HIV, Aging and LGBT people: A Metamorphosis

On April 3, 2008, my longtime friend Don (last name withheld) tested positive for HIV, the same day as his mother’s 56th birthday. He remembers the day vividly. “I had given blood to my doctor and a couple weeks later, I still hadn’t received a call. I called my doctor’s office and they said, ‘There’s an anomaly with your blood.’ I immediately freaked out and thought, ‘God, this is it.'” Don took the last appointment of the day and a few hours later received his diagnosis, along with a few referrals. He went home “to pull myself together, call my mom and wish her a happy birthday.” He wouldn’t share his HIV status with his mother for several years.

“It stopped me dead in my tracks,” he says of that day. “And even though having an HIV diagnosis isn’t the same as it was 15 or 20 years ago, I immediately saw the end. I had dreams where I would see this road that said: ‘dead end.'”

At 42, Don represents a notable demographic segment of the U.S. population living with HIV/AIDS. According to the Centers for Disease Control and Prevention (CDC), the highest rates of HIV prevalence, by age group, are among people ages 45-49 and ages 40-45—20% and 16%, respectively. As these people in their 40s and their older peers age, spurred in large part by medical advances, people age 50 and older will make up roughly 70 percent of Americans with HIV by the year 2020.

Yet aging with HIV can be especially difficult. Older adults with HIV report high levels of isolation, yet few community spaces embrace their full identities as older people, people with HIV and, in most cases, given the epidemic’s prevalence, LGBT and people of color. Additionally, medical research has found multiple health concerns related to aging with HIV—and the psychological dimensions of living with HIV, or a new diagnosis, can spur its own storms. Without a large-scale, dedicated response, the “younger” end of this older adult spectrum, including Don, will join their older peers over the next decade in entering an aging system unprepared to meet their unique needs, despite their overwhelming numbers.

*****

Don was born in 1972 in Maple Heights, Ohio, a suburb of Cleveland he describes as comprised largely of Polish and Italian people (similar to his family), and one that depleted in size over the decades as the economy worsened. He recalls a mixed childhood that included a family dynamic in which tough issues were never discussed openly and only worsened as he grew older. “We laughed and we loved each other, but there was the divorce and the fighting and the aggression that overshadowed all of it.”

Don’s first memory of HIV is from 1985, when screen legend Rock Hudson publicly disclosed he had AIDS. Don remembers his family reacting to—though not discussing—the controversy that erupted regarding a kiss Hudson had shared with his “Dynasty” co-star Linda Evans on an episode a year prior. “I remember just hearing ‘AIDS’ and they would show pictures of him, and they would show pictures of people with lesions and looking sickly. Those were the first images that were infused into my brain.”

AIDS raged through the 1980s—inciting more than 100,000 cases by the end of 1989, according to the CDC—yet Don doesn’t recall any mentions of the topic until his freshman year in college in 1990. “During student orientation, they give you information about all of the available resources on campus, and they talk about the health center, and if you get an STD, and how to get an HIV test. ‘An HIV test?’ I thought. That was the first time it registered as something that people needed to pay attention to.”

As Don matured into his gay identity throughout his 20s, he still didn’t feel at risk for HIV. “I felt like, well, I’ll just pick the right guy who looks like he’s ‘clean.’ It was a beautiful, blissful denial and ignorance that allowed me to behave like I did and not see a connection between my behaviors and the consequence of what could have been.” In fact, after his first handful of HIV tests yielded negative results, he admits it gave him license to continue having unprotected sex for a few years longer, believing himself immune from HIV and other sexually transmitted infections.

Years later, he would seroconvert and find solace in disclosing his HIV status to a select network of friends. “When you tell people, when we come out, we’re telling people not just to share information, but it’s also to better accept ourselves.” He would reconcile his relationship with his estranged biological father. He strengthened ties with his sister and brother, the two remaining next of kin after a series of untimely family deaths over the course of a decade. And for two years, he co-facilitated an HIV support group for a local nonprofit that gave him a sense of purpose and exposed him to a multitude of motivational stories. He soon saw himself as “one little story among a greater picture.” He realized then, “Okay, we’re all in this together and we’ll figure it out.”

*****

But are we united on this issue—and will we figure it out? My experience in lesbian, gay, bisexual, transgender and queer (LGBTQ) rights shows that few organizations prioritize HIV/AIDS, an omission that’s more glaring in the aging and long-term field.  More broadly, this topic seems virtually absent in the media, in government, and across progressive activist circles and community spaces. Governments rarely support this population, and too few aging and health providers are versed in the clinical and social support needs of people aging with HIV.

At SAGE, we frequently encounter older people with HIV who are severely isolated, in poor health and without proper financial means. Some have lived with HIV for years; others have been recently diagnosed, often with both HIV and AIDS; and many probably don’t know they have HIV. Recently I asked a case manager who runs an HIV support group in New York City about the group’s willingness to discuss end-of-life planning and set in place the necessary documents. He replied that people who have long fought to survive avoid discussing death for fear of jinxing their good luck. And what do we make of older people who tested positive in the 1980s and early 1990s, assumed they would pass away, spent their savings and then miraculously survived—impoverished and jarred by their newfound survival?

A May 2014 policy report offers large-scale recommendations. Federal agencies should fund HIV prevention programs that are aimed at older people who might require unique messaging rooted in generational differences. The CDC should encourage HIV testing among people older than 65 and promote their overall testing guidelines among all health providers. All states should adopt Medicaid expansion under the Affordable Care Act to ensure that more low-income people can access proper care—a disparity that disproportionately affects people of color largely concentrated in states that have opted out of Medicaid expansion. Federal agencies should fund more research on what it means to age with HIV, especially among LGBT people and people of color, the hardest hit groups. And the U.S. Department of Health and Human Services should issue treatment guidelines for the clinical care of older people with HIV, many of whom have increased comorbidities as early as age 50.

Six years after his diagnosis, Don grapples with remaining optimistic in a time of grief. “I’m probably healthier than I have ever been, yet I’m continually reevaluating my life and purpose, especially with the death of my family. You can’t help but think, ‘What’s my fate?” He nevertheless sees the fact that he was diagnosed on his mother’s birthday (who passed away from cancer in December 2013) as symbolic motivation. “It’s her birthday. But it also became a different sort of birth process for me because it was me seeing my life and myself in a new way for the first time.”

Don now seeks to create a simple life with clear priorities, minimize his material belongings, and focus his time on people who matter, such as his partner of three years. And when he ponders how he wants to live his later years, he replies: “Enjoying the day. Not worrying about what’s going to happen five or 10 years from now, or a year from now. I want to enjoy this moment and take it all in for what it is.”

