How many older adults live in the St. Louis region? 535,836.

The figures above come from a single column in a single public file. The Census Bureau publishes a county age and sex file for every state, and the 2024 vintage carries a row per county per reference year. The row this desk reads is the one coded YEAR 6, which is the estimate for July 1, 2024. The column is AGE65PLUS_TOT. Adding that column across the fifteen counties of the St. Louis MO-IL metropolitan statistical area returns 535,836.

That number is a population, not a caseload. It counts every resident aged 65 and over, including the large majority who need no assistance of any kind. It is a denominator, not a demand forecast, and this desk does not convert it into one.

The regional share, 19.1 percent, is higher than the Missouri statewide share of 18.7 percent computed from the same file. That gap is small. The variation inside the region is not: county shares run from 15.5 percent to 25.5 percent, a ten point spread across counties that sit within an hour of each other.

Each page states the file it stands on, the column it reads and the pull date.

The region is defined here exactly as the Office of Management and Budget defines it: fifteen counties, seven in Missouri including the independent city of St. Louis, eight in Illinois. Ranked by count of residents aged 65 and over, the distribution concentrates hard at one end. St. Louis County alone holds 37.2 percent of the region's older adults. The four largest counties hold 69.9 percent between them. The seven smallest hold 7.7 percent.

Tinted chips mark the seven counties whose older population is under 10,000. Full ranked table with population, count and share: the county ranking page.

Population alone does not describe access. The second file this desk reads is the Bureau of Labor Statistics county employment file, which reports how many private establishments in each county are classified under NAICS 621610, home health care services. Dividing that count by the county's older population gives a supply figure that is not published anywhere in either source: home care establishments per 1,000 residents aged 65 and over.

Across the region the two urban cores hold 319 of the 409 establishments the file reports, against 46 percent of the older population. Jefferson County, with 41,443 residents aged 65 and over, reports three. Five Illinois counties have no row for this industry code at all. What that absence means, and why it is not the same as a suppressed figure, is set out on the supply page and in the methodology.

One caution belongs here rather than in a footnote. NAICS 621610 mixes medical and non-medical operations into one industry code. A Medicare certified skilled nursing agency and a company that sends a caregiver to help with bathing, meals and errands are counted in the same column. The ratio therefore measures registered business presence, not the availability of any particular service.

The same Census file covers all 115 Missouri counties, the independent city of St. Louis included. Sorted by share rather than count, the ranking inverts. Stone County, population 32,630, is 33.1 percent aged 65 and over, the highest share in the state. Benton County follows at 32.4 percent, then Hickory at 32.1 percent and Camden at 31.1 percent. Every county in the top four sits in the lake and Ozark tier of southern Missouri, and none of them appears anywhere near the top of a count ranking.

At the other end, Pulaski County reports 10.1 percent, the lowest share in the state, followed by Johnson County at 13.9 percent and Boone County at 14.5 percent. All three carry large institutional or student populations that pull the denominator up without adding to the numerator, a reminder that a share moves with both of its parts.

Of the seven Missouri counties inside the St. Louis region, none reaches the statewide top twenty by share. Franklin County, at 20.3 percent, is the highest placed. The full statewide cut is on the oldest counties page.

The Census file carries a second column, AGE85PLUS_TOT, and reading it separately changes the geography. The region holds 55,917 residents aged 85 and over. St. Louis County holds 22,623 of them, more than the next three counties combined. Measured as a share of total county population, the leader is Calhoun County, Illinois, at 2.70 percent, on a base of 4,224 residents. Measured as a share of the county's own older population, St. Louis County and Macoupin County tie at 11.3 percent.

Those three readings answer three different questions. A count tells a provider where the largest group is. A share of total population tells a county board how much of its community sits in that band. A share of the older population describes that cohort's internal structure. The full table carries all three for all fifteen counties, on the 85 and over page.

This desk publishes county totals and a computed ratio. It does not publish municipality figures. The place level tables that would carry Ballwin, Chesterfield or Valley Park separately come from the American Community Survey rather than the population estimates programme, and that survey's data interface now requires a key. Requested without one, it answers HTTP 200 and returns an HTML error page, which a parser will happily accept as data. Publishing town numbers on that basis would poison the file silently, so none are published here.

Nothing on this desk is a statement about health, care needs, diagnosis or treatment. Population counts describe who lives where. They do not describe who needs help, what kind, or how often, and no page here converts one into the other.

Establishment counts describe registered employers, not service coverage. A company headquartered in one county routinely serves several, so a county with few establishments is not necessarily a county without providers. Read the ratio as a measure of where the industry is registered, and check a provider's own service area before drawing a conclusion.

Every source file, column code, licence and pull date behind these pages is listed on the methodology page, together with the exact reason a figure is shown as not published rather than as zero.