Why Nurses Need More Authority

Here’s one of my first outings as part of the Network on an Aging Society. Jack Rowe and I wrote this piece for the Atlantic’s “America the Fixable” site on one way to lower health care costs–give well-trained nurses more authority, especially in rural areas that suffer from doctor shortages.

But alas, even this straightforward, seemingly practical option garners outrage. It’s a tight race, but I think “bewareoffalsegods” in the comments wins for sheer and utter stupidity. If the comments are any indication, there’s quite a contingent that needs to go back to fourth grade and bone up on reading comprehension.

Parents Are Spending $7500 Annually on 20-Something Children

At dinner with friends the other night, Sarah, a mother of two young adults, said something that struck me. We’ve all heard how hard young adults have it during this recession. Latest estimates are that more than 50% of recent graduates are either unemployed or underemployed (working at a job they’re overqualifid for). But as Sarah said, it might just be the parents who are getting the rawest deal.

“We expected to be supporting our kids for only so long,” she said. “We’re the ones who are squeezed. We hadn’t planned on this part.” Indeed. Rising health care costs (and now young adults can stay on the family plan until age 26, adding to the fee), decimated 401ks, aging parents, and falling housing values are all added on to a new cost: supporting their young 20-somethings.

Indeed, a new study by the University of Michigan for the MacArthur Network on Transitions to Adulthood (whose research I based my book on), finds that 60% of young adults age 19-22 received money from their parents in the past year, and the amounts were not unsubstantial: on average, $7,500. And that was before the recession. It is sure to have risen.

Familial Financial Assistance to Young Adults, [pdf] by Patrick Wightman and Robert Schoeni of the University of Michigan’s National Poverty Center, and Keith Robinson of the University of Texas at Austin, uses data from 2,098 interviews conducted between 2005 and 2009, with young men and women and their families to examine how much parents are giving and for what.

“Young people in the U.S. are taking longer to leave home, finish their schooling, get stable jobs, get married, and have children,” says Wightman. “And the slow transition to traditional adult roles has been accompanied by an increase in the financial support young adults receive from their parents.”

Interestingly, the researchers found that a child’s demeanor early on predicts how much financial help they will receive later. So any 12-year-olds reading this: shape up and play nice.

“Basically,” says Wightman in a press release, “this finding shows that parents are more inclined to provide extra support to children whom they perceive as more positive and outgoing. They’re more likely to help those who, even at a young age, help themselves.”

About 65 percent of the young adults lived at home for a significant portion of every year, and the analysis did not include the value of room, board or food. However it did include money for housing away from home, a vehicle, college tuition, help paying pills or just as a gift or personal loan.

Among the key findings:

  • About 42 percent of respondents reported their parents helped them pay bills, with those receiving help getting an average of $1,741;
  • Nearly 35 percent of young adults said their parents helped with college tuition, with those receiving help given an average of $10,147;
  • About 23 percent received help with vehicles (about $9,682 on average);
  • About 22 percent received help with their rent away from home ($3,937 on average);
  • About 11 percent said they received loans from their parents ($2,079 on average) and nearly 7 percent said they received financial gifts (average amount of $8,220).

“As expected, we found a large difference between high- and low-income families both in terms of whether or not they provided financial help to young adult children, and in terms of the amount they provided,” says Wightman.

About 80 percent of high-income parents provided help to young adult children, Wightman found, compared with slightly less than half of low-income parents.

“The gap is especially large for education related assistance,” he reports, which is pause for concern, given the widening income disparity in the US between those with and without college degrees. “While just 11 percent of low-income youth received tuition assistance from their parents, 66 percent of high-income youth did. And among those who did get help, kids from high-income families received an average of $12,877, compared to $5,788 for those from low-income families.”

Still, he reports, poorer families who did help their young adult children provided as great a share of their income overall as wealthier families did – about 10 percent.