*****

I remember the day Don shared his HIV status with me. He brought me into his kitchen and told me in the clearest of terms, a mix of bluntness and vulnerability in his tone—everything I know about his personality. I measured my reaction, asked questions and downplayed the severity and stigma, a response I would want in a reverse scenario. We both agreed HIV was a different illness than what we read and witnessed from the 1980s and 1990s. We had a dinner party to attend that evening and before we left the house, I escaped to his upstairs bathroom, shut the door and wept. Outside, the streets of downtown Denver were lined with delegates and supporters for the 2008 Democratic convention, celebrating the possibility of a new era. As we drove through this tide of hopefulness, I sat still next to my rattled friend. I thought about life’s inevitabilities, what awaits and changes us, and how often we as LGBTQ people have had to defend our bodies from the forces that routinely assault us. A new era, yes. A different narrative, no.

Is this the dilemma that rests at the heart of sexual liberation for LGBTQ people? We crave fulfilling sexual lives, autonomy over our bodies, new norms, and the freedom to express ourselves as we see fit, without judgment, discrimination or criminalization. Yet we still encounter consequences, and our culture seems ill-prepared to deal with the contradictions that come with the fluidity and complexity of identity, desire and choice. And we know too well that a serious illness can be transformative or debilitating, depending on one’s resources and level of support. Life can seem so pressed and so short.

We have also been trained to critique and reform the same health care system that we must ultimately rely on. Many of us are too well-read and historically astute to blindly trust the industries and institutions that profess to protect us. Medications are conceived in laboratories governed as much by profit as by medical need. Government and private funds to nonprofits come with illogical restraints, ideological assumptions and unrealistic deliverables. So how do we live healthy, sexually liberated lives as queer people in the context of cultural repression and widespread economic exploitation? Does this explain the apathy, even aggression, against new PrEP treatment that could prevent scores of HIV infections if more people were on it? We remain rightfully dubious about the lines between altruism and marketing, prevention and “poison,” our health and their profit.

I’m inspired that Don sees the date of his diagnosis as a form of re-birth; it’s both poetic and precise. Yet Don’s inspiring metamorphosis, strength-based outlook and access to both medications and social support are not evenly shared among older people. What we need are solutions that draw from the hardship of people who struggle with the daily coping of HIV/AIDS, physically and financially, as well as from people such as Don who have survived HIV, grown wiser and in many ways, healthier.

It might be that HIV and aging, when seen as distinct concepts, are two manifestations of the same notion; your life becomes either more meaningful or more precarious depending on your state of mind and what surrounds you. Or perhaps the pervasiveness of death clarifies our identities; we anticipate our end as a means of reformulating our old selves. When I ask Don about the legacy he’d like to leave when he passes, he replies, “I want people to know that HIV influenced me because it made me look at life in a totally different way. It took me out of myself temporarily in order to get to know myself all over again.”

Follow Robert Espinoza on Twitter: www.twitter.com/EspinozaNotes

This article by Robert Espinoza originally appeared in the Huffingtonpost.com Gay Voices blog.

Robert Espinoza is Senior Director for Public Policy and Communications at Services & Advocacy for GLBT Elders (SAGE). The opinions expressed in this article are those of the author and do not necessarily reflect those of the Diverse Elders Coalition.

AIDS AND AGING: A REALITY THAT DEMANDS OUR ATTENTION

Maria Eugenia Hernandez-Lane, Vice President of NHCOA

Maria Eugenia Hernandez-Lane, Vice President of NHCOA

The AID Institute’s 7th annual National HIV/AIDS and Aging Awareness Day (NHAAAD) will be observed September 18, 2014 with the theme “Aging is a part of life; HIV doesn’t have to be!” For more information about HIV/AIDS and older Americans or to become involved with the campaign, visit www.NHAAAD.org.

Among diverse communities, the stigma of HIV is a cause of shame, embarrassment, and worse of all, denial and silence. When denial and silence are present, the lack of communication and information lead to myths and misinformation. Worst of all, silence results in increased infections and is inevitably compounded by stigma, which leads to people living with HIV who are undiagnosed and therefore, untreated.

In the U.S. alone, 1 out of 6 persons is unaware s/he is HIV positive. The reality is that older Americans are just at risk of HIV infection as younger age groups are.

[Learn more HIV statistics in the United States]

In fact, adults 55 years and older represented nearly one-fifth of the U.S. population living with HIV in 2010. The CDC estimates that by next year (2015), this number will double, which means that half of the people living with HIV in this country will be 50 years and older. There are several reasons why older Americans who are HIV+ may not be aware of their status:

  • HIV tests aren’t always included as part of the check up routine, and seniors tend to think they don’t know need to ask for one;
  • The signs of HIV/AIDS can be mistaken for the aches and pains of normal aging;
  • Older adults are less likely to discuss their sex lives or drug use with loved ones or a health care provider;
  • Myths and misinformation that lead seniors to believe that they are “too old” to get infected;
  • Lack of targeted public education*.

However, we should not only be concerned with reducing HIV infections among the older adult population.

Medical advances have allowed people with HIV who get treated— and stay in treatment— to lead longer, healthier lives. Yet, the success of these new treatments and the increased longevity of patients have led to new challenges to the proper prevention and care of older Americans living with HIV, especially those who are from diverse communities. There is a lack of research aimed at aging with HIV, as well as few prevention campaigns, clinical guidelines, demonstration projects and training initiatives targeting older adults living with HIV, particularly diverse seniors. While the Affordable Care Act does include provisions to support people living with HIV/AIDS, including older Americans, the public policy landscape is scarce when it comes to seniors and HIV/AIDS.

[Related content: Learn how the ACA is helping older Americans living with HIV.]

Older Americans with HIV are often excluded from major legislation, policy initiatives and programs— from the White House Conference on Aging, to the Older Americans Act and the Ryan White CARE Act, to the Medicaid expansion, and more.

Left unaddressed, generations of older adults with HIV/AIDS will lack the supports they need to age with dignity and in the best health possible. This is why the Diverse Elders Coalition in collaboration with ACRIA (AIDS Community Research Initiative of America) released 8 recommendations that have the potential of dramatically improving the lives of diverse seniors, and all older Americans, living with HIV.

What you can do on National HIV/AIDS and Aging Awareness Day

* To combat this, NHCOA is a partner of the CDC’s Act Against AIDS Leadership Initiative, which is focused on reducing the incidence of HIV/AIDS among diverse communities. Through culturally and linguistically appropriate, and age sensitive outreach and education, NHCOA conducts HIV outreach and education among Hispanic older adults and families to dissipate the stigma and silence.

Additional Resources

www.cdc.gov/hiv

www.aids.gov

www.hhs.gov/ash/ohaidp

www.aoa.gov/AoARoot/AoA_Programs/HPW/HIV_AIDS

Posted by Maria Eugenia Hernandez-Lane, Vice President of the National Hispanic Council on Aging (NHCOA). The opinions expressed in this article are those of the author and do not necessarily reflect those of the Diverse Elders Coalition.

