Perceived in the local community . Also for dr. Frieden, a group of staffers like myself were at the cdc headquarters and were able to meet with your team combatting and organizing the response. One of the things we heard was when it comes to Public Infrastructure the Health Ministers dont get as much attention as other ministers. How is this outbreak changing that environment . Are we able to leverage that situation to get them to pay more attention for longterm growth . It is generally our experience in Public Health that people pay most attention to us in the middle of an outbreak or epidemic. Within countries you will find that Health Ministries are generally weak compared to other ministries and that the Public Health aspect of that is particularly weak. Congressional initiative from senator harkin and others to establish Public Health institutes that would be able to run Laboratory Networks and train and host Operation Centers are very important. And it would be tragic if we didnt ensure that as we respond to ebola we also put in place the kind of systems that would prevent the next outbreak like this from getting out of hand as this has. And the first question was the role of Health Care Workers in the front line . Well, you know, they face enormous challenges and enormous risks. One of the overlooked there is a lot of focus on ebola treatment units but those most at risk are in the normal health system. When someone presents with ebola symptoms if that facility does not have the equipment needs and the staff person does not have the training that they need then they are extremely at risk. These are countries with extremely weak health systems. So there is traditionally not fantastic Infection Prevention within the health system. The Community Care program that the president announced is intended in part to address that. It will be at Priority Health facilities providing training and equipment so that Health Workers can better protect themselves and will also help to set up ebola care centers which will be already popping up. Communities are self organizing to set up care centers. They are just not getting support. This will provide support, a degree of training and Equipment Support to the centers so Health Facilities will have a place to go with people infected with ebola rather than have to keep that in the Health Center where they may not be equipped to handle it. I will give a minute to dr. Tapero from cdc who was just in liberia and has very valuable final comments about ebola. Thank you for the opportunity. Im more than happy to talk with people afterwards. I know we are about ready to close. I would like to reiterate that the Health Care Workers on the front lines have been largely liberia Health Care Workers. They have taken a tremendous toll in the early days of the epidemic. We need to turn it off quickly. We can do that. We know how to do that. We have been working in this space for four decades. So the support that we can give to communities as they try and provide Community Care centers while these ebola treatment units are built is critical. The most critical element is that when a Family Member takes care of their loved one in these facilities that we give those Family Members and those caregivers who leave the hospitals to work in these Community Care centers the best opportunities for good Infection Control practices to bridge the gap to when we actually have the ebola treatment units fully functional and set up with the support of dod and others. There are tragic stories but the most compelling reason for moving in this direction is that the Health Care Workers that remain on the front lines, they are there and they want to come to work. They just want to be trained. They want the physical facilities and the personal protective equipment and the training that allows them to do the job effectively. The Infection Control training practices that were doing the training will have long term benefits well after the epidemic is put under control and will decrease all kinds of hospital acquired infections as well as protecting Health Care Workers who see people when they come for care. I would be happy to take questions. I will stick around and talk about my personal experience and other things. Thank you. Thank you for being here and being part of this. Just one more word on the Health Care Workers experience. I think many of us in this room have friends or colleagues that are working on the front line in west africa and struck us at our center that there isnt an easy way for people to be sharing real time information and learning. That is being built into the system. So we are trying an experiment in our center which is called sharing exchange ebola Knowledge Forum to put first impressions, anecdotes and stories they are learning that can make their way into formal guidance. So i think its now two minutes past time. And i want to thank all of our very distinguished panelists for their time today and for their service for this country and west africa. A special thank you for those who really worked in the last few weeks to put this together. I want to thank our panelists all together for their work. [ applause ] and keep up the good work on the hill. Thank you. Here is a look at tonights primetime network. Bill gates discusses the Ebola Outbreak in west africa and his foundations pledge to donate 50 million to fight the virus. On cspan 2 the communicators with maureen ohlhausen. She discusses net neutrality, privacy and data security. And a series of discussions on mars and Science Education including discussion on the difficulties nasa would face