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.

Webinar: Marketplace Outreach for Diverse Populations – Thurs. Sept. 25 at 2pm EDT

cms                    DEC Logo enclosed

When: Thursday, September 25, 2014 at 2:00pm EDT

Webinar Link: https://webinar.cms.hhs.gov/marketplacedp92514/

Call in number: 1-877-267-1577        Meeting ID: 995 471 476

No advanced registration is required.

Speakers:

  • Jeanette Contreras, MPP, Outreach Lead – Partner Relations Group, Centers for Medicare & Medicaid Services (CMS)
  • Jonathan Tran, California Policy and Advocacy Manager, Southeast Asia Action Resource Center (SEARAC)
  • Patrick Aitcheson, Interim National Coordinator, Diverse Elders Coalition

Who should attend? Advocates. Policy makers. Older adults. Funders. Anyone interested in learning more about ACA enrollment as we approach the start of year 2, especially lessons learned for enrolling and supporting typically difficult to reach populations such as Southeast Asian Americans, Hispanic Americans, American Indians & Alaska Natives, and LGBT Americans.

What: Please join CMS and the Diverse Elders Coalition for a webinar that will highlight ACA Marketplace Year 2 enrollment guidance for immigrant families and auto-enrollment; Marketplace outreach resources and campaign materials; and lessons learned for reaching older people of color and LGBT older people.

Background: Year one open enrollment for the Affordable Care Act/ACA/Obamacare ran from October 1, 2013 to March 31, 2014. Over 9 million people obtained health coverage via the Marketplace and another 8 million people obtained Medicaid coverage. As year one open enrollment ended, educational needs continued regarding special enrollment periods, immigrant families, health insurance literacy and how to get the most from this new coverage. Year two open enrollment begins November 15. While year one enrollment brought much needed health coverage to many millions of people, not all communities were reached equally well. Language and cultural issues, lack of health literacy, and limited individualized enrollment support were among the barriers faced by certain communities. Many lessons were learned in year one on how to reach hard to reach populations and these lessons need to be shared and followed in order to boost coverage levels among older adults of color and LGBT older adults. This webinar will discuss the challenges and barriers to reaching Southeast Asian Americans, Hispanic Americans, American Indians and Alaska Natives, and LGBT Americans and convey the lessons learned and tips that can be applied to boost year two success.

One last push – Getting the Older Americans Act (OAA) reauthorized in 2014

August in Washington, DC usually means Congressional recess, when all Congress members take a break from Washington and return to their districts. Depending on whom you ask, August in DC could either be a peaceful and quiet time or a time to schedule meetings and diligently prepare for Congress’ return post-Labor Day. For the National Hispanic Council on Aging (NHCOA), it has been the latter. As we enter the last quarter of the year, NHCOA is focusing efforts on scheduling Hill visits to educate Congressional staffers and reiterate how critical it is for Congress to reauthorize the Older Americans Act as they return to Washington from their states and districts this week.

The Older Americans Act (OAA) is one of the most important laws for older adults, and as it nears its 50th Anniversary, it is in need of greater recognition. The programs of the OAA are also extremely important in allowing older adults to age in place, with dignity, and in the best possible health, as it authorizes a wide variety of programs focused on health, nutrition, job training, and caregiver support. The OAA, which expired in 2011, has not been renewed— or reauthorized— since. Each year, the various programs are funded individually through appropriations bills, but this is neither an efficient nor a sustainable method. Reauthorization is urgently needed!

As we’ve written in previous blogs, NHCOA strongly supports a reauthorization of the Older Americans Act—but it must happen before the end of 2014. While a straight reauthorization would be better than none, it would be more effective to have a reauthorization that accounts for the growing size and diversification of the older adult population and one whose needs are ever fluid and changing.

Thus far, there are four bills on record, asking for reauthorization: H.R. 4122 (Rep. Bonamici- Oregon), H.R. 3850 (Rep. Gibson, New York), S. 1562 (Sen. Sanders- Vermont) and S. 1028 (Sen. Sanders). Of these, S. 1562 is the most advanced in the legislative process, having been sent to committee, where it is currently stuck. It is this impasse that has delayed the much-needed reauthorization of the OAA.

Given that it is an election year and a change in the political climate might make it even harder for a committee compromise to be reached, NHCOA and its fellow Diverse Elders Coalition co-founders urge Congress to take action now before all the hard work put forth in the past year is lost and millions of America’s older adults lose access to programs and services which currently allow them to age in place and remain engaged and active members of their communities.

