Do You Have Diabetes? – National Diabetes Alert Day

March 25 is National Diabetes Alert Day. It is an annual one-day, wake-up call to inform the American public about the seriousness of diabetes, particularly when diabetes is left undiagnosed or untreated and to encourage everyone to take the Diabetes Risk Test.

Diabetes is a serious disease with 1.9 million Americans diagnosed with diabetes every year. Currently ~26 million Americans have diabetes and another 79 million adults have prediabetes. 27% of diabetes is undiagnosed. If present trends continue, 1 in 3 American adults could have diabetes in 2050.

The complications of diabetes are wide ranging leading to higher rates of heart disease, stroke, adult blindness, kidney failure and kidney disease, neuropathy, hearing loss, and lower-limb amputations.

The impact of diabetes is much more pronounced among diverse elders. Highlights of the racial disparities include:

  • 10.2% of all non-Hispanic whites aged 20 years or older have diabetes (diagnosed or undiagnosed) whereas 18.7% of black adults have diabetes (diagnosed or undiagnosed).
  • American Indians: 16.1% of American Indian/Alaska Native adults have diagnosed diabetes.
  • Compared to non-Hispanic whites, the risk of diagnosed diabetes is 1.2 times higher among Asian Americans, 1.7 times higher among Hispanics, and 1.8 times higher among non-Hispanic blacks.

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A Video Review of Native American HIV/AIDS Issues

March 20 is National Native HIV/AIDS Awareness Day (NNHAAD). NNHAAD is a national effort to raise awareness about how HIV/AIDS affects American Indian/Alaska Native (AI/AN) and Native Hawaiian people and to promote testing.

An Overview

  • HIV infection affects AI/AN in ways that are not always apparent because of their small population size.
  • The rate of HIV infection is 30 percent higher and the rate of AIDS is 50 percent higher among AI/AN compared with white Americans, according to HHS’ Office of Minority Health.
  • Compared with other races/ethnicities, AI/AN have poorer survival rates after an HIV diagnosis.
  • AI/AN face special HIV prevention challenges, including poverty and culturally based stigma.

The following five videos give us a window into the HIV/AIDS crisis facing Native Americans.

Recognizing and Combatting Stigma: HIV & AIDS Impacting Indian Country

Advocating for Tribal HIV/AIDS Education and Legislation: A Success Story

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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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Fund more Alzheimer’s studies, a high black risk (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.

This article by Lewis W. Diuguid (ldiuguid@kcstar.com) originally appeared in The Kansas City Star

Since my mother died of Alzheimer’s disease in 1994, I always wondered as I attended fundraisers and events for caregivers why so many African Americans filled the rooms.

A recent study by John Hopkins University helps explain it. It shows that older African Americans are two to three times more likely to have Alzheimer’s disease compared with whites. That’s a new Black History Month concern for young African Americans and their elders whom new generations depend on for wisdom and advice.

Alzheimer’s is the sixth leading cause of death for all Americans, and the fourth leading cause of death for older African Americans age 85 and older, the study notes. The African American Network Against Alzheimer’s calls the disease “an unappreciated disparities issue,” adding that Alzheimer’s in general should “create a sense of urgency among policymakers to deal with this growing problem.” Keep in mind that African Americans are 13.6 percent of the U.S. population, but more than 20 percent of Americans with the disease are black.

There is no known cause or cure for Alzheimer’s. However, the study notes strong correlations between Alzheimer’s disease and the high incidence of hypertension, diabetes, strokes and heart disease among African Americans.

For the full article, which originally appeared in The Kansas City Star click here

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

READ OUR OTHER BLACK HISTORY MONTH STORIES:

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

You won’t believe what I learned from our black elders (Black History Month)

10 things Black Americans should know about HIV/AIDS (Black History Month)

35 quotes to help guide your life from famous African American older adults (Black History Month)

When the Healer is not Healed – The Pain of Losing a Child in Your Later Years (Black History Month)

10 things Black Americans should know about HIV/AIDS (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.

February 7th is National Black HIV/AIDS Awareness Day (NBHAAD). NBHAAD is an HIV testing and treatment community mobilization initiative for Blacks in the United States with four specific focal points: Get Educated, Get Tested, Get Involved and Get Treated.

Of special note to black older adults is that 17% of new HIV diagnoses in the U.S. occur in those 50 and older. Soon older adults will represent half of those in the U.S. infected with HIV and yet HIV+ black older adults often face rejection and feel discouraged from talking about the disease. The stigma and silence around HIV/AIDS in the Black community contributes to the rise of infections, later diagnoses, poorer prognoses and delayed treatment in black older adults.