The Ins and Outs of LGBT Caregiving

We, (those of us older than 50) are now finding out what Bette Davis knew, that “Old age ain’t no place for sissies.” Those of us who are also lesbian, gay, bisexual or transgender (LGBT) may have additional challenges including homophobia and heteronormativity, which can send us running back to the very closets we fought so hard to leave, according to Stein and colleagues in a 2010 article in the Journal of Gerontology Social Work.

Recently I did a study with African-American lesbians and gay males. All study participants experienced a sense of alienation, in the African-American and majority-LGBT communities, described consistently as “a hurt that lasts a long time.” They also talked of a sense of not being wanted in the mainstream population. More than half of the participants had been called names, whispered about or harassed because of being perceived as gay or lesbian. Not surprisingly, a majority of participants were not out to their family, at work, in church or to neighbors. Some revealed that they always “pass” as heterosexuals in the majority environment. This fear of being harassed or discriminated against, the fear of being outed and the lack of LGBT-welcoming photos and brochures in care environments, as well as on websites or in social media, translates into elders trying to stay “safe,” according to Pope et al. in a 2007 article in Adultspan Journal.

So what happens when these closeted elders need to access healthcare and other services, and need the support of family members, including adult children? It remains a difficult situation. Research has shown that a majority of LGBT elders’ age without a partner, compared to less than 40 percent of the overall older adult population aging without a partner, and 90 percent of LGBT elders have no children, compared to 20 percent of the overall older adult population being childless. Furthermore, LGBT elders with children are often estranged from or not out to those children. There is a poignant scene in the film Gen Silent where an older transgender woman needs her son’s support. He has been estranged from her for years. He finally and briefly comes into her life, but is unable to accept his now-female parent as anyone but “Dad.”

Remarkably, adult children who accept and care for their elder LGBT parents seem to be aware of the perceived need for their parents to be closeted. In a qualitative study in 2007 of caregivers of gay and lesbian older adults, one heterosexual adult son observed, “My dad’s generation was more conservative, more guarded… . So they are [more] reluctant to accept help… . My dad wouldn’t want to be stigmatized as a gay.”

Another adult child, a gay son, said, “They [staff in nursing homes or assisted living facilities] told me that it would be better to hide this aspect … the identity of my father.”

Upon further questioning, these adult children articulated that they often faced overt and covert discrimination when accessing services while caring for their elder parents. The discrimination seemed to be based on the perception of the elder being gay or lesbian. In some cases, caregivers were reluctant to leave parents in institutions because of the increased vulnerability of being old and LGBT. Adult children caring for LGBT parents felt the combined perceived or actual oppressions of heterosexism and ageism directed toward their parents.

Clearly, institutions that provide resources and respite to care recipients and caregivers need training in cultural competency to create positive social environments for the closeted LGBT elder and their adult children. Moreover, additional research is required to investigate the outcomes of caregiving among this heretofore invisible group.

 

Dr. Imani Woody is the principal of IWF Consulting, LLC, president and CEO of Mary’s House for Older Adults, Inc. and the SAGE Metro DC representative to SAGENet – SAGE’s network of local affiliates around the country – that work to reduce isolation, improve financial security and enhance quality of life for LGBT older adults. The opinions expressed in this article are those of the author and do not necessarily reflect those of the Diverse Elders Coalition.

This article by Dr. Imani Woody originally appeared on the American Society on Aging’s blog. Read it here.

Other articles in this series from the editorial committee of ASA’s LGBT Aging Issues Network (LAIN)

Recognizing and caring for our grandparents (National Grandparents Day) with a view towards the 2015 White House Conference on Aging

Sunday, September 7, 2014 is National Grandparents Day. What a great opportunity to recognize those that have given so much love and support! Grandparents Day was established as a national holiday in 1978 as a way to recognize and value the contributions of our nation’s seniors. Our elders have often done much to support our families in economic, emotional and spiritual ways and yet these contributions are often overlooked and unappreciated.

In the years since the establishment of National Grandparents Day, there has been a grandparents boom with the numbers rising from 40 million in 1980 to 65 million in 2011 and an estimated 80 million in 2020. This “Elder Boom” is not a crisis but a blessing. We’re living longer and have the opportunity to spend more time together. The question is how do we live as we age?

Our friends at Caring Across Generations have run a summer long campaign “ThrowbackSummer” to celebrate the culture, memories and relationships that unite us across generations. Their goal is to build a national movement to transform the way we care in this country. And that includes caring for our elders.

Right now, our country has no comprehensive plan to care for our aging parents and grandparents. More broadly, seven in ten of us will need home care at some point in our lives, due to disability or the simple natural process of getting older. And the vast majority of us – 90% – would prefer to stay at home instead of being placed in a facility. But for too many of us, home care is not an option.

Grandparents Day is the perfect time to discuss issues such as long-term care. The process of aging, or losing mobility due to disability, can also be scary and challenging for many people – and therefore something that most people want to avoid thinking about. Our grandparents have done so much for us. SEARAC’s Bao Lor learned about love and courage and hard work from her grandpa, a refugee from Laos. However some grandparents can face a wide range of challenges when performing primary childcare for their grandchildren. Now it is time to consider what we can and should do for them so that they can age with dignity and independence.

Preparations have begun for the 2015 White House Conference on Aging (WHCOA). Occurring every ten years, the WHCOA is an opportunity to look ahead to the issues that will help shape the landscape for older Americans (our grandparents) for the next decade. In late July, Cecilia Munoz, an Assistant to the President and Director of the Domestic Policy Council, outlined possible themes for next year’s WHCOA:

  • Retirement security – Financial security in retirement provides essential peace of mind for older Americans
  • Long-term services and supports – Older Americans prefer to remain independent in the community as they age but need supports such as a caregiving network and well-supported workforce
  • Healthy aging – As medical advances progress, the opportunities for older Americans to maintain their health and vitality should progress as well
  • Protection – Seniors, particularly the oldest, can be vulnerable to financial exploitation, abuse and neglect. Protect seniors from those seeking to take advantage of them

In honor of National Grandparents Day, the Diverse Elders Coalition recognizes and appreciates the many and varied contributions of our nation’s seniors. In the year ahead, we plan to ensure the voices and needs of our diverse communities are fully represented in the 2015 White House Conference on Aging.

Thank You Grandparents!

Photo: courtesy Caring Across Generations

Photo: courtesy Caring Across Generations

Photo: courtesy Caring Across Generations

Photo: courtesy Caring Across Generations

Photo: courtesy Caring Across Generations

Photo: courtesy Caring Across Generations

Photo: courtesy NHCOA

Photo: courtesy NHCOA

Patrick Aitcheson is the Interim National Coordinator for the Diverse Elders Coalition (DEC). The opinions expressed in this article are those of the author and do not necessarily reflect those of the Diverse Elders Coalition.