We ask Congress to take into account the millions of baby boomers who cannot wait for another year of political in-fighting and who urgently need these services in their local communities. While we understand that the list of urging and pressing matters awaiting Congress is long, it is important to highlight that OAA is equally as important to those whom it affects most, and through compromise and strong Congressional leadership, this Act can be reauthorized within the few legislative days left.

In the meantime, NHCOA and the DEC will continue to fight for the OAA on behalf of the millions of diverse seniors who rely on the services, programs, and funding this law provides.

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.

Related Older Americans Act posts:

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.

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

Medicare & the Windsor Decision: Where do we stand?

By Aaron Tax and Kira Garcia

Last year’s Windsor decision has triggered a series of ongoing changes that impact many of us on a day-to-day basis. For LGBT older adults, Medicare is one of the most critical Federal programs undergoing change. So where do Medicare recipients currently stand? Our Q&A with Casey Schwarz of the Medicare Rights Center answers some important questions.

I live in a same-sex marriage state like Massachusetts, Iowa, New Mexico or one of the other 18 states and the District of Columbia (as of May 19, 2014) that allow for same-sex marriage. What new or increased Medicare benefits am I eligible for as a spouse in a same-sex married couple? Read More

LGBT seniors face AIDS, limited housing options, isolation, discrimination and more

This seven part series by Matthew S. Bajko (m.bajko@ebar.com) originally appeared in the Bay Area Reporter/New America Media. Matthew explores a range of issues facing LGBT elders including aging with AIDS, isolation, limited housing options, discrimination on many fronts and a lifetime of struggle.

Trauma of AIDS Epidemic Impacts Aging Survivors

SAN FRANCISCO–The nightmares terrorized San Francisco resident Tez Anderson for years. He would dream he was buried deep underground and wake in the middle of the night feeling panicked.

Photo: Author and AIDS activist Sean Strub, left, with Let’s Kick ASS (AIDS Survivor Syndrome) co-founder Tez Anderson. (Rick Gerharter/Bay Area Reporter)

Photo: Author and AIDS activist Sean Strub, left, with Let’s Kick ASS (AIDS Survivor Syndrome) co-founder Tez Anderson. (Rick Gerharter/Bay Area Reporter)

“It felt like I was in a lot of danger. It was not so much about death, it was more that I was in peril,” recalled Anderson, who is 55. 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

The NAPCA Helpline: A Critical Lifeline for Limited English Proficient Seniors

Think about the last time you had to call your credit card company to dispute a charge: navigating complex menus, explaining the problem multiple times, answering the customer representative’s questions, providing information to the representative from your nearly indecipherable credit card statement . . . now imagine if the representative spoke a language you didn’t understand and the phone menus and credit card statement were both in that language. 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

Aging and HIV: New Insights, New Recommendations

by Kira Garcia

In the early days of the HIV/AIDS epidemic, most people diagnosed faced death within a few years, if not sooner. Thirty years on, much has changed; HIV has become a more manageable chronic illness and many people are aging with the disease.

The proof is in these startling statistics: it’s predicted that 50 percent of people with HIV in the U.S. will be age 50+ by 2015—and by 2020, more than 70 percent of Americans with HIV are expected to 50+.

With that in mind, SAGE, the Diverse Elders Coalition (DEC) and ACRIA (AIDS Community Research Initiative of America) have created a report outlining eight recommendations to address the needs of a growing demographic of older adults with HIV, many of whom are LGBT and people of color. The full report, Eight Policy Recommendations for Improving the Health & Wellness of Older Adults with HIV, can be found online here. Read More

Dion Wong: A conversation with a 69-year-old Chinese gay man (AAPI Heritage Month)

In recognition of Asian American and Pacific Islander (AAPI) Heritage Month, the Diverse Elders Coalition is featuring stories relevant to AAPI older adults (their successes, their struggles, their history) during May. A new story will be shared every Thursday with additional posts shared throughout the month. Be sure to visit diverseelders.org regularly during the month of May.

By Dion Wong

Dion Wong: from GRIOT Circle

Dion Wong: from GRIOT Circle

Dion Wong is a 69-year-old Chinese gay man. Retired since 2002, Dion was a middle school teacher for over 34 years in San Francisco and was married in Canada in 2006 to his partner, Benjamin Aquino, Jr. They have been together for 18 years. Read his experience as a gay Chinese man and his views on the broader older LGBT AAPI community.

