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This speech was presented to forecast the health care challenges and costs created by an aging baby-boom population and its susceptibility to incontinence, osteoporosis, and other conditions of advancing age. Koop also emphasized that the degree of health or impairment experienced by Americans in their old age was directly related to the quality of health care--such as immunizations--they had received over the course of their lives, as well as to personal decisions they had made with regard to smoking, nutrition, and exercise.