The older adults are one of the fastest rising segments of the American population. In the wake of their increased numbers, there has been a rise in many unique health concerns. However, it would be important to note that recent statistics have shown an improved life expectancy and reduced disability rates among members of this population. The most significant challenge that has been witnessed among the members of this population is the widespread lack of environmental and socioeconomic resources. The mental decline, coupled with the lack of resources has placed the elderly at an increased risk of acquiring various health concerns. According to the World Health Organization (WHO), as people continue to age, they become increasingly susceptible to diseases and disability. The WHO further documents five critical areas that need to be addressed as a way of mitigating the risk factors associated with the aged people. They include injury, poverty, social isolation, maltreatment, and noncommunicable illnesses. The Center for Disease Control (CDC) documents that chronic illness is one of the common diseases affecting members of this population segment (Ortman, Velkoff, & Hogan, 2014) Examples include diabetes, arthritis, dementia, and cardiovascular diseases amongst others. Health disparity among the elderly continues to be a significant problem leading to high rates of morbidity and mortality among members of this population segment.
Demographics
First, it remains fundamentally important to understand the definition of the elderly population. According to the U.S Census Bureau, an older adult is anyone aged 65 and over. The Census Bureau further identifies three subgroups that could be used in categorizing the older adult population including the young-old, old, and the oldest-old (Adams, Kirzinger, & Martinez, 2012). The young-old fall between the age of 65 and 74 with the old falling between 75 and 84 (The Demographics of an Aging Population, 2015) . Lastly, the oldest-old are individuals starting from 85 years to infinity. The baby boomer population involves people borne between mid-1946 and mid-1964. It was a period when a sharp and unprecedented rise in the birthrate was recorded. The Census Bureau further noted that in 2012, approximately 76.4 million baby boomers were residing in the US. Further research has shown that the older population will exponentially increase to 83.7 million in 2050 down from 43.1 million recorded in 2012 (The Demographics of an Aging Population, 2015). Prospectus research has also shown that the older adults in the coming decades will be more educated and racially diverse compared to those witnessed in the previous generations. Studies have also revealed that the oldest-old, which includes people of above the age of 85, is the fastest growing part of the older adults. Studies have shown that by 2030, approximately 4.5% of the entire US population will be 85 years and above (The Demographics of an Aging Population, 2015)
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Morbidity and Mortality
First, it is important to note that older adults have a higher probability of getting hospitalized than the younger ones. According to research conducted by the National Discharge Survey, individuals aged 65 years and above were hospitalized at a rate that was three times much higher than all the groups. According to the CDC, the three major causes of death among the older population include heart disease, cancer, and chronic lower respiratory disease. The rapid growth in the population of this individuals especially those aged 85 and above experience illness that necessitates not only hospitalization but also long-term care. Research has shown that about 85% of the elderly have at least a single chronic disease. The CDC documents that another 60% have at least two chronic illnesses (Ortman, Velkoff, & Hogan, 2014). Most of the older adults experience many challenges in their endeavor to cope with chronic conditions. Some of the common examples of common chronic illnesses associated with the elderly include dementia, glaucoma, osteoporosis, depression, cardiovascular diseases, and Alzheimer's disease among others. The primary condition affecting individuals of 65 years and above is arthritis. The CDC documents that it affects up to 49.7% of all the seniors and causes no pain and a deteriorated quality of life.
Heart disease is the second common condition affecting older adults. According to the Federal Interagency Forum on Aging and Statistics, heart disease affects both men and women with a prevalence of 37% and 26% respectively (Ortman, Velkoff, & Hogan, 2014). As individuals continue to age, they get exposed to risk factors such as high cholesterol and high blood pressure thus increasing a person's chances of acquiring heart diseases and stroke. The third significant disease affecting older adults is cancer. According to the CDC, 28% and 21% of men and women respectively 65 years of age and above are living with cancer (Adams, Kirzinger, & Martinez, 2012). Statistics have also shown that Alzheimer's disease is a common condition that will grow exponentially among the aging population. Research conducted in 2014 showed that over 5 million older adults are living with the infection. Other than morbidity, it remains fundamentally critical to assess the mortality of people in this age category. The CDC documents that heart disease remains the primary killer for many seniors and in 2014 alone, it killed up to 489,722. The second cause of death among the elderly is cancer with statistics showing that it caused the death of up to 414,000 people in the US (Ortman, Velkoff, & Hogan, 2014). The third major cause of death among the older population is the chronic lower respiratory disease with the CDC recording a death toll of 124,494 in 2014.
Access to Health
One of the reasons why this segment of population experiences healthcare disparities is due to their lack of access to healthcare. As earlier intimated, more Americans are continuing to age. As a result, policymakers are experiencing more pressure to provide accessible healthcare to this populace. A lack of health care access among the aged means that many diseases are left untreated thus increasing the cost of treatment and the mortality rates. When discussing access, it remains fundamentally important to determine the barriers that might implicate an older adult from receiving much-needed care for a particular condition. Research conducted by Pew concluded that approximately 20% of elderly Americans fail to address their health concerns due to a lack of resources. The lack of the required resources implicates their ability to visit doctors, fill prescription medications, and order for a wide variety of medical tests due to their costs. Therefore, it remains essential to appreciate the medical bills as one of the barriers to accessing health needs. Although the Affordable Care Act has helped in reducing the number of uninsured people, the population of older adults without insurance is significant with statistics showing somewhere between 5% and 10% of the entire older adult population (Horton & Johnson, 2010).
