Rurals of Nevada - The Aging Rurals, Part 3 (art. 06)

"Nevada has been and will continue to experience an aging tsunami." - Center for Healthy Aging, "Elders Count Nevada 2021", 28 January 2021

Waiting patiently for the aging tsunami. Photo courtesy pxfuel.

In discussing the myth of the aging rurals, the emphasis to date has been to show the young and working-age populations. But there is the “graying” side of the aging myth—that the population which remains is older in itself—which needs to be added to this analysis. So let’s get started.

The fact that the United States (and, indeed, many Western countries) is aging is not new, and the need to support a rapidly graying “baby boomer” cohort threatens to place severe strains on the healthcare and social support systems. The most recent Elder Count Nevada 2021 Report put out by the Center for Healthy Aging and the Nevada Aging and Disability Services Division paints Nevada as worse off than most, aging faster than the rest of the nation. The “aging tsunami” that this report sees hitting the state through the next decade is worrisome.

Discussion of aging populations is one area where the distinctiveness of rural communities has received targeted attention. Central to this attention is the fact that while rurals have a smaller number of elderly citizens, those citizens are likely to form a higher percentage of the overall population. Questions of available capacity of healthcare and housing, distance from care, and the unique demographic circumstances of Nevada’s elderly (for instance, more likely to be living alone) are clear factors that seriously impact the most basic civic infrastructure policies for aging communities.

With that in mind, let’s look at the “graying” end of Nevada’s “aging rurals.”

Note up front: no “greys” (note the spelling) from Area 51 were harmed or even included in this analysis.

Shiny New Data! The 2021 American Community Survey

Last Thursday, December 8th, the Census Bureau released the latest 5-Year Estimate data from the American Community Survey (ACS) program. Covering the years 2017 through 2021, this dataset is the most recent set of data available on ages in the United States. I want to do a deeper look at this particular dataset in the future, but for now, I thought I would go ahead and incorporate it into this discussion.

Unfortunately, some issues need highlighting. First, the 2020 Census data is still not fully available, so the 2021 ACS had to make some minor adjustments to provide a consistent data series (you can read the Census Bureau comments here, pages 5-6 of the transcript). Second, there continue to be some issues with smaller-population counties due to the sampling size issues inherent to the process. In short, lower-household-density counties see more data variability.

The 2021 American Community Survey data tracks closely with previous datasets and the same patterns are continuing for the Three Rurals of Nevada.

The end result is a few striking issues with the data. For instance, the 2021 ACS continues to show Esmeralda County with a rather significantly higher population than the 2020 Census (more than 20%), which follows the pre-2020 Census ACS trends. This oddity just has to be worked around. Also, both Mineral and Pershing Counties showed sharp declines in median age from the 2020 to the 2021 ACS datasets. For both, my inclination is this reflects a sampling size issue, although Pershing is actively seeing new families move into the area which might account for some of the “younging.”

In the end, however, the 2021 ACS data is tracking close enough to what we have been discussing and the patterns of the earlier 2020 ACS and 2020 Census datasets are continuing. I am confident enough in the new data to incorporate into this analysis. As always, I will be sure to be clear about which dataset I am using.

The Core Age Measure: Population 65 Years Old and Older

The most basic aging measure is the population 65 years of age or over. This demarcation came from social service markers such as entry into full Social Security benefits and the retirement age. Of course, restaurant discounts and groups such as the AARP mark 55 or older as “senior citizens. And many policy groups are tracking this cohort along with the 65 and older. Since my purpose at the moment is with the current “gray” population of the rural counties, I am going to stay with the 65 and older group.

So, let’s look at the 2021 ACS data for this population group of 65 and older. The table below shows the 2021 ACS data for the United States, Nevada, the three urban counties (Clark, Washoe, and Carson City), as well as the 14 rural counties collectively. I have included both the 2020 and 2021 ACS median ages (note the general slight aging), the percentage of each region’s population 65 or older, and for the Nevada regions the percent of Nevada’s 65 and older population contained within that region. Also, note that again the 14 Rurals collective median ages are averages.

First, note that Nevada is again reasonably close to the national average for median age and percentage of the population 65 or over, as we noticed back in the first article looking at the Aging Rurals. The 2021 ACS shows a slightly older Nevada—except for the rurals, which is trending slightly younger. But none of these differences are significant enough to worry about for our purposes today.

