Education + Action = Prevention Power (National Minority Health Month)

In recognition of National Minority Health Month, the Diverse Elders Coalition is featuring stories relevant to the health disparities and health issues affecting diverse older adults during April. A new story will be shared every Wednesday with additional posts shared throughout the month. Be sure to visit diverseelders.org regularly during the month of April.

My stepmother, Miss Fannie embodies this year’s National Minority Health Month theme “Prevention is Power: Taking Action for Health Equity.” She didn’t always. She used to be one of the statistics that abound in the African American community about Black people. You see as an African American adult female, aged 65+, with less than a college education, she was among the percentage of people with uncontrolled hypertension, and in the group of elders with uncontrolled diabetes whose “sugar” dropped on a regular basis. Miss Fannie also lived a somewhat isolated and sedentary life and tipped the scales at over 200 pounds, becoming part of the largest cohort of obese individuals in the country – yes, African American women.

We know that many of these outcomes are the result of health and economic disparities, cultural barriers and outright discrimination. However, I contend that programs and initiatives that provide culturally appropriate and consistent messaging, and foster awareness and encourage simple changes – do supply the tools required to induce steps toward positive changes and can improve health.

Miss Fannie’s health did improve. Almost four years ago, at age 76, Miss Fannie began to attend one of the DC Office on Aging Senior Wellness Centers three times a week. The Center picked her up at her home and brought her home in the evening. The workers called her Ms. Woody or Miss Fannie and called when she was not out waiting on the porch. She became less isolated and made friends with many people who were her peers and had similar life experiences. In addition to a nutritional lunch and the traditional bingo, she and her companions learned about and participated in a City activity. One day my nonpolitical stepmother is telling us she participated in a conversation with the Mayor at a senior forum she attended!! [My silent response although positive, took a deeper dive to: who are you and where is my stepmother??]
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The Growing, Neglected Challenges of LGBT Latino Elders

Latino elders who are lesbian, gay, bisexual and transgender (LGBT) face additional challenges as they age, compounded by barriers rooted in their racial and ethnic identities, as well as LGBT stigma and discrimination. Yet the attention and infrastructure to ameliorate these conditions is generally lacking. That’s the overarching conclusion reached by the National Hispanic Council on Aging (NHCOA) in a first-ever national needs assessment examining the social, economic and political realities of a growing, though multiply marginalized, population.

NCHOA’s report speaks to a timely moment. Demographics project a significant increase in Latino people and older people over the next few decades, trends rooted largely in immigration and the aging of the Baby Boom generation, respectively. For example, the U.S. Census estimates that the number of Latino people age 60 and older will sky-rocket from 4.3 million in 2010 to 22.6 million in 2050. And as societal attitudes and policy changes have made it easier for some segments of the LGBT population to “come out” and live openly, LGBT older people have become increasingly visible in both the aging and long-term care system, as well as society at large.

Yet NHCOA’s new report—released in partnership with the national LGBT aging advocacy non-profit, SAGE—contends that this wave has left behind a more marginalized population: LGBT Latino elders. Based on a year’s worth of expert interviews, a literature review (that tellingly emphasizes the general dearth in research on LGBT Latino people) and focus groups in four major metropolitan cities with high concentrations of Latinos and LGBT people, NHCOA paints a portrait of Latino LGBT elders aging in communities that aren’t accepting of their full identities. LGBT Latinos also report both fearing and encountering biased care providers without the skills or resources to support their unique needs. Read More Read More

Health Benefits of Pet Ownership for Older Adults (National Minority Health Month)

In recognition of National Minority Health Month, the Diverse Elders Coalition is featuring stories relevant to the health disparities and health issues affecting diverse older adults during April. A new story will be shared every Wednesday with additional posts shared throughout the month. Be sure to visit diverseelders.org regularly during the month of April.

April is National Minority Health Month, and the theme for this year is “Prevention is Power: Taking Action for Health Equity.” There are a lot of things diverse older adults can do to prevent serious health problems. Eating a healthy diet, exercising, and having regular checkups from a health care provider can all help prevent serious health issues. Pet ownership can also help improve the health of older adults. For those who are able, walking a dog or just caring for a pet can provide exercise and companionship. Unlike dieting, exercising, and visiting health care providers, however, pet ownership does not require a high level of health literacy.

