“He basically shut his business down to come here and has to restart his business when it’s safe,” his father said. “It was a very difficult decision.”

Alex Rose, a 33-year-old event producer and recording artist, didn’t need much persuasion. She spent a couple of weeks alone in her 500-square-foot Hollywood apartment, taking long walks to break up the days. In mid-March, her event bookings and performances began to disappear. Then a neighbor showed her video of an arsonist setting trash can fires on their street and she saw the melted cans next to her building.

“All of a sudden I didn’t feel safe anymore,” she said. “I didn’t feel safe, and frankly, I felt totally alone.”

The next morning, she and her cat, Eloise, flew home to Austin to her mother and stepdad.

As COVID-19 has ripped through densely populated communities, millennials have fled their own cramped quarters for less congested cities with more room in their parents’ homes. They are near family should someone get sick. The familiarity is comforting in an uncertain time. Overwhelmingly, parents and their adult children view the arrangement as temporary. Of course, no one knows how long “temporary” might last.

Lawrence Maze said the thinking was that Gregory could help him or his wife if they got sick, and they could help him if he did. Also, they believed Austin’s health care system would be less stressed than L.A.’s.

“He’s lived on his own now for a very long time,” Lawrence said. “It’s not like he moved back into his old house. He knows he’s living in a guest bedroom.”

It’s a major disruption for young adults who have established their lives thousands of miles from home: They keep paying rent on empty places. They have left behind their routines and social lives. Some have lost their work. Others can work remotely alongside parents who are doing the same.

The magnitude of the outbreak has, for a time, reordered American lives. It’s fostering unexpected togetherness.

Rose’s mother, Elizabeth Christian, said her daughter hasn’t visited Austin this long since she was in college, and now “nobody is rushing off to do anything.”

“We’re having meals together. And we’re watching movies at night,” she said.

Christian and her husband, Bruce Todd, a former Austin mayor, wanted to make sure Rose got back before California wouldn’t allow her to leave or Texas wouldn’t let her in.

Sarah and Ken Frankenfeld had barely moved into their downsized townhome when the coronavirus pandemic brought their 31-year-old son and his girlfriend from New York City to quarantine with them.

“I was nervous about how this was going to work,” Sarah Frankenfeld said of their lack of furniture and readiness for houseguests. They’d met his girlfriend for one evening a few months earlier. “He hasn’t lived here in a while. But it’s worked and it’s been lovely.”

Kevin Frankenfeld, who works in digital, social strategy and marketing, has lived in New York almost nine years. He and his girlfriend, Maddie Haller, wanted to quarantine together.

“In Manhattan or Brooklyn, people are just on top of one another,” he said. “So we wanted to get out of town.”

This shared feeling of lockdown with so much unknown can cause stress and make us feel lonely and anxious, even with others around, said Dr. Vivek Murthy, U.S. surgeon general from 2014 to 2017.

“In this moment, we have no idea when the pandemic will end,” he said. “We don’t know when our lives will go back to normal.”

Well before the stay-at-home orders, Murthy recognized Americans’ increased loneliness, prompting his new book, “Together: The Healing Power of Human Connection in a Sometimes Lonely World.” Now that many are isolated by themselves, he urges us to “step back and take stock of our lives.”

“The silver lining of COVID-19 is that it’s given us the opportunity to reset our social lives and remember how essential relationships are to our well-being,” he said.

Rose is doing her own reset. She’s among California’s estimated 2 million self-employed. But because of the pandemic, she’s applying for full-time jobs around the country in digital media and project management.

“When I left L.A., I never expected that I would not go back to that apartment,” she said. With her lease up in June, she asked a friend to pack up her place and move everything into storage.

Rose and her mother returned late Sunday from a quick turnaround to California to retrieve Rose’s tiny 2016 Fiat 500 that was stranded six weeks in long-term airport parking.

Gregory Maze, 33, is a private chef, event caterer and part-owner of a coffee truck business. He moved to L.A. five years ago.

“I’m fortunate to have a situation like this, but leaving L.A. was not on my terms,” he said. “It’s out of my hands. I really don’t know what the landscape is going to look like at the end of this.”

While some younger adults mock baby boomers with the “OK boomer” meme, the pandemic seems to have shifted the tone — at least where parents are concerned.

Suzanne and Stuart Newberg’s older son, Jared, 27, and his girlfriend, Melissa Asensio, both of Manhattan, arrived March 21 to quarantine together.

“They bought one-way plane tickets and we said, ‘You’re welcome as long as you need to be here,’” Suzanne Newberg said.

Jared and Melissa, who both worked full time in their New York City offices, now work remotely from Austin. His three roommates left for their hometowns about a week before Jared and Melissa. Her two roommates left New York around the same time.

“It was a lot safer and more comfortable to come here,” Jared said. “We’re super-lucky and super-fortunate.”

Back in New York, one of Kevin Frankenfeld’s roommates remains in their three-bedroom apartment. The other went home to Boston. Maddie lives in the same neighborhood. Her apartment is empty now. Both Kevin and Maddie work full time remotely and are glad they’re not in the city.

“We didn’t want to be stuck in a small apartment to isolate in a hotbed,” Kevin said. “Here we’ve got a green area, dishwasher and laundry.”

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Instead, he killed himself on June 8 — the first day of summer break.

Caleb Stenvold was 14. He was a high school freshman in the gifted and talented program. He ran track and played defensive cornerback on his school’s football team. Just two months into high school ― and four months after Alec’s suicide — Caleb killed himself on Oct. 22.

The teenagers, both from Reno, Nevada, didn’t know each other. But their families now do, bonded by loss. Their parents are haunted by what they don’t understand: why.

They ― along with mental health experts, school leaders and researchers — are trying to understand why suicide by children ages 10 to 14 has gone up and up. The suicide rate for that age group almost tripled from 2007 to 2017. Newly released 2018 data from the Centers for Disease Control and Prevention show a 16% increase over the previous year.

While experts point to a host of explanations for the alarming rise, scientific proof about cause isn’t conclusive. Some research shows correlations with social media use, cyberbullying and the internet, but studies citing them as a suicide cause are less decisive.

The parents of Caleb and Alec believe impulsivity ― very common in teens because their brains aren’t fully developed — played a role in their suicides.

Kerri Countess, Caleb’s mother, called his suicide “totally unexpected and unimaginable.” He was the youngest of her five sons.

Paige Murray said son Alec “showed no signs of mental distress or depression or anxiety.”

“We think it was an incredibly impulsive act by a hormonal young man,” she said, noting that Alec’s stellar grades were posted online the day of his suicide.

Experts suggest that our celebrity culture, where suicidal thoughts are sometimes romanticized or normalized, also plays a role. Alec’s parents and Caleb’s parents say they need to speak out and warn other families.

When Caleb died, “we wanted everyone to know he died of suicide because if it can happen to my child who was not bullied and did not fit into the reasons people kill themselves, it can happen to anyone,” Countess said. “It was an impulsive and immature act.”

Amy Kulp, executive director of the Washington, D.C.-based National Center for the Prevention of Youth Suicide, said youth, in particular, “have very few experiences with dealing with outside stressors” and “tend to be quite impulsive.”

“If they have a precipitating event like they are bullied or don’t make a team or a friend stops talking to them or something is on social media that they’re embarrassed about,” she said, “they don’t know they will get through it.”