Ten percent of household income is the unexpected outlay that my friend Sarah was talking about. When Boomers like Sarah were starting out in life, they felt they had a clear idea of how life would unfold, and part of that was that they would financially support their children until they were 18 and then their kids would be off on their own. They also thought they’d have a pension to fall back on, and health care costs were the last thing on their minds. But in their lifetime, everything has changed. The pensions are gone along with job security. Health care costs have risen astronomically. And now, their children are remaining at home longer as the paths into adulthood stretch out longer. It’s enough to cause anyone gray hair.

What are your thoughts? Should parents continue to support their kids? How much do you spend on your young adult kids? Are you sacrificing your retirement income to offer this support? Is there a benefit to all this?

“Older workers tire more easily” and other myths an Atlantic Magazine article promotes

Over lunch, I usually like to read “pleasant” stuff. All day I read reports on poverty or failing education policy, or how on earth we’re going to feed 9 billion people (a new topic!). So at lunch, on my break, I like to dabble in Vanity Fair or the New Yorker’s cartoons. But today I decided to read the Atlantic. Mistake.

As I mentioned a few weeks back, I’m doing a lot of work with the MacArthur Foundation’s Network on Aging in Society–a decidedly impressive group of doctors, economists, and other scientists— so a headline in the Atlantic caught my eye. “Europe’s Real Crisis: The Continents problems are as much demographic as financial,” by Megan McArdle. (Yes, I’m a nerd).

I figured I’d dip in and see if there was anything I could learn about the aging population in Europe that might apply to the Aging Network. It started out well enough, but about halfway through, I started to detect the “Kony” effect: simplifying something to grab eyeballs only. Granted, this topic of aging and its effects on the economy is not exactly an attention grabber, so you need to make it palatable. But, as much as I respect journalists, this one got to me.

A couple of flags went up in reading McArdle’s two-paragraph trot through 200 years of demographic shifts, but I’ll give her that. It’s kinda dull after all. But then she started in on the “Morningburg/Twilight City” analogy and it was downhill from there.

She uses these analogies to illustrate how good it is to have a majority of young workers and how perilous for an economy it is to have a majority of old people–those old-heads who cling to jobs and prevent young people from advancing, who are risk-averse and hate change, who aren’t as productive on the job, and who start up businesses that will never expand beyond their hobby clientele.

In Twilight City, time horizons are shorter—people aren’t looking for projects that will make them rich or famous 20 years from now. They are interested in conserving what they have. That’s mostly rational, given Twilighters’ life stage; but studies show that older people worry more than younger ones about losses and are therefore especially averse to risk. Twilighters also tire more easily and need more time off for illness, so hours worked slowly decline each year. Wages stay steady, however; Twilighters, like most people, get very angry if you try to cut their salary.

That makes Twilighters expensive—so when they lose a job, finding another is tough.  As a result, Twilighters tend to cling fiercely to their positions, and may block younger workers from getting a foothold in the labor market.

The difficulty of reemployment contributes to Twilight City’s surprisingly high, but somewhat deceptive, rate of entrepreneurship. Looking closely, we find that businesses there are disproportionately owned by semi-retirees who have hung out a consulting shingle, or become part-time caterers, or invested in a hobby business like an antique store. These businesses typically don’t have much growth potential, in part because cautious Twilighters won’t (or can’t) borrow money for expansion.

There are so many wrong presumptions there I don’t know where to start. But here’s a few, with what I’ve learned from the Network:

  • Older workers need more time off for illness: I’m not sure what her sources are, but disability rates have been rising for young workers and falling for older workers. Granted, disability is a little different from “time off for illness” but the overall trend here is one of healthier 50+ workers and unhealthier younger workers.  The sharpest aggregate growth in disability rates—50%— occurred among those aged 30-39 between 1984 and 1996 (they’d be age 46-55 today).
  • Older workers block younger workers from getting a foothold in the labor market. That is just patently untrue. The “lump of labor” theory just doesn’t hold up. The economy expands with new businesses and new job opportunities. It’s not a finite thing. There aren’t only x number of jobs in the economy to hoard.
  • Twilighters tire more easily. Ok, maybe if we were all doing manual labor on the farm, but come on. Tire more easily?