As an older Chinese gay man, what do you think are some common issues you (and your community) face? Read More

What can we do to honor older Americans? Reauthorize the Older Americans Act (OAA)! (Older Americans Month)

By Aaron Tax, Director of Federal Government Relations at Services & Advocacy for GLBT Elders (SAGE).

May is of course Older Americans Month. And given that it is Older Americans Month, what is one of the most important things we can do to honor older Americans? Reauthorize the Older Americans Act (OAA)! What is that, you ask? It’s probably the most important piece of aging legislation that most people in our country don’t know anything about.

  • Did you know?
    • The OAA originally passed in 1965 as part of Lyndon Johnson’s Great Society?
    • The OAA is one of three big pieces of legislation that form the safety net for older adults in the United States, with Social Security providing income supports, Medicare providing healthcare supports, and the OAA providing the “everything else” that allows older adults to stay at home and age in place in their communities.
    • In fact, the OAA is the primary vehicle for the organization and delivery of social services and supports and nutrition programs for older adults and their caregivers in our country.

Read More

Doing a better job of telling diverse elders’ stories, starting with AAPI Elders + an exciting reveal! (AAPI Heritage Month)

May is Older Americans Month. It’s also Asian American and Pacific Islander (AAPI) Heritage Month. As the National Coordinator of the Diverse Elders Coalition, I am honored to work alongside many diverse aging advocates, including leaders in the field of AAPI aging.

Partnering with our member organizations, the National Asian Pacific Center on Aging (NAPCA) and the Southeast Asian Resource Action Center (SEARAC), I have become very intimate with the daily realities of AAPI elders and their loved ones. I’ve learned many lessons along the way, such as the silence of AAPI elders who identify as LGBT, to why the “model minority” myth is damaging to the AAPI elder community. Read More

AGING INTO POVERTY: Economic Insecurity among Older Adults of Color & LGBT Elders

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Join us for a Webinar on May 7

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Space is limited.
Reserve your Webinar seat now at:
https://www1.gotomeeting.com/register/203341944

By most economic measures older adults of color and LGBT elders are aging into poverty. Recent research highlights that over 90% of older African American and Latino elders are financially vulnerable and will be unable to support themselves over the course of their lifetime. Elders of color report greater difficulty in affording necessities, such as food, health care, and housing, than the general population. 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

The Growing, Neglected Challenges of LGBT Latino Elders

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

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

Call for stories/interviews: diverse older adults 50+ living with HIV/AIDS

Please help us make a difference by sharing your story. We’re looking for stories (we can use your name or an alias) to include in our upcoming report. About the report: In May, the Diverse Elders Coalition will publish a critically needed and groundbreaking report about diverse older adults living with HIV/AIDS. It will detail how the Affordable Care Act (ACA) has affected health coverage for diverse older people (people of color and/or LGBT) and now that enrollment has concluded offer policy recommendations to our nation’s decision makers. Read More

HHS announces important Medicare information for people in same-sex marriages

Today, the Department of Health and Human Services (HHS) announced that the Social Security Administration (SSA) is now able to process requests for Medicare Part A and Part B Special Enrollment Periods, and reductions in Part B and premium Part A late enrollment penalties for certain eligible people in same-sex marriages. This is another step HHS is taking in response to the June 26, 2013 Supreme Court ruling in U.S. v. Windsor, which held section 3 of the Defense of Marriage Act (DOMA) unconstitutional. Because of this ruling, Medicare is no longer prevented by DOMA from recognizing same-sex marriages for determining entitlement to, or eligibility, for Medicare. Read More

One Last Push: What you must know before March 31 if you are HIV+

Time is ticking. You and your loved ones only have until March 31st to apply for health insurance. Don’t delay.

Under the Affordable Care Act (or ACA), the Health Insurance Marketplace ensures that no application for health insurance is rejected due to preexisting medical conditions, such as HIV, which disproportionately affects communities of color and older people. Did You Know? Research projects that within the next few years, one in two people with HIV in this country will be age 50 or older. One in Two!

The Diverse Elders Coalition (DEC) knows that understanding the Health Insurance Marketplace can feel a lot like piecing together a puzzle.  With only days left to apply for insurance, it can be especially overwhelming—and there is no time to waste. Read More

Aging in America 2014: Health Reform Advocacy and Engagement in Communities of Color and LGBT Communities

Will you be joining the 3,000 engaged aging professionals and experts March 11-15, 2014 in Sunny San Diego for the ASA Aging in America 2014 conference?