Kulp said the rise in suicide among the youngest adolescents has spawned prevention programs targeting elementary and middle schoolers, teaching things like resilience, wellness, self-care and coping behaviors.

Psychologist Mary Alvord said she’s been seeing “younger and younger kids” in her practice.

“At ages 6, 7 and 8, I’m now seeing kids with depression,” said Alvord, of Rockville, Maryland. “It used to be suicide attempts were more in high school. Now, I’m seeing more completed suicides in middle school and even upper elementary school.”

The CDC data illustrate “a steady consistent increase,” that “deserves our focus and our attention,” said CDC statistician Sally Curtin. “It’s linear and has gone up every single year since 2010.”

The CDC also monitors suicide attempts and self-inflicted injuries, based on data from emergency rooms. The published Jan. 31 found that from 2001 to 2016 such visits for those 10 and older increased 42%, with “substantial increases occurring in younger age groups.”

During the most recent study period, from January 2017 to December 2018, such visits increased more than 25%. For girls ages 10 to 14, data from 2009 to 2015 reflects almost a 20% increase in emergency visits for self-inflicted injury.

Youth today are much more familiar with death, said Jonathan Singer, board president of the nonprofit American Association of Suicidology, citing more than 20 years of mass shootings at schools among reasons.

“Death has become public,” he said. “With the internet and social media, when somebody dies, it’s all over your newsfeed. Hundreds of millions knew within minutes that Kobe Bryant had died. Death is much more a part of their generation.”

Among those aiming to reverse the trend is the National Association of State Boards of Education, based in Alexandria, Virginia, which examined the 2017-18 school year and determined that 25 states and the District of Columbia required or encouraged school districts to develop suicide prevention policies.

According to the organization’s policy review, author Megan Blanco said only three of 10 states with the highest youth suicide rates (ages 10-24) had a suicide prevention policy. The youth suicide rate for Nevada — where Alec and Caleb lived ― is 14.4 deaths per 100,000, which is higher than the national average of 10.6 deaths per 100,000. Nevada was not among the 25 states with a prevention policy, she said.

Alvord, the psychologist, has conducted programs to promote suicide awareness as a joint effort of National PTA and the American Psychological Association. She also helped APA develop for parents to talk to teens about suicide.

Dr. Kenneth Ginsburg, a pediatrician and an adolescent medicine specialist at the Children’s Hospital of Philadelphia, co-founded the Center for Parent and Teen Communication.

“It’s never a mistake to ask a person about their emotions or whether [someone should] be worried about them,” he said.

“People think depression is always seen as sadness,” Ginsburg said. “While sadness is a very important clue, adolescent depression irritability, rage or anger, instead of just sadness. Physical symptoms such as headaches, fatigue, belly pain, dizziness, loss of weight ― these are all things that can present as having problems with mood or depression. Parents may miss the signals.”

The day after his death, Caleb’s parents sought answers on his phone and computer, asking their son Matthew, then 16, to search Caleb’s history back to middle school for possible clues. They found one thing: a search for “suicide” the day before Caleb hanged himself.

Nadine Kaslow, a professor of psychiatry and behavioral sciences at Emory University School of Medicine in Atlanta, said parents need to realize that kids communicate differently today and any thought of banning social media or phones isn’t realistic or wise.

“Parents often get mad at kids because they’re texting or Instagramming or Snapchatting,” she said. “I worry when kids are not doing those things. If they stop doing that, they’re not having fun.”

Jean Twenge, a psychology professor at San Diego State University and author of the book “iGen,” has a darker view of the effects of media consumption and technology, based upon her research. Studies published in several journals in recent years — including the , and — found detrimental connections between the omnipresent smartphone, social media, sleep disruption and depression.

The mother of three (including a 13-year-old) believes technology should not be in a child’s room overnight, and she doesn’t believe anyone 10 to 14 “absolutely needs a smartphone.”

Twenge said it’s difficult to determine a reason other than technology for the suicide spike in recent years.

“Phones and smartphones check all the boxes of possible causes,” she said. “It’s something that’s affected a very large number of people and affected their everyday lives. It’s hard to think of anything else that fits that criteria.”

Perhaps the most significant analysis supporting Twenge’s worries in the Canadian Medical Association Journal. The evidence from cross-sectional, longitudinal and empirical studies “implicates smartphone and social media use in the increase in mental distress, self-injurious behaviour and suicidality among youth.” The review also found that social media “can affect adolescents’ self-view and interpersonal relationships through social comparison and negative interactions, including cyberbullying; moreover, social media content often involves normalization and even promotion of self-harm and suicidality among youth.”

A Pew Research Center released in 2018 found 56% of 13- to 14-year-olds had experienced cyberbullying; more than one-third said they had been the victim of offensive name-calling or false rumors.

Their parents said neither Alec nor Caleb were bullied. But many others are.

“We don’t know if bullying is the cause, or if kids who are depressed make better targets for a bully,” said Justin Patchin, co-director of the Cyberbullying Research Center.

Henry Kautz, a professor of computer science at the University of Rochester in New York, sees a similar dynamic with technology.

“People have been quick to point to studies that show increases in screen time and increases in depression. But it’s really unclear which way the causation goes,” he said. “Are people who are bullied and isolated seeking refuge in more screen time or is it the other way around?”

The parents of Alec and Caleb are moving past blame into action. The Murrays are working with the Reno Behavioral Healthcare Hospital and other agencies to better coordinate local suicide prevention. Caleb’s parents created , a website dedicated to promoting conversation and human connection in order to prevent teen suicide. They have filed paperwork to create a nonprofit with the same mission.

“Don’t think it’s too young to talk to your kids about if they might feel like hurting themselves. You might think you have time to tell them, but you can’t go back,” Caleb’s father, Storm Stenvold, said. “I don’t know what pain he was in for that time that he felt he needed to do this. He decided on this very quickly. He was rarely alone. He was home less than three hours by himself.”

Paige Murray agrees, which is why she and her husband, Lee, said they weren’t going to be silent about Alec’s suicide.

“Every family needs to have a conversation about suicide with their children —starting very young. Don’t just spring it on them when they’re 10,” she said. “It should be part of everyday conversation about loving yourself and making sure tomorrow is another day. Make sure it becomes a part of everyday knowledge.”

“This wasn’t a conversation that ever entered our house until June 8, but knowing what we know now, it should be. We were blindsided by it,” Lee Murray said. “It’s hindsight. We could have done better, but how would you know?”

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Shea is among a growing number of seniors in America who have struggled to keep affordable housing. He has, at times, been homeless. He has arthritis and manages to get around with the aid of a walker. He said he looks forward to giving up the steep ramp he’s had to negotiate when entering or exiting the RV he’s called home.

“I’m over the top about it,” said Shea, a native of Stratford, Connecticut, who made his way to Austin in 1993. “They had an interview process where a bunch of people applied. Then I found out it was a 3D-printed home, and I was gung-ho.”

The promise of 3D printing has others excited, too.

In a Northeast Austin neighborhood, these homes are taking their distinctive shape on the grounds of Community First Village, where about 180 formerly homeless people have found shelter and camaraderie in the most expensive city in the state. The 51-acre development (which will eventually include more than 500 homes) provides affordable permanent housing, including the 3D variety.

