Latinos are the largest and fastest growing ethnic group in the U.S., and comprise 17% of the population. They are often viewed as a monolithic group by mainstream culture. However, the term Latino, referring to people of Mexican, Central American, and South American origins, encompasses great diversity with regard to nationality, immigration history, language use, educational and occupational opportunities, and socio-economic position. These aspects of diversity also serve as indicators of social-structural determinants of health disparities (or differences in how often a disease affects people). How these social-structural determinants of health affect the lives of older Latino adults help us to better address the needs of this population. Understanding health disparities also provides insight into challenges faced by diverse elders from a variety of racial, ethnic and cultural backgrounds who deal with many of these same issues. The intersection of HIV/AIDS and depression among older Latinos will be used to illustrate how these social-structural determinants affect the health and well-being of a diverse aging population.
Double Jeopardy: HIV and Depression
Latinos are disproportionately affected by HIV/AIDS. The overall HIV prevalence rate for Latinos is nearly three times the rate for whites. Further, Latinos are the most likely to be classified at Stage 3 (i.e., AIDS) at the time of their HIV diagnosis (48%), as compared with whites (42%) and blacks (39%). Due to successful anti-retroviral therapy, by 2015 more than half of those with HIV in the U.S. will be 50 years or older, a proportion that will rise to 70% by 2020. The disparity in HIV prevalence is amplified among older people with HIV/AIDS. Among Latinos who are 50 and older, HIV prevalence is five times that of older non-Hispanic whites. In addition, older Latinos have a 44% increased risk for major depression and are more likely to present with clinically significant depressive symptoms compared with older whites. This syndemic (convergence of two disorders that magnify the negative effects of each) of HIV and mental distress among Latino older people with HIV (“OPWH”) is an important public health concern since the most consistent predictor of HIV treatment non-adherence is depression, and only 26% of Latinos with HIV achieve the clinical goal of viral suppression.Read More
The 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.
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
September 18 marks the annual National HIV/AIDS and Aging Awareness Day, a day to shine a spotlight on HIV/AIDS and its impact on the aging body. The Diverse Elders Coalition and our member organizations know well that this disease greatly affects our nation’s older people. In fact, adults 50 years of age and older make up the fastest growing population with HIV, and by 2015, more than half of Americans living with HIV/AIDS will be over 50.
While individuals with HIV/AIDS are living longer lives, older adults have more than three other (usually chronic) health conditions in addition to HIV versus their age peers without HIV. As a result, they have a host of health and services needs that neither HIV nor aging services providers are fully prepared to meet. Yet older adults have rarely been targeted in HIV/AIDS prevention and awareness campaigns. As a result, many do not realize that their behaviors can put them at risk for HIV infection. Additionally, health care providers may mistakenly assume that older patients are no longer engaged in high risk behaviors, and therefore do no initiate conversation about the importance of using protection and getting tested regularly.
This is why representatives from our member organizations SAGE (Services & Advocacy for GLBT Elders) and NHCOA (National Hispanic Council on Aging) are at Capitol Hill today for a briefing, reception and hearing to highlight the needs and challenges of older adults with and at risk for HIV. You can follow what happened and get live updates by following @nhcoa and @sageusa on Twitter. Read More
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.
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.
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
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.
I grew up during the civil rights movement, seeing powerful black activists around me fight for our civil rights as a people. I also grew up during the Stonewall Riots, feeling the hostility society harbored toward lesbian, gay, bisexual and transgender (LGBT) people. And I grew up during a time when I lost many loved ones due to HIV/AIDS, a disease that was viewed by the world as a critical epidemic.
Now it’s 2013. Today as a black gay man, I enjoy more freedoms and rights (as a New Yorker, I have the right to marry my long-term partner Stanton). Yet, for older black gay men who are living with HIV/AIDs, it’s still a difficult journey.
There are certain topics that many families and caregivers might try to avoid discussing with older adults. The issue of HIV/AIDS is certainly one of them.
It is easy to sweep any conversation steering in that direction under the rug because many find it an uncomfortable topic to talk about. What should make all of us uncomfortable, though, is the increasing number of seniors 50+ who are living with HIV/AIDS.