KILMARNOCK, Va. — More than a half-century after the baby boom, echoes shake the nation.
The first boomers are now 66, the number of people younger than 45 has declined in most states over the past decade, and the 2011 birthrate was the lowest on record, at nearly half the 1957 rate. The divide between the population needing care and the working adults who do the earning and caring worsens each year.
In a withering Rust Belt and melting Snow Belt, youngsters have fled but their childhood homes have remained, concentrating the aged as schools have emptied and hospitals have filled. But these aging outposts are only on the frontier.
"It's the Floridaization of the U.S. By 2030, the U.S. will basically look like Florida looks now," said Kristina Hash, an aging specialist at West Virginia University, a state with a median age of 41. In 2000, the nation had a median age of 35.
Here in Virginia's Lancaster and Northumberland counties, where the median age is 54, and a nursing home, hospital and cemetery are neighbors, Main Street is lined with vacuum cleaner repair shops, doctors offices and antiques stores, filled, in turn, by antique humans.
Between them on nearly every block are small businesses hawking long-obsolete dial-up Internet service, installing Web browsers and showing residents how to check email in exchange for $50.
"That's a role my son would have played," said Augusta Sellew, a volunteer at the town museum.
This is an economy functioning in the absence of much of the working age and the young, centered on providing services for the elderly. It's a scene equally familiar in Alcona County, Mich., where half of residents have reached retirement age and only 14 out of 100 are children, or on Maryland's Eastern Shore, where in Worcester and Talbot counties, more than 37 percent of the population is retirement age.
In at least one way, Virginia's Northern Neck, which computer store proprietor Doug Schaefer, 58, jokes peaked in 1720, is ahead of the curve. In the years to come, this is what the majority of America will look like.
Baby boomers, those born between 1946 and 1964, have overwhelmed the nation's infrastructure at every stage. But old age will represent the final and longest-lasting test, with all of them between 65 and 83 by the year 2029. It is the economic story of the century, happening before glaucoma-stricken eyes.
"The aging-in-place phenomenon is a stealth phenomenon because you know these people are around, but in 10 years they're going to be older," said William Frey, a demographer at the Brookings Institution.
On Kilmarnock's Main Street, the dog park is larger than the children's park, and in Lee's Diner, all 13 patrons have gray hair, while four younger waitresses serve them.
"The pace is slower here. Even if it's an emergency, you've still got to wait," said Clifford Gratz, 83.
Kristina Ramsey, 19, waits tables at a bowling alley that fills with senior bowlers on league nights, but where attempts at DJ nights and laser tag failed for lack of interest.
"They'll rub their silver quarters together for you. They don't tip well," she said of serving pastries to the geriatric. But the bay isn't providing the waterman's life it did for decades; farming isn't as profitable; and other service-sector employers, like nightclubs, aren't viable.
"It is hard to make a living here, unless you want to work in the nursing home or hospital or cut someone's grass. After people graduate, they end up working somewhere else," said Town Manager Tom Saunders.
Migration patterns, chiefly of the young following one another to meccas of cool with jobs and momentum, have insulated broader metropolitan areas such as Washington and Las Vegas, but they have exacerbated the age imbalance in other places, including Buffalo, N.Y., and Noble County, Ohio, where 39 percent of residents are 55 or older, compared with 21 percent a decade ago.
In Pennsylvania, 600,000 people 65 or older live in solitude, many of them women whose husbands have passed away, and they need or will need a gamut of services. They need young people to provide these services and to pay into the Social Security system from which they draw.
It is no surprise that people are fleeing places such as upstate New York, Appalachia and Ohio, where jobs in factories and mines that sustained generations have receded. But contrary to notions of Florida as God's waiting room, most middle-aged to elderly are reticent to uproot and "age in place," regardless of circumstance.
For America, growing old is a white person's problem, and it is only immigration and higher birthrates among minorities that have stabilized the population of more cosmopolitan areas. There is a straight line between the white percent of the community and its share of elderly. With its large Hispanic population, Texas has the third-lowest rate of people 55 and older. One the other end of the spectrum are West Virginia and Maine, nearly entirely white, and with the highest.
So even those places that are not symbols of industrial decline, but merely reserved stoicism – places that haven't experienced exodus, only failed to draw newcomers – have rapidly become retirement homes the sizes of small countries.
In Maine, the median age has risen from 34 to 43 over the past 20 years. In New Hampshire, Alaska, Vermont, Montana and Oregon, more than 6 percent of the population has crossed the age 55 marker in the past decade, rising in New Hampshire, for example, from 20 percent to 27 percent.
Rocking the suburbs
In distinct and isolated communities such as Kilmarnock, where an ambulance can take 15 minutes to arrive for a person experiencing a heart attack, and where expectant mothers must travel an hour to deal with complications because a maternity care center stands abandoned because of lack of demand, the most urgent effects of an age imbalance are felt.
The most prevalent changes are occurring in the subdivisions where the "Wonder Years" generation settled, in the vast and traffic-clogged tracts surrounding New York, Los Angeles and other cities.
"The suburbs are ground zero. That's where the infrastructure gap is going to be the biggest. They were built for younger people: Parks, playgrounds, schools," Mr. Frey said.
Four-bedroom houses purchased to raise three children have done their duty, but empty-nesters stay put, dusting vacant rooms attentively. Mom and Dad moved there to be around people like them. That they are now utterly out of place, two aging adults on a cul-de-sac with a basketball hoop out front and an elementary school down the block, isn't apparent because their neighbors, too, have traveled life's journey with them.
But the neighborhoods lack mass transit, for example, and that could be a problem when fading eyesight makes driving difficult.
"As a nation, we have to understand there are very tough issues we're going to have to face in terms of government services and support for the elderly population," Mr. Frey said.
If the AARP crowd wants Medicare and Social Security to be solvent, he said, suburbanites may have to welcome people who are different.
"The aging population has to think of what's going to be coming directly and what's coming indirectly in terms of supporting children who are going to pay for their support. If you completely cut out the money for playgrounds, that's not going to happen."
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