In this city of disruptors, Austin-based construction technology company Icon has formed a variety of partnerships to explore how 3D-printed homes could not only provide housing for people on the margins but also demonstrate how to dramatically reduce the time and money spent on construction.

“I see this innovative idea as being a powerful piece of the puzzle, along with other ideas of what it’s going to take to have more affordably built houses,” said Alan Graham, a real estate developer turned founder of the nonprofit Mobile Loaves & Fishes, which opened the village in 2016. The average age of residents is 55, he said.

These 400-square-foot houses are the nation’s first 3D-printed residences, according to Icon. Its process — which incorporates an 11-foot-tall printer that weighs 3,800 pounds — relies on robotics. Beads of a pliable concrete material dubbed Lavacrete ooze from the behemoth printer in ripples that stack and harden into a wall with curved corners.

The idea is to cut the time and as much as half the cost associated with traditional construction, limit the environmental footprint and trim the number of workers on crews, said Jason Ballard, Icon’s co-founder and CEO.

The process, he added, also could allow more design freedom.

“Because 3D printing uses slopes and curves, in the future new design languages will emerge that are only accessible through 3D printing,” Ballard said.

Icon has generated interest from the federal government, including NASA and the Defense Department, whose Defense Innovation Unit is focused on strengthening national security with new commercial technology. The unit (which has an Austin office) is under contract with Icon to train Marines and develop prototype structures that can be built quickly for military and humanitarian purposes. In late January, about a dozen Marines trained for a week at Icon. Further training is planned this year at Camp Pendleton in California.

Housing and Urban Development Secretary Ben Carson visited Austin twice last year, checking out Icon headquarters and touring the village.

“Innovation is key to solving our affordable housing crisis,” Carson said in an email. “The work that companies like Icon are doing could have a huge impact on housing affordability in communities across the country.”

Such a move is overdue, according to the Harvard Joint Center for Housing Studies. The center in October issued a study that illustrated a growing income disparity among older Americans.

The federal government considers housing affordable when a resident can spend 30% or less of income on it. Those who spend more, according to the Harvard study, are “cost burdened.”

“While many households now of retirement age have the means to age in place or move to other suitable housing, a record number are cost burdened and will have few affordable housing options as they age,” the analysis said. “In addition, many older renters are less well positioned than homeowners because they have lower cash savings and wealth.”

Moreover, the study said homelessness among older adults is increasing. The share of people age 50 and older experiencing homelessness rose to 33.8% in 2017 from 22.9% in 2007. Those statistics, according to the study, suggest that the “need for affordable, accessible housing and in-home supportive services is therefore set to soar.”

Such housing insecurity can affect a person’s health and well-being. “Financial pressures can also lead to depression and other physical problems,” the study said.

Not everyone is convinced 3D is the answer for the masses.

“Basically, 3D printing is creating a wall system,” said Chris Herbert, the Harvard center’s managing director. “It still has to have a foundation. Someone needs to put on a roof. It’s another way to lower the labor cost of producing components of the house, but it’s not printing every piece of the house.”

“If you can show me how 3D printing can produce components that can be stacked with multiple rooms and dimensions, that would have wider applicability for the overall housing stock,” he added.

Architecture professor Ryan Smith, director of the School of Design and Construction at Washington State University, said he agrees it’s early days for the technology.

“It’s worth investment and work on research in the industry, but I don’t see how it’s going to work in the current supply chain and labor market,” he said. “I personally still feel it will be 30 to 40 years before it will be having an impact.”

But architect and 3D advocate Alvin Huang, an associate professor at the USC School of Architecture in Los Angeles, said 3D’s advantages “are about precision and customization.”

“Its actual benefit is in larger projects that have a high deal of customization,” he said. “More and more construction sites will become more and more like factory settings, and instead of laborers, you’re looking at technicians. I’m a very big proponent of thinking about how the 3D printer can change the way we design.”

Brett Hagler is co-founder of New Story, a San Francisco-based social housing nonprofit to end global homelessness. His group and Icon are working on the world’s first 3D-printed community of 50 houses, under construction in Tabasco, Mexico. New Story and Icon partnered to create the first 3D-printed structure in East Austin that debuted in March 2018 at the annual South by Southwest festival. That building, now an office, served as a prototype for the 3D-printed homes at Community First.

“With one type of technology, you essentially get a lower-cost home — the exact percent in price is TBD. Two, it’s faster. Three, it’s very exciting to us because you get a much better custom design based on a family’s need,” he said. “What I do believe is that it has a very real chance to usher in a quantum leap in how we build shelter.”

Hagler said he’s confident the technology will be developed to affect more than just the current single-story detached house and provide solutions to large-scale projects.

“There’s an opportunity for a two-story. That’s going to happen,” he said. “Right now, if we can figure out a two-story, we can figure out a 10-story. It’s just a matter of time.”

At Community First, residents pay monthly rents ranging from $220 to $430 and can earn wages by working on-site. The six new houses that will rent for $430 were created by the second-generation 3D printer called Vulcan II, which last year printed the village’s welcome center.

Shea has come a long way from Ohio, when he was married and lived with his wife and two kids in a house he bought in 1971. He was married 12 years, he said, “until I struck out on my own.”

“We were comfortable,” he said, explaining that he had attended Ohio State University but didn’t graduate and then worked at several jobs in Ohio and Austin until poor health caught up with him and forced him onto the streets. He lives on a modest fixed income of disability and Social Security payments.

“I had never been homeless before I got in bad shape physically. I didn’t feel equipped for it and didn’t handle it very well,” he said. “Some people I’ve met here have been in and out of homelessness all their life. It’s a shock to your system. All I could do was hide. I was embarrassed.”

Now with his new 3D-printed home in sight, Shea is optimistic — for himself and the prospect of 3D-printed homes.

“I feel like it’s going to help people in every situation in life,” he said. “It’s one of the most innovative steps — not just for the homeless — but for affordable housing. It’s pretty amazing.”

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“I love to exercise, and I like to stay fit,” said Caldwell, who tried out a recumbent bike, a low-impact option that can be easier on the back. “It keeps me young.”

Benford encouraged Caldwell to join the organized rides, which have attracted more than 225 riders at city rec centers and senior activity centers. The cyclists can choose from a small, donated fleet of recumbent bikes, tandem recumbents and tricycles.

“With seniors, it’s less about transportation and more about access to the outdoors, social engagement and quality of life,” said Christopher Stanton, whose idea for Golden Rollers grew out of the Ghisallo Cycling Initiative, a youth biking nonprofit he founded in 2011.

But that’s not all, according to brain scientists. They point to another important benefit: Exercising both body and brain can help people stay healthier longer.

The new thinking about aging considers not just how long one lives, but how vibrant one stays later in life.

“If you’re living, you want to be living well,” said Tim Peterson, an assistant professor of internal medicine at the Washington University School of Medicine in St. Louis. “Most people who were interested in life span and were studying genes — which control life span — switched to ‘healthspan.’”Ìý

“Healthspan,” a coinage now gaining traction, refers to the years that a person can expect to live in generally good health — free of chronic illnesses and cognitive decline that can emerge near life’s end. Although there’s only so much a person can do to delay the onset of disease, there’s plenty that scientists are learning to improve your chances of a better healthspan.