This pitting of older and younger workers is dangerous. It foments intergenerational battles that don’t need to happen. In fact, older workers complement younger workers in many ways. Younger workers may take more risks and try new things, but innovation is not necessarily a purview of the young only. And — the experience and emotional steadiness that comes with age are a nice counterpoint to more youthful rashness.

Granted, having a graying society is not ideal, but to portray it in these simplistic either/or ways is disingenuous at best and at worst prevents any serious discussion of how to change our social institutions to adapt to this inevitability.

That’s what David Canning more or less tells McArdle later in the article:

“Aging is a good thing,” Canning says. “It means health improvements and longer lives. We only think it’s a bad thing because we’re trying to hang on to these institutions. We should be welcoming these changes, but changing our institutions to match.”

Sadly, he gets no more time than that. The Network on Aging in Society is grappling those very issues– how do we recast work, for example, to increase productivity? How do we rethink our institutions of learning so they can better accommodate the need for life-long learning? How should we rethink Medicare and Social Security to encourage longer careers?  How can we tap the potential of elderly volunteers in more effective ways?

Stay tuned: I’ll be writing about them more as I dig in and learn  more.

Intergenerational living–the new normal?

It’s starting to get hard to keep up with the new wave of stories about young adults moving back home. This round, though, I’m happy to report the articles are becoming a little more positive and less snarky and judgmental. The turn of tune is testament to the growing ‘normalacy’ of intergenerational living.

The latest Pew Research survey released today reports the highest share (21.5%) of young adults living in multigenerational households since the 1950s. The survey finds that finds not only are increasing numbers living at home longer, but the fact that young adults and parents are pretty much ok with it. As the Pew study writes:

If there’s supposed to be a stigma attached to living with mom and dad through one’s late twenties or early thirties, today’s “boomerang generation” didn’t get that memo.

It’s also become, with time, a more equal co-residence. About half of those surveyed said they paid rent to their parents, and more than 90% said helped with household expenses. I’ve been saying this for about a year now–that eventually we will get so used to this pattern that the stigma will fade and it will all become just, well, normal. In Europe, which is ahead of us in living home longer and intergenerationally, it started out as a worry as well. But with time and familiarity, it became the stuff of the Gallic shrug.

In fact, Kathy Newman’s new book, Accordian Families, looks at intergenerational living broadly, comparing trends in the United States with those in Europe and elsewhere.

Christian Science Monitor article –which features yours truly– also has a more positive spin on the trend. It conveys a sense that maybe this trend is shaking out in positive ways. And looking longer-term, the rising numbers living  at home for longer could create positive sense of mutual obligation down the road, when mom and dad are in need of some support themselves as they age.

However, not all is sunny. As a recent New York Times article noted, this generation is the least mobile in decades. In “The Go-Nowhere Generation,” Todd Buchholz and Victoria Buchholz lament the loss of the quintessentially American urge to hit the road. While generations of youth have packed up and moved almost as a rite of passage, this generation is staying put. As they write:

The likelihood of 20-somethings moving to another state has dropped well over 40 percent since the 1980s, according to calculations based on Census Bureau data. The stuck-at-home mentality hits college-educated Americans as well as those without high school degrees.

They report that it’s not economics that is keeping young people tethered to their home towns, but an urge to stay more connected to where they grew up. Even if the jobs are elsewhere, they’re not keen on making the leap, they write. Could this be another sign that we’re in a new era of Americanism–one that is more rooted to place (ala Europe) and more intricately tied to extended family? If so, that can only be good for an aging society such as ours. Kids can take care of their parents, and parents can take care of their grandkids in a seamless swap of support.

More generally, this risk aversion might not be so surprising. The Great Depression cemented a long-lasting fear of risk and spending. My mother is a prime example. She has an entire cupboard of CoolWhip containers for tupperware and she buys the cheapest toilet paper on earth.  She’s not alone. A recent study finds that those who come of age in times of uncertainty are for decades later significantly more hesitant and timid in their financial matters (and other realms of life) than those who are coming into their own during flush times. An article in the Daily Beast expands on this point.

