(HealthScoutNews) -- While advances in medical care are greatly improving the lives of people over 50, rising health costs and increasing obesity threatens to eliminate many of the gains.

That's the claim of a study that AARP released today.

"There are alarmingly high rates of obesity and growing numbers of uninsured people in the middle- and high-income groups," says Susan Raetzman, associate director of the Public Policy Institute for the AARP, formerly known as the American Association of Retired Persons. "Health costs are rising at twice the rate of inflation, and consumers have lower levels of confidence in the future of their insured coverage and affordability of care."

The second annual report examines "health security" among older people and senior citizens.

Over the past 20 years, more older people are getting vaccinations and screening tests and far fewer smoke, the report says. The rate of smoking has declined by 36 percent among men over 50 over the past two decades, and by 23 percent among women. Even so, 25 percent of those aged 50 to 64 reported smoking in a 1998 survey. Men are more likely than women to smoke.

With the exception of those older than 85, Americans 50 and older are more likely than in the past to consider themselves to be in excellent or very good health. Hospital visits are less common, and there are a growing number of alternatives to nursing home care, the 19-page report adds.

"On several fronts, older Americans can be optimistic about the future," the report says.

On the other hand, most older people suffer from at least one chronic condition. One in 20 people between 50 and 64 years old suffers from a combination of chronic disease and disability that limits their normal daily functioning. That number grows to 44 percent for people aged 85 and older.

The report contends there is a gap between how the elderly (those over 65) and younger people look at the health-care system as a whole. Those aged 50 to 64 are more skeptical of doctors, more willing to use alternative medicine, and more likely to want to a role in making medical decisions.

In general, older people like their doctors, even though a survey found that 20 percent to 30 percent of patients said their doctors didn't ask about what medications they've been prescribed by other doctors, says Cheryl Matheis, AARP's director of state affairs.

"People love their doctors and think they're getting good quality of care, whether they are or not," Matheis says.

The AARP report saved some of its most stringent warnings for the threat posed by obesity. According to the National Center for Health Statistics, 26.7 percent of people aged 50 to 64 were obese in 1999, compared to just 14.4 percent in 1982.

The obesity rate declines with age. Even so, 8.3 percent of those 85 and older were too fat in 1999, compared to 4.1 percent in 1982.

Hectic schedules without time for exercise and extensive use of television and computers could be to blame, the report suggests.

As for solutions to the problems it lists, the AARP is calling for the nation to focus on quality of life during aging and adopt a "social insurance" program -- such as Medicare -- to provide long-term care for older Americans. The organization is also pushing for a more cohesive national health "infrastructure."

The nation hasn't been able to use technology to improve quality of health care because the health-care system is too divided between public and private sectors, the AARP report says.

What To Do: Learn more about health care for older persons from the AARP.The National Institute on Aging provides its own resources on senior health.

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