The work takes on special resonance in light of a published in the Journal of the American Medical Association showing that life expectancy in the United States has decreased in recent years. A rise in midlife mortality (ages 25 to 64) has dragged down the overall expectancy.

“The idea is to make people productive, healthier and happier longer and more capable taking care of themselves,” said Andreana Haley, a psychology professor at the University of Texas at Austin who is among this breed of researchers working to understand healthspan. “We now live a long time with a lot of chronic diseases, and it’s not fun. It’s costly — in terms of productivity, caregiving responsibilities, cost of health care.”

Haley, who collaborates with exercise physiologists, nutritionists, behavioral neuroscientists and physicians, said researchers from many other disciplines are also studying healthspan, such as nurses, speech pathologists and pharmacists.

Their work is inspired by an aging U.S. population with changing needs. According to the U.S. Census Bureau, 10,000 people a day turn 65, the nation’s fastest-growing population segment.

“We have a lot of people who will need to be taken care of in the next 50 years,” she said, “and fewer young people to do the care.”Ìý

Haley, with UT’s Aging and Longevity Center, focuses her work on midlife, which she defines as ages 40 to 60, a time when health choices can have a big impact on older years. She’s especially interested in brain health.

Her team is collaborating with UT’s Human Laser Lab to pilot the use of low-level light therapy to increase brain energy and improve cognitive performance.

Because of this close brain-body connection, any degeneration in the brain affects not only cognitive function but also areas that control weight, appetite, personality, mood and blood pressure.

Online games and brain-training exercises have become popular as another way to keep the brain sharp.

However, research on brain training reflects mixed results, including a study published last year in the journal Neuropsychologia, which “calls into question the benefit of cognitive training beyond practice effects.”

Still, aging experts urge people as they age to work to keep mentally active, as well as physically active, to lengthen their healthspan.

One of the country’s largest continuing-care companies, Acts Retirement Communities, offers residents weekly social-based classes for brain fitness and memory developed by Cynthia Green, an assistant clinical professor of psychiatry at Mount Sinai in New York City. Green said her brain health approach, available since 2015, is offered at 150 retirement communities around the country.

Some of the Acts communities are participating in a two-year study about memory improvement supervised by a researcher at the University of Alabama.

Helen Marner and her husband, Jim, both 76, are study participants at Indian River Estates, an Acts community in Vero Beach, Fla.

“I’m always interested in bettering my health, my brain and my body,” Helen Marner said. “I’m interested in keeping myself as alive and current and bright as I can.”

Marner bikes, swims and attends exercise classes. The former kindergarten teacher also sings in two choirs, designs and sews quilts, and is active around town as well as at Indian River Estates.

Mary Beth Vallar, 74, and her husband, Bill, 88, joined the study at Vero Beach.

“We figured it couldn’t hurt,” Mary Beth Vallar said. “They’re teaching us certain techniques to remember people’s names and remember lists and remember sequences. Their techniques are very helpful.”

To remember a list, techniques include taking a mental snapshot of it, organizing the items into categories or linking one word on the list to another. As for names, said Robin Leatherow, the Vero Beach community’s fitness director, a creative strategy could be making up a story in your mind about the name or repeating it to yourself.

“There’s a lot of different things you can do for brain health,” said Theresa Perry, Acts’ corporate director of wellness services. “One is to engage with other people. We thought it would be good for our residents and better than sitting in front of a computer and playing games by yourself.”

Because research shows that people who stay active and exercise their brain “tend to be healthier and have better brain function and will be physically healthier because of the brain-body circuitry,” the recent shift to improve healthspan makes sense, said Peterson, of Washington University.

“It’s quality of life versus quantity of life,” he said. “It’s probably as simple as that.”

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“We wanted to find a house that we could live in literally for the rest of our lives,” Dennis Cavner said. “We were looking specifically for a one-story house and one that had a flat lot, to age in place.”

For most of American history, people have moved in with relatives or gone to a care facility to live out their final years. Baby boomers don’t want either, and those with resources have generally created the modern idea of remaking old age to fit their lifestyle and retrofitting their homes for aging in place. Design and construction firms are coming up with safety features that look good as well. Think of it as the age-defying home.

Aging in place is a major financial commitment, one that may be at odds with retirees’ plans to downsize their lives and budgets and squirrel away cash in anticipation of rising health care costs. The Cavners are rebuilding this house — assessed at $700,000 around the time of the sale — from a shell. The remodel could easily cost $300,000 in the hot Austin market.

Leaving nothing to chance, the Cavners are paying for a number of modifications they might never need. For instance, neither uses a wheelchair, but contractors are making all doorways 3 feet wide — just in case. The master bath roll-in shower, flat and rimless, will provide room to maneuver. In the kitchen, drawers, rather than cabinets, will allow easy access in a wheelchair.

The Cavners are closely watching details of the renovation, but this dramatic late-life relocation wasn’t a hard decision.

For some seniors, aging in place might amount to simple modifications, such as adding shower grab bars or replacing a standard toilet with one that sits taller. But many seniors anticipate a financial crunch as they try to plan for their future on a fixed income, uncertain how far their savings and retirement funds will stretch.

by the Harvard Joint Center for Housing Studies may fuel these concerns. It cites growing income disparity for older Americans in the wake of the Great Recession, and says “ensuring financial and housing security in retirement will be a struggle.”

For those 65 and older, it said, “the number of households with housing cost burdens has reached an all-time high. By 2050, almost one-quarter of Americans will be 65 or older, according to the Census. Surveys conducted over the past decade show that older adults in .

Yet many houses aren’t suited to “aging in place,” said Abbe Will, associate project director of the Remodeling Futures Program at Harvard.

“Currently, a lot do not have single-floor living — especially in certain parts of the country. There are lots of stairs and multistory homes when land is more valuable,” she said. And “many homeowners don’t necessarily have the funds to do aging in place.”

Home modifications and costs vary widely — starting with those simple safety features in the bathroom or lever doorknobs throughout the house — to more extensive changes, such as widening doorways or lowering light switches to wheelchair height. Will said simple retrofits, such as grab bars, “could be several hundred dollars,” but a “whole bathroom remodel would be in the thousands or tens of thousands.”

In a recent survey of 1,000 people age 65 and older by the California-based nonprofit SCAN (formerly the Senior Care Action Network), 80% of respondents were concerned about their ability to age in place. The driver appears to be financial: About 60% said they have less than $10,000 in savings (including investments and retirement plans).

“We don’t know what’s coming down the pipeline as we age,” said sociologist Deborah Thorne of the University of Idaho, lead author of a study that found skyrocketing bankruptcy rates among those 65 and older.

The research, recently published in the journal Sociological Inquiry, finds the share of older Americans filing for bankruptcy has never been higher. “And bankrupt households are more likely than ever to be headed by a senior — the percent of older bankrupt filers has increased almost 500 percent since 1991,”

The Harvard report also cited the burden of debt among those ages 65 to 79, with nearly half of those homeowners carrying a mortgage in 2016. And people are carrying substantially more student loan and credit card debt into retirement as well.

James Gaines, an economist with the Real Estate Center at Texas A&M University, attributes the increase “to the labor market and employment downsizing and letting older people go first. It can force them into retirement whether they’re ready for it or not. Retirement income may not be enough to carry their debts, and they don’t have enough savings.”Ìý

“The leading edge of baby boomers has not hit 75 yet,” said , lead author of the Harvard report. “When you think about the next five, 10 or 15 years when they’re in their 80s, you’re really going to see the needs shift.”