Interested in exploring best practices and learning about successful advocacy and engagement tactics to better engage older adults of color and lesbian, gay, bisexual and transgender (LGBT) elders around the Affordable Care Act and their health?

Yes? Join us Friday March 14, 2014 from 1-2:30pm for a presentation entitled Health Reform Advocacy and Engagement in Communities of Color and LGBT Communities. Leading experts from our nation’s diverse aging organizations will be on hand to share lessons learned, opportunities and challenges within their communities in accessing the benefits of the Affordable Care Act and living full and healthy lives. Speakers include: Read More

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

Photo: Laurent Hamels via Getty Images

Photo: Laurent Hamels via Getty Images

There are mornings when the hour-long commute to work feels Odyssean. Today is one of those mornings. February has unfurled a litany of winter storms that have left New York City awash in slush and my Facebook feed soaked in bemoaning. As I trudge through Brooklyn and board the D train to Manhattan, I’m stirred by the resilience of people to survive winter—huddled overnight in subway trains and housing shelters, or living miles from work to afford one’s rent, a mortgage and the accumulating costs of surviving. 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

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

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

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

When the Healer is not Healed – The Pain of Losing a Child in Your Later Years (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.

cythnia_diaoBy Cynthia Diao, Assistant Program Coordinator at SAGE Harlem, a safe haven for LGBT older people in Harlem, East Harlem and the Bronx.

About a year ago, my only son died by suicide and it has caused a rollercoaster of feelings. It was hard to enter 2014 without my baby boy. And Valentine’s Day is coming, couples and families will be celebrating their loved ones, while I will be mourning.

Because I am a religious woman, I look to God and ask: “How do I get through this pain?” Read More

35 quotes to help guide your life from famous African American older adults

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.

As a tribute to Black History Month and this year’s theme, Civil Rights in America, we have pulled together quotes from various prominent African American older adults to motivate you and to help guide your life.

1. Our mistreatment was just not right, and I was tired of it. – Rosa Parks Read More

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

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

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

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

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

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

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

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

Focus turns to aging with AIDS

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

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

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

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

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

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

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

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

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

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

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

Fighting the Good Fight Against Isolation

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

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

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

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

Webinar Recording: Why the Affordable Care Act Matters to Diverse Older People

The health coverage expansions under the Affordable Care Act (ACA) will affect you, your loved ones and your communities. The Diverse Elders Coalition represents millions of diverse older people age 50+ who are among those affected: they include the Health Insurance Marketplace, the Medicaid expansion, new benefits for elders 65+ on Medicare, and a range of protections that make health care more accessible for lesbian, gay, bisexual and transgender (LGBT) older people and older people of color. The number of uninsured older adults age 50-64 continues to rise—from 3.7 million in 2000 to 8.9 million in 2010. In addition, people of color make up more than half of uninsured people in the U.S.— and research shows that people of color, across the age span, face significant disparities in physical and mental health. Additionally, many people of color delay care because of potential medical costs and out of fear of discrimination or cultural incompetence from medical providers. This webinar highlights both national and state-specific examples on what is being done to ensure that older people know about the changes that are taking place under the ACA and how it affects them.

Speakers: Yanira Cruz, President and CEO, National Hispanic Council on Aging; Michael Adams, Executive Director, Services and Advocacy for GLBT Elders (SAGE). Special thanks to our co-sponsors, The John A. Hartford Foundation and The California Wellness Foundation.

Original Webinar date: Wednesday, November 6, 2013.

Watch it at http://www.screencast.com/t/yzeTQbgEze2.

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

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When: Thursday, December 5, 2013 at 2:00pm ET

Where: Please register early for the event.

Webinar link:  https://12-5acaandmedicare.eventbrite.com  

Who: Cara V. James, Director, Office of Minority Health, Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services (Bio below)

What:  Please join CMS and the Diverse Elders Coalition for a webinar that will highlight how the Affordable Care Act strengthens Medicare and provide an overview of the Health Insurance Marketplace for older Americans of color.

Background: October 15, 2013 marked the start of Medicare open enrollment. It will end on December 7. During this time, all people with Medicare are encouraged to review their current health and prescription drug coverage, including any changes in costs, coverage and benefits that will take effect next year, and decide whether they would like to change their coverage.

