Diversity of Aging Population -- Innovative Healthcare
Over the past several decades there has been an avalanche of research and scholarly narratives focusing on the aging of millions of Americans -- among them the "baby boomers" that were born between 1946 and 1964 -- including their numbers and their health vis-a-vis the impact on the sometimes struggling healthcare system. But there has been a dearth of research on how American healthcare services will respond -- and is currently responding -- to an increasingly diverse older population when it comes to racial, cultural and ethnic identities. This paper points to the numerous issues and challenges that not only face an increasingly diverse older American population when it comes to healthcare, but also the challenges that the healthcare system itself faces as these Americans move into the twilight of their lives.
What should be the Vision and Mission of Healthcare Professionals in the U.S.
Goals and objectives in healthcare settings are necessary and informative to the public that the healthcare system serves. To that end, the Centers for Disease Control and Prevention posits that the goals of healthcare services in the United States -- with specific reference to aging Americans -- should extend well beyond the idea of helping people live longer. Indeed, the goal for older people should also be to assure that they are "living well" (CDC, 2007). Hence, the major public health challenges for America -- with reference to the increasingly diverse over-65 population -- include: living longer; living "high-quality, productive and independent lives"; providing care with leading edge technologies; eschewing bias based on culture, sexual preference or ethnicity; and reducing those behaviors "that contribute to premature death and disability" (CDC, III).
The vision and mission of the healthcare industry should include the prevention of "cognitive decline" in the elderly, and the prevention of "…end-of-life suffering" (CDC, V). The healthcare professionals' goal certainly should be to ensure that baby boomers and the aged population in general have an opportunity to enjoy the so-called "golden years"; but for the 360,000 to 480,000 adults over 65 that sustain "fall-related" fractures each year in the U.S. there is nothing golden at all about moving on in advanced years. Hence, the healthcare industry has as a goal to help the elderly avoid those falls, which are "…the leading cause of injury deaths" and the most common reason that older people are admitted to hospitals (CDC, V).
Zeroing in on older people and their inability to balance themselves, a fair question should be posed. To wit, how can healthcare professionals help prevent the diverse population of older people from the "suffering" that results from falls -- accidents which result in "significant mortality, disability, loss of independence, and early admission to nursing homes"? The CDC asserts that falls are preventable: a) if elderly persons' medications are monitored adequately; b) if vision problems are addressed properly; and c) if risk factors (hazards that cause tripping) are removed and handrails are installed (CDC, V).
As this diverse population copes with advancing years, in addition to the moral and ethical issues linked to taking care of the elderly, the American nation has a "strong economic incentive" as well, according to the CDC (III). The cost of providing healthcare for Americans over 65 is "…three to five times greater" than for those younger than 65 years; and moreover, those costs can be significantly lowered when steps are taken to "address health disparities among older adults, particularly in racial and ethnic minority populations" (CDC, V).
Indeed, the survey referenced by the CDC reveals that about 40% of Caucasian adults over 65 report "very good or excellent" health but just 24% of African-Americans and 29% of Latinos report "very good or excellent" health (III). Granted, this article is ten years old, but because there is continuing relevance within the data, these facts should cause every healthcare professional in every component of the healthcare field to sit up, take notice,...
In a 1991 article published in the peer-reviewed journal, Generations, the authors, while no doubt well-intentioned, asserted that "Acknowledging diversity can also cause us to be overwhelmed with differences and discourage us from seeing the progress or lack of progress" toward improving the quality of life for all older people (Stanford, et al., 1991). The article also suggested that comparing older African-Americans with older Caucasians implies that minorities "need to 'catch up' to whites" -- which has negative implications for this much-needed research. Still, the authors acknowledge that studying the diversity of the aged population provides a "…opportunity to expand the tools and models" that will help healthcare professionals to fully grasp the "…major economic, social, and political issues in gerontology today" (Stanford, p. 4).
Meanwhile, in a much more recent Generations research article, eight out of ten in the over-65 population in American are listed as Caucasian; African-Americans comprise 8.5% of that elderly population, Latinos make up 6.8% and 3.3% are said to be of Asian ethnicity (Treas, et al., 2010, 38). That seems to go against recent demographic reports which continually list Latinos as the fastest-growing and most influential minority group, which is true for those younger than 65. To wit, Treas reports that 17% of the population that is younger than 65 is Latino and 13% is African-American.
But for the future, "…much of the growth in the old population" will involve Latinos and Asians, populations that currently are expected to more than double by the year 2050, and every alert person in the healthcare field should be thinking about how these minority populations will be served in the coming years (Treas, 39). Older Latinos are expected to become 19.5% of "all older Americans" by 2050, and older Asians could make up 8.4% of the over-65 population by 2050 (Treas, 39). As for African-Americans, they will make up 11.8% of the older population by 2050, Treas continues (39).
A peer-reviewed article in the Journal of Aging and Social Policy offers data showing that according to the 2000 U.S. Census, Latinos made up 10% of the 80 million baby boomers, and that about a third of Latino baby boomers (37%) were either born in the U.S. Or born in a territory to an American parent (Gassoumis, et al., 2010). About 6% of Latino baby boomers were born in a U.S. territory; 21% were naturalized citizens; and 36% were non-citizens (illegally living in the United States) (Gassoumis).
Looking briefly at where the older Latino population resides, Treas explains (p. 40) that 70% of Latinos over the age of 65 live in four states: California (27%); Texas (19%); Florida (16%); and New York (9%) (Treas, 40).
Many older Mexican-Americans are "…disproportionately poor and are at a disadvantage when the costs of health services are increasing…especially along the Texas-Mexican border," where several counties report half of the population lives below federal poverty standards, according to Jacqueline Angel, sociologist at the University of Texas (Gomez, 2013). Notwithstanding the struggles that elderly Latinos go through to receive healthcare in Texas, the governor, Rick Perry recently rejected federal Medicaid funding, which would have been helpful to older Texas Latinos (Latinos make up 37.6% of the entire population of Texas).
The conservative governor said, "I will not be party to socializing healthcare and bankrupting [Texas] in direct contradiction to [the] Constitution and [the] founding principles of limited government" (Chadwick, K, 2012). Perry's refusal to accept federal money for healthcare that would be beneficial to low-income residents -- in particular, elderly Latinos -- in his state means that he was willing to leave "…$79 billion of federal money on the table" because of his conservative ideology (Fuquay, 2013).
Meanwhile, the Latino baby boomers are "disadvantaged relative to [Caucasians] for all socioeconomic status and several health outcomes" (Villa, et al., 2012). In fact Latino baby boomers are "disadvantaged" for "diabetes, obesity, and fair/poor self-related health," Villa explains in the peer-reviewed journal Gerontologist. As the Latino baby boomers move into very old age, the "cumulative disadvantage of existing disparities are likely to result in continued or worse health disparities" (Villa).
Elderly African-Americans today -- how will they fare in the Future?
While it is clear from the data that elderly Latinos have struggled to maintain the dignity that comes with good health, African-Americans have also had their own struggles, albeit language does not present barriers for black people as it often does for Latinos. First, this paper will provide…
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