Molinsky said just about housing “is a good question and is a tough question.” Many states have loan and grant programs for home modifications if individuals have a documented disability, she said, yet “what we need more of are programs that help you do this before you need it.”

Molinsky said communities need to create housing near city centers so seniors don’t have to drive. And in the suburbs, communities need to offer more multifamily options, including condos and apartments to buy and rent.

“We just need options,” she said. “It’s important to think about housing options that help people stay in that community. Low-income people need housing that’s affordable. Some people want to trade that single-family home for a condo. Others want to reassess their money and sell their home for a rental. Not everybody wants the same thing.”

Don and Lynn Dille, both 75, built their Austin home with the intention of staying there for a long time. After living in California, Virginia and elsewhere in Texas, they moved to Austin in 2012 and, within a year, began drawing plans with an architect for an energy-efficient home to age in place. Their home was featured this summer in Austin’s annual Cool House Tour for its design making the most of natural light, cross-ventilation and solar panels, as well as wider-than-normal doorways and level floors for wheelchair use.

One key feature of the construction acknowledges that they might need live-in help down the road to avoid long-term nursing care. Just as the Cavners may convert a bedroom and bath on the opposite side of their new home into caregiver quarters, the Dilles constructed a second floor above their detached garage that could convert into living space.

“We think having a separate apartment where we could have a caretaker or part-time help to maintain our property makes us able to stay where we’d like to be and be independent,” said Don Dille, who retired from the federal government.

The renovations are meant to meet very personal needs, but that doesn’t mean they wouldn’t appeal to others and even add to the resale value down the road.

For his part, Cavner, an investment adviser and co-founder of a new health care startup, said he believes what they’re spending to renovate the house for the years ahead will prove a sound investment: “The modifications we’re making are not going to make it less desirable. It will feel more spacious.”

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The report, presented Thursday both in Austin and Atlanta, where the CDC is headquartered, covers 87 days last fall in Austin when almost 200 people were injured in scooter crashes. Just one of the riders wore a helmet and 33% of those riders were hurt on their first scooter ride.

Austin city officials requested the CDC’s help in tracking injuries last spring as e-scooters started taking over the city. The investigators identified 271 individuals with potential e-scooter-related injury incidents during the study period last fall; of those, 190 confirmed an e-scooter riding-related injury. Most accidents occurred on streets. Most riders were men. Among the injured, 48% suffered a fracture, laceration or abrasion to the head; 70% injured upper limbs; and 55% injured lower limbs. Of the 190 riders, 35% suffered some type of fracture.

Despite injuries, 38% indicated they will use a scooter again.

“These injuries may have been preventable,” the study concludes. “Studies have shown that bicycle riders reduce the risk of head and brain injuries by wearing a helmet. Helmet use might also reduce the risk of head and brain injuries in the event of an e-scooter crash.”

With the increasing availability of scooters as an urban transit alternative, Austin and other cities around the world are trying to balance the safety and needs of scooter riders and the motorists, bicyclists and pedestrians who must navigate around them on sidewalks and streets. Some localities ban the scooters outright, while others try to control the number permitted or specify boundaries for use or places to park them. Dockless scooters arrived in Austin last April and quickly went from zero to more than 15,000 permitted as 10 companies were licensed to operate, according to the .

Although all those scooters aren’t out at once, the two companies with the most devices in Austin — Bird and Lime — each boast on their websites about availability in more than 100 cities around the globe. As those numbers continue to multiply, the CDC’s report will help shape how cities approach transportation policies, regulation and public safety.

Paul Saffo, who has spent more than 20 years exploring large-scale, long-term change, teaches forecasting at Stanford University. He said cities also need to consider a fundamental question about private use of public property.

“Scooters are lying around on sidewalks and being used by a private company making profit off use of the public infrastructure. The question is: Is the public being fairly compensated for the private use by a for-profit of a public infrastructure?” he said. “Whose right of way is it? The pedestrian annoyed by scooter is presumably a taxpayer. Who gets the privileged use of a public infrastructure?”

The CDC epidemiologists, collaborating with Austin Public Health and the city’s Transportation Department, arrived in Austin last December to examine scooter-related injuries from September to November, including interviewing the injured and studying their medical records to determine road conditions, weather, helmet use and other behaviors, such as alcohol use while riding.

The CDC’s Laurel Harduar Morano said, “We know we’re missing cases of injuries. These are the injuries severe enough to require emergency medical care.”

Among the findings, 55% of the injured riders identified as male. The median age was 29, although riders ranged in age from 9 to 79. Most injuries (55%) occurred in the street, while 33% were injured on the sidewalk.

The study also notes that findings don’t support the perception that scooter injuries are due to collisions with vehicles. But speed is a factor, the study suggests.

“While more than half of the interviewed riders were injured while riding a scooter in the street, just 10% of riders sustained injuries by colliding with a motor vehicle,” the study found. However, 37% of injured riders reported that excessive e-scooter speed contributed to their injury. And 29% of riders had consumed alcohol within the 12 hours preceding the scooter ride.

“Overall, 63% of the injured riders had ridden an e-scooter nine times or fewer before injury,” the study said.

“This study is a critical first step in cities adopting clear standards for safety that all operators must adhere to,” said Paul Steely White, Bird’s director of safety policy and advocacy. “There’s actionable information here for riders, operators and cities alike.” Bird, based in Santa Monica, Calif., turns its scooters off between midnight and 5 a.m. and limits the top speed to 15 mph.

Injuries, which are being recorded at hospitals and emergency rooms across the country, have resulted in fewer than a dozen fatalities nationwide — including one in Austin earlier this year. Two scooter riders died in March in California and two others were killed last month after being hit by cars in Fort Lauderdale, Fla., and Hollywood, Calif. Last week, a 5-year-old in Tulsa, Okla., was killed while riding a scooter with his mother, who escaped the vehicle collision with minor injuries.Ìý

The University of Texas at Austin in March reduced scooter speeds from 15 mph to 8 mph — made possible through geofencing, which uses GPS technology to create a virtual boundary and enables scooter companies to adjust scooter speeds within a defined area, such as the university campus.

The Texas Senate on Wednesday approved a bill to regulate e-scooters statewide, including prohibiting them on sidewalks and at speeds over 15 mph, as well as setting 16 as the minimum age to ride. The measure now moves to the House for consideration.Ìý

During the city’s South by Southwest Conference & Festivals in March, Austin Mayor Steve Adler appeared at a session about scooters and explained the challenges communities such as Austin face.

“It’s hard when you’re trying to figure out what to do and you look around for other examples,” he said. “You look to California and you learn that the best practice is to make sure that the scooters are not on sidewalks but are in the street — until you look to Denver and the best practice is to make sure that the scooter is on the sidewalks and out of the street.”

Saffo, the Stanford forecaster, said discussion now needs to be “where do scooters fit in this larger, ever more complex ecology of transportation options. People better sort out how they feel about scooters quickly because there’s a whole menagerie of others,” he said.

Urban planner Sarah Kaufman, associate director of the NYU Rudin Center for Transportation, said scooters present a safety issue for riders and pedestrians alike, and it’s up to cities to provide the right infrastructure, such as protected lanes or wider sidewalks.