And finally, another new book adds a twist to the trends. Rather than worrying over the numbers living at home, Eric Klinenberg in “Going Solo: The Extraordinary Rise and Surprising Appeal of Living Alone,” regales readers with the benefits of single life. He’s on to something. While the numbers living at home have risen, the numbers and time spent living alone are much more pronounced. According to him, more than 50%  of American adults are single — a number that has jumped from 22%  in 1950. While he also touches on the darker side of solo lives (dying alone, social isolation), his is an upbeat assessment of this dramatic shift. It’s worth a read. Both Klinenberg and Edin’s books are reviewed here.

Rethinking old age

What do you think of when you hear this statement: America is a graying population?

I think, uh-oh. An older population means lower birth rates, higher medical costs, young paying for the old and then not getting their fair share, grouchier people.

That’s the “frame” most of us immediately work from. (And if you don’t think our brains are programmed to work on fast categorizations, read Daniel Kahneman’s Thinking, Fast and Slow. It’s fascinating).

But it’s the wrong frame.

I recently spent a few days in lovely Vancouver with the Network on an Aging Society, which I’ve joined as their communications person. While I’m not abandoning 20-somethings directly, I think I’ve said about all I can on the topic–at least in a fresh way. Instead, I’ll be folding their story into the story of the elderly in society because the two are integrally linked.

So what is this different framework we should be using in thinking about an aging society? Well, it begins from a point of strength. Sure, the elderly face declining health, declining productivity on the job, and sometimes greater dependence, but those things are minor compared with the positives we can tap. And tap them we must.

As one of the Network members put it, we have a scotoma when it comes to aging.  A scotoma is a small stroke in the eye that makes us blind to certain things yet we’re not aware were missing it. In this case, we’re blind to the positives that an aging society can create– but only if we fundamentally change how we do things.

To tap into the potential of an aging society, we have some serious work to do in both changing the conversation we have about the topic and changing the way we now compartmentalize the life course. If you think about it, our lives are divided into three spheres, broadly: education, work, retirement. We pack all the education in the front end, to be completed by about 25. Then we spend the next big chunk of life working, and the rhythms of the work day shape our lives in big and small ways. Finally, we quit working and rest and play–in often a role-less role.

What if, instead, we rethought those big blocks? What if we spread learning throughout life? What if we staggered work differently? What if we redesigned retirement? Rather than rigid boundaries, what if the learning-work-retirement parsing was more fluid.  So instead of retiring at age 60 or 65, what if we allowed a worker to just change jobs, even within the same company? They could scale back to a part-time position or take a job with less stress and more flexibility, but they’d stay working until, say, 75.

Changing tasks on the job regularly has been linked with a cognitive boost, so changing to a different job, something that interests you or something that is simply different, could help stem cognitive decline slightly, and make employers fret less about lost productivity among older workers.

Young adults often feel like the elderly should move on and make room for them in the workforce, claiming that the elderly are taking their jobs. But that’s a fallacy. The workforce is not a lump of labor vying for a fixed number of jobs. There’s simply no hard evidence that older workers displace younger workers on the job escalator. As Bloomberg Business recently put it:

The idea that older workers displace younger ones assumes that there’s a fixed amount of work to be done. That’s known as the lump-of-labor fallacy—and it’s at play in the anti-immigration camp as well. By and large, economies don’t work that way. Workers earn incomes and spend the money and the recipients of the money hire more people and off we go. Growth.

They’re basing their assessment on the result of a paper by economists Jonathan Gruber and Kevin Milligan.

Or in another re-imagining of how things work, what if we shifted learning from only at the front end and made it truly a life-long opportunity. The nature of our workforce today requires that we have regular tune-ups of what we thought we knew. In many respects, we have to continually reinvent our jobs if we want to stay employed and viable. But maybe there’s a better way to integrate learning and education throughout the life course, and sync it up with work and other demands more seamlessly.

