Guest Post by Cara V. James, PH.D.
October 15 marked the start of the Medicare Open Enrollment period. It will end on December 7, 2013. During this time, all people with Medicare are encouraged to review their current health and prescription drug coverage, including any changes in costs, coverage and benefits that will take effect next year, and decide whether they would like to change their coverage.
Webinar Opportunity: Please join Dr. Cara James, Director of the Office of Minority Health at CMS on December 5, 2013 at 2:00pm EST for a webinar that will highlight how the Affordable Care Act strengthens Medicare and provide an overview of the Health Insurance Marketplace for older Americans of color: https://12-5acaandmedicare.eventbrite.com Read More
December 1st is World AIDS Day
By Mark Brennan-Ing, PhD, Director for Research and Evaluation, ACRIA Center on HIV and Aging
Latinos are the largest and fastest growing ethnic group in the U.S., and comprise 17% of the population. They are often viewed as a monolithic group by mainstream culture. However, the term Latino, referring to people of Mexican, Central American, and South American origins, encompasses great diversity with regard to nationality, immigration history, language use, educational and occupational opportunities, and socio-economic position. These aspects of diversity also serve as indicators of social-structural determinants of health disparities (or differences in how often a disease affects people). How these social-structural determinants of health affect the lives of older Latino adults help us to better address the needs of this population. Understanding health disparities also provides insight into challenges faced by diverse elders from a variety of racial, ethnic and cultural backgrounds who deal with many of these same issues. The intersection of HIV/AIDS and depression among older Latinos will be used to illustrate how these social-structural determinants affect the health and well-being of a diverse aging population.
Double Jeopardy: HIV and Depression
Latinos are disproportionately affected by HIV/AIDS. The overall HIV prevalence rate for Latinos is nearly three times the rate for whites. Further, Latinos are the most likely to be classified at Stage 3 (i.e., AIDS) at the time of their HIV diagnosis (48%), as compared with whites (42%) and blacks (39%). Due to successful anti-retroviral therapy, by 2015 more than half of those with HIV in the U.S. will be 50 years or older, a proportion that will rise to 70% by 2020. The disparity in HIV prevalence is amplified among older people with HIV/AIDS. Among Latinos who are 50 and older, HIV prevalence is five times that of older non-Hispanic whites. In addition, older Latinos have a 44% increased risk for major depression and are more likely to present with clinically significant depressive symptoms compared with older whites. This syndemic (convergence of two disorders that magnify the negative effects of each) of HIV and mental distress among Latino older people with HIV (“OPWH”) is an important public health concern since the most consistent predictor of HIV treatment non-adherence is depression, and only 26% of Latinos with HIV achieve the clinical goal of viral suppression. Read More
The health coverage expansions under the Affordable Care Act (ACA) will affect you, your loved ones and your communities. The Diverse Elders Coalition represents millions of diverse older people age 50+ who are among those affected: they include the Health Insurance Marketplace, the Medicaid expansion, new benefits for elders 65+ on Medicare, and a range of protections that make health care more accessible for lesbian, gay, bisexual and transgender (LGBT) older people and older people of color. The number of uninsured older adults age 50-64 continues to rise—from 3.7 million in 2000 to 8.9 million in 2010. In addition, people of color make up more than half of uninsured people in the U.S.— and research shows that people of color, across the age span, face significant disparities in physical and mental health. Additionally, many people of color delay care because of potential medical costs and out of fear of discrimination or cultural incompetence from medical providers. This webinar highlights both national and state-specific examples on what is being done to ensure that older people know about the changes that are taking place under the ACA and how it affects them.
Speakers: Yanira Cruz, President and CEO, National Hispanic Council on Aging; Michael Adams, Executive Director, Services and Advocacy for GLBT Elders (SAGE). Special thanks to our co-sponsors, The John A. Hartford Foundation and The California Wellness Foundation.
Original Webinar date: Wednesday, November 6, 2013.
Watch it at http://www.screencast.com/t/yzeTQbgEze2.
When: Thursday, December 5, 2013 at 2:00pm ET
Where: Please register early for the event.
Webinar link: https://12-5acaandmedicare.eventbrite.com
Who: Cara V. James, Director, Office of Minority Health, Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services (Bio below)
What: Please join CMS and the Diverse Elders Coalition for a webinar that will highlight how the Affordable Care Act strengthens Medicare and provide an overview of the Health Insurance Marketplace for older Americans of color.
