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Health care shows bias By
Bill Walsh Cleveland
Plain Dealer, May 19, 2003 Washington - People over 65
suffer the highest suicide rate in the nation, but are rarely diagnosed as
being depressed. They are routinely discouraged from participating in
clinical trials even for treatments that might help them. And they rarely
receive preventive medical screenings to which they are entitled. Those are some of the findings
from a report expected to be released tomorrow by the nonprofit Alliance
for Aging Research decrying what it sees as rampant age discrimination in
the U.S. health care system. The report will be presented at
a hearing of the Senate's Special Committee on Aging that will feature
testimony about misdiagnoses of illnesses among senior citizens, a problem
said to stem from a lack of authoritative research and a shortage of
health professionals trained in geriatrics. "At the root of shoddy
health care for America's seniors is the very common tendency of health
care providers and patients alike to view many serious medical conditions
in older people as simply a natural part of getting older," the
report states. "That attitude results in
providers missing out on millions of opportunities every year to prevent,
treat and enhance the lives of people over 65." The Aging Committee has held
several hearings in recent years raising concerns about the nation's
ability to care for an over-65 population projected to double in size by
2030, when almost one in four Americans will fit into that age group. The
report expected out tomorrow, "Ageism: How Health Care Fails the
Elderly," takes aim at the quality of medical treatment for seniors -
the most prolific users of the health care system. It cites studies showing that
seniors commit suicide at four times the national average as evidence of
widespread depression - estimated to be 20 percent of the over-65
population - and poor detection. One study found that 75 percent
of seniors who kill themselves do so within four weeks of having seen a
physician. Experts say that the
health-care system discourages many seniors from getting mental health
treatment. Medicare requires a 50 percent
co-payment for mental health care, while ordinary medical treatment
requires just a 20 percent co-payment. "Mental health services in
our country are designed for young- and middle-aged adults in good
physical health, ignoring the unique needs of older adults who typically
have concurrent medical conditions that complicate their care,"
according to the prepared testimony of Dr. Joel Streim, president of the
American Association of Geriatric Psychiatry. Seniors are also routinely
steered away from clinical trials, the report said. In fact, a study by
the International Longevity Center found that 40 percent of clinical
trials between 1991 and 2000 explicitly excluded people over 75 years old.
Seniors are often left out of
trials for drugs and medical treatments aimed at helping their age group.
A Duke Medical Center study found that only 2 percent of trials for
procedures to unclog arteries involved patients over 75. In heart disease
trials, no participants were over 65. The result, according to Robert
Butler, president of the New York-based Longevity Center, is that
physicians have little research on the effects of medical treatments on
the elderly. "This lack of
representation increases the likelihood of adverse drug reactions and
inappropriate treatments," Butler said. The report found that making
health care available doesn't always mean seniors get it. Medicare pays
for preventive screening for flu, but one in three seniors never get a
shot and even fewer get a subsidized vaccine for bloodstream infections or
cancer. Experts blame a lack of public information about the benefits, but
the report also says that doctors are "less aggressive when
recommending preventive measures to the elderly." Copyright
© 2002 Global Action on Aging |