What is significant is how closely the four major regions of Nevada mirror in population percentage over 65 to the median age distribution. Clark County has slightly less than the state/national average, Washoe slightly more, and Carson City and the 14 rural counties collectively the most. These two lines are in parallel, which we would generally expect if median age reflected a regular distribution pattern and the rurals are, indeed, aging and graying.

But note the last column: percentage of the Nevada population of the 65+ age group. This gets to the distribution question of vital concern to rural communities. Clark County has just over 68% of the total 65-and-over population—but remember it has about 73% of the state population and 75% of the Under-18 population. Again, a younger urban area. Both Washoe and Carson City have about 0.5 percent more of Nevada’s 65-and-older population than their share of the total population. So, large numbers of older people are going to require services but not in percentages enough to create significant concerns for gerontological services compared to a balanced healthcare system.

But look at the 14 rural counties. Collectively, they have just over 9% of the state’s total population but 13% of Nevada’s 65-and-older population. There is indeed an issue with the concentration of senior citizens in rural areas, even if the overall number is small. Yet, as you might guess, this aging population is not distributed evenly across the Three Rurals—as shown in the table below:

Both the Western Rural and Central Rural regions are graying, and rapidly. Both have significantly higher portions of their populations 65 and older. Indeed, the Central Rurals have over 27%! Moreover, they represent a major portion of the “rural Nevada” 65+ population—52,400 of the 62,600 elderly rural Nevadans, over 82%. These are truly the aging rurals. Combined with the dispersed population in the Central Rural region and the lack of healthcare infrastructure, the graying population is a serious issue.

Rural Nevada—the 14 non-urban counties—have a higher share of the 65 and older population (13%) than their share of the state population (9.5%). But the vast majority of this elderly population—82%—is concentrated in the Western and Central Rural regions.

The surprising find to me was the relatively low proportion of the population 65 or older in the I-80 Corridor counties. I was under the impression that this region’s youth was the result of large numbers of children and young families, and that the senior citizen population would look like the rural areas in the rest of the state. I was wrong. It is much lower. The I-80 Corridor region has a much smaller percentage of the state’s elderly population than it does of the state population as a whole. Certainly, caring for over 11,000 senior citizens scattered over an area roughly the size of the state of Ohio will be a daunting task. But compared to the other rural regions, the “aging tsunami” might be manageable here.

Where Do the Rural Elderly Populations Come From?

The question above might seem odd. Aging is inevitable, right? And certainly, an aging rural population is closely associated with the “hollowing-out” model: rural children grow up, leave for jobs, and their parents are left in place to age. But what if that hides the fact that while aging is inevitable, where to age is a choice?

Remember the 65-74 age bracket is the wealthiest age group in the U.S., with a median net worth in 2019 of about $266,400 (see this Business Insider article for a good summary). The two age brackets on either side—particularly the 55-64 age group who are now entering retirement—are also much wealthier on average. Granted, there are sharp discrepancies in wealth between urban and rural senior citizens (real estate prices are the key difference). But perhaps more than any other age group on average, those at 65 or older have a greater choice of where to live. And, indeed, they are choosing to do so—if the frequent stories in both traditional and social media about the best states for retirement are any measure.

So does the aging rural population in Nevada reflect abandoned rural areas or an influx of retirees? The answer is both. The Elder Count Nevada report notes that southern Nevada remains by far the major migration destination for new Nevadans 55 years old or older (see chart on page 15 in particular). This population group is going to be one of the major contributors to the aging tsunami.

Further confirmation comes from national sources. John Cromartie of the USDA’s Economic Research Service looked at this question back in June 2021. His question of “why are rurals aging” is based on dividing counties based on whether they were recreation economies that encouraged voluntary retirement (“scenic”) or true aging rurals suffering from persistent population loss (or other, which fit no county in Nevada). The map he produced is fascinating and on its surface backs up the generalized “aging rurals” idea, particularly for the Midwest. And note he is looking specifically at the 65 and older cohort.

