The elderly population is large and growing. The phenomena of the graying of America also could be called the feminization of America; for as our population ages, it also will become more predominantly female. Today, there are 68 men for every 100 women over the age of 65. With age, the ratio of men to women decreases steadily. There are 83 men for every 100 women between the ages of 65 and 69, and only 40 men for every 100 women among those 85 and older. This trend is expected to grow into the next century. This disparity in numbers of men verses women results in significant numbers of older women living alone.

Of all the older persons living alone, more than 6.5 million--77%--are women. By the year 2020, this total will be 13.3 million and 85% of those will be women. The percentage of older women living alone exceeds that of men in each age group, but women become progressively more likely than men to live alone with age.

Widowhood is by far the most common situation for older women who live alone. Between the ages of 65 and 74, 77% of women living alone are widows, as are 88% of those over 75. Men who live alone are far more likely to be divorced or never to have married. This phenomenon occurs both because women tend to marry men older than themselves, and because women live longer than men.

INCOME -- Poverty affects women disproportionately throughout their lives, but particularly in their later years. Income is a particularly critical issue for older women who live alone. Forty-five percent of older women living alone are poor or near-poor. While some of these women are from low-income families, many face poverty for the first time, after divorce or death of a spouse.

Poverty plagues older women for several interrelated reasons. Women tend to have limited or intermittent stays in the paid work force, largely because our society leaves to women the care of the young, sick, and old family members. The work history patterns common among women make it difficult to accrue adequate private pensions, or to become eligible for pensions at all. A woman's Social Security retirement benefits reflect any reduction in hours or absences from the paid work force. Yet, one-third of older single women rely on Social Security benefits for at least 90% of their income with the average monthly benefit of $412.

Many widows rely on the Social Security spousal benefits. Yet there are many widows who forfeit their spousal Social Security benefits if they divorce after having been married for less than ten years. They also frequently lose their spouse's private pensions regardless of the length of marriage. Widows are likely to experience a sharp drop in income and benefits upon the death of their spouse. Once a man is out of her life a woman often finds herself in reduced financial circumstances. One study revealed that within three years, widows found their income reduced by 44%.

Poverty and living alone make all other elements of well-being more difficult to attain. Housing, food, clothing, medical care, health, and assistance with chores are all affected to a greater or lesser extent by the amount of income one has and by the availability of routine or emergency care from others or a family member.

The Supplemental Security Income (SSI) program is intended to provide an income safety net for older persons, but it falls short of this goal. The program provides a monthly benefit to low-income older persons but brings poor women to only 76% of the federal poverty level. Still, many elderly poor are ineligible for the program because their assets exceed the asset limit of $1,900 for individuals. Another problem is that a large group of older women do not receive benefits they are eligible for either because they do not know about them or how to get them, or because they are too proud to accept this assistance. Others, especially those for whom English is a second language, may not understand the complicated paperwork necessary to initiate payments. Thus, only half of elderly persons eligible for Supplemental Security Income actually receive benefits.

EMPLOYMENT -- is critical for many older women to avoid poverty. Yet when widowed or divorced women try to find jobs, if they have been a housewife for most of their adult life, they find that all there is available are poorly paid jobs such as salesperson, file clerk, or receptionist. Many women past 50 encounter the great prejudice that exists against hiring older women. Those older women who do find work are more likely to work in jobs that are less secure and lower paying than younger or male workers. For all workers, a woman makes 68 cents to a man's dollar, but a woman over 45 makes only 61 cents for every dollar a man her age makes, and a woman over 65 makes only 57 cents for his dollar.

HOUSING -- Adequate housing options are critical for the well-being of older women, but particularly so for those older women who live alone. While most older people own their own homes, older women are less likely to do so than are older men. Since the incomes of older women are smaller than those of older men, housing consumes a larger part of their income. Older women may be forced to choose between safe, adequate housing and other necessities. Public housing units are in short supply and frequently fail to meet even minimum standards of health and safety.

The high cost of housing is a particularly difficult burden for older women who live alone. Financial strains often mean that the woman has to sell her house and move to cheaper quarters.

HEALTH -- Older women have healthcare needs that are quite distinct from those of older men. The illnesses, appropriate treatment, avail-ability of unpaid caregivers, and financial resources of older women are very different from those of older men. Treatments, research, medical insurance, and government health programs fail to address the needs of older women because older men are treated as the norm for the elderly. In addition, although women of different ethnic and racial backgrounds have different health needs, the situation of white elderly is treated as the norm.

Older women are more likely to suffer from long-term, chronic illness and disabilities and are less likely to have acute illnesses than older men. The institutional bias of Medicare and Medicaid, therefore, has a negative impact on women. Frequently, home healthcare and home-making assistance are more appropriate and effective services for persons with chronic health problems than are hospital or nursing home stays. Women are much more likely to live alone, and therefore, to lack in-home, unpaid assistance.

HEALTHCARE COSTS -- also have a disproportionate impact on older women. In 1986, Medicare paid for 48% of the total healthcare expenditures of an unmarried man over 65, but only 33% of unmarried older women. Since the income of a woman alone is far less than that of either a couple or a man living alone, every dollar spent on healthcare is a greater percentage of a woman's income than it is of a man's. In addition, since most women outlive their husbands, they are more likely to pay for the cost of a spouse's medical care, particularly for nursing home care, and are less likely to have someone to help pay for their own care. The income requirements for nursing home coverage under Medicaid require that a couple "spend down" to poverty level to obtain care for one spouse. While recent legislation has increased the amount the spouse in the community may retain to live on, the assault on the dignity and the resources of the couples affected remains.

WOMEN AS CAREGIVERS -- Women are more likely to carry the burden of being primary caregivers themselves. Approximately 75% of home care for disabled elderly was unpaid and generally provided by a female relative. Caregiving represents an additional financial, emotional, and physical burden to women in mid- and late life. The average age of caregivers is 57. Support services, such as respite care, are rarely available to these caregivers.

SAFETY AND SECURITY -- Safety in the home is a special problem for older women living alone. While there is some disagreement about whether elderly women are victims of crime at rates greater than the general population, there is no doubt that the fear of crime causes tremendous isolation and anxiety for older women. For those who live alone, the consequences of accidents can be considerably more serious than for older people who have someone continually available to monitor their safety. In particular, hip fractures and their complications are a major factor in institutionalization for older women.

DIVORCE -- One of the most emotional experiences a woman now living alone must overcome is a divorce. Many women after many years of marriage joined a growing number of other women who, on their path to the golden years, made a pit stop in the courtroom. Women who believed in "til death do us part" find that many older couples are getting divorced more than their counterparts of 10 or 20 years ago. Today, there are 1.3 million divorced Americans 65 and older, a group that, since 1980, has increased more than twice as fast as the population of older Americans as a whole.

Marriages run into different challenges upon retirement and can end in divorce. You have heard of the old saying "For better or for worse, but not for lunch." All of a sudden with all that time with one another you come to realize that you have not worked at the relationship. Dividing up friends after a long-term marriage often is as stressful as dividing up the property. The most serious consequences of a divorce for women in their later years may be the economic impact. The men usually have pensions; the women may not.

LONELINESS -- It is safe to say that loneliness is one of the greatest problems of living alone for women as well as for men. However, women in general have more friends and acquaintances than men who they can call upon to talk about their troubles or to get together with just for company. Fortunately, any individual has the opportunity to become more comfortable with this problem by doing something about it. (See the article on loneliness, Lonely