Utah’s approach to aging with care and connection

Utah has the nation’s youngest population, but the state is thinking hard about the challenges — and opportunities — of growing old.

The Beehive State is not immune from the questions that come with a maturing population. Utah’s share of older adults is projected to more than double in the next 35 years. By 2060, one-fourth of Utahns will be 65 or older. Right now they make up just 12.2% of the population.

Tuesday, experts in health care, the economy and government policy were among those gathered at O.C. Tanner in Salt Lake City for a symposium called “Aging with a WISE Purpose,” focusing on critical issues that will impact seniors and those around them. WISE stands for wealth independence, security and engagement. Gov. Spencer J. Cox hosted the gathering, which looked at health, isolation, economics, aging in place and preventing fraud that targets older adults.

The heart of the discussion, across topics, was connection and how the state and its residents can help and take care of each other.

“We know what makes Utah so special is the caring nature of our community,” Salt Lake County Mayor Jenny Wilson said in her opening remarks. She noted that besides health challenges, people as they age often have difficulty meeting their basic needs. And they can feel various emotional impacts with aging, including sometimes isolation and loss of loved ones. Those challenges, Wilson said, do not call solely for solutions from one level of government or another or from nonprofits. Rather, “We are in it together.”

Compassion and volunteer spirit of a community, however, are unlikely to make up for the demographic shift occurring nationwide as millions of baby boomers begin to retire. Cox noted one of the biggest challenges will be that many older Utahns will lose or haven’t ever prioritized having social connections. That lack is comparable in terms of physical damage to smoking 15 cigarettes a day, as research has shown, he said.

Julianne Holt-Lunstad, professor in the Brigham Young University Social Connections and Health Research Lab, said people see social connection as emotional, which it is. But they don’t see the impact it has on physical health. Like alcohol abuse, obesity and air pollution, isolation impacts survival and well-being.

Nor are Utahns uniformly prepared for the financial challenges of aging, experts said during the series of presentations.

Utah’s aging population

In 1980, fewer than 8% of Utah residents were at least 65, according to the Kem C. Gardner Policy Institute at the University of Utah. That share has been growing and will continue to do so.

The institute said that Utahns' financial stability improves with age “until retirement age, when incomes drop and poverty rates increase.” Median income is just below $60,000 in retirement years.

After age 75, nearly 1 in 10 Utah women will be impoverished.

Home ownership increases with age, but nearly 6 of 10 Utah renters who are 65 or older are what the institute calls “cost-burdened,” meaning they spend more than 35% of their income on housing.

On a brighter note, older Utahns do have the highest rate of insurance coverage, at 99%.

A human connection crisis?

Holt-Lunstad said there’s “extremely robust evidence” that the incidence of Type 2 diabetes, dementia, susceptibility to viruses, crime, violence and other ills rise due to lack of social connection and interactions. Connection is “not just important for emotional well-being, it’s critical for physical health,” Holt-Lunstad said.

That message was really brought home during the pandemic, she added.

Cox noted that in the pandemic, people learned how to be disconnected, seeing the possibilities of remote work, online shopping and other tools that keep folks from face-to-face encounters. “We’ve got to stop that” and find our way back to being in-person, he said.

Maintaining health gets more expensive as people get older, because they tend to need and use more care. Rob Allen, CEO and president of Intermountain Health, said that 10% of entire health expenses overall is near the end of life, where people over age 65 average $11,300 a year, compared to much lower annual amounts when they were younger.

Dealing with health and related issues, as well as the expense, is something that should inform decisions people make much earlier in life, not just at age 65, per Holt-Lunstad. Investments must be made earlier or “it’s going to be far more difficult.”

Panelists seemed to agree that Americans are not great at investing in healthy longevity.

Allen said that in a study of 10 countries, the U.S. had the shortest life expectancy and the highest rate of avoidable death. It was also the least affordable. Utah, he added, looks much better than the nation as a whole. For instance, the average life expectancy is 80.1 years, compared to far fewer nationally. And the cost of care is “the lowest in the country.” He cited a Fortune magazine report that noted if every health system delivered care comparable to that of Intermountain Health, which it rated No. 1, 200,000 Americans would not die in a given year.

And while Utah ranks very well on many measures, including a low number of smokers, a healthy place for retirees and good social support, it’s not all rosy. Allen said that Utah also has the highest suicide rate among older adults, likely in part because of access to firearms. While a suicide attempt may be a cry for help, he said, death by self-inflicted gunshot is not.

He also noted factors that influence overall health and quality of life, such as crime and food and housing insecurity. Those are among issues that come up during an every-three-year discussion with community agencies of problems that impact Utahns.

What about money wellness?

Many older adults are on a fixed income, which makes inflation especially challenging. Robert Spendlove, an economist with Zions Bank, said inflation’s manageable as long as wage growth is better than price growth. That hasn’t been the case recently, hurting both workers and older adults whose incomes are set.

When the Federal Reserve Bank asked what challenges people are facing recently, one-third said they struggle with inflation, while 21% said meeting basic living expenses is hard.

For many years, people retired on some kind of defined benefit plan — Social Security and/or a pension. Now, he said, “it’s overwhelmingly defined contribution.” That is the money that people manage to set aside themselves for the most part. “And they’re not saving enough.”

A survey found that 51% of households have “some retirement,” Spendlove said. That means 49% don’t have any.

The median amount saved for those who have done so is $81,000, he said. Applying the general rule of thumb that one can safely take 4% from those savings and expect money to last, that $81,000 would be about $400 a month, he said.

Hard to live on that amount.

People generally need in retirement about 25 times what they expect to spend in a year or eight times their income. Someone making $100,000 would need about $2 million, he said. Most simply don’t have it.

“We have got to be talking about this now,” Spendlove told the crowd. He added that Congress needs to figure out how to prevent Social Security from being insolvent, or in about a decade benefits will need to be reduced.

One way that many Utah policymakers, including Cox, hope to help the aging population is by eliminating the state tax on Social Security. In the last few years, the Utah Legislature has exempted increasingly higher income levels from paying the tax, so that now those with incomes up to $74,000 do not pay state income tax on Social Security. Sen. Wayne Harper, R-Taylorsville, and Rep. Walt Brooks, R-St. George, both spoke about the benefits of tax breaks, including on Social Security. Military retirement exclusion from state tax is another area that helps, Harper said.

Spendlove noted that housing and medical costs, including long-term care, are also salient to economic well-being for older adults. Priorities should change as demographics change so that people can thrive.

But expectations need to change, too, he said, citing housing as an example. With fewer houses than families that want houses, not everyone’s going to be able to have a big backyard and four bedrooms.

On a sign outside the conference, the governor’s office touted ways Cox’s proposed budget benefits seniors, including a proposed $143.8 million tax exemption, $20.5 million for aging in place, $1.4 million to safeguard older adults and $4.5 million to help keep people connected.