Vaccinations are not just for kids

Maria Eugenia Hernandez-Lane, Vice President of NHCOA

Maria Eugenia Hernandez-Lane, Vice President of NHCOA

August is National Immunization Awareness Month (NIAM), and when it comes to vaccines, it’s important to keep in mind that immunizations are not just for kids – we all need to get vaccinated at different points throughout our lifetimes. That is why it is important for older adults to know what vaccines they may need, where they are administered, and receive encouragement from their trusted health care providers and loved ones to get immunized.

The fact is that the existence of vaccines is the one of the reasons we are able to live longer, healthier lives. Diseases that used to be deadly are now preventable, and NIAM presents an opportunity to highlight the value of immunization across one’s lifespan.

As one of several DEC founding members dedicated to improving the lives of our diverse seniors across the country, the National Hispanic Council on Aging (NHCOA) knows that keeping up with the CDC-recommended vaccination schedule is a key part of staying healthy for all older Americans. Therefore, in commemoration of NIAM, here are five reasons why older Americans should get vaccinated:

1. Vaccines are not just for kids.

Vaccines are an important part of a person’s preventive care at all stages of life, not just childhood.

2. Vaccines are an important step in protecting adults against serious, often deadly diseases.

While it may not seem to make sense, the truth is that vaccinations are necessary throughout childhood and beyond. Every year the CDC issues vaccine recommendations based on the latest research on vaccine safety, effectiveness and patterns of vaccine-preventable diseases.

[Click here to see the 2014 CDC adult vaccination schedule by age group. A Spanish version is available as well.]

3. Vaccines can protect older adults from serious and sometimes deadly diseases.

The CDC recommends older adults get vaccinated to prevent serious diseases such as the flu (influenza), shingles, pneumonia, hepatitis and whooping cough. Many of these diseases are common in the United States and therefore all adults— especially diverse elders—can benefit from immunization.

There are also vaccines that prevent cancer, such as the hepatitis B vaccine. The vaccine prevents chronic hepatitis B, which in turn prevents liver cancer.

The reality is that avoiding vaccinations results in the needless hospitalizations of thousands adults in the U.S., and in the worst of cases, death. However, perhaps the most important function of vaccines is to prevent the spread of certain diseases among those who are most vulnerable to serious complications, which includes diverse seniors.

[Click here to find out which vaccinations are covered by Medicare.]
[The new ACA Health Insurance Marketplace plans cover vaccinations as free preventive services with no copay or coinsurance charges]

4. Most adults have probably not received all the immunizations they need to stay healthy.

The rates of adult immunizations among older adults aren’t as high as they should be, exposing them and their loved ones to preventable diseases. And, although many older adults may consider immunizations to be important, many may be unaware that they need to get vaccinated as well, which is why health care professionals play an important role in informing their patients about the need to get immunized. Seniors should also talk to their health care providers about which vaccines are best for them given their specific health situation.

[Click here to find out your closest vaccination provider]

5. Vaccines are safe.

All vaccines are thoroughly tested before being released to the general public to ensure they are safe for use. While vaccines do have side effects, they are usually minor and temporary. It is possible for some people to have allergic reactions to certain vaccines, but serious and long-term effects are rare.

The week of August 24-30 is dedicated to raising vaccination awareness among adults, including diverse seniors. NHCOA is a proud partner of the CDC in helping inform and raise awareness about getting vaccinated among Hispanic older adults, their families, and caregivers through its signature immunizations program, Vacunémonos (Let’s Get Vaccinated). Vacunémonos is a culturally, linguistically, and age sensitive community intervention that aims at increasing adult vaccination rates among Hispanics. For more information, please visit www.nhcoa.org.

Additional Resources

NHCOA Vacunémonos Pinterest Board [Bilingual]
NHCOA Vacunémonos Immunization Brochure [Spanish]

Posted by Maria Eugenia Hernandez-Lane, Vice President of the National Hispanic Council on Aging (NHCOA). The opinions expressed in this article are those of the author and do not necessarily reflect those of the Diverse Elders Coalition.

New health coverage? Now what?

Millions of Americans obtained health coverage through the new Health Insurance Marketplace or through Medicaid. For many of these newly insured individuals and families, this insurance is their first health coverage in a long time or ever. Now what? How can you get the most from this coverage? What do all these terms such as in-network, deductible, co-insurance (and many, many more) mean? How do you find and choose a doctor (“provider”), make an appointment, prepare for a visit and more? The Centers for Medicare & Medicaid Services (“CMS”) has launched an education initiative entitled From Coverage to Care with educational materials and videos available in both English and Spanish to help people make the most of their coverage.

From Coverage to Care roadmaps (48 page information and resource guides):

Roadmap to Better Care – English

Roadmap to Better Care – English

A Roadmap to Better Care – Español

Roadmap to Better Care – Español

 From Coverage to Care videos (11 short videos available in English and Spanish):

HealthCare.gov also answers many common coverage questions. Some of the topics covered include:

  • Understanding your health care coverage: Make sure you start by knowing how your health plan or coverage works. Become familiar with the services that are covered and how much you’ll have to pay. You can also learn what any new terms mean and how they apply to your coverage.
  • Using prevention to stay healthy: Your coverage is designed to serve you beyond just getting sick. At regular check-ups, you can ask questions on the steps you can take to become healthier. After all, prevention is a critical part to staying healthy – and under the Affordable Care Act, many preventive services are covered with no copays or additional costs.
  • Understanding Primary Care vs. Emergency Care: You’ll visit your primary care provider for both routine check-ups and when you feel ill. When you are feeling extremely sick or are in a life-threating situation, you’ll visit the emergency department. You may pay a higher copay or coinsurance for emergency care visits.
  • Following up after appointments: Remember that good care doesn’t stop when you leave your provider. Make sure you follow your health care provider’s instructions, schedule your follow-up appointments, if needed, and fill any needed prescriptions.

If you have questions about your new health care coverage, contact your insurance company directly or healthcare.gov at 1-800-318-2596 (TTY: 1-855-889-4325). Trained representatives are available at the Marketplace Call Center 24 hours a day 7 days a week if you need help. If you have questions about your Medicaid coverage, you can contact your state agency directly for more information.

For American Indians and Alaska Natives (AI/ANs), health coverage under the new Health Insurance Marketplace works a bit differently. Members of federally recognized tribes and Alaska Native shareholders can enroll in Marketplace coverage any time of year. Out-of-pocket costs like deductibles, copayments and coinsurance may not apply based on income levels. AI/ANs can get (or keep getting) services from the Indian Health Service, tribal health programs, or urban Indian health programs as well as using their new coverage to get services from providers on the Marketplace plan or via Medicaid, as applicable. Utilizing your new health coverage when accessing services at Indian Health Services, brings more funding into the IHS and allows IHS to provide more health care to all AI/ANs. More information is available at HealthCare.gov and tribalhealthcare.org.

You have this great new health coverage, learn how to get the most out of it!

Patrick Aitcheson is the Interim National Coordinator of the Diverse Elders Coalition. The opinions expressed in this article are those of the author and do not necessarily reflect those of the Diverse Elders Coalition.

