Security in old age is dependent on three pillars--an adequate retirement income, accessible quality health care and affordable housing (Gonyea 2005). The security of the older population, those age sixty-five and over, has become a pressing policy concern of policy makers, academics, aging advocates and others. This concern is driven in large part by the aging of the U.S. population and the reliance of that part of the population on the largest social programs in the country--Social Security and Medicare. Over the next five decades the population age sixty-five and over is expected to double from over thirty-six million individuals to eighty-seven million individuals (Federal Interagency Forum on Aging-Related Statistics 2004). The most rapid growth will occur starting in 2011 when the first of the baby boomers turns age sixty-five. Somewhat less well known is the increasing racial and ethnic diversity that will accompany the aging of the population. While the older population currently is more EuroAmerican (non-Hispanic White) than younger population groups, the aging of the population will bring increased representation of minority populations into old age. The population age sixty-five and over currently includes thirty million non-Hispanic Whites, three million African Americans, two million Hispanics, almost one million Asians Americans and 150,000 Native Americans. The fastest-growing population among those age sixty-five and over is Hispanics. Between 2003 and 2050 the number of non-Hispanic Whites age sixty-five and over will nearly double to 53.2 million. In contrast, the elderly Hispanic population will increase sevenfold to fifteen million individuals and will be the largest minority group in the older population (Federal Interagency Forum on Aging-Related Statistics 2004).
While in aggregate elderly individuals have generally achieved the three pillars of security in old age, wide disparities exist among the population. In particular, Hispanics age sixty-five and over have continued to experience disparities in social, health and economic status (Villa and Wallace 2006). Additionally, in the current political climate many of the programs and services that Hispanics and low-income populations have relied on are at risk of cutbacks, restructuring and elimination. This has the potential to increase the economic and health vulnerabilities of the older Hispanic population, making it even more difficult for them to attain security in old age. By articulating the health and economic issues facing the population we can begin to shed light on the impact that policy choices may have on this population's ability to build the three pillars necessary for security in old age. In what follows we examine two closely related pillars that define security in old age: access to health care and socioeconomic status among the Hispanic population age sixty-five and over, and the policy interventions that can improve the circumstances and therefore security of current and future cohorts of elderly Hispanics.
Disparities in Health and Access to Care
The available data on the health status of the Hispanic population finds a mixed picture of advantage and disadvantage. Mortality data show that Latino older persons have an advantage relative to non-Hispanic Whites for mortality from certain diseases. This has been commonly referred to as the "Hispanic Paradox"(Markides and Eschbach 2005). Put simply, the Hispanic paradox refers to the fact that in spite of their relatively poor overall socioeconomic status, Hispanics have lower death rates than better-off non-Hispanic Whites. In particular, Hispanics age sixty-five and over have lower death rates than non-Hispanic Whites from heart disease, cancer and stroke, which are the three most common causes of death among the elderly in the United States (National Center for Health Statistics 2004). Further, the advantage in mortality for cancer and heart disease also extends to middle-aged Hispanics age forty-five to sixty-four. …