Podcast Summary: Deborah Carr, "Aging in America" (University of California Press, 2023)

Podcast: New Books Network
Host: Rachel Pagonis
Guest: Deborah Carr (Professor of Sociology, Boston University)
Episode Date: November 28, 2025

Episode Overview

This episode of New Books in Medicine features Rachel Pagonis in conversation with sociologist Deborah Carr about her new book, Aging in America. The discussion explores the historical evolution, contemporary landscape, challenges, and opportunities of aging in the United States. Carr provides accessible insight into the lives of older adults, explaining how social structures, policies, and individual lifecourses shape later life. The conversation traces fundamental shifts in demography, health, economics, diversity, and the social roles of aging Americans, positioning older adults as both vulnerable and resourceful members of society.

Key Discussion Points and Insights

1. Deborah Carr's Background and Motivation for the Book

• Carr's career centers on the sociology of aging, a topic she considers one of the most pressing societal challenges (03:21).
• Motivation: Opportunity to synthesize 20+ years of research and offer a comprehensive, accessible portrait of older adults in the 21st century (03:21).

2. Defining "Old Age" and Its Complexities

• Statistically, "old age" starts at 65+, but Carr emphasizes age is “more than just a number”—social location, education, and type of work all affect the experience of aging (05:01).
• Societal perceptions and policy boundaries (e.g., Social Security, retirement) don't always match individual realities (06:22-06:56).

3. Audience for the Book and Importance of Aging Literacy

• Intended for students, professionals in social work and public policy, and the general population (07:20).
• One in five Americans will soon be older adults; aging literacy is vital for every profession and family (07:20-08:30).

4. Policy, Community, and Everyday Ageism

• Federal government handles programs like Social Security and Medicare, but many supports and services are local (08:59).
• Ageism pervades customer service and professional interactions, necessitating respectful training and policy (09:59).

5. Historical Context: Aging before Social Security

• Life before the Social Security Act of 1935 was often "wretched" for older people—responsibility fell on families or poorhouses if family was absent (10:46-12:07).
• Despite lower average life expectancy due to high infant and child mortality, a segment of the population did live into old age (12:30).

6. Impact of Social Security and Medicare

• Social Security and Medicare transformed older age by reducing poverty and enabling independent living (13:43-14:41).

  “It really did lift millions of people above poverty...allowing older adults to live on their own and not to live with their families, to avoid the...poor house.” – Deborah Carr (13:43)

• Independence also led to increased rates of loneliness, as many prefer "intimacy at a distance" from their children (14:56-15:52).

7. Aging Theories: From Disengagement to Life Course

• Epidemiologic Transition: Modern times see fewer deaths from infectious diseases, more from chronic conditions.
• Disengagement Theory (1960s): Advocated for older adults stepping back from social roles to prepare for death. Found to be oversimplified and not universally beneficial (16:44).
• Activity Theory: Suggested well-being through ongoing engagement—yet must be tailored to individual preference (16:44-20:05).
• Life Course Paradigm & Cumulative Inequality: Older age outcomes are shaped by lifelong accumulation of advantage/disadvantage; interventions must start early (21:05-25:11).

  “The benefits and disadvantages of old age don’t instantly crop up on one’s 65th birthday. Really, they’re the end result of the accumulation of experiences that we’ve had throughout our lives.” – Deborah Carr (21:27)

8. Demographic Trends Among Older Adults

• Growing Diversity: Oldest-old (85+) and centenarians (100+) are fastest growing groups (27:24).

• Gender Imbalance: Older adults are disproportionately female due to differences in life expectancy (27:24-28:50).

• Education Up: Each generation is better educated, which aids healthier lifestyles (29:10).

• Increasing Racial and Ethnic Diversity: Especially among Latino and Asian populations (29:40-31:04).

• On the “Hispanic Paradox”—Latinx Americans live longer despite socioeconomic disadvantage due to factors like healthier traditional diets, migrant selection, and return migration (31:04).

9. Social Support, Loneliness, and Gender Differences

• High rates of loneliness and isolation persist, even within marriage; men seek romantic partners, women more often rely on children or friends (38:31-41:27).
• “Men tend to seek out romantic partners as their source of emotional support...Women who are alone and unmarried may not necessarily be lonely because they turn to their children...or to friends.” – Deborah Carr (39:25)

10. Health Challenges in Later Life

• Leading causes of death: heart disease, cancer, COVID-19, chronic lung conditions.
• Chronic conditions often come with prolonged periods of disability, increased need for care, and can last decades (43:01).
• Cognitive decline (Alzheimer’s, dementia) rises sharply after age 85 (44:38-45:14).
• Most older adults fear severe cognitive impairment more than physical pain (45:24).

11. Older Adults as a Social Resource

• Older adults contribute enormously as volunteers, caregivers for grandchildren, transmitters of culture, and sources of wisdom (46:59-48:09).

  “They are among the largest volunteer labor force in the United States...our source of memory, our source of history, our source of culture.” – Deborah Carr (46:59)

• Economic interdependence: Older adults often support younger family members financially and through caregiving; investments in their well-being benefit all generations (48:19-49:57).

Notable Quotes & Memorable Moments

• On shaping later life:

  “Giving people economic benefits at 65 or giving them health care access at age 65 is too little, too late.” – Deborah Carr (22:49)

• On Social Security’s transformation:

  “It really did lift millions of people above poverty...allowing older adults to live on their own and not to live with their families, to avoid the...poor house.” (13:43)

• On activity theory’s limits:

  “Activity is good, provided it’s an activity that an older person likes and wants to engage in.” (19:44)

• On older adults as resources:

  “Older adults bring so much...They are our source of memory, our source of history, our source of culture.” (46:59)

• On climate change and aging:

  “Any kind of climate change policy needs to consider the distinctive needs that older adults have because the impacts of heat are much more dire for them.” (53:57)

Important Timestamps

• 03:21 — Carr describes her background and inspiration for the book
• 05:01 — Defining "old age" beyond the number 65
• 10:46 — Life before Social Security: families, poorhouses, and hardship
• 13:43 — Impact of Social Security and Medicare on poverty
• 16:44 — Theories of aging: disengagement and activity theory
• 21:27 — Life course and cumulative inequality perspectives
• 27:24 — Who are older adults today? More diverse, more educated, more female
• 31:04 — The Hispanic paradox in longevity
• 39:25 — Gender and marital differences in loneliness
• 43:01 — Main chronic health conditions among older adults
• 45:24 — Fears surrounding cognitive decline and end of life
• 46:59 — Older adults as a global resource
• 53:57 — Climate change's growing impact on older populations

Current and Future Research

• Carr is now studying the intersection of climate change and aging, identifying hotspots where older populations are most vulnerable to rising temperatures and disaster events (52:22-55:46).

Conclusion

Carr's Aging in America reframes aging as a multifaceted and fundamentally social phenomenon. The episode challenges listeners to move beyond stereotypes and embrace older adults as vital contributors, while addressing persistent structural challenges. Solutions lie in cross-generational policy reform, early proactive support, and recognizing the wisdom and labor older Americans provide.

Recommended for:
Students, policymakers, healthcare professionals, caregivers, families, and anyone who’s part of an aging society.

Book Information:
Aging in America by Deborah Carr, University of California Press (2023).