New developments in the current political climate.
For approximately four decades in the United States, gerontologists and some public policy makers at all levels of government have assessed and discussed the social, health, and other policy ramifications of the emergence of an aging society. Despite demographic data anticipating that the number of older Americans will rise to 20 percent of the total population by midcentury (Federal Interagency Forum on Aging Related Statistics, 2000), a sense of urgency has not been reflected in the legislative score cards accumulated over the years. Indeed, domestic policy issues are being reprioritized or "deprioritized" as a result of dramatic shifts in the economy, in international relations, and in views of the nation's defense requirements since September 11, 2001.
Aging issues have not been exempt. Social Security reform, around which no consensus has emerged, may be headed toward privatization or may be stalemated for the foreseeable future. Medicare reform activities have not advanced beyond the discussion of various congressional proposals, although overwhelming evidence shows that a prescription drug benefit is essential to the health and economic security of a significant number of older Americans. Similarly, a comprehensive national long-term-care policy is not expected to materialize in the near term, if at all.
Three pressing questions emerge in relation to social policy issues and concerns in a multicultural aging society. First, what are now the most critical policy issues related to minority aging? Second, what factors are likely to shape national policy in the decades ahead? And, third, how will our social and health policies respond to the requirements of an aging population in an increasingly ethnically and racially diverse society? A continuing examination of these questions is essential in order to inform, stimulate, and then prod the development of the national policy that is needed.
CRITICAL POLICY ISSUES
Kenneth Prewitt (2001), former director of the U.S. Census Bureau, notes that Americans in the United States have a contradictory relationship with the diversity of the country's population. Although we tout ourselves as a nation distinguished among all others by diversity and tolerance, Prewitt notes that throughout much of our history American diversity has been almost inextricably tied to painful, persistent discrimination against those who are "different" because of race, ethnicity, or religion. Thus, even as the United States is becoming increasingly diverse , welfare reform measures have been unsympathetic to immigrants in general and have had particularly challenging consequences for elderly minority people. Further, the current political situation, including hostile treatment of ethnic minorities and non-Christians in the aftermath of the events of September 11, provides more evidence that we cannot simply assume that social policies will embrace multiculturalism and inclusion.
It is true that we have achieved progress over a span of more than a century in prohibiting discrimination based on race, color, religion, sex, or national origin through the use of legal instruments. And, while they have not yet attracted the same visibility as the civil rights laws enacted in the 1960s and thereafter, a number of other program and policy initiatives have been similarly important in the lives of poor older people, enabling them to gain greater access to social welfare, health, and long-termcare services. Examples are those programs and initiatives introduced during the War on Poverty in the 1960s and 1970s and Medicaid expansions in the 1980s and 1990s.
Several laws, executive orders, and programs generated during the Clinton administration are also likely to have considerable impact over the long term on the quality of life of minority Americans, among whom older people are at considerable risk. For example, two executive orders issued by President Clinton in 2000 addressed access issues that minority people, particularly those who do not speak English, frequently face. …