sending humans to mars. That is all tonight beginning at 8 00 p. M. Eastern on the cspan networks. Live tomorrow the House Oversight committee holds a hearing looking at the secret security protocols looking at an incident in which an armed intruder entered the white house. You can watch it live at 10 00 a. M. Eastern on cspan. Next a look at the Housing Needs of seniors. A report by the Harvard Joint Center for housing studies examine the consequences of housing cost burdens and what is needed to meet the needs of the increasing aging. The groups managing director talked about the findings at this event cohosted by the Harvard Joint Center. Good morning. Its nice to see so many people here today, the day after labor day weekend. When we set the date, we heard grumbling back that no one would come. I think this is a testament both to the importance of the issue and the fact that people are ready to get back to work after a good summer and a good labor day weekend. Let me first start by sending my thanks to the hartfords for funding and to the aarp foundation. Thank you. This is an issue that the joint center identified for a number of years as one to spend more time on and the grant gave us the opportunity to do it and build the infrastructure and capacity. I also want to thank the folks we work with closely at the foundation. Vivian and tyler who have been instrumental in helping marshall this through the process and have been certainly not funders but collaborators. They have been instrumental in helping us put together an Advisory Committee to shape the report and review drafts. I will not go through the process of naming them now but they are named on the website. Their input was critical in terms of informing us and pointing us many the right direction. I would have to thank the joint center staff. A number of whom are here today. I wont call them out. I think the effort that goes into the report, our state of the nation report and the American Housing report is phenomenal. I think we under estimated to some extent the amount of effort that goes into learning the issues that intersect with senior and older American Housing. So the amount of work that our staff did to get up to speed on that literature, all the data sets we analyzed was really quite amazing and been working very hard this summer, i should add. I have to give a special thank you to jennifer molisnski, sitting here in the front, who was the manager of this project and who is incredibly passionate about this issue and really put blood, sweat and tears into getting this report to be what it is today. So to the extent that the report, if it passes, i think the credit goes to jen. Let me turn to the report itself. Obviously the motivation for the study begins with the fact that we are at a time of unprecedented growth in the older population. Its growing not just because of longevity which is increasing. Because the baby boom generation has been crossing important thresholds. We have seen it growing for years. Since 2011. Beginning to accelerate and ten years from now, the oldest old population beginning to grow. Ten years from now we see the oldest old population beginning to grow. It is a tremendous need to meet the needs of an aging society. The needs are great. There are challenges we face as we age. Challenges to maintain our health and physical security. To remain connected to our communities. And to remain productive members of society. As lisa said in her remarks, i think if you look at it, housing is critical to so many of the elements of maintaining wellbeing, and we use the phrase lynchpin. We have discussion if anyone would know what it is. Im really grateful that you defined it. As we say in the report, housing is a lynchpin of well being. Because it intersects with so many key issues. One is the Financial Security of households. Housing is typically the largest item in a household budget. Whether your housing is affordable or not will have a lot to say about whether or not your overall financial picture is in good shape. Its also the principal source of wealth. If you are a homeowner whether you have the nest egg or not is an important asset people can tap potentially as they age. In terms of physical security, whether the home is suitable to your needs as the inevitable challenges arise. Does the house provide a safe and secure environment. As we learned more and more the ways if which the house is also related to Health Issues in terms of both the interior environment of the home and how it connects to communities. In terms of social connections, where you live, what your housing situation is. Does it facilitate you interacting with the community. Do you have access to Transportation Options to engage with the community. The housing is central to that. Finally in terms of links to long term supports and services, as we age when we needer more supports in the home, those are helping in situations facilitating getting the services so we can age in our communities and avoid the high costs of institutionalized care. In each of these areas we face significant challenges. In terms of Financial Security, older households are already facing high housing cost burdens. And given the situation of those approaching retirement, they may well worsen. More people are entering retirement with mortgage debt. In terms of physical security, there is a shortage of housing with accessibility features. There are important trade offs between spending on food and therefore hunger and health care and therefore health. In terms of social connections there are deficiencies in terms of the house ing thats well connected