Long-term outcomes:

Health and Well-Being of Older Adults in California

Since the 1950s, self-rated health has been a common measure used in a wide range of research and surveys. Importantly, it has been broadly validated as a predictor of future health outcomes and even mortality. This data point, therefore, not only gives us a sense of older adults’ health and well-being today, but it can also tell us something about their future as well.

Between 2013 and 2022 the percentage of older adults reporting excellent or very good self-rated health has remained fairly consistent at around 40-45 percent, with about 20 percent reporting fair or poor overall health.

Older adults who are White, non-Hispanic, whose primary language is English, who reside in rural areas, or have higher incomes are consistently more likely to report excellent or very good health. However, even within these populations, the share reporting excellent or very good health hovers around 50 percent.

Accelerated Action:

If California maintains current trends, the expectation would be for about 46 percent of older adults to report excellent or very good health in 2030. Accelerating action would raise that to 56 percent, meaning an additional 958,000 older adults would report excellent or very good health.

Psychological distress, which can include feelings of depression, hopelessness, anxiousness or nervousness, and other kinds of psychological discomfort may be caused by a variety of physical and cognitive changes and/or a variety of stressors including social isolation, financial insecurity, and health problems. Psychological distress can impact well-being and affects quality of life and relationships.

Between 2013 and 2022, the percentage of older adults who experienced moderate or greater psychological distress increased from about 20 to 27 percent. However, much of this increase occurred after 2020, and may be related to the COVID-19 pandemic. Whether psychological distress among older adults will return to pre-pandemic levels remains to be seen.

Psychological distress was more common among older adults who reported lower incomes, females, those who reported their race as American Indian or Alaska Native, and those who speak a language other than English at home.

Accelerated Action:

If California maintains current trends, the expectation would be for about 32 percent of older adults to experience moderate or greater psychological distress in 2030. Taking accelerated action to reduce this trend would realize a goal of 25 percent, reversing this concerning trend and decreasing the number of older adults with psychological distress by about 660,000.

Functional health reflects whether older adults are able to engage in a range of daily activities. This can include social activities outside the home, errands, and making plans and decisions. It also can include personal care activities, such as bathing, dressing, and getting around one’s home.

Ageism in our media, cultures, and care systems can contribute to the notion that functional decline and loss of independence and dignity are an inherent or inevitable part of aging. However, many factors can shape older adults’ functional health. More responsive health and social care systems can help prevent, detect, and address avoidable declines in functional health and help to preserve older adults’ independence.

Between 2019 and 2020 the percentage of older adults in California who needed help with routine activities or personal care remained relatively constant.* Functional limitations were more common among older adults who identify as American Indian or Alaska Native, as multiple racial identities, as African American, or as female, and who experience greater poverty.

Accelerated Action:

If California maintains current trends, the expectation would be for about 14 percent of older adults to experience functional limitations in 2030. Taking action to reduce this trend by 20 percent would realize a goal of 11 percent. Improvements to the systems providing health care and social services for older adults, and working to address disparities, can reduce the proportion of adults affected by these limitations and their impacts on independence.

* Note: This question is being fielded again in the 2023 UCLA Long-Term Services and Supports Survey, and the data shown here will be updated when available.