Key resources to learn more: Medicare.gov and HealthCare.gov/CuidadodeSalud.gov

Presenter Biography: Cara V. James is the Director of the Office of Minority Health at the Centers for Medicare and Medicaid Services (CMS). Prior to joining the Office of Minority Health at CMS, Dr. James was the Director of the Disparities Policy Project and the Director of the Barbara Jordan Health Policy Scholars Program at the Henry J. Kaiser Family Foundation, where she was responsible for addressing a broad array of health and access to care issues for racial and ethnic minorities and other underserved populations, including the potential impact of the Affordable Care Act, analyses of state-level disparities in health and access to care, and disparities in access to care among individuals living in health professional shortage areas. Prior to joining the staff at Kaiser, she worked at Harvard University and The Picker Institute. Dr. James is a member of the Institute of Medicine’s (IOM) Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities and has served on several IOM committees including the Committee on Leading Health Indicators for Healthy People 2020. She has published several peer-reviewed articles and other publications, and was a co-author for one of the background chapters for the IOM Report Unequal Treatment. Cara received her Ph.D. in Health Policy and her B.A. in Psychology from Harvard University.

Our Issues Entwine: LGBTQ Aging and Economic Justice

MY IMMIGRANT MOTHER sits silently in a room the size of a small kitchen. Earlier this year, she survived multiple failures of the heart, kidneys, and limbs over the course of six weeks. She is seventy-three, uses a wheelchair, and for the first time in her life is surrounded by white people who do not speak Spanish, in the only nearby nursing home my parents can afford. In turn, my father drives through the days confronted by three omnipresent realities: hour-long daily visits with my mother, a night shift to keep him mentally and financially afloat, and a mailbox flooded with health care bills, insurance disputes and the complexity of navigating Medicare, Medicaid, and private insurers. When I speak of health reform, queer rights, or racial and economic justice, he gazes at me solemnly. He survived a lifetime of racial discrimination, fought in two wars and lived through the ensuing decades with a cacophony in his psyche. At seventy-eight, nearly blind and deaf, he will hear nothing of systems and reform. More often than not, these days we sit in silence.

This silence haunts me as an advocate who works at the intersection of aging and lesbian, gay, bisexual, transgender, and queer (LGBTQ) rights. The aging and LGBTQ advocacy fields often propose policy solutions that are too narrow to address the complexity of how all marginalized people — including heterosexual people of color such as my parents, members of the LGBTQ community, and more — experience the process of aging. We need social transformations that address the intersecting forms of oppression that older people face — and that can make sense of the chaos and silence that shroud my parents. This has become especially clear to me through my work as the director of a national policy program devoted to improving the health and well-being of LGBTQ older people.

A closer look at the lives of aging LGBTQ people reveals how deeply identity politics and class politics are entangled. Here, an older protester rallies for marriage equality in Pasadena, California.

A closer look at the lives of aging LGBTQ people reveals how deeply identity politics and class politics are entangled. Here, an older protester rallies for marriage equality in Pasadena, California.

For the full essay, which originally appeared in Tikkun Magazine click here

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

The Puzzle that is Obamacare. Explained in English, Spanish, Chinese, Korean & Vietnamese

Understanding the new Health Insurance Marketplace can feel a lot like piecing together a puzzle. Despite the setbacks, the Marketplace is up and running.  For community groups and advocates, it’s time to help our communities shop for health coverage that fits their many needs. For older adults, it’s time to get covered.

To make it simple, the Diverse Elders Coalition has created a simple flyer, “Why the ACA Matters to Our Communities,” which offers step-by-step instructions for enrolling in the Marketplace, as well as a rationale for the Affordable Care Act (commonly known as the ACA or Obamacare) and older people of color, LGBT older people and older immigrants.  It’s available in English, Spanish, Chinese, Korean and Vietnamese.

Our member organization, Services and Advocacy for GLBT Elders (SAGE)  has also created a special flyer on why the ACA matters to LGBT elders. Download here.

  • Share this flyer with older people—age 50 and older—in your life to effectively explain how they can apply for health insurance
  • Print this flyer for presentations, events or meetings to educate other leaders about why the ACA matters to older people of color, LGBT elders and older immigrants.

For more information on the ACA and its impact on diverse elders, visit diverseelders.org/our-health

Have a question about Obamacare and why it matters to diverse elders? Ask us on Twitter. @diverseelders Read More

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.

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