The author, Jason Coates, and his cat, Sal

The author, Jason Coates, and his cat, Sal

Many diverse older adults are at risk of isolation, though the companionship of a pet can help reduce this risk. Cultural and linguistic barriers keep many diverse seniors from developing new social contacts, and this is harmful to health. Hispanic and Asian American older adults are at particular risk of becoming isolated by cultural and linguistic barriers. LGBT seniors, including many that have experienced a lifetime of discrimination, are at risk of isolation as well. Pets provide a contact for older adults and the routine of caring for a grateful pet can provide meaning and a sense of self-worth for older adults. Taking dogs and cats for a walk also gives older adults a reason to go outdoors and interact with others. Read More Read More

Women and HIV/AIDS: What about Older Adults, Women of Color, and Cancer?

March 10, 2014 is National Women and Girls HIV/AIDS Awareness Day (NWGHAAD). NWGHAAD is a nationwide effort to help women and girls take action to protect themselves and their partners from HIV – through prevention, testing and treatment. The HIV epidemic is rapidly aging with 17% of new HIV diagnoses in the U.S. occurring in those 50 and older. By 2015 the CDC expects half of the HIV infected population to be over 50. Older Americans are more likely than younger Americans to be diagnosed with HIV at a later stage in the disease. This can lead to poorer diagnoses and shorter HIV to AIDS intervals. And with HIV and age, comes cancer.

Statistics – An Overview

  • One in four people living with HIV infection in the U.S. are women.
  • According to the CDC, 275,700 American women are living with HIV/AIDS.
  • Women made up 20% (9,500) of the estimated 47,500 new HIV infections in the U.S. in 2010 with most (84%) of these new infections in women being from heterosexual contact.
  • 4,014 women with an AIDS diagnosis died in 2010 and an estimated 111,940 women have died since the beginning of the epidemic.
  • Only 41% of HIV positive women are retained in HIV related medical care and only 26% of HIV positive women achieve viral suppression. Viral suppression improves survival and reduces transmission to others.

Disproportionate Affect on Women of Color

  • Black and Hispanic women continue to be disproportionately affected by HIV, compared with women of other ethnicities.
  • While only 13% of the U.S. female population, Black women represent 64% of new female HIV infections.

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LGBT People: Our Longing for Home, Our Right to Housing

Photo: Laurent Hamels via Getty Images

Photo: Laurent Hamels via Getty Images

There are mornings when the hour-long commute to work feels Odyssean. Today is one of those mornings. February has unfurled a litany of winter storms that have left New York City awash in slush and my Facebook feed soaked in bemoaning. As I trudge through Brooklyn and board the D train to Manhattan, I’m stirred by the resilience of people to survive winter—huddled overnight in subway trains and housing shelters, or living miles from work to afford one’s rent, a mortgage and the accumulating costs of surviving. For generations, economic injustice has been designed into the housing realities of moderate- to low-income Americans as structurally as their home floor plans; it has concentrated wealth into the privileged few and left the rest with housing instability, enduring inequality and, at its worst, homelessness. New research confirms these realities. In this context, I am privileged to afford an apartment that offers shelter through the bitter storms let loose increasingly through climate change. And I am comforted by knowing that the closest people to me constitute a home that makes the broader storms of life more bearable.

These two notions—the physical shelter afforded through adequate and affordable housing, and the sanctity of a “home” comprising loved ones we can proudly claim as our own—form the heart of the housing debate for lesbian, gay, bisexual and transgender (LGBT) people. As with most people, we migrate from one place to the next, uprooting ourselves in search of belonging. Yet as two recent reports demonstrate, for many LGBT people—specifically LGBT people of color and elders—this quest for home routinely comes up against a housing supply that’s dilapidated, stretched thin, too expensive and far removed from the cities and neighborhoods we deserve to inhabit. We are blocked by biased housing providers unwilling to treat us on fair, negotiable terms. We crave homes through severe economic distress and pervasive inequality. It’s an unrelenting journey, begun at birth and made more fragile in later life.

The relationship between aging and housing discrimination forms the subject of a new report from the Equal Rights Center, in partnership with SAGE (Services and Advocacy for GLBT Elders). Read More Read More

Aging Out: Exploring Ageism and Heterosexism Among African American Lesbians and Gay Males (Black History Month)

In honor of Black History Month, the Diverse Elders Coalition is featuring stories relevant to black aging during February. A new story will be shared every Wednesday, with additional posts shared throughout the month. Be sure to visit diverseelders.org regularly during the month of February.

People are complex, and African-American older LGBT adults are no exception. They live at the intersection of multiple identities experienced over the life span, in a culture steeped in racism, sexism, ageism, heterosexism and homophobia. African-American lesbian and gay males experience at a minimum two hostile environments: being lesbian or gay in a heterosexist society; being a person of color in a racist culture; being female in a sexist culture; and being old in a youth-worshipping culture.