Ìý“At some point, cities have to change the streets to move away from cars as the main mode of travel,” Kaufman said. “We can’t change the design of our cities overnight, but when we think of the long-term plans we’re making, the car cannot be the dominant mode.”

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“I lost control and ended up getting a concussion and a broken rib,” said Glangchai, a 41-year-old mother of four.

And Austin’s first scooter-related death occurred over the weekend. Police identified the scooter rider as Mark Sands, a 21-year-old UT student from Ireland, who died Saturday, just one day after suffering critical injuries when the electric scooter he was riding collided with a car.

As many as 14,000 are on the streets of Austin, whose 326 square miles areÌý. That likely makes Austin one of the cities with the highest scooter-to-citizen ratio in the nation — though the electric vehicles are also rapidly multiplying on the streets and sidewalks of Atlanta, San Diego, Nashville and Washington. At least 1,200 more are poised to appear in Austin whenever already-licensed operators deploy them. Ten companies have licenses to operate now.

Austin city leaders, worried about injuries for both users and pedestrians, asked the Centers for Disease Control and Prevention to investigate scooter-related crashes and injuries. The first-ever CDC scooter study will also look at how accidents could be prevented.

“We’re totally paranoid,” said Forrest Preece, a retired advertising executive who lives in a downtown condo and leads a largely pedestrian life.

“I’m 72 and my wife is 70. It would be easy to knock us over,” he said. “My wife actually went online and found a little mirror to attach to her wrist to look behind her so she’s not constantly turning around. We go single file so she can see that mirror and see what’s behind us.”

These scooters are everywhere — speeding by or strewn on sidewalks — and are likely to overwhelm the city this spring as Austin readies for an onslaught of scooter-riding visitors during the annual SXSW Conference & Festivals, running March 8-17. Last year’s SXSW drew 432,500 people.

The scooter study was launched in December when three CDC epidemiologists spent two weeks in Austin reviewing incidents and scooter-related injuries during a 60-day period from September to November. They began contacting the 258 individuals identified through EMS calls or who visited emergency rooms with a scooter-related injury. Findings from this study will likely be released in March and could have far-reaching effects as cities across the country grapple with reports of injuries from these e-scooters.

“We don’t know if there’s something unique about Austin or the population there that may be different from other parts of the United States or globally,” said Eric Pevzner, chief of the Atlanta-based CDC Epidemic Intelligence Service, which is conducting the probe. “The rate of scooter injuries in Austin may be consistent with what’s being noticed in other places, or it may be much higher.”

These zippy, colorful motorized scooters, which are rented with a smartphone app and dropped off almost anywhere, are hard to resist. The companies behind them — Bird, Bolt, Lime, Scoot, Skip and Spin, among others — promote them as smart, low-cost transportation alternatives for short distances, especially in cities. Neither Bird nor Lime responded to multiple interview requests.

Data on scooter-related injuries are collected by the Consumer Product Safety Commission’s (NEISS), but the category also includes skateboards and hoverboards, which account for the bulk of the injuries in the most recent data from 2017 — well before scooters proliferated across the country.

The Austin study will help develop a baseline for comparison. So far, what’s believed to be the examining scooter injuries was released last month in JAMA Network Open, a peer-reviewed medical journal. UCLA researchers studied 249 patients (228 scooter riders and 21 pedestrians) treated at two emergency departments over a year’s time. Head injuries and fractures were the most common diagnosis. Among scooter riders, 80 percent were injured in a fall, 11 percent collided with an object, and almost 9 percent were hit by a moving vehicle or object. For almost 5 percent of patients, intoxication was a factor. Just 4 percent of riders wore a helmet.

Such findings don’t surprise physicians.

“We’re seeing five to six minor injuries a week, almost one a day — hand and arm fractures, broken bones and facial injuries, such as scrapes and bumps and fractures,” said Dr. Oscar Guillamondegui, trauma ICU medical director at Vanderbilt University Medical Center in Nashville.

“Approximately one to two major traumatic brain injuries a month are admitted to the trauma center. The reason is simple. Who’s carrying a helmet? No one. No one is wearing them because no one is carrying them.”

Guillamondegui will appear this week on a panel dubbed a “community conversation about scooters in Nashville” as that city mulls more regulation.

In Atlanta, the number of injuries per month has increased from about 30 to about 100, said Dr. Hany Atallah, chief of emergency medicine at Grady Health System, which includes Grady Memorial Hospital, the largest hospital in Georgia. Grady, which is among the nation’s busiest Level 1 trauma centers, is looking at the rise and scope of scooter injuries as a new internal project.

“I’m concerned people are riding these things without helmets and on roads in busier traffic,” he said “As opposed to motorcycles, these wheels are pretty small. Certainly, hitting a pothole can send someone over.”

Cities are trying to balance the electric scooter as a boost to mobility with ensuring the safety of riders who travel amid motorists and pedestrians. There are plenty of reports of pedestrians tripping or falling over parked scooters, as well as tales of being hit by moving scooters. A handful of scooter-related deaths occurred last year: one each in Dallas, Washington, D.C., Chula Vista, Calif., and Cleveland. Some cities have introduced regulations that include banning the scooters, regulating the numbers allowed on the streets and specifying where they can park or ride. In Fort Lauderdale, Fla., the City Commission this week plans to evaluate its dockless mobility permit program and consider adjustments that could enhance safety, spokeswoman Dayana Diaz said.

Officials in decided in January to conduct a second scooter pilot program this spring studying the impact of e-scooters on the city. This one will last a year, following a that found 176 people went to emergency rooms with scooter injuries. Of those, 84 percent fell from a scooter and 90 percent of riders didn’t wear a helmet.

As electric scooters multiply around the country and the world, a of 7,000 people in 11 major U.S. cities by the San Francisco-based data platform Populus found that 70 percent of those surveyed had a positive view of scooters. Atlanta placed first, with 79 percent of its residents in the positive category. Austin was a close second, at 76 percent.

The CDC Austin study will calculate injuries per number of scooters ridden and per mile traveled. As researchers speak with those hurt, they’ll ask about road conditions, street types, weather, helmet use and behaviors, including alcohol use while riding.

While the study continues, Austin’s transportation department announced a “pause” in issuing new licenses to dockless mobility operators to assess the level of demand for those currently licensed and to ensure safety. The city is also reviewing its current rules and expects to revise the scooter rider ordinance this spring.

And, with the start of a new semester at UT-Austin, university officials announced for scooter use and indicated more changes are ahead, including dropping scooter speed limits on campus from 15 mph to 8 mph.

Glangchai, the injured CEO, said she’ll now “always wear a helmet and be a little more cautious” when she resumes riding following a six-week doctor-ordered hiatus.

“Scooters empower people. It seems so easy to hop on and press go,” she said. “It seems like it’s easier to take more risks on a scooter. They’re great because you get around places quickly, but it’s almost like it’s too easy for people to hop on and go fast.”Ìý

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But the familiar Texas braggadocio disappears when it comes to health care:

Texas has both the largest number (4.7 million) and highest percentage (19 percent) of uninsured residents under age 65 in the country, according to a new . Two-thirds of the uninsured are in families with at least one full- or part-time worker. The state ranks 37th in the “,” an annual state-by-state assessment of the nation’s health. Thirty-three percent of adult Texans are obese. The state’s maternal mortality rate is 34.2 per 100,000 live births, a rate that has increased 9 percent since 2016 and is one of the worst in the country. It ranks 45^th in the number of primary care doctors per capita.