Salud y Bienestar: Helping Latino Seniors and Families Prevent and Manage Diabetes

Obesity is a foothold for chronic diseases, such as diabetes, posing a particularly serious health challenge for all diverse communities, including Hispanic older adults. Sadly, the number of Latino diabetics increases with age: one out of three Hispanic older adults suffer from the disease, which is often accompanied by related complications such as kidney disease, amputations, heart disease, high blood pressure, and nerve damage. While factors such as obesity predispose Latinos to diabetes, there are also myriad cultural, educational, linguistic, financial, and institutional barriers that keep Hispanics from being diagnosed in the first place. In fact, two of out every seven diabetics in the United States are undiagnosed. This is poses a significant health threat and challenge not only among families, but also in the realm of public health. Read More

Medicare and Medicaid at 49: Keeping the Generations-Old Promise Alive

While the concept of national health insurance was developed in the early 20th century, President Harry S. Truman elevated the issue during his Administration:

“Millions of our citizens do not now have a full measure of opportunity to achieve and to enjoy good health. Millions do not now have protection or security against the economic effects of sickness. And the time has now arrived for action to help them attain that opportunity and to help them get that protection.”

Twenty years later, his vision was brought to life under President Lyndon B. Johnson with the Social Security Amendments of 1965, which provided millions of older Americans and low-income families with access to healthcare through the Medicare and Medicaid programs. At the time, health insurance wasn’t attainable for older Americans, especially those living in poverty, because of their age and chronic conditions. Private insurance was also out-of-range for low-income families. By providing our most vulnerable populations with health insurance access, over the decades, Medicare has become a game-changer, especially for diverse seniors. The bottom line is that: without it, many diverse elders would have to assume their healthcare expenses, accrue substantial debt, and most likely not receive the care they need. Today, 49 years later, the Medicare and Medicaid programs have continued to fulfill their promise to all of our generations, allowing seniors and families to have access to the quality healthcare they deserve and otherwise, wouldn’t be able to afford.

Medicare

Thanks to the Affordable Care Act, the life and solvency of Medicare has been extended with expanded benefits and savings for its beneficiaries. Since the ACA was enacted, over 8.2 million beneficiaries have saved $11.5 billion on prescription drugs, an average of $1,407 per person. The ACA is also successfully closing the “donut hole,” a gap in coverage in which beneficiaries pay the full cost of their prescriptions out-of-pocket, before catastrophic coverage for prescriptions takes effect. Beneficiaries affected by the “donut hole” will receive savings and discounts on brand-name and generic drugs that gradually increase each year until the gap is closed in 2020.

The use of preventive services among Medicare beneficiaries has also increased thanks to the ACA. The elimination of coinsurance payments and the Part B deductible for recommended preventive services, such as cancer screenings, has allowed more beneficiaries to take control of their health by preventing and monitoring health conditions as well as detect health problems in early stages.

Medicaid

Medicaid also provides health insurance for more than 4.6 million low-income older Americans, the majority of whom are concurrently enrolled in Medicare. Medicaid also covers nearly 4 million people with disabilities who are also enrolled in Medicare. This population of “dual eligibles”— those who are enrolled in Medicare and Medicaid— represents 17% all Medicaid enrollees. When the ACA was passed, states were required to expand Medicaid coverage to bring more low-income folks under the insured tent. However, the Supreme Court later ruled it voluntary, which has resulted in states “opting out” of expansion. Due to this, there are seniors whose incomes are too high to qualify for Medicaid under the current rules, yet too low to qualify for help purchasing coverage through the Marketplace.

A Birthday Wish for Medicare and Medicaid

As advocates for diverse elders across the country, our birthday wish for Medicare and Medicaid is two-fold: for these social insurance programs to be protected for future generations, and for the states which “opted out” of Medicaid expansion to reverse their decisions. However, for this birthday wish to come true, it will require less gridlock and resistance and more consensus and bipartisanship. It will require less rhetoric and more action. It will require our communities to speak up and speak out on behalf of those who benefit from these programs, and those who could.

Today, July 30, join the millions of seniors and families Medicare and Medicaid serve each year in wishing these programs a happy birthday. And, here’s to many more!

Take Action

 

Dr. Yanira Cruz is the President and CEO of the National Hispanic Council on Aging. The opinions expressed in this article are those of the author and do not necessarily reflect those of the Diverse Elders Coalition.

Hepatitis, HIV and Older Americans: Get the Facts and Take Action

Diana Moschos - picBy Diana Moschos

World Hepatitis Day is one of four official disease-specific world health days

While viral hepatitis is the 8th leading cause of death in the world, it is a largely silent killer. Each year, the disease kills approximately 1.5 million people worldwide. In the United States, the CDC estimates 4.4 million people live with chronic hepatitis. However, most are unaware they are infected. Four years ago the World Health Organization designated July 28 as World Hepatitis Day to raise awareness and encourage action, especially among vulnerable and high-risk populations, including older Americans. Viral hepatitis is a life-threatening disease on its own, but often times it can be present along with other life-threatening infections, such as HIV. Read More

From Coverage To Care

A message from Cara James, Ph.D., Director of the Office of Minority Health at the Centers for Medicare & Medicaid Services:

We are excited to tell you about From Coverage to Care: A Roadmap for using your new coverage

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If you’re one of the millions of Americans who recently obtained health coverage through the new Health Insurance Marketplace, or Medicare, Medicaid, Children’s Health Insurance (CHIP), From Coverage to Care materials can help answer questions you might have so you can make the most of your health coverage. Resources are available at marketplace.cms.gov/c2c. Some of the topics covered include: Read More

Senior Wellness Fairs: Bringing Health Education and Screening to a Vulnerable Population

By Eun Jeong Lee

By Eun Jeong Lee

Asian American and Pacific Islander (AAPI) older adults are often in vulnerable positions when it comes to taking care of their health. AAPI seniors face many barriers including: a lack of adequate health insurance, language barriers, cultural beliefs, changes in their diet after immigration, and a lack of resources and information. Many older AAPI adults have less access to health screening opportunities compared to the general population. In order to help address these issues, senior health fairs can be a good way for AAPI seniors to check their health status.

Recently, the National Asian Pacific Center on Aging (NAPCA) partnered with the American Heart Association (AHA) to host Senior Wellness Fairs in Seattle and Los Angeles. These fairs provided important educational presentations related to heart health by physicians and health professions, and provided free health screenings, including blood pressure, glucose, cholesterol, Body Mass Index, dental screening, stroke test, eye sight to seniors. Read More

8 Ways the U.S. Must Prepare for More Seniors with HIV

This article by David Heitz originally appeared on HealthlineNews.com

On the eve of National HIV/AIDS Long-Term Survivors Awareness Day, a new report shows that the median age of Americans with HIV is 58 and that the the United States is woefully unprepared for a growing population of seniors with the virus.