There’s much to think about, and much to do in a very quick time frame. We’ve been coasting along on policies and institutional ways of doing things that are backward-looking, not forward-looking. If you imagine the country in 2035, it’s going to look amazingly different than it does today. The path into adulthood will likely remain slow and circuitous as more young people delay marriage, build and rebuild careers, and explore their options. As a result, there will be a slower accumulation of assets and financial stability. There will be more single people. There may be more intergenerational living. And there will be more elderly people –especially if scientific breakthroughs slow the aging process (and you know they’re trying: think of the profits potential!). A few hitches might alter that scenario: namely, the high rates of obesity. But nonetheless, society will look and function differently than it does today. It’s time to rethink the game plan.

Obama to support community colleges as a path to middle-class jobs

Now here’s a sign of progress. As the Center on American Progress reported:

President Barack Obama today [Feb 13] announced a new initiative to boost our nation’s community colleges and help workers attain the skills they need to earn middle-class jobs. President Obama’s Community College to Career Fund would invest $8 billion over the next three years to boost partnerships between community colleges and regional employers. This initiative, jointly administered by the Departments of Education and Labor, aims to train 2 million workers for careers in high-growth industries such as health care and advanced manufacturing.

Loyal readers, you know how I feel about community colleges and a quick path to advanced manufacturing. Win-win. And if employers get on board and help schools tailor their training to fit the local demands, it’s even better. (And “local demands” is important in this equation as young people are often looking for work near home, and employers are looking for local talent).

These advanced manufacturing jobs are high-paying with solid career ladders. I’ve been spending some time out at Austin Polytech, here in Chicago, a high school that is working very hard to train the next generation of manufacturing employees. The school, which serves a largely African American student body, has designed a career track for students that leads directly to advanced manufacturing jobs. The people behind the program are leaders in the city’s manufacturing community, and kids leave high school with a nationally recognized manufacturing credential–if all goes well. They also leave with pre-calculus classes and other advanced math because today’s factory worker isn’t stuffing sausages anymore. He or she is running machines that need computer programming to shave off a piece of metal to an nth degree.

And these jobs pay well. Starting salary for a young person out of high school is in the high $30s (without a college degree mind you), and the career path can take one to earnings of $80,000. Not bad for a day’s work.

The thing I like about the Polytech program is that it works with employers directly to place students in summer jobs first and later full-time jobs. And it urges employers to assign the young person a mentor to make sure both the employer and the employee are having a good experience. And, they also ask that the employers pay for continued training–which many employers willingly do. As one human resources director said of manufacturing jobs today, employees in their company are never done learning; constant training is a part of the job.

I tagged along with a student who was doing a mock interview with one of the employer partners, Arrow Gear, in Downers Grove. In this case, the young woman said upfront that she was going to college for engineering. For her, that’s probably a great decision. She loves math and she’s a sharp kid. But as I sat there, with 30 years of hindsight, I couldn’t help think, are you kidding me? Why not work a couple of years at $40,000 and then go to college? You’d have the money to pay for it instead of taking out loans, and you’d also have something truly valuable to bring an engineering degree: real experience in building things.

I know, I know, college is a great idea too. It truly is. But maybe because I came from a family that saw no shame in a hard day’s work, I don’t see a job in manufacturing as a “second place” prize. I see it as an interesting job that pays well and has a lot of learning potential.

Hopefully, the new funding for community colleges that Obama is promoting will help sharpen the classes that colleges offer, and make them more relevant and viable. If actual employers get involved and help shape the curriculum, that will certainly help. Right now, too many students get lost in a meandering stream of classes with a vague idea of “getting a degree.” Perhaps with a more direct, and clear, path from school to work, whether it be in manufacturing or health care (another booming field), more kids will see the wisdom of spending tuition money on something that will get them a foothold on a middle-class life. And perhaps as more kids meet with success, the second-class status that these routes now have will vanish.

