The Availability of Care for Late-Middle-Aged Adults With Chronic ...

Finally, federal and state aging services that provide nutrition and transportation have helped to alleviate some of the need of frail elders, but have done little for middle-aged adults (Administration on Aging [AoA], n.d.; Allen & Mor, 1997). Programs such as Meals on Wheels and RIDE serve thousands yearly, but because they are organized by Area Agencies on Aging rather than disability-based groups, eligibility criteria include an age cutoff of 60 (AoA, 2004). Ultimately, therefore, individuals in late middle age without informal help or adequate health insurance must go without help or rely upon their own financial resources to purchase it. Here again, they may be at a distinct disadvantage compared with the older population. Many who have yet to see their full earnings potential may be forced to leave the labor force, perhaps greatly reducing any pension that they would have been eligible for had they worked to normal retirement age (Freedman et al., 2002). They may still be supporting dependent children, or they may have become disabled early in life and have experienced the cumulative economic disadvantage of being disabled throughout adulthood (Wang, 2005).

Cohort Differences

In addition to life stage differences, there are substantial cohort differences between individuals in late middle age and their older counterparts. This study’s older old group (previously defined as 75 and older) entered old age at a unique point in American history. They benefited from medical and public health advances that increased their life spans and reduced their years of morbidity (National Institute on Aging [NIA], 1999). As a group, they were better-off financially than those who came before. At the time, the poverty rate of 9.7% in 1999 for people 65 and older was the lowest for this group ever measured by the U.S. Census Bureau’s Public Information Office (2001).