The state’s “Don’t Mess With Texas” mantra drives much of its politics and policies, as limited government, low taxes and individual rights have prevailed at the statehouse for almost a quarter-century. That freewheeling formula has worked gangbusters for the economy, including the business of medicine, giving rise to some of the nation’s wealthiest hospital systems, as well as hundreds of freestanding emergency rooms and surgery centers.

But it has, ironically, also left citizens struggling to get care and pay bills in health care’s wild west. It has allowed and supported entrepreneurial health care practices that are illegal in many states, including freestanding emergency rooms, doctor-owned hospitals and balance billing. Texas has more uninsured residents than any other state, in part because its largely Republican state politicians elected not to expand Medicaid.

“We’re not having honest discussions about medical needs,” said Sen. Kirk Watson, a Democrat, a cancer survivor and former Austin mayor. Instead, the discussions focus on health care costs, he added.

In August, Ken Blankenship, 48, of McKinney, Texas, was suffering from intense headaches, muscle pain and weakness. “I was hanging outside all day. It was hot,” he said, adding that he played basketball and threw around a baseball in the park. His wife forced him to go to an urgent care clinic, which diagnosed him as dehydrated, then referred him to a freestanding emergency room to rule out a stroke. Though the facility was in his insurance plan, his copayment was over $2,300 for fluids and a CAT scan.

“I was shocked. The first thing I thought was, ‘That’s crazy. It must be a mistake,’” Blankenship said. He got the bill reduced by more than $600 after calling the ER.

“All I know is they have me wanting to be thankful for paying $1,600,” he said.

In many cases, there has been “somewhat more of a free rein,” with corporate entities now involved in the practice of medicine, said economist David Warner, professor emeritus of health and social policy at the LBJ School of Public Affairs at the University of Texas at Austin.

In 2009, Texas was the first state to allow ERs that were independent of hospitals, prompting a rush of highly profitable ERs. At last count, 214 freestanding ERs have popped up across the state, in addition to hundreds of urgent care clinics and surgery centers.

“Basically, they can charge what they like,” Warner said. “They can have a charge scheme that has no relation to cost [of care].’’ He adds that the freestanding ERs often mislead patients, telling them that their insurance will pay for everything and then going after the individuals for unpaid balances.

For the most part, the Texas Medical Association — the country’s largest state medical group — has championed doctors’ and also lobbied against giving nurse practitioners more leeway to practice independently, as they do in neighboring states.

When the Texas Legislature convenes next month, the TMA will focus on “broken issues” including freestanding ERs, Medicaid and overall access to care, said Dr. Douglas Curran, TMA’s president and a family physician in East Texas.

Without policy changes, Texas’ working poor and uninsured will continue to find it almost impossible to access quality care.

The state’s failure to expand Medicaid — even in the midst of a robust economy — keeps millions of people in the Lone Star State living without insurance, straining the medical system, driving up costs and compromising public health.

“We can be a state that’s wildly economically successful and still have more than one-quarter of our working-age adults uninsured,” said Anne Dunkelberg, associate director of the Center for Public Policy Priorities, a nonpartisan, nonprofit policy institute in Austin.

Health care experts maintain that the political leadership has no interest in reducing the number of uninsured. The chairman and vice chairman of the Texas House Public Health Committee — Reps. Four Price and J.D. Sheffield, both Republicans — declined to be interviewed.

“It’s not the cost per Medicaid enrollee that’s going up and up,” said Ken Janda, president and CEO of Community Health Choice, a nonprofit HMO for the Houston area. “We have too many poor people. A couple of years ago, there were only 3 million people on Medicaid, and now there’s 4 million people,” he added.

The poor are “not immigrants coming over the border. It’s people working at jobs that make minimum wage. These are not people sitting on their front porch waiting for their welfare checks,” Janda said.

The poor health outcomes aren’t confined to the uninsured. Employers are increasingly reducing or eliminating altogether subsidies for employees to meet monthly premiums and are shifting to high-deductible plans for their workers.

“We all have to be personally accountable for health,” Janda told the audience at a two-day Healthier Texas Summit in Austin in October. “But it’s very expensive and it’s very difficult if you have people not getting the care they need because they’ve got a $5,000 deductible.”

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New research suggests this perception of becoming irrelevant is very real. And that’s why some seniors are determined to stay social, remain relevant and avert the loneliness often linked with aging.

“As people get older, there are fewer and fewer opportunities to feel like they make a difference and matter,” said sociologist Markus Schafer, a faculty associate at the Institute for Life Course and Aging at the University of Toronto.

“One thing about Western societies, in general, is they’re much more a youth-centered society and don’t oftentimes give careful thought on ways older people can contribute to the lives of future generations,” Schafer said.

When people reach their 60s, opportunities to offer advice drop dramatically, said Schafer, the lead author of a study on how offering advice gives life more meaning. Overall, 1 in 5 adults in their 60s said they did not give advice to anyone in the past year, and the rate dropped to 1 in 4 people 70 and older, according to a 2016 of more than 2,500 adults published in Social Psychology Quarterly.

That’s not all. A of 1,000 adults age 64 and older conducted in August by the California-based nonprofit SCAN found almost one-quarter of respondents agree “they aren’t important to anyone anymore.”

Having purpose and meaning forestalls loneliness, which takes an emotional and physical toll. Studies by Lisa Jaremka and other researchers have found that loneliness is associated with weaker immune systems and poorer physical health.

In published in 2013, Jaremka, an assistant professor of psychological and brain sciences at the University of Delaware in Newark, found that lonely people had more inflammation than those who felt more socially connected. Chronic inflammation is linked to various diseases, as well as functional decline and frailty.

“Maintaining that social engagement can give you a greater sense of purpose and give a sense of motivation that can make you behave in ways that are better for your health,” said sociologist Patricia Thomas, a faculty associate in the Center on Aging and the Life Course at Purdue University in West Lafayette, Ind., who among older adults.

Some older adults in Austin, Texas, are finding their purpose with a community created by , an active-aging company founded just over a year ago.

“It’s about staying visible and staying engaged,” co-founder Amy Temperley said. “If you hunker down in your house and you don’t interact with the world, you will decline.”

The model she and her husband, Damien, devised offers options to keep individuals active and engaged. For $24 a month, members can attend unlimited classes and group activities, including brain and memory training; social and volunteer activities and fitness classes that stress strength, mobility and flexibility.

Rosie Cortez, 66, a grandmother of two, got involved after a heart attack spurred her to lose weight and exercise more. She also needed more stimulating company.

“At one time, I did spend a lot of time with my grandkids and I loved it — but you also need adult time,” Cortez said.

“We really wanted people to have a sense of community,” Amy Temperley said. “Now they’re starting to talk about themselves as a tribe. They get together after classes. It’s evolved into not what we expected but better than we expected.”

In addition to the membership group, the company offers 40-50 classes a month at assisted living and senior living communities. It also maintains a nonprofit fund at a local community foundation, allowing it to raise money for free classes at senior housing and recreation centers in low-income neighborhoods to spur social connections.

