Federal legislation in 1996 imposed severe restrictions on immigrant eligibility for public benefits, which created a chilling effect that discouraged even eligible immigrants and their families from accessing needed income, healthcare, and food. States recognized the harm to the community as a whole when some members are excluded from public benefits and have filled in some of these gaps. But the better solution is to reverse the 1996 federal restrictions and reform our public benefit programs for a future society that is increasingly older, and an older adult population that is increasingly immigrant.
The estimated 5.4 million children in the United States providing unpaid care, support, and assistance to their family members and other individuals are called "youth caregivers." Before the COVID-19 pandemic, youth caregivers existed on the fringes of American society, without recognition in state or federal policy. They experience higher levels of social isolation, depression, anxiety, and absenteeism from school in comparison to their non-caregiving peers. The pandemic has only served to widened the disparities they face. This article presents recommendations for research, policy, and practice to build a more equitable "Post-COVID-19" society for youth caregivers.
This article discusses the intersection of culture, cultural competence, cultural humility, and implicit bias, and how they impact the diversity spectrum of older adults including people of color, members of the LGBTQIA population, those with differing abilities, rural, tribal, and immigrant communities.
Many older adults struggle to meet their daily expenses, but persons of color have amplified risk of economic insecurity. In this article, by situating older adults in their geographic locations of residence, we discuss how life-course experiences intersect with aspects of older people's communities to produce disparities in experiencing precarious financial situations. Race-based risks and disadvantages that accumulate over time yield racial disparities in income among older adults. Taking into account local cost of living reveals substantial disparities in economic security by race. Disparities are far greater in some states than in others.
Food insecurity is an enormous problem in the United States, including in the older adult population, with notable negative health impacts such as malnutrition. Food insecurity has increased with the COVID-19 pandemic. Federal nutrition programs such as the Supplemental Nutrition Assistance Program and the Older Americans Act Nutrition Services Program can help alleviate food insecurity. These programs have had some issues, both pre- and post-pandemic, but have been able to adapt to meet the challenges they faced. Food insecurity must be tackled head-on to invest in better health for all older Americans.
COVID-19 and its resultant economic decline have underscored inequities faced by women and people of color. In the United States, policymakers pursued different paths when attempting to recover: Some, like state lawmakers in Georgia, chose to cut funding for programs and services. Other policymakers invested dollars where the need is greatest. Moral investments that put the needs of people first, by creating jobs that pay living wages and help people afford necessities, and equitable policies that ensure everyone pays their fair share of taxes are needed to create a system where everyone can recover and thrive.
Care work is the work that makes all other work possible, although detrimentally undervalued and often unseen. This devaluation is deeply rooted in the historically racist, patriarchal structures of uncompensated slave labor, which viewed caregiving as women's work in the home, associated with women of color, and which is increasingly performed by undocumented immigrant women. This article explores the firsthand experience black caregivers continue to face today, with a particular focus on inherited values, challenges, and the women behind this essential yet undervalued work.
Area Agencies on Aging (AAAs) respond to elders' needs in most communities in the United States, playing a critical role in assessing those needs and developing plans to address them. AAAs also evolve continuously, and the Older Americans Act (OAA) has adapted to allow AAAs to seek out revenue streams, including partnerships with healthcare entities to help their mission. USAging is the home of the Aging and Disability Business Institute, which since 2016 has been helping to build and strengthen partnerships between aging and disability community-based organizations and the healthcare system to ensure better quality care for elders.
Area Agencies on Aging (AAAs) are entering a new phase marked by a heightened focus on social determinants of health. With a mission, a history, and a legislative mandate to serve as the local hub for a coordinated system of health- and independence-enhancing services, AAAs are well-positioned to address needs related to the social determinants of health. Contracting with healthcare partners to meet these needs is an opportunity to expand their role in the communities, protect their mission, and communicate and reinforce their unique areas of expertise.
Tracing the 1960s origins of what became one of the first of nine area agencies on aging in the U.S., led by influential women with ties to local power brokers and driven by poverty and social change movements. Southeastern Virginia Areawide Model Program, Inc. (SEVAMP) was an expansion of Elise Margolius's original vision to create a community-based network of services to assist older adults. After the 1965 passage of the Older Americans Act, funding was secured and what was then the Senior Citizens Service Center opened its doors in 1968.
The story of the forming of the National Association of State Units on Aging, now known as ADvancing States, and the Older Americans Act objectives for programs for older Americans. The article also addresses funding for this programming and the evolution of the state aging director's role. ADvancing States has also extensive new resources, which are described.
The 1992 Older Americans Act reauthorization included the creation of Title VII focused on advocating for rights of vulnerable older adults, improvements in the long-term care ombudsman program, efforts to prevent abuse, neglect, and exploitation, strengthened legal assistance, and critical programs for American Indian and Alaska Native elder rights. Former Congressional staffer and long-time aging advocate Bill Benson shares his reflections on the development and implementation of Title VII of the Older Americans Act, including its successes and shortcomings.
This article focuses on elder incarceration and highlights the need for New York Senate Bill S15A, informally referred to as the Elder Parole Justice bill, which failed to pass into law in the early 2021 legislative session. The author quotes Jose Saldana and Laura Whitehorn, two formerly incarcerated people who work in their communities to end mass incarceration. The article also relies upon the author's experience of growing up with her father in prison.
Under Medicare, older Americans have access to government-subsidized health insurance to protect them from catastrophic healthcare costs and ensure access to needed care. And yet, one in ten Medicare beneficiaries report delaying care due to cost, and 6 percent report having problems paying medical bills. The health and economic impacts of the coronavirus pandemic have exacerbated issues of healthcare affordability for older adults, particularly those with low incomes. This article reviews the financial impact of gaps in the Medicare program, and proposals designed to meet Medicare beneficiaries' evolving needs.
This article details two critical points regarding wealth and inequality in the United States. First, retirement wealth inequality is extreme-Black and Hispanic households have less than half the retirement wealth of White households. Second, this inequality would be much worse but for the presence of Social Security. As the U.S. population becomes more diverse, it will be increasingly important for policymakers addressing Social Security's solvency to understand the extent to which various racial and ethnic groups rely upon Social Security versus other sources of retirement wealth.
Climate change and disasters present mounting health risks to the U.S. population, especially for adults ages 65 and older. Generally, across all age groups, older adults are the least prepared and the most at-risk during all phases of a disaster (e.g., mitigation; preparedness; response; recovery), and, have the highest rate of disaster-related deaths. This article identifies vulnerabilities of older adults to climate change and disasters, including those related to chronic health conditions, disabilities, and depleted social networks. It then discusses two critical resources that can reduce older adult vulnerability, including individual and community emergency preparedness and increased social support.
The positive impacts of Older Americans Act (OAA) programs are often accepted as fact. If a home-bound older adult receives a home-delivered meal, or family caregivers attend support groups, or a tribal elder uses a wheelchair from a lending closet, then these program participants are better off. But is it enough to accept that these services are beneficial? In supporting the aims of the OAA, there is often pressure at local, state, and federal levels to "show me the data." This article reviews pressures and opportunities as the aging network demonstrates the value and impact of the OAA.
