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Many of our communities have been involved with Community Needs Assessments, Community Health Needs Assessments, Community Economic Development Plans, and ongoing planning for the built environment. All of these planning lenses are helpful ways to look at communities, and build for the future. One of the most important lenses to use for community planning for the next 10 to 20 years is the projected impact of aging on our communities, counties and states. What will is mean for a state to move from being 39th in proportion of older adults in 2010, to being 4th by 2030? What does it mean for a county to have a population shift that includes an increase of older adults by over 100% in the next 10 years, along with a projected reduction of people under 40 years old?

Understanding the Demographic Trend
The demographic trend has been called by many names, such as the “Age Wave,” or “Silver Tsunami,” with arguments in meetings and on blogs about whether those terms are helpful or pejorative, descriptive or ageist. In addition, some people find the terms “elderly” difficult, while others find “seniors” to be patronizing. Once people have dealt with parsing the grammatical minefield, then the most important issues are to understand both the demographic trend and other substantive factors.

Although a few in the field indicate that the aging of the population is rather slow and easily absorbed, the vast majority of experts agree that this is a significant, fast-moving trend that will not be easily absorbed. Research I’ve conducted has covered everything from future health professional shortages and health system gaps to the built environment, funding and policy trends. The potential impact of the aging of our population on communities and states is significant. It will require proactive, sustained responses at community, state and national levels.

Some communities and states are better positioned to respond to this trend than others.

Impact Also Depends on a Few Other Key Factors
The ability of groups to effectively respond depends upon a number of other key factors. Although the demographic trend is the primary issue, other important factors impacting our ability to respond include the following:
– Overall community health;
– Poverty levels, average and median incomes (especially for middle aged and elderly);
– Local municipal budgets, economic ratings, and taxing capacity;
– Legislation, policies, and funding related to both aging and community development;
– Regional infrastructure and built environment.

The impact of the demographic trend is also shaped by the state of community and regional planning already in place to deal with the impact of aging upon our communities. Leadership and citizen engagement are also important factors that could help drive and mobilize initiatives. Leaders can and should respond. The issues are complex, but not overwhelming. However, they need to be addressed proactively.

How a Social Calculator can Predict the Potential Impact of Aging for Communities and States
Many of these factors have been analyzed by our team through a number of aging related research and planning projects over the past few years. We are now completing an Aging Social Impact Calculator that can provide an initial scan of the local environment, and the state environment. It looks at key factors that shape a county’s or state’s social, economic, and community health.

Research projects that I’ve recently completed demonstrate that the Social Determinants of Health, health rankings, economic benchmarks and policy issues either help communities and states to move forward, or serve as additional challenges.

Social Determinants. The Social Determinants shape us as individuals, families and communities. They include things such as family income, jobs, poverty and financial assets. Income, assets, poverty, and unemployment have been demonstrated to be some of the most important shapers of family and community health, health disparities, and health equity. Race and ethnicity have been seen as extremely important by the World Health Organization, U.S. federal government bureaus, and the health research and funding community. Individual, family and community educational levels are also significant. Taken together, or aggregated, one finds community snapshots that reflect the local economy, jobs and poverty; racial and ethnic mix; and educational levels. They help to predict how our lives will be shaped in the future.

Community and State Health Rankings. Communities and states are rated on their overall health by many research groups. One of the key national ratings used is the Robert Wood Johnson Foundation’s (RWJ) annual County Health Rankings and Roadmaps. They provide excellent state and county ratings based upon an analysis using more than a few dozen separate indicators. That ranking provides extremely important information to help determine whether an area faces significant health disparities and inequities. Rankings can tell planners whether community health challenges will pose additional difficulties that negatively impact the community’s ability to respond to the aging trend; or whether the positive community health will facilitate communities to implement strategies to respond. These health rankings can help inform plans that more effectively address key issues.

Economic Benchmarks. Communities are very much shaped by large and small economic trends. Short and long-term economic ratings provide a picture of community economic health. Counties and states with strong economic ratings have more ability to respond to these challenges than do those with a weak economic picture. Communities that face a loss of jobs and capital, and a diminishing tax base, are not as well positioned to respond to the Age Wave as communities that have a different economic picture.

Other factors that can also help predict the impact of the demographic trend include whether or not a region has a net population loss. Areas that are losing population also begin to lose jobs and infrastructure over time, unless this can be proactively addressed.

Laws, policies, legislative initiatives and funding priorities and strategies can also shape how well a local community or state is able to respond to this trend. Policies and funding that support economic development, the built environment, and services for older adults provide an environment that facilitates a community or county’s proactive response to this demographic trend.

The Power of Collective Impact
The combined, or collective impact of (1) demographic trends, (2) Social Determinants, (3) health rankings, (4) local and state economies, and (5) policies together shape a region’s sustainability. They also can serve as general predictors of how hard hit a community may be by the aging of the population. Taken together, these factors provide a picture of what may happen for communities, counties and states. They help us understand current and projected collective impact.

Aging Social Impact Calculator
The Aging Social Impact Calculator looks at states and counties, and provides an initial prediction about the level of impact you may expect from the aging of the population in your region. Some of the most important benchmarks that make up the predictive picture include:
– Demographic Factors
– Social Determinants of Health
– County Health Ranking (Health Outcomes and Health Risk Behaviors)
– County Economic Picture
– Policy and Funding Framework

Working with a Predictor
Any social impact calculator has predictive capabilities. Many economic calculators have been used successfully by the World Bank, the Low Income Investment Fund, and others. The Robert Wood Johnson’s County Health Rankings and Roadmaps and state level health department profiles (like the New Mexico Community Snapshots) provide pictures of community health that capture both the present and the near future. The Aging Social Impact Calculator offers snapshots of projected impact on a community, and the community’s strengths and weaknesses in that will affect its ability to respond. It provides a helpful picture of local and state capacity, which can help leaders to choose priorities that fit their capacity to respond.

Predictors offer a holistic general picture that can serve as an important starting point for communities and states to respond to the needs of older adults. They serve as broad frameworks or roadmaps. Once a predictor profile is developed, then community leaders can look deeper into the community to:
– Understand and address key issues;
– Choose priorities, and create the size and scope of a response that fit community capacity;
– Build upon community strengths and assets;
– Reduce risks;
– Create plans that bring stakeholders together and leverage resources.

Every state and community has its own unique assets that can be utilized to respond to this issue, which are complex, and difficult to measure with a social impact calculator. These include the rich family and social networks, community leaders, volunteers, faith communities and civic organizations that represent significant community assets.
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Ihab Salloum