Similar efforts are underway across the country as organizations from the National Council on Aging to local YMCAs as well as city parks and recreation centers create social and recreational programs for “active older adults.”

A program to boost well-being, strength and social activities called SilverSneakers, for adults 65 and older, is free with certain health plans. Although approaches vary, the overall aim for active older adults is to promote physical and mental agility and keep loneliness at bay.

Among these strategies, volunteering is now seen as an effective way to battle irrelevancy and loneliness. Buoyed by research that’s found health benefits for older adults who volunteer, one such study led by a Florida State University sociologist showed that volunteering appeared to have the same positive influence on health as exercise and not smoking.

“Volunteering is shown to be, in many ways, a health behavior,” said Dawn Carr, an assistant professor of sociology at Florida State in Tallahassee.

Her , published last year in the Journals of Gerontology: Social Sciences, found that “becoming actively engaged in volunteering in later life is related to lower levels of subsequent disability.”

Retired school nurse Linda Levy, 69, has always been an active volunteer, even as a mother working full time in Pikesville, Md. But after she and her husband moved to Austin about 18 months ago to be closer to their son’s family, Levy is doing something new — working part time in retail.

“I just wanted to do something I could fit in with my schedule for family and to meet people,” she said. “It gave me a purpose. I needed to be able to say ‘I’m going to work.’”

Finding employment isn’t so easy for older adults, which is why job search strategist Toby Haberkorn co-wrote a book, out last year, titled “Best Job Search Tips for Age 60-Plus: A Practical Work Options Resource for Baby Boomers.”

Haberkorn advises job seekers to update their appearance and “show you have the energy and expertise to manage the workload.”

Haberkorn’s tips to stay relevant in the workplace are also pertinent in daily life: “Show flexibility and adaptability rather than regurgitating the past. Become reasonably social media- and technology-savvy. Familiarize yourself with what young employees have an interest in — the music, whatever current events, the apps — and be able to have a reasonable discussion. Do not say ‘Boomers have a better work ethic.’ Never, ever say ‘I’m having a senior moment’ or ‘I have a child your age.’ Don’t discuss your grandchildren. And keep your aches to yourself.”

Haberkorn also advises taking a hint from 96-year-old actress Betty White.

“She still produces good work and she has a great amount of energy,” Haberkorn said. “Her entire package promotes a youthful and optimistic attitude.”

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“When women came forward with allegations of sexual abuse and sexual harassment, the woman was the person blamed and the woman was not believed,” she said. “I was very angry that I would pay the price for coming forward. I knew what would happen.”

Like most who’ve had similar experiences, Welch, a relationship expert in Eugene, Ore., kept quiet. She wanted to bury the inappropriate encounters initiated by men who outranked her in the workplace. Welch worried that her fledgling career would be doomed.

That was until .

“I jumped in immediately,” she said. “I knew that this was our moment. It was the first time I became very public about abuses and inappropriate sexual conduct that I’ve experienced.”

But figuring out why Welch and the millions who have posted on social media using #MeToo isn’t as simple as chalking it up to the power of the hashtag. Rather, a complex set of psychological and sociological factors is at work. Sparked by , the mushrooming list of accused harassers and those unwilling to stay silent any longer illustrate that what’s happening with this avalanche of disclosures is more than just a show of strength in numbers.

“Admissions of being a victim are stigmatizing,” said John Pryor, a professor of psychology emeritus at Illinois State University who has studied sexual harassment for more than 30 years and is participating in a National Academy of Sciences study of sexual harassment in STEM fields — science, technology, engineering and mathematics.

“Research has shown that people with stigmatizing conditions that can be hidden often engage in what is called ‘label avoidance.’ With regard to sexual harassment, the more people who come forward and say ‘me, too,’ the less stigmatizing the label,” he said.

Gayle Pitman, a professor of psychology and women’s studies at Sacramento City College in California, said the sense she’s gotten from the #MeToo posts are “almost like a catharsis.”

“‘Finally, I can release this.’ There’s also some fear. ‘What happens now that I outed myself? What are people going to think of me and how am I going to feel now?’” she said. “There is definitely a possibility of reliving a traumatic experience or dredging up past wounds. A lot of people who have been victims of sexual violence probably have untreated PTSD [post-traumatic stress disorder] and can lie dormant for a long time until something triggers it — even a deliberate disclosure.”

The risk of triggering a traumatic experience is lessened as more women step up and validate the experience. “You think less that it’s my fault and I did something wrong and you’re blaming yourself,” said Lucia Gilbert of San Jose, Calif., a professor emerita of psychology at Santa Clara University. “It validates that you have been validated. Now there’s a validation in the culture, and that’s huge.”

Social media is at the heart of this change, experts agree.

“It connects one person’s story to a much broader story and simultaneously creates heft to your story. It’s not just me. My voice is a part of this giant groundswell,” said Amanda Lenhart, of the nonpartisan think tank New America, who has studied the internet and American life at the research institute Data & Society as well as at the Pew Research Center.

Although viewed as a critic of social media, psychology professor Jean Twenge of San Diego State University — whose book “iGen: Why Today’s Super-Connected Kids Are Growing Up Less Rebellious, More Tolerant, Less Happy — and Completely Unprepared for Adulthood — and What That Means for the Rest of Us” explores the detrimental effects of smartphones on youth — said the #MeToo trend illustrates the positives of social media.

“It allows people to band together and share their stories at lightning speed,” she said. “The workplace certainly ups the stakes for the person experiencing the sexual harassment, and it also ups the level of anger because you’re talking about someone’s livelihood. You’re talking about a career or feeding their kids. Part of the conversation is not just the Hollywood starlet but the cashier at the grocery store.”

Women may believe now is a safer time to disclose what they wouldn’t have before, said Gilbert.

“Women are speaking up, and the political environment feels different,” she said. The on Jan. 21 “was huge. Women may better understand the importance of fighting for their rights.”

She suggests that change is possible when power shifts to more women at the top in certain traditionally male-dominated industries, such as the entertainment and media arenas, politics, the sciences and tech.

“It’s much harder to change the pattern of behavior and the sense of entitlement when you don’t change the power differential,” Gilbert said.

In his 1995 study of more than 2,600 employees at a government agency with more than 8,000 employees in 37 offices nationwide, Pryor found that office norms and the workplace culture are underlying factors — which hasn’t really changed in the decades since.

“If you look at women in those offices, office by office, women were more likely to say they were sexually harassed in the offices where the men said it was tolerated,” Pryor said.

Family law attorney Cindi Graham, 53, of Amarillo, Texas, knows all about how such behavior can be tolerated.

“There’s a lawyer who says inappropriate statements, and everybody just laughs and says that’s who he is,” she said. “It’s offensive. He’ll blatantly stare at women’s breasts. He won’t go so far as grope, but he’ll leer.”

Welch said the inappropriate behavior and harassment she experienced ranged from having a supervisor expose himself to her in his office (which caused her to quickly transfer and take a pay cut) to being harassed over a two-year period by a man whose office was located in her path.

“He had a lot of power, including power over my career,” she said. “I found another way to get into the building and he came to my office and said, ‘It’s starting to feel like you’re avoiding me.’”

“In my early 20s, my story would have been an isolated event brushed away and me blamed for it,” Welch said. “I wanted to add to what I see is a really important cause. Now most people are believing us.”

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