Moreover, research shows that living with racism on a daily basis influences the health and well-being of African Americans, leading to major gaps in health and financial equality, higher levels of infirmity and chronic illness, even earlier death than other populations. African-American elders are likely to experience poverty at more than two times the rate of all other older Americans.

This article comes from research cited in Lift Every Voice: Treading our Path, (NGLTF Task Force, 2012) that tells the stories of lives lived and the very real problems of lesbian, gay, bisexual and transgender African Americans coming-of-age and how those experiences shaped their lives as they grew older. People remember being conflicted in telling family members their sexual orientation and sexual identity, fearing rejection and abandonment. A 66-year-old African-American lesbian woman described it this way:

  • “I knew I was different as a child. … But I guess I was in my early teens [before I knew the words], because you don’t know what the word is. When I was coming up, the word was bull dagger. It was so negative, so you still don’t know. You are a kid; you don’t know, there were no words for it, I hate that word. It’s just I’ve gotten older, I just, ugh. … That’s so derogatory. It’s negative.”

Many older African-American lesbian women and gay men have experienced a sense of grief and loss from being alienated within one’s own race and ethnicity because of perceived sexual identity and orientation. Often the disaffection happens early and scars last for life. Many elders speak of living in hostile environments within the African-American community. As this 63-year-old African-American man explains:

  • “I know I have an androgynous look, it was even more so when I was younger. So therefore, there was some discrimination against me by assumption rather than fact because they would look at me and because I am androgynous looking they would assume. … One of my issues being African American and looking like this was really when I came out in college in the late ’60s at the height of the Black Power Movement and I was distinctly told by a couple of Black organizations at the time, ‘we don’t want your kind here.’ ”

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On the Shoulders of our Black Elders: Powerful Images from our Past (Black History Month: Civil Rights in America)

In honor of Black History Month, the Diverse Elders Coalition is featuring stories relevant to black aging during February. A new story will be shared every Wednesday, with additional posts shared throughout the month. Be sure to visit diverseelders.org regularly during the month of February.

February is Black History Month, also commonly known as African-American History Month—a time for us all to reflect on and remember the important people and events in the history of the African diaspora. The theme for this year’s Black History Month is “Civil Rights in America.”

It’s no secret that when the Civil Rights Movement, the fight against racial segregation and discrimination in the U.S., reached its height during the turbulent 1960s, it was one of our country’s most difficult times. Many of today’s black elders risked their lives and courageously led the movement to fight against racial inequality and bestow upon us the many freedoms we enjoy today. We at the Diverse Elders Coalition publicly thank our black elders and encourage you to take a moment to share this post and thank the black elders in your life.

Images hold power. The media’s role in bringing many of the significant events of the civil rights movement to light helped the nation progress towards more equality. These images were often difficult to view, but were necessary to show the people of the United States the inhumane and often violent acts committed against African Americans. Read More Read More

Focus turns to aging with AIDS

This article by Matthew S. Bajko (m.bajko@ebar.com) originally appeared in the Bay Area Reporter

Estimated percentage of the adult population (15 years and older) living with HIV which is aged 50 years or over, by region, by 2012. (Source UN.org)

Estimated percentage of the adult population (15 years and older) living with HIV which is aged 50 years or over, by region, by 2012. (Source UN.org)

As the global AIDS epidemic continues to age, greater focus is being paid to older adults living with HIV.

AIDS advocates are calling on service providers and health departments to tailor HIV prevention services, including HIV testing, to meet the needs of people aged 50 and above. And new guidelines for doctors with patients who have HIV are being released that highlight the need to focus on preventive care.

The issue of an aging HIV and AIDS population has been a growing focus for local health officials for several years now, with new programs being developed to address the specific needs older adults are confronting due to the AIDS epidemic.

A 2011 Bay Area Reporter story noted that for the first time people 50 years of age or older accounted for the majority of people living with an AIDS diagnosis in San Francisco.

The 2012 HIV/AIDS Epidemiology Report released by the Department of Public Health demonstrated the aging of persons living with HIV, with decreasing proportions in the 30-39 and 40-49 years age groups accompanied by persons aged 50 years or above rising from 42 to 51 percent between 2009 and 2012.

For the full article, which originally appeared in the Bay Area Reporter click here

The opinions expressed in this article are those of the author and do not necessarily reflect those of the Diverse Elders Coalition.

