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Experts Expose Health Reform Gaps for Ethnic Elders
By
Paul Billingsley and Farid Sadri, New America Media
December
2, 2009
“If I had know I was going to live this long, I would have taken better care of myself.”
– Comedian Henny Youngman
The way we live and how long we live may separate the various races, genders and classes in the United States, but there is one thing that connects all groups – they all are aging.
Regardless of the kind of health care reform Congress finally delivers to the nation, Americans have to figure out how to reduce the health of ethnic and minority elders. This was one of the many issues examined by the 3,500 attendees at the recent Gerontological Society of America’s 62nd Annual Scientific Meeting in Atlanta, Ga.
The theme this year was “Creative Approaches to Healthy Aging.” New research was presented in more than 1,000 sessions and papers.
Researchers sought to bridge the gap between America’s scientific know-how and decisions by policymakers. Experts agreed that when they can share information with political leaders, it would be much easier to improve long-term care for the nation’s growing elder populations of color.
According to the U.S. Census Bureau, aging baby boomers will almost double the country’s 65-plus population by 2030. While the number of white seniors will grow in that time by about 70 percent, African-American elders will increase by double that percentage, and older Hispanics will rise by more than 250 percent.
Over the last decade, Mexican Americans had a 30 percent increased risk of death compared to European Americans, according to a study by the San Antonio Longitudinal Study of Aging (SALSA).
Even more striking was the impact on Mexican American elders of diabetes and physical frailty, which are more prevalent among Mexican Americans than whites.
The SALSA study showed that among Mexican Americans, those with diabetes were 50 percent more likely to die, compared to older Chicanos without the disease. And frail Mexican-American seniors faced an 80 percent greater risk of death compared stronger Chicano seniors.
"We can improve the survival rate of older Mexican Americans” by reducing the effects of diabetes and frailty, stated Sara E. Espinoza, MD, an assistant professor of medicine in the Division of Geriatrics and Gerontology at the University of Texas Health Science Center in San Antonio, who presented the study.
Espinoza added that, although she had no data to this effect, she believes physical activity and good nutrition are two important keys to healthy aging. She based her conclusion on her observations of highly active older veterans at the VA medical center where she works with patients. These veterans have benefited from good nutrition, she said, and have been highly active throughout their lives.
Toni P. Miles, M.D., Ph.D., a professor of family and geriatric medicine and the Wise-Nelson Endowed Chair in Clinical Geriatrics Research at the University of Louisville, said that many of the groups she talks to don’t believe that they are going to live well into later life. She urged reporters to encourage their readers to plan for old age.
“The older you get, the older you will get. That’s the way the statistics are,” Miles said. “If you look in the mirror today and you are around 40, plan for 50 to 55 more years of life – and be ready for it. Be able to go that mile and be able to lift that 15-pound weight. That mile will get you around the grocery store and that 15-pound weight is your infant grandchild.
“So if you’re 30, 50 or 70, wake up in the morning and ask yourself, ‘Can I do what I need to do today?’ And that will set you in motion for healthy aging,” Miles said.
Beyond what individuals can do, Miles continued, U.S. policymakers need to improve access to care for elders. Long-term care coverage, for instance, is not currently offered under Medicare and is available only to impoverished seniors under Medicaid or a small percentage of Americans with special insurance policies. Miles became so concerned with public policy issues that she spent the last year as a Health and Aging Policy Fellow on the health care-reform team of the Senate Finance Committee.
Carmen R. Green, M.D., a professor of anesthesiology, obstetrics and gynecology at University Hospital at the University of Michigan, Ann Arbor, stressed the need for more funding for research in pain, which affects more people than cancer and diabetes combined. Green’s research focuses on pain management for African Americans.
As the chief investigator for the Michigan Pain Outcomes Study Team, she said that their findings reveal that there is a “health care bubble,” due to disparities in age, race, gender and class.
“We have increased longevity in our lives and know that we are going to have an increase in cases of pain if we don’t intervene,” Green said. “We also know that minorities have a history of having their pain poorly assessed, but they don’t have to tolerate that. There are things that we actually can do for pain.”
Too often ethnic elders see pain as the price for growing old and don’t want to complain to family members or their doctors that they are in pain, Green said. It’s important for health care professionals, physicians and loved ones to listen to seniors to determine when they are actually in pain, she advised.
An elder also needs an advocate for them, a trusted family member or friend, to let the doctor or health care professional know when the older person is suffering.
“Pain is not something that you have to live with," Green stressed. "You should come to the doctor and say, ‘I am in pain.’”
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