By the end of 2010, more than 630,000 people in the United States had died from AIDS, according to the Centers for Disease Control and Prevention (CDC). At the end of 2009, more than 1.1 million people in the U.S. ages 13 and older were living with HIV. Some 80,000 of these people have been living with the disease for decades, and they are known as long-term survivors. Thursday, June 5, is National HIV/AIDS Long-Term Survivors Awareness Day. Read More

Creating unlikely partnerships to improve the health of diverse older adults

Community Catalyst and the Diverse Elders Coalition (DEC) are thrilled to announce the launch of two new partnerships on the ground in New Mexico and Georgia. The unlikely partnerships will facilitate the ongoing education and enrollment of Native American, Bhutanese and lesbian, gay, bisexual and transgender older adults (age 50+)—and their loved ones—in these two states.

In both states, partner organizations are working collaboratively to inform their communities about the Affordable Care Act’s benefits. While the Health Insurance Marketplace closed on March 31 for most, enrollment continues year round for Native Americans and those eligible for Medicaid. In Georgia, these new partnerships also serve as additional, targeted support for the state legislature and administration to take up the Medicaid expansion. Read More

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. Read More

Enthusiasm and Partnerships Overcome the Vastness of Alaska for Healthcare Enrollment (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.

The Alaska Native Tribal Health Consortium (ANTHC) has a bold vision: to ensure that Alaska Native people are the healthiest people in the world. By working to ensure that all Alaska Native and American Indians in Alaska have health insurance, the ANTHC is helping to eliminate long entrenched health disparities. ANTHC was formed almost 20 years ago as a nonprofit health organization that offers quality health care services for all Alaska Natives and American Indians. 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. Read More

10 Key Points to Know About Health Disparities among Asian American and Pacific Islander Elders (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. It is a great time to raise awareness of the health disparities that affect racial and ethnic minorities.

In the spirit of raising awareness, here are 10 important things you should know about health disparities among Asian American and Pacific Islander (AAPI) elders including some helpful resources from the National Asian Pacific Center on Aging (NAPCA): Read More

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. Read More

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. Read More

Battle Misinformation and Stand Up for the Affordable Care Act (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.

By Angie Boddie, Director of Health Programs at The National Caucus and Center on Black Aged, Inc.

Black history month reminds us that African Americans come from ancestors with a legacy of overcoming obstacles far and wide. Five decades since the oppressive days of Jim Crow, African Americans have a lot to celebrate— achievements in science, business, government, medicine, arts, sports, and a two-term elected president of the United States who delivered on his promise to provide universal healthcare to all Americans.

Affordable_Care_Act_100413Originally written with the premise of putting consumers back in control of their healthcare, the Affordable Care Act required all states to assist its residents by expanding their Medicaid program’s to their residents with incomes below $16,000 ($32,000 for a family of four), with the understanding that the federal government would foot most of the bill.

Upon enactment, opponents took dead aim at the legislation. Coining the Affordable Care Act “Obamacare”, opponents tirelessly worked to repeal and replace the law. Read More

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. Read More

Creative Approach Leads to Success in Enrolling American Indians and Alaska Natives in the New Mexico Health Insurance Marketplace

Roxane Spruce Bly

Roxane Spruce Bly

Recently, the National Indian Council on Aging (NICOA) spoke with Roxane Spruce Bly, a member of the Pueblo of Laguna, who has been leading the ACA outreach and enrollment effort for American Indian/Alaska Natives (AI/AN) in New Mexico. Ms. Spruce Bly brings invaluable experience in the field of health policy research, analysis, and development. She is the Director of Healthcare Education and Outreach for Native American Professional Parent Resources (NAPPR), Inc. NAPPR is one of two navigator entities in New Mexico.

She reflects that the Affordable Care Act (ACA) got off to a rocky start but her team turned that barrier into an opportunity to focus on outreach and education. The older Indians they target are those in the 55–64 age group, too young to receive Medicare and yet perhaps ready to plan for their retirement or address a long standing health issue. Ms. Spruce Bly is excited to get the message out about health insurance in New Mexico. Her theory of change is that once people increase their knowledge they will in turn change their behavior. Her initial approach resulted in 441 inquiry calls which led to 269 appointments, culminating in 244 individuals signing up for coverage. Read More

ACA: Vital to Diverse Older Adults – Don’t Be Left Out

With the start of the New Year, people across the country started coverage on insurance plans selected through the Health Insurance Marketplace. For racially and ethnically diverse and LGBT older adults, the Affordable Care Act (ACA) and the Marketplace pose both the opportunity for better health and the challenge of possibly being left behind by a new program. The Diverse Elders Coalition (DEC) is now working to improve the health of the populations that it serves and to empower them to fully participate in the ACA.

A recent article by Kaiser Health News identifies some of the opportunities and challenges California’s Hispanic population face. The article highlights the tremendous help the Health Insurance Marketplace has been to Maria Garcia, who worked with a community health center to enroll herself and her husband in an insurance policy costing $36 per month after subsidies. The article also describes the need for culturally and linguistically appropriate enrollment assistance. Many Hispanic older adults enrolling in the Marketplace like to enroll with the help of a person that they trust. Health Care Navigators can also help diverse older adults overcome barriers such as lower levels of internet connected home computers and fear of putting personal information online. Read More

The Road Less Traveled: Medicare and the Medicare Savings Programs as a Potential Solution for the Underinsured Immigrant

Every year, the National Asian Pacific Center on Aging (NAPCA) receives over 9,500 phone calls through a national, toll-free, Asian language Helpline from limited and non-English speaking seniors needing help understanding benefit programs for which many are eligible but unable to access.

Mrs. Pang and Mrs. Taduran (not their real names) represent thousands of immigrant seniors in the United States, who are legal permanent residents but have little or no work history in this country and go without adequate healthcare because they cannot access affordable insurance. Many are eligible for Medicare or Medicare Savings Programs but are unaware of their eligibility. Read More

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

Reminder: One Month Left in Medicare Open Enrollment

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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

WEBINAR: Why Obamacare/the Affordable Care Act Matters to Older People of Color and LGBT Older People

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.

WEBINAR DESCRIPTION
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.

Southeast Asian American Elders and the Affordable Care Act

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

Attention Diverse Elders: Medicare’s Open Enrollment Period Starts Today!

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

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

National Indian Council on Aging: Then (Creation of NICOA) and Now (The Affordable Care Act – ACA)

The first National Indian Conference on Aging was sponsored by the National Tribal Chairman’s Association (NTCA) in Phoenix, Arizona on June 15-17, 1976. Close to 1,500 American Indian and Alaska Native (AI/AN) people representing 171 tribes came together to speak of their needs and present recommendations for action to improve the quality of their lives. The meeting was coordinated by the National Tribal Chairman’s Association and led by President Wendell Chino.