Background: October 15, 2013 marked the start of Medicare open enrollment. It will end on December 7. During this time, all people with Medicare are encouraged to review their current health and prescription drug coverage, including any changes in costs, coverage and benefits that will take effect next year, and decide whether they would like to change their coverage.
Key resources to learn more: Medicare.gov and HealthCare.gov/CuidadodeSalud.gov
Presenter Biography: Cara V. James is the Director of the Office of Minority Health at the Centers for Medicare and Medicaid Services (CMS). Prior to joining the Office of Minority Health at CMS, Dr. James was the Director of the Disparities Policy Project and the Director of the Barbara Jordan Health Policy Scholars Program at the Henry J. Kaiser Family Foundation, where she was responsible for addressing a broad array of health and access to care issues for racial and ethnic minorities and other underserved populations, including the potential impact of the Affordable Care Act, analyses of state-level disparities in health and access to care, and disparities in access to care among individuals living in health professional shortage areas. Prior to joining the staff at Kaiser, she worked at Harvard University and The Picker Institute. Dr. James is a member of the Institute of Medicine’s (IOM) Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities and has served on several IOM committees including the Committee on Leading Health Indicators for Healthy People 2020. She has published several peer-reviewed articles and other publications, and was a co-author for one of the background chapters for the IOM Report Unequal Treatment. Cara received her Ph.D. in Health Policy and her B.A. in Psychology from Harvard University.
November is Native American Heritage Month and November 29, 2013 is Native American Heritage Day. What does this mean to me? I am American Indian of Navajo descent. I was raised on the Navajo Nation all my life. Since I grew up on the Navajo Nation I thought the world was like me. I was taught in school that I am American and I accepted that. I was taught at home to be a good and capable person.
I had inadequate preparation in our public school so I never contemplated going off to college. My mother on the other hand had other dreams for me. She filled out my paperwork to attend the local community college. It was there that I began to consider going away to attend University, and of course, mother helped me to apply. Fortunately, I was able to graduate from the University with dual degrees in the discipline of human services. Today I am using the educational skills I acquired to help create better opportunities for Older Indians.
I know that many America Indian people gave up land, resources, language, culture and complete sovereignty in the name of the English colonization westward. Many atrocities were committed against American Indian People in the taking of the land and cultural livelihood. Read More
By Hitomi Yoshida, Research Associate, Temple University Intergenerational Center
Thanksgiving is a time for gratitude, reunions, and celebrations with family. However, many of us have ambivalent feelings about these family interactions. Our mixed feeling can range from the joy of re-connecting to anxiety around different values and expectations that exist within the family, especially between generations. This ambivalence may be experienced every day in multigenerational families, and statistics indicate that immigrant seniors are more likely to live in multi-generational households. Contrary to the stereotypical picture of a large, tight-knit immigrant family surrounding their elders with relevance and constant caregiving support, the nature of intergenerational relationships within immigrant families is more complex. Older immigrants interviewed in the research conducted by the Temple University Intergenerational Center (the “Center”) shared their sense of isolation within their family and community due to lack of time for meaningful interactions, language and value differences, and the acculturation of younger generations.
A Vietnamese senior from Philadelphia expressed his sense of disconnect.
“In Asian culture…parents take care of children, then children take care of parents when they are old…but in America, …[your adult children are] busy spending time working, their children go to school…so these things separate the family…you have to compete with these things [and] there is no room [for elders] to teach about culture.”
The role loss and the decreasing value of elders’ wisdom in American society are major barriers to the well-being of immigrant seniors. As one Somali community leader in Minneapolis explained, “Elders as advisors….that concept is lost here.” Read More
This year, the Obama administration will surpass the 2 million mark – this is, it will have deported 2 million people since 2008, more than any other administration in history. The largest numbers of people being deported are those without legal status, but many Green card holders are also among the 2 million deportees. Since 1998, over 13,000 Southeast Asians (from Cambodia, Laos, and Vietnam) have been deported, including many Green card holders who arrived in the U.S. decades ago as refugees fleeing war and genocide. The majority of those deported are under the age of 35, but many elders also get caught in the deportation machine. Even more elders who remain in the U.S. suffer emotionally and financially when their adult children are taken away.