Past tense

I have to get used to talking about my dad in the past tense. It’s strange, this sudden shift of tense, this abrupt reworking of reality, of presence then absence. He died last week, at age 95, and amid the swirl of the funeral and decisions about life insurance policies and Social Security, the sense of loss didn’t settle in—until  yesterday, when I corrected myself, and said “Dad was…”

The death of a parent, as anyone will tell you, is never easy. It helps a little–but only a little– that my dad lived a long and good life. It also helps to feel the outpouring of support from family and friends, and the small-town rallying when a member of their community dies.

As many of you readers know, I grew up in a tiny town, population 1,000, rimmed by farmland, a mere interruption of sight lines, in northern Iowa. In a town that size, if you didn’t know someone personally, you at least knew of them. And so, as the doorbell set to ringing on Friday as the news of Dad’s death made its way along the gossip chain, faces I hadn’t seen in 20 years–a little more wrinkled perhaps but still identifiable–transported me back to an earlier time.

The bell would ring, and there they’d be, these memories of my childhood. I’d take the tupperware filled with snickerdoodles, warm chocolate chip cookies, or   the delicious Norweigian cracker/cookies (that I can never remember the name of) to the kitchen and pour a couple cups of coffee for the company. Black, no sugar, no cream. The now gray-haired couple of my youth, or in many cases, the remaining widow, would profess not to want to intrude, but with a little coaxing would take a seat on the couch “only for a minute.”

Mom would retell the story of dad’s last days, and everyone would express such surprise at his quick decline, while noting the blessing it was that he didn’t have to go to the nursing home. Inevitably, they’d tell a funny story about dad, and then, tapped out of thoughts about dad, would turn to me and ask, “And Barb, are you still in Chicago then?”

The rules of behavior are ingrained and well practiced in this aging community. The acceptable dishes to bring to the grieving family are set: sweets of any kind, coffee cakes or cinnamon buns breakfast, sloppy joes or hot dishes for lunch, and rolls–always rolls. You can never have enough rolls. The mode of delivery is the same: sweets are delivered in tupperware, the hot dishes in glass casseroles, the sloppy joes in one-gallon plastic ice cream buckets. Attached to each is a piece of masking tape with “Johnson” or “Sversen” printed in magic marker,  for easy return and thank-you cards.  If you can’t deliver the food yourself, you send your daughter.

My dad was a well-known guy. He owned a local business and had been one of the town’s leaders. He was also a very dear man. Not everyone I’m sure remembers him that way, but you’d never know it. He had outlived most of his close friends, and many others had fled the cold Iowa winter for warmer climes this particular February. But yet the doorbell kept ringing. My brother’s friends showed up. Two of my high school friends came by. My mom’s bridge partners stopped in. A few people from church, dad’s business friends, and people who lived down the street from us years ago stopped by.

Most touching, to me at least, the parents of the two brothers who lived across the street came to pay their respects, since their boys “were working the evening shift at GrainMillers or they’d have come themselves.”  Dad had always loved watching those two boys–young men really–come and go. A few years back, they’d bought the ranch-style home within viewing distance of my Dad’s lazy-boy, when they’d both taken a job at the mill and moved into town from nearby Stacyville. “Those two are hard-working boys,” he’d say with a nod of appreciation. At the first flake of snow, they’d be over shoveling mom and dad’s walk, unasked. And one night at 11pm they came running when my mother knocked because dad had fallen and she couldn’t lift him.

By Saturday afternoon, the food was piled in stacks on the counter tops. The two local restaurants were competing to send the best broasted chicken with all the trimmings, and we’d come home from making the funeral arrangements to find a plate of cheese and cold cuts arranged in the shape of a flower from the local grocery store. The rolls were going fast, and the doorbell did not stop ringing.

It’s that kind of connection, and goodness, that sustains us. It will be the support that keeps my mother from slipping into isolation and depression. It is the support that keeps people rooted to place. Small town life is not my own choice–the inward-looking tendency, its rigid rules and repressions leave me cold– but it is a tribe, my tribe, with its own sustaining culture.

My visits home now will be less frequent, my connection to place less firm. That’s ok. I’ve been slowly leaving for 30 years. But that place has left an indelible mark, a culture, that I’ll take with me.