Looking To the Future: Aging Issues in Health and Health Care

Rachel D. Maree, M.P.H.
2012 MD Candidate, Medical University of South Carolina

Since 1900, the percentage of Americans aged 65 years and older has tripled, largely due to advancements in technology and lifestyle changes.  These statistics are important when considering the future of health and health care in the United States.   As such, every effort should be made to continue identifying disparities in health and health care and effective methods to eliminate them.  It has become ever more important to not only research and effectively address health disparities prevalent in the elderly population, but also to train the next generation of health care providers to care specifically for this particular demographic.

Research confirms that several health disparities exist among the elderly population including, but not limited to the following: heart disease, stroke, diabetes, and Alzheimer’s disease.  As the elderly population continues to grow, the minority elderly population will also see an increase in numbers; in 2007, 19.3% of persons 65 years and older were minorities (DHHS, 2009). However, continuous monitoring/research of these health disparities will be a difficult, logistical, and investigative challenge, especially given the anticipated increases in the elderly population.

Researching any population will have its challenges, but particular concerns arise when studying minority aging populations.  Some of the data used to study the health status of older people include self-reported measures, which may be less reliable because they are subjective variables that may vary in meaning from person to person.  While subjectivity of the reporting can be questioned, it is also important to ensure that the methodology and instrumentation used for assessments can be applied cross culturally (Whitfield, 2008).  Another important issue that arises in studying minority or ethnic populations in general is the difficulty in qualifying the racial and ethnic categories used to describe people.  The categorization of race and ethnicity is constantly changing, and is not the best predictor of disparities within this population demographic (Stahl, 2006). Other variables (i.e., socio-economic status (SES), gender, education, income, language, housing, etc.) provide better comparisons for disparities research (Moody-Ayers, et al., 2007, Angel, 2006).

However, research is not the only way that future health care providers can have a positive impact on the care given to aging populations.  Medical schools across the country including, but not limited to, the Medical University of South Carolina (MUSC) (Charleston, SC) and the Virginia Commonwealth University (VCU) School of Medicine (Richmond, VA), have incorporated geriatric training into their curricula throughout the four years of medical school.  At MUSC, students are paired with a senior mentor who is an elderly member of the local community.  Students complete assignments with their mentor including proper nutrition assessments, activities of daily living evaluation, and mental health status examinations. VCU features curricular items such as forums on issues pertaining to geriatric medicine as well as residential visits to geriatric patients in the community (White, 2009).  Medical schools across the nation should be encouraged to incorporate geriatric components into the curriculum if not already in place.

As the aging population increases, the knowledge that health care providers will need concerning elderly health care will increase, regardless of the medical specialty.  It is imperative that every effort is made to equip health care providers with the necessary tools, information, and clinical skills to properly care for this demographic before additional increases in the geriatric population, and especially the minority geriatric population, occur.

References
Angel, J.L. & Angel, R.J. (2006). Minority Group Status and Healthful Aging: Social Structure Still Matters. American Journal of Public Health. 96, 1152-1159.

Department of Health and Human Services Administration on Aging. (August 2009).         Profile of Older Americans. Retrieved from    (http://www.aoa.gov/AoARoot/Index.aspx.

Moody-Ayers, S., Lindquist, K. Sen, S., & Covinsky, K.E. (2007). Childhood Social and Economic Well-Being and Health in Older Age. American Journal of Epidemiology. 166, 1059-1067.

Stahl, S.M., & Hahn, A.A. (2006). The National Institue on Aging’s Resource Centers for Minority Aging Research. Medical Care. 44, S1-S2.

White, H.K., Buhr, G.T., & Pinheiro, S.O. (2009). Mentoring: A Key Strategy to Prepare the Next Generation of Physicians to Care for an Aging America. Journal of the American Geriatrics Society. 57, 1270-1277.

Whitfield, K.E., Allaire, J.C. Belue, R., & Edwards, C.L. (2008). Are Comparisons the Answer to Understanding Behavioral Aspects of Aging in Racial and Ethnic Groups? Journal of Gerontology. 63B, 301-308.

This article first appeared in the Summer 2010 JSNMA, Volume 15, Number 4

Filed Under: Global Health

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About the Author: publications@snma.org

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