As Parents Age, Asian-Americans Struggle to Obey a Cultural Code

This article by Tanzina Vega originally appeared in the New York Times

Savan Mok, a home health aide, assisting Oun Oy, 90, right, who had a stroke in 2012. Ms. Oy is from Cambodia and lives in Jenkintown, Pa., with her son and his wife, at rear. Jessica Kourkounis for The New York Times

Savan Mok, a home health aide, assisting Oun Oy, 90, right, who had a stroke in 2012. Ms. Oy is from Cambodia and lives in Jenkintown, Pa., with her son and his wife, at rear. Jessica Kourkounis for The New York Times

SOUDERTON, Pa. — Two thick blankets wrapped in a cloth tie lay near a pillow on the red leather sofa in Phuong Lu’s living room. Doanh Nguyen, Ms. Lu’s 81-year-old mother, had prepared the blankets for a trip she wanted to take. “She’s ready to go to Vietnam,” Ms. Lu said.

But Ms. Nguyen would not be leaving. The doors were locked from the inside to prevent her from going anywhere — not into the snow that had coated the ground that day outside Ms. Lu’s suburban Philadelphia home, and certainly not to her home country, Vietnam.

Ms. Nguyen has Alzheimer’s disease, and Ms. Lu, 61, a manicurist who stopped working two years ago when her mother’s condition worsened, is her full-time caretaker. In Vietnam, children must stay home and care for their aging parents, Ms. Lu said. Elders “don’t want nursing home,” she said: Being in a nursing home creates “trouble in the head.” The family now relies financially on Ms. Lu’s husband, a construction worker.

In a country that is growing older and more diverse, elder care issues are playing out with particular resonance for many Asian-Americans. The suicide rate for Asian-American and Pacific Islander women over 75 is almost twice that of other women the same age. In 2012, 12.3 percent of Asian-Americans over 65 lived in poverty, compared with 9.1 percent of all Americans over 65. Nearly three-quarters of the 17.3 million Asians in the United States were born abroad, and they face the most vexing issues.

For the full article, which originally appeared in The New York Times click here

The opinions expressed in this article are those of the author and do not necessarily reflect those of the Diverse Elders Coalition.

Fighting the Good Fight Against Isolation

As we advance in life it becomes more and more difficult, but in fighting the difficulties the inmost strength of the heart is developed. Vincent van Gogh

W., 66, a former journalist and man about town, entered the meeting on LGBT issues a little late and his gait was slower than usual. When the meeting ended, he asked for a ride to the subway. As we rode, he talked about why he was late: not knowing the bus routes for this part of the city, the bus being late and the neighborhood being less than desirable. He hadn’t been feeling well and almost didn’t come to the meeting. It occurred to me that this African American elder continues to “fight the good fight” to beat the isolation that can plague us as we age and attended the meeting anyway.

Isolation is one of the great robbers of an enriched quality of life for older adults across the spectrum of race/ethnicity, class, religion, national origin, familial status, disability, gender identity, or sexual orientation. Self-imposed isolation related to aging can include an unwillingness or inability to drive, limited transportation options, chronic ailments and disabilities, lack of events for their peer group, the lack of compatriots and a youth oriented culture. Read More Read More

Don’t Be Left Behind: Accessibility and Mobility Challenges in an Aging Society

At the start of October, the National Hispanic Council on Aging (NHCOA) held a Capitol Hill advocacy day as part of its 2013 NHCOA National Summit. During the advocacy day, groups of seniors met with members of Congressional staff and told them about the lives of Hispanic older adults and the issues they faced in their communities. The staff members and Congressional offices were happy to meet with the older adults and gave them a warm welcome. Overall, everyone that took part in the event agreed that it is important to all people to have access to their elected officials.

As the advocacy day continued, walking from office to office in Capitol Hill became difficult for the seniors. While the people we met with were accessible, the places themselves were not. Many of the seniors taking part in the advocacy struggled with physical limitations to their mobility, and the distances between Congressional offices posed a challenge. As the population of older adults increases as a percentage of the population, the places where we live and work will have to adapt.

Older women with a walker unable to access stairs from the Equal Rights Center’s “Visitability” Quiz

Older woman with a walker unable to access stairs from the Equal Rights Center’s “Visitability” Quiz

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Webinar. Dec. 5: The Affordable Care Act and Medicare

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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.

Sharing Stories, Leaving Legacies: How Intergenerational Programs Empower Diverse Elders

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 Read More

Our Issues Entwine: LGBTQ Aging and Economic Justice

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.

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