Despite official Immigration and Customs Enforcement (ICE) guidance that agents should not “expend detention resources” on those who are elderly, many immigrant elders are detained and deported. According to information gathered through a Freedom of Information Act (FOIA) request by the NYU School of Law Immigrant Rights Clinic, the Immigrant Defense Project, and Families for Freedom, between 2005 and 2010 the New York City ICE Field Office apprehended 1,275 noncitizens over the age of 55, and of these, at least 141 were subject to mandatory detention. Seniors struggle more than most in detention – they are more likely to be Limited English Proficient, and are more likely to suffer from health problems and dementia.
Huyen Thi Nguyen, an elderly Vietnamese woman, was detained in an immigration detention center for 16 months after serving her sentence for cash-for-food stamp fraud. She continues to fight her deportation, while suffering from mild dementia. Claudette Hubbard escaped LGBT violence in Jamaica in 1973 and became a U.S. Green card holder. She has been detained by ICE for over two years because of a 20-year-old conviction from a drug charge, even though she has fully rehabilitated and is mother and grandmother to U.S. citizens.
Claudette Hubbard with her U.S. citizen daughter and granddaughters
MY IMMIGRANT MOTHER sits silently in a room the size of a small kitchen. Earlier this year, she survived multiple failures of the heart, kidneys, and limbs over the course of six weeks. She is seventy-three, uses a wheelchair, and for the first time in her life is surrounded by white people who do not speak Spanish, in the only nearby nursing home my parents can afford. In turn, my father drives through the days confronted by three omnipresent realities: hour-long daily visits with my mother, a night shift to keep him mentally and financially afloat, and a mailbox flooded with health care bills, insurance disputes and the complexity of navigating Medicare, Medicaid, and private insurers. When I speak of health reform, queer rights, or racial and economic justice, he gazes at me solemnly. He survived a lifetime of racial discrimination, fought in two wars and lived through the ensuing decades with a cacophony in his psyche. At seventy-eight, nearly blind and deaf, he will hear nothing of systems and reform. More often than not, these days we sit in silence.
This silence haunts me as an advocate who works at the intersection of aging and lesbian, gay, bisexual, transgender, and queer (LGBTQ) rights. The aging and LGBTQ advocacy fields often propose policy solutions that are too narrow to address the complexity of how all marginalized people — including heterosexual people of color such as my parents, members of the LGBTQ community, and more — experience the process of aging. We need social transformations that address the intersecting forms of oppression that older people face — and that can make sense of the chaos and silence that shroud my parents. This has become especially clear to me through my work as the director of a national policy program devoted to improving the health and well-being of LGBTQ older people.
A closer look at the lives of aging LGBTQ people reveals how deeply identity politics and class politics are entangled. Here, an older protester rallies for marriage equality in Pasadena, California.
For the full essay, which originally appeared in Tikkun Magazine click here
When our nation talks about Asian Americans, it often groups together people from different cultures and those who speak different languages. Someone from China faces different challenges than a refugee from Cambodia, yet research typically wouldn’t show this. As a group, Asian Americans and Pacific Islanders (AAPIs) are the fastest growing population in the United States. Despite the large and rapidly growing population, research and data on AAPI elders is limited and often presented in aggregate (i.e. grouped together). Aggregate data belies the diversity and the challenges faced within the AAPI older adult population.
The National Asian Pacific Center on Aging (NAPCA) recently published five reports that paint a fuller and more accurate picture of the challenges many APPI older adults face. The reports divide the population into three groups (aged 55 & older, aged 55-64, and aged 65 & older) and highlight the language, economic, and employment characteristics of AAPI elders. NAPCA used publically available sources from various government agencies, and disaggregated (or separated) the data to better depict the realities of the AAPI older adult population (55+). See an example below.
Source: U.S. Census Bureau, 2006-2010 American Community Survey, 5-Year Estimates
Demystifying the “Model Minority” Stereotype Read More
Medicare Open Enrollment is the time of year when beneficiaries can change their Medicare health plan and prescription drug coverage for the following year. Each year Medicare Open Enrollment runs from October 15-December 7. The National Hispanic Council on Aging (NHCOA) encourages you to consider reviewing your Medicare drug or health care plan, and/or assist your loved ones in reviewing theirs. You can use the materials provided in NHCOA’s Medicare Open Enrollment toolkit to assist you in reviewing your options in order to find the coverage that best meets your needs. However, if you and your loved ones are satisfied with your current health plan, no action or change is required.
