Social Policy in Gerontology and Geriatrics Education
Binstock, Robert H., Annual Review of Gerontology & Geriatrics
A gerontology or geriatrics curriculum that does not include social policy is missing essential ingredients for understanding the everyday situations of older individuals and how they come about, what may pose threats to them, and-when needed-how their situations might be changed for the better through new policies. Knowledge of social policy also illuminates relationships between older people and younger generations, a variety of social institutions, and the society at large.
As exemplified by the preceding paragraph, this discussion of social policy in gerontology and geriatrics education contains many assertions and opinions. Such observations are based on my ongoing experience in teaching social policy and aging for more than 40 years. My students have included various types of PhD, MD, and master's degree students, as well as undergraduates. Their backgrounds, concentrations, and majors have been in anthropology, bioethics, economics, gerontology, health services research, history, law, management, medicine, nursing, nutrition, political science, psychology, public health, social policy, social work, and sociology. In this chapter I first briefly outline the superficial terrain of the potential scope of education in social policy and aging. Next, I suggest a variety of educational resources for both students and teachers. In a final section I discuss selected concepts and perspectives that I have found useful in teaching aging and social policy. Policy examples provided in these discussions are drawn primarily from the United States because of space considerations. However, as indicated through brief allusions to policy experiences in other countries, cross-national comparisons can be valuable in social policy education.
THE POTENTIAL SCOPE OF EDUCATION IN SOCIAL POLICY AND AGING
Teaching social policy can include attention to a wide variety of existing policies in both the public and private sectors of society. It can also encompass analyses of current policy proposals, development of new ideas for policies, and study of the history of policies in order to understand how and why they became what they are.
The mention of public policies in the field of aging immediately brings to mind such major federal policies as Social Security, Medicare, and Medicaid, the Older Americans Act, the Age Discrimination in Employment Act, the Employee Retirement Income Security Act, and the establishment of a National Institute on Aging. But of course there are myriad other policies affecting aging and older persons at the federal and state levels, as well as the actions and inactions of municipal, county, and special district governments. Think, for instance, of nursing home fires and poor enforcement of city fire safety codes, county support for social services, and transit authority provision of special access vehicles for the aged and disabled.
Legislative policies are only a small piece of the public policy puzzle. Also important, for instance, are executive orders, court decisions, and decisions by regulatory agencies such as the Food and Drug Administration, the Federal Trade Commission, the Pension Benefit Guaranty Corporation, the Equal Employment Opportunity Commission, and many regulatory activities of states and localities such as health care licensing, oversight of private insurance sales practices, and zoning. State, county, and local referenda also affect older people, both as beneficiaries (e.g., of social services) and as taxpayers who fund services (e.g., through school bond levies).
Among the most important private sector policies related to aging and old age are the policies of employers toward workers and retirees. They include the provision and details of defined benefit pensions, defined contribution pensions, family leave policies for caregiving, and retiree health insurance. Although mandatory retirement has been outlawed in most sectors of American society since 1986 by the federal Age Discrimination in Employment Act, for several decades employers have been offering early retirement incentive programs (or buyouts) to reduce or "freshen" their workforces. …