But Nevada—remember, one of the five fastest-growing states since 2010—looks a little different. Below is a map of Nevada counties, showing those counties where more than 20% of the population was 65 and older and where they fit in the scenic/population loss county model, based on Cromartie’s metrics (his national map being really difficult to zoom in on). Please note for this analysis Storey County is not included as “rural,” although given its proximity to Reno it likely represents more of a “scenic” (that is, voluntary) retirement destination.

The first point is, again, how young the northern Nevada rural counties are. In addition to the I-80 Corridor counties (Elko, Eureka, Humboldt, Lander, and Pershing), Churchill and White Pine Counties have less than 20% of their population 65 or older. Most of the rural 65+ population is located in the Central and Western Rural regions. But per Cromartie’s argument, only Mineral and Esmeralda Counties are aging as a result of a declining population. This matches the data we have already seen which shows a much smaller portion of their population under 18 as well. The other counties are “scenic” destinations where some of the aging population is coming in voluntarily.

The question of “scenic” retirement destinations might strike some people as odd. Douglas County, nestled at the base of the Sierra Nevada, makes sense, as does perhaps the fertile Mason Valley around Yerington. They are no less “retirement-friendly” for certain groups than the golf course communities of Clark County such as Mesquite or Laughlin. But are places like Tonopah, Pioche, and Fernley really retirement destinations? Not likely. But places like Pahrump (“scenic” might be a stretch here) in Nye and Caliente or the Pahranagat Valley in Lincoln are popular retirement options for those seeking to escape urban Las Vegas.

The “voluntary graying” of some Central and Western Rural counties from migrating senior citizens could result in different elderly communities decidedly less “rural” in everything but their current county of residence.

And this means the current 65-and-older populations as well as the 55-64 population who will be joining them over the next decade in these counties might be more heavily concentrated than elsewhere—and decidedly less “rural” in everything but their current county of residence.

This “voluntary” graying, if I can use the term, represents a real wildcard in policy formulation. Not only does it present a looming cohort that over the next decade could overwhelm some social programs already lagging, but the relative wealth and pre-retirement experiences elsewhere could also significantly alter expectations for elder care policies. Policymakers increasingly are going to have to examine more than just age and current location for elder care policies.

The Graying Rurals: Fact or Fiction?

In discussing the “aging rurals,” it is useful to separate the “graying” part of the population from the rest. The aging of the rurals is neither inevitable, due only to the lack of children, nor hitting all the rurals the same way. As always, differences matter.

The Central Rural region comes closest to the stereotypical “graying rurals” and presents the starkest policy dilemmas for senior care going forward. Particularly for Esmeralda, Mineral, and Lincoln Counties, the possibility of improvement of services—and staffing those services—will depend on extensive outside aid. There is simply not a younger population to assist. Central and Northern Nye County is in a similar situation. Pahrump’s status as an exurb of Las Vegas and the location of the largest percentage of the county’s population (young and old) marks a rather different dynamic at work, however. Nor should White Pine’s relative youth indicate that policy will be easier. Its general isolation and incredibly close dependence on mining create unique issues there as well which are closer to the other Central Rural counties than its age profile indicates.

For the counties in the Western Rural region, the “graying” is rather more voluntary. The increase in migration of the younger cohort of senior citizens to these counties combined with the resident elderly population is contributing to the aging tsunami here. But these counties are also more densely populated, have some younger populations (Fernley and Churchill County) for support, and have greater access capability to the Reno-Sparks service complex. Moreover, the relative wealth of the incoming cohort may provide a cushion that the more rural areas might not simply have. The aging tsunami is going to look different here, even if it hits strongly.

The I-80 Corridor counties, however, remain a major outlier. The relatively low median age in these counties is not just a function of large numbers of children under 18 and young adults, but also a relatively small number of senior citizens. This fact argues strongly against the “hollowing out” myth taking place in these counties: that children move out when they grow up, leaving their aging parents to work elsewhere. In the I-80 Corridor, families and working-age adults are common—but fewer stay or retire here. Must be the pogonip.

Pogonip in Spring Creek, Nevada. Photo from icon.wunderground via Pinterest.

So, now that we have looked at three sets of aging data, the last article in the series will try to bring these strands together and look at a couple of policy issues where the “aging rurals” myth is problematic.

In the meantime, please feel free to leave any comments or drop me a question. And do feel free to pass this on to anyone interested.