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The population of Rhode Island is aging more rapidly than that of most states and, therefore, can be used to illustrate the effects of aging on health systems, effects that may occur somewhat later or less extensively in most other states. Rhode Island population projections indicate a lull in aging between 1990 and 2010, followed by a 50 percent increase in the elderly cohort as the post-World War II "baby boom" population becomes 65 years of age and older between 2010 and 2030. Current (constant) Rhode Island rates of physician visits and hospital and nursing home use were applied to the projected population and translated into physician and hospital bed requirements and health expenditures, demonstrating that the resource costs of aging will be very large between 2010 and 2030 unless health service needs are reduced substantially and/or alternatives to hospital and nursing home services are developed. During the next 30 years, there will exist a unique and critical opportunity to restructure the medical care system. By developing alternatives to hospital inpatient care and nursing home care and by investing in primary, secondary, and tertiary prevention efforts, the baby boom population may remain healthier longer and, therefore, may require less medical care than elders today.