MT. ORAB, Ohio -- It's winter, so Donna Robirds puts on two sweaters in the morning and keeps heavy blankets handy as she sets her thermostat low -- 60 at night -- and bundles up to keep her utility bill down.
At 67, with a fixed income and a $563-a-month mortgage, she lives on a tight budget. Food stamps help the retired state employee stretch her budget in this Appalachian village. So has the mild winter.
"We haven't had the extreme cold, so it hasn't been too bad," she said. "I really need to watch my money. It's going to be a struggle."
Robirds' daily battle is being played out across the Appalachian region, which stretches through 13 states from northeastern Mississippi to southern New York. A part of the country that has long lagged behind the rest of the U.S. economically finds itself on the leading edge of a national trend: The number of Americans 65 and older is increasing, and many are struggling as government services are being cut in a rough economy.
Nationally, with the aging of the baby boom generation, people 65 and over are expected to account for 1 of every 5 Americans by 2030. Some places in Appalachia have already reached that benchmark, such as southern Ohio's Brown County, where Robirds lives.
"These counties are like the canary in the coal mine," said Suzanne Kunkel, who heads the Scripps Gerontology Center at Miami University of Ohio. "This is a pretty dramatic change coming."
More than 15 percent of Appalachia's population is already at least 65, compared with 13 percent nationally, according to the 2010 Census. And projections show the number rising steadily in much of the region, as it is nationally.
The aging population means more demand for health care, economic help, transportation and home help, which are already in short supply in much of Appalachia.
"It's getting more urgent in the number of people needing those services and having those available to them," said Robert Roswall, commissioner of West Virginia's Bureau of Senior Services. "We have people waiting for all those type of programs."
Appalachia has long been plagued by isolation, poor roads, sewer systems and other infrastructure needs, lack of education and the decline of coal mining, manufacturing and other key industries. The region has low per-capita income (less than $30,000 in 2009, 18 percent lower than the nation's), low college graduation rates, an exodus of young working people, and high rates of heart disease, cancer and diabetes, along with poor access to health care.
Peggy Basham, 74, of Summersville, W.Va., is worried.
"I think most everybody in the area is," she said. "You've got baby boomers coming on. You've got so many seniors. ... Nothing stretches very far."
Basham helps craft quilts that are sold to support the Nicholas County Senior Citizens Center. The senior center feeds 500 people per month, and Basham said more would come if only they had transportation from their mountain homes. She said she sees elderly people regularly forced to choose whether to pay for prescription drugs, heat their homes or buy groceries.