Talking About the Generations: The Health and Healthcare of Boomers, Gen Xers, Millennials and Gen Zers. Part 1, The Boomers

First of four parts

A decade ago, much of the medical literature related to the baby boom generation was focused on the burden the healthcare system would shoulder once a majority of the baby boomers crossed the threshold into
senior citizenship.

Now that the demographic bolus has traveled that far, the reality has been a bit different — and a bit more complex — than expected, says Stephan Chung, Ph.D., M.S., a health sciences professor at California State University, Northridge. He says baby boomers, people born from 1946 to 1964, have turned out to be much more active and technologically savvy than stereotypes of older adults might suggest.

Those characteristics — high activity and engagement with health technology — are not standalone traits but part of a broader and quite conscious effort by boomers to buck stereotypes and “maintain their health, vitality and relevance in society,” he says. Chung says staying relevant includes putting off retirement and seeking new academic degrees to expand their skills and marketability.

Stephan Chung, Ph.D., M.S.

This is not to say boomers are not putting stress on the healthcare system. Chung says the sheer size of the generation — approximately 72 million people — means it is sparking a major increase in demand for things such as preventive care, acute care services and chronic condition management.

It may seem paradoxical that a generation with a reputation for being active and engaged might experience a high chronic condition burden. However, Chung says it is precisely because boomers are living longer that the chronic disease burden is increasing. “Although baby boomers lead healthier lives, it is inevitable for some to develop chronic conditions, which will ultimately appear in the later stages of their lives,” he says.

In fact, results of a 2022 study published in The Journals of Gerontology: Series B found that boomers were more likely to have multiple chronic conditions than previous generations. Those study results also showed that boomers were being diagnosed with multiple chronic conditions at younger ages.

So how well prepared is the healthcare industry for the challenge?

Chung says the answer is complex. In his view, the U.S. healthcare system has done a good job of increasing its focus on prevention and wellness and of adopting technology such as online resources that allow boomers to better manage their health. He says mental health is also getting more attention. “Programs and resources that support mental health, cognitive function and social engagement are increasingly available for older adults,” he says.

Yet Chung says older adults still face significant hurdles in terms of access to care and affordability of care. A 2018 article published in the Journal of General Internal Medicine warned that the nation’s over-65 age cohort was growing rapidly at a time when the number of available hospital beds was shrinking. From 2006 to 2014, the study found, the number of hospital beds in the U.S. shrank from 2.8 beds per 1,000 people to 2.5 per 1,000 people. The authors of that study said one way to avoid the problem is to do a better job of avoiding unnecessary hospital stays, partly by focusing on in-home care. Of course, in 2018, few envisioned anything like the COVID-19 pandemic and a reframing of healthcare as a service that can, in many instances, be delivered remotely to people in their homes.

Chung agrees that there’s a need for more tailored healthcare services that specifically target the needs of older patients, such as specialized geriatric care and home health services. He also said the development of more age-friendly communities would help boomers live independently and actively for as long as possible, thereby lightening the load on the healthcare system. The growth in Medicare on a per capita basis slowed appreciably from 2010 to 2020 compared with prior decades. There are many explanations for that, but it is perhaps a signal that boomers will be healthier septuagenarians, octogenarians and nonagenarians than the generations before.

Still, Chung says some of the predictions about the impact of aging boomers on healthcare costs have materialized. Technological advances and new drugs help people live longer but come at a significant cost. “These dynamics suggest that while some aspects of the cost impact were anticipated, the overall picture is complex and influenced by broader economic, technological and policy factors,” he says.