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Fiscal Notes


Fiscal Notes

A Review of the Texas Economy from the Comptroller of Public Accounts

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An Interview with Michael Wilson, Ph.D.


Projected percentage growth in tx population by age group. 2010-2050. Age 0-4, 43.11%, Age 5-17 41.56%, Age 18-44 48.96%, Age 45-64, 54.61%, Age 65 plus, 202.39%. Source: Texas office of the State Demographer

"We need to take a multi-pronged approach in making aging and elders a visible community priority."

Program officer for healthy aging, St. David's Foundation

Texas is once again in the midst of a boom, but this one poses different challenges than the frenzy in our oil and gas markets.

Between 2010 and 2050, the state demographer says seniors — those aged 65 and older — will be the fastest-growing Texas age group, tripling in size from 2.6 million in 2010 to over 7.8 million in 2050.

Texas cities and counties already feel the effects of this growth, which has stretched resources for seniors and caregivers, but some communities have begun laying the groundwork to better accommodate their senior residents.

And that's a wise course of action: a 2010 AARP survey indicated that nearly 90 percent of persons aged 65 and above want to age in place, staying home as long as possible.

Austin, home to the nation's second-fastest growing senior population according to a 2011 Brookings Institution report, responded to demographic realities by creating the Mayor's Task Force on Aging. The task force has made a number of recommendations to city leadership, looking to "focus resources on prudent investments that result in social and economic benefits" for seniors in Austin.

 "We need to take a multi-pronged approach in making aging and elders a visible community priority," says Michael Wilson, Ph.D., a member of the task force and program officer for healthy aging at St. David's Foundation.

Join Fiscal Notes and Wilson as we discuss aging and caregiving, and how Texas communities can best respond to the challenges of a growing senior population.

Fiscal Notes: Can you tell us a bit about your work on the Austin Mayor's Task Force on Aging?

Michael Wilson: About 14 months ago, the mayor's office in Austin created the task force, bringing together providers and concerned citizens. The task force is really trying to create a "best practice": bringing organizations together that support aging populations and providing the services they need.

We aim to create a network of providers and to help organize local nonprofits. What we see coming out of the task force is a better coordination of services and a better understanding of who is providing the different pieces of the caregiving puzzle and the senior-support puzzle.

FN: What are the key areas any city government must address regarding caregiving and aging communities?

Wilson: There's a caregiving component. Most communities need programs somewhat like we have here in Austin: our Caregivers' University. It's a collaboration of 18-plus entities that have come together to deliver some specific kinds of programs — for example, fall prevention programs and tools for caregivers. This is a resource and education place for people who have questions.

Then governments will want to take a look at the senior nutrition component, like a Meals on Wheels program or something similar. Most communities already have a Meals on Wheels program or are located within a Meals on Wheels service delivery area.

And a medical/healthcare component must be addressed. We must make sure seniors have access to healthcare, maintenance and support to ensure they are getting their medications, managing their chronic disease and fulfilling all of what we generally think of as needs for older adults.

The last major area to address is housing and supportive services. Seniors need a place where they can live that is either geared to meet their changing needs or can be adapted to meet their changing needs. For example, as people age, it's always better to get them out of multi-story residences and into single-story buildings. You don't want seniors climbing stairs, and you want their residences to have home modifications: grab bars, good lighting, etc.


According to the Brookings Institution, some of the nation's fastest-growing older populations live in Texas metro areas.

shows maps of cities with fastest-growing older populations


1.Raleigh-Cary, North Carolina60%
2.Austin-Round Rock, Texas53%
3. Las Vegas-Paradise, Nevada50%
4.Boise City-Nampa, Idaho46%
5.Atlanta-Sandy Springs-Marietta, Georgia44%
6.Provo-Orem, Utah42%
7.Colorado Springs, Colorado40%
8.Houston-Sugar Land-Baytown, Texas39%
9.Dallas-Fort Worth-Arlington, Texas38%
10. Charlotte-Gastonia-Concord, North Carolina-South Carolina36%


 1.Austin-Round Rock, Texas110%
   		2.Raleigh-Cary, North Carolina97%
        3.Boise City-Nampa, Idaho92%
        4.Colorado Springs, Colorado81%
        5.Provo-Orem, Utah80%
        6.Madison, Wisconsin79%
	    7.Albuquerque, New Mexico77
        8.Riverside-San Bernadino-Ontario, California77%
	    9.Houston-Sugar Land-Baytown, Texas77%
        10.Portlant, Vancouver-Beverton, Oregon-Washington77%

SOURCE: Brookings Institution analysis of 2000 and 2010 U.S. Census data


house graphic

A 2010 AARP survey indicated that nearly 90 percent of persons aged 65 and above
want to age in place, staying home as long as possible.

FN: Beyond those key areas, what should cities focus on next?

Wilson: The next most significant area is transportation. As people age, they become more and more dependent upon outside transportation: somebody else, or some form of public transportation, because seniors [eventually] can no longer drive. That's something that most larger communities are focused upon developing.

In Austin, we have a poor public transportation network. So we begin looking at organizations such as the Faith in Action Caregivers or Drive a Senior, where volunteers give rides to older adults who can no longer drive themselves to doctor's appointments, grocery stores and other activities of daily living.

Yet with all the resources communities like Austin, Dallas or Houston have, think about rural communities like Bastrop, Luling or smaller places, where it is very difficult for seniors to access transportation resources.

FN: How does a social network come into play for seniors?

Wilson: In many cases, we know seniors don't live in close proximity to one another, to friends and neighbors or to family, so they deal with issues related to isolation. They may not talk to anyone face to face [more than] once a week. They may not have anyone checking on them.

A key component of well-being and aging in place is a social support network. How many people are you coming in contact with on a daily basis? How many people are you talking with, checking in with and engaging in a meaningful way?

This becomes a critical component to identify life satisfaction, and for analyzing for the risk of depression and other behavioral health issues.

FN: If you could give a key piece of advice to any mayor in Texas, what would be the first issue to address?

Wilson: Make aging a priority issue, a public issue.

We talk about children and the needs of children a lot. People readily identify with – and understand – the needs of kids. I think it's much more complicated for some to identify the needs of aging residents in a community. We have to ask some key questions:

One service Caregiver's University in Austin provides is ensuring that seniors take their medications.

  • Are we going to train police and other first responders to understand how to effectively communicate with and assess older adults in our community?
  • Are we going to encourage the churches to rally around causes like volunteer transportation or volunteer check-in, friendly neighbor programs?
  • Are we going to encourage local healthcare providers to screen for depression every time they treat an older adult?
  • Are we going to encourage pharmacies to engage with their clients to assess their medications and look for dangerous drug interactions?
  • Are we going to encourage our local emergency rooms to talk about fall prevention, and how to reduce the risk of accidents at home?
  • Are we going to encourage physical fitness across the total continuum of the life cycle?


For more information on demographic trends in Texas, visit the Office of the State Demographer

FN: Is there a Texas city in particular that has impressed you with its handling of aging/caregiving issues?

Wilson: Some of the most important resources in the state are the Area Agencies on Aging. Across Texas, some of them have done a fantastic job in supporting caregivers and older adults with a variety of programs. These programs include medication management, fall prevention, home safety evaluation and many others.

In San Antonio, the Bexar County Area Agency on Aging has been a phenomenal leader in this kind of work. The leadership there has brought nationally recognized, beneficial programs to the community. They have supported adult day programming. They have talked about falls and chronic disease management. These sorts of programs lay a great foundation for aging well in the San Antonio area.

Published April 28, 2014

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