Medicare is health insurance for people 65 years or older. The U.S. Federal government provides this health care service from revenue collected through payroll taxes. If you’ve paid into Social Security and Medicare for 10 years as an employee, you are most likely eligible for Medicare benefits.
Following the three C’s is a good criterion to keep in mind when reviewing your current plan and making the decision whether or not to make changes. Read More
Understanding the new Health Insurance Marketplace can feel a lot like piecing together a puzzle. Despite the setbacks, the Marketplace is up and running. For community groups and advocates, it’s time to help our communities shop for health coverage that fits their many needs. For older adults, it’s time to get covered.
To make it simple, the Diverse Elders Coalition has created a simple flyer, “Why the ACA Matters to Our Communities,” which offers step-by-step instructions for enrolling in the Marketplace, as well as a rationale for the Affordable Care Act (commonly known as the ACA or Obamacare) and older people of color, LGBT older people and older immigrants. It’s available in English, Spanish, Chinese, Korean and Vietnamese.
Our member organization, Services and Advocacy for GLBT Elders (SAGE) has also created a special flyer on why the ACA matters to LGBT elders. Download here.
- Share this flyer with older people—age 50 and older—in your life to effectively explain how they can apply for health insurance
- Print this flyer for presentations, events or meetings to educate other leaders about why the ACA matters to older people of color, LGBT elders and older immigrants.
For more information on the ACA and its impact on diverse elders, visit diverseelders.org/our-health
Have a question about Obamacare and why it matters to diverse elders? Ask us on Twitter. @diverseelders Read More
When: Wednesday, November 6, 2013 2-3pm EST
Register Now: http://bit.ly/1c0l5zd
Speakers: Dr. Yanira Cruz, President and CEO, National Hispanic Council on Aging (NHCOA)
Michael Adams, Executive Director, Services and Advocacy for GLBT Elders (SAGE)
Who can attend? Advocates. Policy makers. Older Adults. Funders. Anyone interested in learning more about Obamacare and how it affects diverse older people. *There will also be additional information for funders on how they can support both national and state-specific work.
First 30 Minutes: Conversation with Dr. Cruz and Michael Adams about why Obamacare/the Affordable Care Act Matters to diverse older people. Learn about the opportunities, challenges and lessons learned.
Second Half of the Conversation: Dr. Cruz and Michael Adams will take your questions.
The health coverage expansions under the Affordable Care Act (ACA) will affect you, your loved ones and your communities. The Diverse Elders Coalition represents millions of diverse older people age 50+ who are among those affected by these expansions. They include the Health Insurance Marketplace, the Medicaid expansion, new benefits for elders 65+ on Medicare, and a range of protections that make health care more accessible for lesbian, gay, bisexual and transgender (LGBT) older people and older people of color. The number of uninsured older adults age 50-64 continues to rise—from 3.7 million in 2000 to 8.9 million in 2010. In addition, people of color make up more than half of the uninsured people in the U.S.— and research shows that people of color, across the age span, face significant disparities in physical and mental health. Additionally, many people of color delay care because of potential medical costs and out of fear of discrimination or cultural incompetence from medical providers. These issues are especially true for LGBT people of color who face challenges on multiple aspects of their identities. The ACA has the ability to create a path to better health by offering more affordable health insurance options, improving services and eliminating the usual obstacles. This webinar will highlight both national and state-specific examples of what is being done to ensure that older people know about the changes that are taking place under the ACA and how it affects them.
This webinar is in collaboration with Grantmakers in Aging (GIA) as part of their “Conversation with GIA” series.
Special thanks to our co-sponsors, The John A. Hartford Foundation and The California Wellness Foundation.
Historically Southeast Asian Americans have faced significant barriers to accessing affordable health insurance and culturally and linguistically appropriate health care. These barriers have contributed to health disparities:
• Southeast Asian American communities experience high uninsurance rates; 26.7% of Hmong Americans live in poverty and 18.3% of Vietnamese Americans lack health coverage.
