to conduct a complete study of the problems of the aging, including the needs of the aging, the programs of various agencies in meeting their needs, and the extent to which additional Federal programs should be undertaken to help solve the problems of our senior citizens.

What we are considering here this morning is a very substantial portion of Americans who are concerned now with enough income to live on a decent, American standard; with their constant struggles to stay well in later years; with finding a suitable place in which to live; and with obtaining meaningful activity in old age.

There is no simple answer to any of these problems. We have, therefore, asked some of the best informed people in the Nation to meet with the members of the subcommittee beginning today and on through Thursday to explore the whole range of problems in the field of aging and to provide us with guides and standards for our further investigation.

We are immensely grateful to this outstanding panel of consultants for a cencentrated effort to provide the Senate the best available advice and guidance on the implications of this tremendous population change. We must reach solutions to these problems, not only at the immediate, local level, but by the Nation as a whole acting through its Government.

We are extremely fortunate this morning to have as our first panel speaker Prof. Wilbur Cohen of the University of Michigan. Mr. Cohen is one of the Nation's foremost thinkers in the field of aging and is internationally recognized for his studies in income maintenance and social security administration. Mr. Cohen will appraise the trends in the field of aging and provide a bird's-eye view of what has been taking place and the prospects for the future.

We then will concentrate the rest of the morning on the health needs of persons as they grow older. Health is man's greatest gift, but too often an unpredictable fate may paralyze or seriously damage this basis of well-being. All of the members of this subcommittee, I am sure, have received those deeply tragic letters, perhaps from a retired insurance man, or a former railroad employee whose wife or mother survived cancer or a stroke.

Long period of hospitalization, surgery, drugs, practical nurses, X-rays and so forth ran bills up into the thousands. Savings and dreams of a happy retirement fade-leaving frustration and despair.

This is, in my view, the most difficult problem older people face. We need real help on this matter, and we are looking forward to the combined insight, experience, and wisdom of a highly qualified panel. Other members serving on the panel with Professor Cohen are:

Dr. Frederick Swartz, chairman, Committee on Aging of the Council of Medical Services, American Medical Association; Dr. Maurice Linden, Director, Division of Mental Health, Department of Public Health, Philadelphia; and Dr. Murray Ferderber, School of Medicine, University of Pittsburgh.

STATEMENT OF WILBUR COHEN, PROFESSOR OF SOCIAL WELFARE, UNIVERSITY OF MICHIGAN, AND FORMER TECHINAL ADVISER AND DIRECTOR OF RESEARCH FOR THE SOCIAL SECURITY ADMINISTRATION

Professor COHEN. I would suggest first that the entire statement that I have prepared be inserted in the record as a whole at this point. Then I will proceed to deal with some of the points more intensively as we go along.

Senator MCNAMARA. Without objection, we will follow that procedure.

You have no objection, Senator Randolph?

Senator RANDOLPH. No.

(Professor Cohen's prepared statement follows:)

BASIC INFORMATION ON THE AGED

Summary of Remarks by Wilbur J. Cohen, Professor of Public Welfare
Administration, The University of Michigan

1. Aged increasing nearly a thousand a day

About 1,230,000 persons became age 65 in 1956, over 3,000 every day.

About 900,000 persons age 65 and over died in 1956.

The net increase was about 330,000, nearly 1,000 every day.

There are 15.4 million persons aged 65 and over representing 8.6 percent of the total population.

By 1975 there will be 20 million aged persons.

2. Life expectancy for older women is longer

The life expectancy of men at age 65 is about 13 years; for women 151⁄2 years. This difference diminishes with age. At age 70, for men, life expectancy is 10.3 years; for women 12.2 years.

At age 80, it is 6.0 years for men and 6.6 years for women.

3. Only a small proportion of the aged live in institutions

Three-fourths of all aged persons live with some family member.

About 15 percent of all the aged live in their own households but live alone or with nonrelatives. Another 4 percent live with nonrelatives but not in their own homes. About 6 percent live in other places-about 3 percent in institutions, and about 3 percent in hotels, rooming houses, and the like.

4. The aged are not evenly distributed throughout the country

Five States had 10 percent or more of their population age 65 and over in 1950 (Iowa, Massachusetts, New Hampshire, Oregon, and Vermont).

Seventeen metropolitan areas with a total population of 100,000 or more had an aged population of 10 percent or more (Tampa-St. Petersburg; Brockton; Atlantic City; Terre Haute; Lowell; Spokane; Portland, Maine; Utica-Rome; Topeka; Lawrence; Worcester; Orlando; Cedar Rapids; Lincoln; Springfield, Mo.; New Bedford; Rochester).

In a State like Illinois, with a slightly higher than average proportion of aged, there were 16 counties with more than 13 percent of the population age 65 and

over.

5. Small towns have the highest proportion of older persons

About 13.5 percent of the population of incorporated places of less than 1,000 are aged persons. Aged persons on farms were a slightly smaller proportion of farm people than aged persons in urban areas.

6. Nearly half of the total income of the aged comes from income-maintenance programs

Total income of all the aged was about $25 billion in 1958.

About $6.7 billion was received from social security, $1.7 from public assistance, and $2.2 billion was received from other governmental programs (civil service

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