1. HIV/AIDS remains a crisis, especially for Black Americans.

Source: CDC

Source: CDC

 

2. The rate of new HIV infections for Black Americans far, far exceeds that of other major racial/ethnic groups.

Source: CDC

Source: CDC

 

3. The reasons why HIV infection rates are higher in Black communities.

Source: “African Americans and HIV” by Abby Young-Powell

Source: “African Americans and HIV” by Abby Young-Powell

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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.

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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In the Crosshairs of Health Disparities: Older Latinos, HIV and Depression

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 Read More

Not All Asians Are the Same: Diversity within the AAPI Older Adult Population

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.

Percent Below Poverty Level

Source: U.S. Census Bureau, 2006-2010 American Community Survey, 5-Year Estimates

Demystifying the “Model Minority” Stereotype Read More Read More

Open Letter to Health Reform Advocates: Pay Attention to Discrimination

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 Read More

National Grandparents Day – Grandparents Contributing More Despite Numerous Challenges

Since 1978, when the first Sunday following Labor Day was designated “National Grandparents Day“, the number of grandparents in the U.S. has been growing from 40 million (1980) to 65 million (2011) to an estimated 80 million (2020). Over time the roles of grandparents, especially those among diverse elder populations, have also shifted. Grandparents are now providing important caregiving support, raising our children, and are the backbone of multi-generational families.

Present and former NAPCA staff members (L to R) Cora McDonnell, Danny Principe, and Wah Kwong.

Present and former NAPCA staff members (L to R) Cora McDonnell, Danny Principe, & Wah Kwong.

Grandparents living in multi-generational households often face numerous challenges. According to the U.S. Census Bureau, 2.7 million grandparents are responsible for the basic needs of one or more grandchildren under the age of 18. Of these, 594,000 grandparents have incomes below the Federal Poverty Level. Over 500,000 grandparents are foreign-born, and over 400,000 do not speak English at home and have limited English proficiency. Read More Read More

Language, Idioma, 語, ភាសា: Speaking limited English can pose unique challenges for older people

Map of people that speak Spanish at home.  Source: Badger, Emily, “Where 60 Million People in the U.S. Don’t Speak English at Home,” The Atlantic Cities

Map of people that speak Spanish at home. Source: Badger, Emily, “Where 60 Million People in the U.S. Don’t Speak English at Home,” The Atlantic Cities

According to the Census Bureau, about 20% of people speak a language other than English at home. That’s 1 in 5 people! And over the years, this number has only grown. The Census Bureau has developed a map that shows in which parts of the country these people live. What the map shows is that there are people whose preferred language is not English in all but the most sparsely populated parts of the country. Language access is a civil right, and these rights are reflected in federal law. It is also becoming more common to see instructions on packages, advertisements, and other messages translated into languages other than English, as well. When it comes to language access, the policies of the United States promote inclusion.

Despite these efforts at inclusion, accessing many government programs poses unique challenges for older adults with limited English speaking ability. Programs like Medicare Part D (the prescription medication program) and the Affordable Care Act’s health exchanges rely on consumers to choose the plans that will balance value and health coverage. However, there are multiple studies from the implementation of Medicare Part D that state consumers do not choose the most economically efficient options. Most people, particularly those who prefer to speak in a language other than English, could benefit from learning more about their health care options. Read More Read More

Addressing the Needs of LGBT Hispanic Older Adults in the U.S

Two Older LGBT Hispanic men at a SAGE 2011 health fair

Two Older LGBT Hispanic men at a SAGE 2011 health fair

With the rapid growth of our diverse population, our country is becoming more beautiful than ever. But unfortunately, there are still some groups that are not well understood by the nation’s service providers, or by local, state and federal governments. One of those groups is lesbian, gay, bisexual, transgender (LGBT) older adults. And in order to better understand the reality of this diverse community, the National Hispanic Council on Aging (NHCOA) conducted an analysis through a literature review, focus groups (one was held at The SAGE Center; SAGE is fellow member organization of the Diverse Elders Coalition) and in-depth interviews with LGBT Hispanic older adults, including the service providers who work with them. Read More Read More

Untold stories of Asian & Pacific Islander LGBT Elders: “I think the need to be accepted overcame their need to be themselves.”

Three things to know as May ends and we look towards June:

  1. May is Older Americans Month.
  2. It’s also Asian American and Pacific Islander (AAPI) Heritage Month.
  3. And I work for the country’s largest and oldest organization dedicated to improving the lives of lesbian, gay, bisexual and transgender (LGBT) older adults.

So, what does this mean?

Well, for me, it made me really think: What are the stories being told about older LGBT AAPI people? Are they even being told? Outside of the amazing George Takei, I can’t think of another prominent openly gay Asian American older person. Can you?

I am Puerto Rican, gay and not yet 30 years old, so the stories of older LGBT AAPI people are not my personal story. Therefore, it was important that I find individuals who could tell and share these stories… And that was difficult. Read More Read More