First members of the National Indian Council on Aging

First members of the National Indian Council on Aging

Then: Creation of NICOA

In his address to the conference attendees Mr. Chino spoke at length about the history of contributions the American Indian/Alaska Native elders have given to this great country. He consistently reminded American Indian/Alaska Native and the US Congressional leaders that American Indians/Alaska Natives have a unique status as they are specifically mentioned in the US constitution. Robert J. Miller author of Native America, Discovered and Conquered: Thomas Jefferson, Lewis & Clark, and Manifest Destiny, explains the following:

American Indian tribes have played a major role in the development and history of the United States and have engaged in official, diplomatic governmental relations with other sovereign governments from the first moment Europeans stepped foot on this continent. Indian tribes have been a part of the day to day political life of the United States and continue to have an important role in American life today. Tribes continue to have a government to government relationship with the United States and they continue to be sovereign governments with primary control and jurisdiction over their citizens and their territories. It is no surprise, then, that the relationship between Indian people, tribal governments and the United States is addressed in the United States Constitution. Read More

Learn about the Affordable Care Act via the Kaiser Family Foundation’s Fun and Educational ACA Videos in Both Spanish and English. 6 Days Left Until Open Enrollment!

The Diverse Elders Coalition is proud to share these entertaining and educational animated videos to help spread the word about the new Health Insurance Marketplaces and how the ACA works. Watch the videos, learn and share them yourselves!


Los YouToons Se Preparan Para Obamacare: Cambios En Los Seguros Médicos Que Llegarán Con La Ley De La Salud a Bajo Precio


The YouToons Get Ready for Obamacare: Health Insurance Changes Coming Your Way Under the Affordable Care Act

Before the Oct. 1 start of open enrollment, the Kaiser Family Foundation presents a Spanish-language video as part of its continuing efforts to increase the public’s understanding of upcoming changes under the Affordable Care Act (ACA). Based on the previously released English-language video, “Los YouToons Se Preparan Para Obamacare” explains the basic changes in how Americans can obtain health coverage in 2014. Read More

Hey California! New Health Insurance Options in 9 days!

In just 9 days, individuals across the nation will be able to begin enrolling in the new Health Insurance Marketplace as part of the Affordable Care Act.

Webinar - Don't Miss California's ACA Enrollment Bus

Webinar – Don’t Miss California’s ACA Enrollment Bus

Please join SEARAC for a webinar so you and your organization are prepared to help community members access health insurance on DAY ONE! This webinar will be California-specific and will focus on what you need to know about the INDIVIDUAL MANDATE and how to get your organization ready to help community members with ENROLLMENT into Medi-Cal and Covered California. To register for the webinar, please click here: http://tinyurl.com/SEARACenrollmentbus

What: Webinar – Don’t Miss California’s ACA Enrollment Bus

When: Thursday, September 26; 1pm – 2:30pm Pacific Time

Health Exchange Open Enrollment Cannot Come Soon Enough

According to the latest American Community Survey, about 30% of Hispanics lack health insurance. Medicare provides nearly universal coverage, however, so the vast majority of uninsured Hispanics are age 65 and under. In fact, about 35% of Hispanics between the ages of 45 and 54, about 42% between 35 and 44, about 48% between 25 and 34, and about 47% between ages 18 and 24 lack health insurance. Despite making up 16% of the population, Hispanics represent 33% of the nation’s uninsured. Open enrollment for the ACA’s Health Insurance Marketplaces starts October 1st and cannot come soon enough for the Hispanic population.

Health and economic security in old age are not determined solely after one turns 65. Having health insurance and the access to the care that it provides has a strong influence on health throughout life. In addition to the health benefits, having health insurance allows people to become familiar with the health care system, to develop health literacy, and to work with health care providers to develop healthy habits. For many Hispanics, Medicare is the first health insurance policy in which they ever enroll. This coverage often comes decades too late, as small health issues, left untreated for years, can grow into major complications.

The National Hispanic Council on Aging (NHCOA) and the Diverse Elders Coalition (DEC) are eager to support enrollment in the Health Insurance Marketplaces. NHCOA and the DEC will conduct culturally and linguistically appropriate outreach to the populations that we represent in order to help them purchase affordable health insurance. NHCOA will begin targeted outreach soon, but Latinos interested in learning more about purchasing affordable health insurance can go to cuidaddesalud.gov or contact the National Hispanic Council on Aging at 202-347-9733.

ACA: A Big Help to HIV+ Older Adults

There are only 41 days left until open enrollment begins under the Affordable Care Act’s (“ACA’s”) Health Insurance Marketplace. Starting October 1st individuals can enroll in insurance plans for coverage beginning on January 1, 2014. The Marketplace brings a range of options to HIV+ people for high quality insurance at lower costs.

How the Marketplace Works GIF
All private health insurance plans offered in the Marketplace will offer the same set of essential health benefits. These benefits include areas of significant importance to HIV+ people such as prescription drugs, lab services and chronic disease management. Without the ACA, private insurance options have varied widely from limited or no coverage in some states to very expensive comprehensive coverage in other states. For example, in New York where there are no exclusions for pre-existing conditions such as cancer, diabetes, heart disease or being HIV+, individual HMO coverage with a major insurer currently costs $1,409 per month. This price point can be extremely unaffordable for many HIV+ older adults. As the ACA is implemented in January 2014, “gold” level coverage from the same insurer will cost $688 per month. That’s $721 less a month or $8,652 more a year in an HIV+ older person’s pocket. For HIV+ older people, the Health Insurance Marketplace is yet another major benefit of the Affordable Care Act. Read More

CALL FOR STORIES: Elders, healthcare and chronic conditions

StoryCorps, the national interview project affiliated with the Library of Congress and NPR, is looking for stories about elders and healthcare.

Two StoryCorps participants after an interview.

Two StoryCorps participants after an interview.

StoryCorps producers are hoping to speak with: Elders who are living with multiple chronic conditions who can talk about the complications of coordinating care (or family members/caregivers who can talk about the complications of caring for an elder in that situation). These stories are being recorded in partnership with Atlantic Philanthropies (AP). AP supports the work of both StoryCorps and the Diverse Elders Coalition. One of the stories will later be showcased on the Atlantic website to help bring attention to elders and their healthcare experiences.

kathrina-proscia

Inside StoryCorps interview booth.

Read More

iPad prevents Isolation?

Watch out, kids — don’t assume you can do things online without your grandma finding out. In fact, if you live in Ward 2, Grandma might be doing things online that you’ve never thought of,  reads The Washington Post.

Harriet Carter-Brown, 63, of Washington, D.C., smiles as she looks at photos of lighthouses on her iPad during the twice weekly Connect to Community class in the basement of Shiloh Baptist Church in Washington, D.C., on July 9, 2013.

Harriet Carter-Brown, 63, of Washington, D.C., smiles as she looks at photos of lighthouses on her iPad during the twice weekly Connect to Community class in the basement of Shiloh Baptist Church in Washington, D.C., on July 9, 2013.

