By Margaret Danilovich, PT, DPT, PhD
Senior Director of Research, Leonard Schanfield Research Institute
CJE has embarked on a robust diversity, equity, and inclusion (DEI) initiative that is highlighted in this issue of LIFE Magazine. In addition to promoting DEI in hiring practices and corporate culture, it must also be proactively fostered in health and medical environments. This emphasis on diversity, equity, and inclusion in healthcare organizations is critical for your own health and to help you have the best possible outcomes to age well.
The population of older adults (those 65 and above) in the US is becoming increasingly diverse. In the next 30 years, over 40% of older adults will be people of color. But diversity is not race or ethnicity alone. Diversity can be reflected by one’s gender and gender preference, religion, age, national origin, or disability. Receiving health care from providers who respect your diversity and work with you in a culturally sensitive way can actually save your life! Research has shown that hospitalized patients with limited English proficiency experienced 25% more instances of physical harm as a result of medical errors compared to native English speakers.
Equity refers to the state of being fair, just, and impartial. While often mistaken for equality, equity means giving people what they need to live and enjoy a healthy life, according to their specific personal situation,. In contrast, equality often refers to giving all people exactly the same resources. In an equitable community, all older adults would have access to the services, healthcare, and opportunities they need and desire to age how they would like. Unfortunately, compared to younger people, older adults face challenging health disparities, or avoidable differences in the burden of disease that have accumulated over their lifespan. These health disparities contribute to lower utilization of preventive care and rehabilitation and worse quality of life.
People age 65 and older have typically been excluded from research studies that test new medical treatments, medications, and other therapeutic interventions. Recent research published in JAMA found that nearly one-quarter of clinical trials for COVID-19 vaccines and other treatments excluded people on the basis of age alone. This is particularly problematic as older people account for 80% of COVID-19 deaths and up to 40% of cases. The current exclusion of older adults from these research studies means that COVID-19 therapies might not be tested and evaluated for the population that needs them the most, and that treatment recommendations are not necessarily applicable to the population most affected. By including older adults in research we can be more assured that the treatments older adults undergo have been tested for safety and effectiveness in others of a similar age and with similar health conditions.
Given the impact of diversity, equity, and inclusion on your own health, how can you best ensure that you receive culturally competent care?
- Ask for language assistance. If English is not your first language, request a translator. If you are unclear as to what the health care provider is saying, ask them to repeat content or explain things better so you have full understanding of your treatment plan.
- Bring up your traditions and values with your providers. Explicitly tell your health care providers what your goals, desires, and wishes are.
- Seek out the services of CJE Consumer Assistance. Their Resource Specialists can help counsel you on health insurance benefits, so you have timely access to health care.
- Consider seeing a geriatrician. This is a physician who specializes in aging. Research shows that one of the most commonly identified concerns of older adults is a feeling that their doctor doesn’t understand the concerns of aging. Geriatricians have special training in aging and can best address those concerns and treat age-associated diseases and illnesses.
Respect, or Kavod in Hebrew, is a central value of CJE’s organization and mission. Staff in departments such as Holocaust Community Services and Counseling work with older adults through a person-centered trauma-informed lens to provide care for each person that considers their unique needs, strengths, and preferences. As an organization, the renewed emphasis on DEI will ensure that CJE continues to celebrate and nourish the diversity of our staff, clients, residents, volunteers, and community members equitably and inclusively today and in the future.