Multiple Services Can Cut Health Disparities

Article excerpt

A major issue in aging facing the new administration in Washington will be reducing persistent disparities in health status and outcomes among underserved populations, especially elders from minority ethnic or racial backgrounds. Doing so at a time when the United States is experiencing a significant increase in the diversity of its older population could reduce financial outlays for the care of elders with chronic disease, improve their quality of life and support their independent living.

Most people would agree that good healdi over a lifetime is the best preventive and the most effective cost-control measure for both the mounting expense of long-term care for chronic health conditions and the high-cost trauma resulting from preventable falls and injuries. Legislative and regulatory action to sustain health education and support interventions can help elders take steps toward remaining active and productive even as they cope with chronic health conditions. Key to achieving this goal is supporting community-based, culturally competent interventions.

An overwhelming body of literature points to the prevalence of disparities re- lated to medical care (diagnosis, treat- ment, management of chronic conditions) and access to healthcare in the United States. Many studies have demonstrated the effectiveness of providing access to supportive services that enable elders to explore healthful behaviors, such as exercise, and develop other healthy habits within their means. Programs that encourage elders to seek counseling, increase their healdi literacy and improve their economic and health security are an important investment in closing the disparities gap and maximizing elders' ability to remain self-sufficient.

In the short run, the U.S. healthcare and services system can develop targeted and multifaceted interventions.

For instance, by targeting the mounting prevalence of a chronic condition, such as diabetes, the U.S. healthcare system could test interventions and replicate culture-specific approaches that reduce the cost of care, improve disease management and possibly allay progress of the disease. Projects funded by the Centers for Disease Control and Prevention and others in the last two decades carried out in America's Indian Country, for example, have shown how tribe-specific interventions that attend to language, community norms and beliefs resulted in effective, strengths-based interventions that can change how a community works to prevent diabetes across generations.

Yet, when older people are first diagnosed with a condition such as prediabetes, the current American healthcare system typically provides few programs for appropriate health education and interventions.

COMPREHENSIVE SERVICES

I work at a program that annually serves about 3,000 Asian elders and their family caregivers. …