to city centers and town centers and transit. There are deficiencies in pedestrian infrastructure that make it difficult to make those. In terms of linking to Long Term Services and supports there are ways in which the housing and health care cysystems dont wor well together and threaten the ability to get services you need. Housing play as Critical Role in making the connections. We certainly are facing a number of challenges today as the list makes clear. Well face more challenges in the future. This is a problem already but going to become a bigger problem. The issue or the good news is there is still time to prepare. Most of the challenges will really accelerate when the population begins to grow. That will happen a decade from now. As lisa said there were a number of promising models and ways we know to address these things. If we are going to build infrastructure in terms of housing and systems to deliver the services we have to start now. The goal is to raise awareness and understanding of the issues. To provide the data thats needed to document it and highlight areas where action is needed and can take place at all levels of government by the private and nonprofit sectors. Most importantly at the individual and family level. There is a need for individuals to take stock of whats going to be the demands on them as they age. And begin to take steps now to prepare for that. Also to provide the support needed for the policies and programs that are going to be needed to support an aging society. With that, let me now turn to the details of the report. As we say, these reports are always chock a block full of information. Every paragraph is carefully honed. So i will be able to touch upon only a part of it. So i really do encourage you to read all of the report. Let me turn to the highlights. So the first portion of the this shows the population in 50 year increments. Which so this chart shows the population in 15year increments. Those are the categories youll see. A preretirement group, 50 to 60. Retirement into the first years post retirement. 6579. And then the oldest old, 80 and over. You can see that we have already experienced a huge runup in the 50plus population. When the baby boom turned 50 in the 90s, that group started to grow. From 1990 to 2010 we saw that population double from 30 million to 60 million. Now were at a point that the baby boom as of 2011 started to turn 65. We are just beginning to see the population grow rapidly. So between 2010 and 2030 well see that grow from 27 million to 43 million. And then up to 53 million by 2030. So by 2030, one in five americans will be 65 and older. A really astounding share of the overall population. The oldest old have been growing with longevity. And that group will start to rapid up again in 2026. That beginning at the 2020s and 2030s well see the oldest old population grow. And as well see, thats the group that really has tremendous needs for supports. While its growing now, it will be growing much more rapidly a decade from now. So this chart illustrates the challenges that grow when you age, in terms of an increased risk of disability, isolation and Financial Stress. So we show here different categories of disabilities from cognitive issues with memory and decisionmaking, selfcare in terms of bathing and dressing. Independent living in terms of running errands and taking care of finances and mobility. As you can see, there is an increase as people from go from their 50s and 60s to their 60s and 70s and a huge increase as they hit 80 plus. By then one in three have issues with independent living. One in five have issues with selfcare. Likewise with People Living alone as people become widowers and widows, more than a third are living alone, increasing the risk of isolation. When we look at housing cost burdens we have less of an increase. This is more of a democratic problem with more than a third of people facing housing cost burdens in their 50s, 60s and 70s. And then it does rise in the 80s as incomes become more constrained. As we see people age, issues around disability issues, issues around isolation and issues around Financial Stress will grow. In terms of disabilities, age in many respects is a great equalizer. So what these charts show is again looking now at incidents of disability. Combining the likelihood of having the issue of hearing, vision, selfcare, mobility and the likelihood of having an issue rises sharply with age. These panels show issues by race and ethnicity, income and housing tenure. And among younger people, we see higher income households are less likely to be disabled. But age over time takes a toll on all. So by the time you get to your 80s 70 of households of all demographic stripes are dealing with disabilities. So this is not an issue for some demographic slice. Its an issue for all of us as we age. In terms of income, the financial pressures also tend to converge. So this chart shows the Median Household Income with different age bands for different groups. Thats the Median Income of people 60 to 64 and by race, tenure and family type. At that point its a wide disparity in meeting incomes. Much higher for whites and asians. Much higher for homeowners. If you look at the red bars, those differences really largely dissipate. So most household types, regardless again of what your demographic stripe is have Median Income household between 20,000 and 25,000. The longer we live t fewer sources of income we have to rely on. So again, more Financial Stress across the spectrum. Now turning to housing and Financial Security. One of the main issues we look at is housing cost bur