Issues and policy: Housing satisfaction as aging in place indicator

Increasing numbers of older adults will further impact the U.S. housing market and policies. Currently, individuals who are 65 years and over total 48 million, which accounts for 15% of the total population; and will reach 98 million (24% of the total population) by 2060 (U.S. Census Bureau, 2017; Population Reference Bureau, 2016). Such demographic shifts have been discussed with aging in place (AIP), which is defined as the ability to live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level (Centers for Disease Control and Prevention, 2013). Often, the AIP concept is considered from a cost-saving perspective. According to the U.S. Department of Housing and Urban Development (2013), AIP can yield cost savings for families, governments, and health systems when compared to long-term care (e.g., nursing home) costs wherein the government pays, i.e., Medicaid (47%) and Medicare (23%) and families pay out of pocket (23%) (Pennsylvania Health Care Association, n.d.). In 2009, the median monthly payment for a nursing home was $5,243 while non-institutional long-term care (e.g., AIP with in-home care service) was $928. Therefore, senior housing costs implies that AIP can yield substantial savings for aging families and for the government. Then, a question is raised in terms of how to support AIP for older adults. In order to respond to this question, we should reconsider that AIP is likely to occur if the older adults are satisfied with their current living places (Kwon et al., 2015), implying more attention should be given to factors relating to housing satisfaction for older adults and how to apply such factors to services or policies for older adults aging in place. HERG’s (Housing Environment Research Group) research outcomes on older adults’ housing satisfaction that include individual home and neighborhood satisfaction can provide an exemplary guideline in terms of factors and policy/service approaches. For example, when assisting baby boomers’ AIP through policies or services, more attention should be given to baby boomers who are younger (age factor) or never married (marital status); in ‘fair’ health (health condition) or unemployed (employment status); have lower incomes (family income); live in multifamily housing units (structure type) or in small home (structure size); or are renters (tenure status) (Kwon et al., 2015). For older single-persons in urban and rural areas (Lee et al., 2016; Ahn & Lee, 2016), their age, health condition, unit location, gender, age of house, housing quality, and structure types are important considerations when supporting single older persons’ AIP through policies or services. However, education, government income assistance, housing affordability, structure size and tenure status are only considerations for urban older single-person adults, not those in rural areas. The increasing and diverse older populations creates a demand for public policy and services on society, which will allow more individuals to live safely and independently long after their retirement. Therefore, it is important to examine housing satisfaction as an AIP indicator and relevant factors, leading to meaningful policies and services for older adults.