A large part of the senior population resides in rural areas. Many quality healthcare facilities that are suitable to take care of the needs of these types of patients such as the hospice, nursing homes, and advanced care treatments are usually found in urban areas. As a result, this leads to a new challenge of transportation. Research has further indicated that transportation barriers can also lead to delayed care, missed or rescheduled appointments, and the delay in medication use. The implication here is the poor management of chronic diseases which eventually leads to deteriorated health outcomes. Transportation is an essential tool for the elderly especially those battling chronic illnesses because they need to frequently get in touch with the clinicians to ensure the provision of evidence-based care (Syed, Gerber, & Sharp, 2013).The third primary factor affecting health access in this segment of the population is the shortage of geriatricians or doctors and nurses with the particular skills to address the health care concerns of the older adults. Golden, Silverman, and Issenberg (2015) asserted that studies have shown that physicians have continued to show disinterest in the field of geriatric medicine in the wake of the increased health care needs among the older adults. With fewer nurses training in this area, this has presented a new challenge affecting health access because many facilities do not have the skills and expertise to address the many chronic illnesses affecting the elderly.
Economics and Education
As earlier mentioned, the aging process creates a unique set of challenges that directly affect the overall health. A large population of people with 65 years and above is no longer working, with a majority relying on meager funds that come from retirement benefits or the government programs. As such, the elderly have shown a propensity towards suffering from economic well-being that significantly leads to poverty. “Health is unevenly distributed across socioeconomic status. Persons of lower income, education, or occupational status experience worse health and die earlier than do their better-off counterparts” (Fiscella & Williams, 2014). Research has further shown that older adults with low socioeconomic status have a greater onset of disabilities, cognitive decline, and limitations in their day to day living. The lack of health insurance among a segment of these populations means that they cannot manage the out-of-pocket health care payment. Education is another major determinant of health disparity. Many scholars have agreed that “having achieved higher education levels tends to be associated with the prevention of functional limitations; while a higher income level is associated with both prevention and delayed progression of functional decline” (Fiscella & Williams, 2014). More educated older adults are better placed to make healthy lifestyle choices and adhere to medication compared to those who are less educated. Therefore, economics and education are two socioeconomic factors that significantly impact health outcomes among this population.
Resources and Organizations to Combat Disparities
Several resources can be channeled towards the reduction of health disparities among older adults. The resources are not only directed towards this segment of the population but also key stakeholders such as the medical professionals and insurance companies. The Mapping Medicare Disparities tool is, for instance, a vital resource designed for professionals in healthcare to determine areas of the country most prone to health disparities thus enabling them to suggest actionable opportunities. The Center for Medicare and Medicaid Services (CMS) provides free training resources to medical practitioners that can help improve their “understanding of how to collect, measure, and ultimately reduce disparities in health care outcomes” (Five Resources to Help Reduce Health Disparities among Vulnerable Populations). Policymakers must also leverage the Affordable Care Act and Medicare policies to ensure that the elderly are well-covered thus improving access by reducing cost. Some of the organizations that can help in this endeavor include WHO, CDC, and CMC all of which can provide important researched information, studies, clinical trials, and further influence policies to combat disparities.
Political Initiatives
Political initiatives are geared toward influencing health reforms through the creation of policies. The ACA was an example of policy initiative aimed at increasing the number of insured people. Creating laws to improve the Medicare insurance plan further is also a viable strategy for individuals aged 65 years and above. Political initiatives can also be geared towards funding to enable research and the training of health professionals to deal with chronic illnesses affecting the elderly properly. Social security services should also be strengthened through the Department of Health and Human Services to limit the number of elderly adults suffering from socioeconomic conditions affecting health.
In conclusion, Health disparity among the elderly continues to be a significant problem leading to high rates of morbidity and mortality among members of this population segment. The three major health concerns causing morbidity and mortality include cancer, cardiovascular infections, and respiratory infections. Disparity primarily comes about due to barriers affecting health access such as lack of health insurance, poverty, and insufficient health professions with the prerequisite skills to deal with geriatric conditions. Lack of education is also a primary factor that significantly influences health outcomes. It is, therefore, incumbent upon private sectors and governments to combat disparities by influencing policies and research.
References
Adams, P., Kirzinger, W., & Martinez, M. (2012). Summary health statistics for the U.S. population: National health interview survey, 2011. Vital and Health Statistics, 10(255). Retrieved from: http://www.cdc.gov/nchs/data/series/sr_10/sr10_255.pdf
Fiscella, K., & Williams, D. R. (2014). Health disparities based on socioeconomic inequities: implications for urban health care. Academic Medicine, 79(12), 1139-1147.
Five Resources to Help Reduce Health Disparities among Vulnerable Populations, Quality Improvement Organizations. Retrieved from: https://qioprogram.org/qionews/articles/five-resources-help-reduce-health-disparities-among-vulnerable-populations
Golden, A. G., Silverman, M. A., & Issenberg, S. B. (2015). Addressing the shortage of geriatricians: what medical educators can learn from the nurse practitioner training model. Academic Medicine, 90(9), 1236-1240.
Horton, S., & Johnson, R. J. (2010). Improving access to health care for uninsured elderly patients. Public Health Nursing, 27(4), 362-370.
Ortman, J., Velkoff, V., & Hogan, H. (2014). An aging nation: The older population in the United States. Retrieved from: http://www.census.gov/prod/2014pubs/p25-1140.pdf
Syed, S. T., Gerber, B. S., & Sharp, L. K. (2013). Traveling towards disease: transportation barriers to health care access. Journal of Community Health, 38(5), 976-993.
The Demographics of an Aging Population (March 2015). Retrieved from: https://www.healthdesign.org/insights-solutions/demographics-aging-population