• Cervical cancer incidence rates are among the highest in the U.S. for Laotian, Vietnamese and Cambodian American women. Factors for this disparity have been attributed to low Pap smear rates, lack of preventive care prior to immigration and a lack of sensitivity by providers.
• Asian American adults aged 65 years and older were 30% less likely to have ever received the pneumonia shot compared to white adults of the same age group.
• One of the greatest health disparities between Southeast Asians and the general population is liver cancer, 80 percent of which is caused by chronic hepatitis B virus infection. Liver cancer rates for Vietnamese men are 13 times higher than rates for White men.
The Affordable Care Act (ACA) has provided many benefits to the Southeast Asian American (SEAA) community, and in particular, its elder population. The positive impacts have continued with the start of Open Enrollment in the Health Insurance Marketplace. The ACA’s benefits include: Read More
Medicare’s Open Enrollment period is October 15 – December 7. This is when ALL people with Medicare can change their Medicare health plan and prescription drug coverage for 2014. You can find information on 2014 plans by visiting the Medicare Plan Finder. People with Medicare can call 1-800-MEDICARE or visit www.medicare.gov to learn all about Medicare. If a person is satisfied that their current plan will meet their needs for next year, they don’t need to do anything.
The Diverse Elders Coalition (DEC) knows well that large numbers of older people of color and LGBT elders nationwide face financial difficulties, making Medicare critically important to their health and economic well-being. Did you know? 46% of Latinos, 43% of Asians, 52% of African Americans over the age of 55 and 92% of American Indians and Alaska Natives are covered by Medicare (based on different studies); and according to a national health study of LGBT older people, almost all (97%) had some form of healthcare insurance coverage, primarily through Medicare. Without Medicare, many older people of color and LGBT elders would be required to pay for health expenses on their own, accrue enormous debts, and likely not receive the health care they need. The Affordable Care Act has further strengthened this vital program.
HOW DOES THE AFFORDABLE CARE ACT AFFECT MEDICARE?
• Your Medicare coverage is protected. Medicare isn’t part of the Health Insurance Marketplace established by ACA, so you don’t have to replace your Medicare coverage with Marketplace coverage. No matter how you get Medicare, whether through Original Medicare or a Medicare Advantage Plan, you’ll still have the same benefits and security you have now. You don’t need to do anything with the Marketplace during Open Enrollment. Read More
The harms inflicted by discrimination reveal themselves in our bodies as we age — as people of color, as poor and low-income people, and as lesbian, gay, bisexual and transgender (LGBT) people. The symptoms manifest as higher rates of high blood pressure, cholesterol, diabetes, heart disease, HIV/AIDS, depression, social isolation and more. In medical charts throughout the country, our bodies record what it means to survive a life shaped by perpetual poverty, higher concentrations in low-wage jobs with no health insurance, thin retirement options and inadequate protections in the workplace. They depict our fractured relationships to health care — from cultural and linguistic barriers to overt bias and discrimination from health and aging providers, to a long-held, hard-earned distrust of medical staff internalized through years of differential treatment.
Our bodies confirm vividly the geographic dimensions of structural inequality, which can predict long-term health as early as childhood, based largely on where a person is born. We inhale the poison of inequality throughout our lives, and it inflames in our later years as a dismal diagnosis, a medical crisis or a preventable death. Yes, severe illness will surprise many of us at some point in our lives, and death is indiscriminate, but as empirical fact, poor health affects certain demographics disproportionately at earlier and higher rates, often the same people with no health coverage to manage the repercussions.
Oct. 1 aims to begin reversing these conditions. The health insurance marketplace established through the Affordable Care Act (ACA) offers opportunities to shop for state health insurance plans and begins improving coverage for the 47 million uninsured people in this country. Millions of people work in jobs with no health coverage, cannot afford insurance on their own and fall through gaps in public support that leave them uninsured or underinsured. Without insurance, people accrue unmanageable debt, delay health care and in turn watch their health worsen over time — a trajectory most often experienced by people of color, LGBT people and low-income people. These hardships intensify for older people who must also contend with age-related bias in the workplace and the challenges of paying for out-of-pocket expenses with meager incomes. An all-inclusive vision of health reform must incorporate the realities of aging as early as age 50. Read More