Last week, I posted about the benefits of older adults getting online.  The Washington Post just published an article about a program called Connecting to Community that teaches older adults in Washington, DC how to use an iPad and go online.  The program has been successful at reducing isolation and will expand to other parts of Washington next month. Read More

Infographic: LGBT Health, Racial Disparities, and Aging—by the Numbers

Preview. Download the full infographic below.

Preview. Download the full infographic below.

Download the infographic LGBT Health, Racial Disparities, and Aging—By the Numbers, today!

Americans who are people of color, older adults and LGBT identified (referred to in this blog post as LGBT elders of color) often have unique needs because of the intersections of identities. LGBT elders of color are historically marginalized on multiple fronts and their needs are often under addressed in the mainstream aging field and in the popular LGBT rights movement. Read More

Alzheimer’s Disease Among Hispanic Older Adults

Over the past several months, the National Hispanic Council on Aging (NHCOA) has conducted focus groups to learn about what Hispanic older adults and caregivers know about Alzheimer’s disease (AD).  We found that people have a wide variety of beliefs about what causes the condition and how to prevent it.  We also heard the insights of caregivers for people with AD.  While there is no known cure or prevention measure for AD, caregivers can pass on advice and teach other caregivers how to cope with the stress of providing care.

 “I would have her tested to be able to help her better, and have a better life for me and all of those who live at home.”

“The doctor told me that she didn’t have Alzheimer’s-she said, who was I to tell her that? After examining her, the doctor admitted that she had early signs of Alzheimer’s.”

“For those of us who love our family members, I believe we have to give them a hand, take them to a doctor, have tests done-because in its early stages, maybe life is better for those who take care of them.” Read More

The Re-launch is here!

Two weeks ago, we announced that we would be re-launching the Diverse Elders Coalition Blog.  Read here to find out more.

We are thrilled that this day has finally come. As we previously promised, in addition to our regular contributing bloggers, we will have exciting guest bloggers.  We will also display our content in a variety of different ways (e.g., pictures, videos, interviews, Top 5 columns, etc.) And much more! Have a suggestion? Contact us.

You can bookmark this page or subscribe to our RSS feed to stay updated. Check back on Wednesday to read our latest post, courtesy of National Hispanic Council on Aging (NHCOA). Until then, enjoy some highlights from the blog’s history:

1) Watch Our Story

2) The Unique Needs of Asian American and Pacific Islander Elders

3) 10 Considerations for Working with the Diversity of Older LGBT Latinos

We are Re-launching On March 18!

The Diverse Elders Coalition (DEC) was founded in 2010, and in July 2012 we launched our official website, which also serves as a news and commentary blog on the social, political and economic issues affecting the growing yet vulnerable demographic of elders who are Black, Hispanic, Asian/Pacific Islander, American Indian/Alaska Native, and lesbian, gay, bisexual and/or transgender (LGBT).In the last eight months, we have put out numerous posts on the issues that affect our communities and the creative ideas and best practices to address them. In the summer of 2012, we also released Securing Our Future: Advancing Economic Security for Diverse Elders, a resource that describes the issues facing elders of color and LGBT elders, who together will represent a majority of older adults in the United States by 2050.

In this time, we have received some wonderful comments on our work, as well as helpful feedback from our readers (all of you) on how to improve the site to better meet your needs—and we listened to you. Members of the Diverse Elders Coalition came together and crafted an exciting plan for moving forward by implementing many of your ideas, which you’ll see starting with our blog re-launch on March 18.  Here are some of the improvements to look forward to:

  • In addition to our regular contributing bloggers, we have some exciting guest bloggers scheduled!
  • Content displayed in a variety of ways (e.g., pictures, videos, interviews, Top 5 columns, etc.)
  • More news and original content from coalition members
  • And more!

 

As we look forward to March 18, please like us (and tell a friend!) on Facebook to stay updated on the events surrounding the launch and the latest news affecting diverse elders. If you have any questions about DEC or would like to submit an idea for a blog post, please contact us.

See you on the 18th!

To learn more about DEC members, click here.

Leaves That Pay

As policy makers gather to discuss the impending fiscal cliff, they will consider many ways to reduce budget deficits and the national debt. This discussion includes the future of health care. Rather than cutting benefits, one of the best ways to lower health care costs is to invest in workers’ health through policies that allow them to take paid time off in event of an illness or to look after a loved one who is sick.

That is why NHCOA has been working across states to raise awareness and empower Latino workers and older adults to advocate for leaves that pay laws at the local and state level. Leaves that pay policies are the best way to ensure that workers don’t have to choose between their family and their job. Job security and steady wages are crucial for the Hispanic community as many workers are also caregivers and heads of households. Read More

An LGBT-Inclusive Older Americans Act

The Older Americans Act (OAA) serves as the country’s leading vehicle for delivering services to older people nationwide, providing more than $2 billion annually in nutrition and social services. Since its enactment in 1965, the OAA has aimed to ensure that older people have the supports they need to age in good health and with broad community support. It places an emphasis on more vulnerable elders who face multiple barriers that can aggravate economic insecurity, social isolation, and various health challenges related to aging.

Yet strangely, despite ample evidence of their heightened vulnerability and their need for unique aging supports, lesbian, gay, bisexual and transgender (LGBT) older people are invisible in this landmark law. As the OAA comes up for reauthorization, and as millions of LGBT people enter retirement age, Congress should ensure that the OAA supports all elders, including those who require unique supports. LGBT older adults should be written into the framework of the Older Americans Act.

Read More

The Unique Needs of Asian American and Pacific Islander Elders

BY SCOTT PECK, DIRECTOR OF POLICY, NATIONAL ASIAN PACIFIC CENTER ON AGING

Asian American and Pacific Islander (AAPI) elders are one of the fastest-growing groups of ethnic elderly in the U.S. but remain largely invisible. Each elder faces unique challenges to obtaining a high quality of life in their later years. Unfortunately, AAPI elder needs are not well-researched, their concerns are often not addressed by current public policies, and few programs and services are designed for their specific needs. Language and cultural barriers present difficult barriers to care since programs and services designed for a broader population are often inaccessible to AAPI elders due to limited outreach efforts in their communities. According to the US Census’ American Community Survey, only 41 percent of AAPI elders feel that they speak English “very well.” Limited English proficiency has profound effects on the ability of AAPI elders to access essential services and understand their rights and obligations.

It is important to remember that this inaccessibility is occurring within rapidly changing demographics. AAPI elders are a growing and diverse population – 2.8 million AAPI elders live in the U.S., with significant numbers of AAPI elders living in California, Hawaii, New York, Texas, and New Jersey. Over time, the numbers of AAPI elders will continue to grow. Between 2010 and 2050, the AAPI elder population 65 years and older is expected to grow 466 percent, while the total population of American elders will grow 120 percent.

Read More