Profiles in Diversity: The Face of Older America

“Righteous people of all nations have a share in the world to come.”
Talmud (Tractate Sanhedrin)

CJE is a staunch defender and preserver of the rights of older adults of all socio-economic statuses, races, religions and ethnicities. We know there have been laws in place for years to protect the rights of most Americans: The 1964 Civil Rights Act prohibiting discrimination because of race, color, religion, sex or national origin; the Older Americans Act of 1965, establishing many programs CJE offers such as Meals-on-Wheels; and the 1968 Age Discrimination in Employment Act, prohibiting employers from discriminating on the basis of age (for those above 40 years). Even with these legal protections, older adult racial/ethnic minorities experience many health disparities due to differences in socio-economic status. That’s because they face discrimination and residential segregation, which leads to unequal distribution of resources and less access to healthcare, affecting their ability to age well.

Because CJE’s values require that we look at each person as an individual and not as a stereotype, we should be aware of the diversity of older adults and the different issues faced by those in the minority. As the overall minority population in the U.S. grows and experiences greater longevity, it follows that the older population is becoming more racially and ethnically diverse. The 2016 U.S. Census reveals that racial and ethnic minority populations have increased from 18% of the older adult population in 2005 to 22% of older adults in 2015 (from 6.7 million to 10.6 million respectively), with a projected increase to 28% in 2030 (or 21.1 million).

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The Administration on Aging projects these population increases between 2014 and 2060: 3.6 to 21.5 million for Hispanics; 4 to 12 million for African-Americans; 1.9 to 8.5 million for Asians; and 231,500 to 630,000 for American Indian and Native Alaskans.

According to the Census, poverty rates of older minorities account for great disparities in minorities’ health and wellbeing, due to unaffordability of healthcare and other factors. Most older persons have at least one chronic condition and many have multiple ones. Almost all racial/ethnic minorities have a greater percentage of chronic conditions than all older Americans. The Census figures in the chart below show the percent of older adults in each group that experienced common chronic conditions (from 2009-2012):

  HISPANICS AFRICAN
AMERICAN
ASIAN AMERICAN
INDIAN/
NATIVE
ALASKAN
ALL OLDER
AMERICANS
Hypertension 75% 85%     71%
Arthritis 45% 51% 36% 57% 49%
Heart Disease 25% 27% 24% 25% 31%
Diabetes 27% 39%     21%
Cancer 12% 17% 12%   25%

Many other health and social issues affect the older racial/ethnic minority population. For example, a 2017 report from the National Hispanic Council on Aging shows that many Mexican-origin Hispanics (two thirds of our Hispanic population) work at such physically demanding jobs and receive substandard medical care. Consequently, as they age, they seem more physically disabled than older non-Hispanic whites. A study in Generations confirmed that Hispanics have more health issues in later years, partly because of poor access to medical care. In a study reported in Pain Medicine, racial and ethnic disparities in pain perception and treatment were found due to complex factors like the patient’s communication abilities, attitudes toward pain and access to medication. In the Journal of Nutrition for the Elderly, many barriers to elderly nutrition programs among racial/ethnic minority older adults were cited because of “lack of information or misinformation; culturally-driven reluctance to ask for outside help; fear and distrust of formal systems; lack of ethnic menus in the program; discomfort due to cultural differences; and inaccessibility and inadequacy of transportation.”

In a large Women’s Health Initiative study, researchers found that overall Quality of Life (QOL) ratings were significantly different, with racial/ethnic minority women less likely to rate theirs high. Also, older women from minority populations disproportionately experience more disease and disability than their white counterparts. Finally, a 2012 study of mental health in the American Geriatrics Society Journal showed that treatment was less frequently initiated and less adequate for African Americans and Hispanics than whites and suggested the need for “culturally appropriate interventions to engage them in mental health care.”

Linkages: A Unique Support for Families With DisabilitiesCJE’s Linkages is dedicated to providing support and resources for older adults with adult children with disabilities.

A program of CJE Counseling Services, Linkages provides information and referrals, socialization events, educational presentations and support groups. Professional staff can help families explore resource options and offer their expertise on service coordination, advocacy, future planning and government benefits.Linkages can also provide referrals to aging and disability services for the older adult as well as the person with the disability. To find out about Linkages, call 773.508.1000.

Another protected group includes persons with disabilities. 2016 Census figures show that 35% of people over age 65 report some type of disability—hearing, vision, movement, cognition, etc. Also, in 2013, over 863,000 adults 60 years and older served as a family caregiver for someone with intellectual and developmental disabilities.

A 2014 survey of religion in America by the Pew Forum found that 48% of adults 65 and older go to religious services on a regular basis, much more than younger adults. With almost half the older population engaged in religious activity, its importance to them should be acknowledged and honored. CJE encourages religious celebrations and rituals. And although we are a Jewish organization, we welcome people of all religions in our programs and services.

Need an Advocate? The Diverse Elders Coalition Goes Deep Into the Issues

The Diverse Elders Coalition (DEC) works for older adult minorities of color and LGBTQs by advocating for policies and programs for minority elders who are aging in the community. Created in 2010 to ensure that the needs and perspectives of vulnerable elders would be heard, today, the DEC represents millions of diverse older people. According to its website, the DEC “has mobilized diverse older adults to speak up to policymakers about their unique experiences; engaged the White House Conference on Aging to include the needs of diverse elders in Federal aging policy; and fought for the rights of our communities to age with health and dignity on the federal, state, and local levels.” Member organizations include:

National Asian Pacific Center on Aging, National Hispanic Council on Aging, National Indian Council on Aging, SAGE | Advocacy & Services for LGBT Elders and Southeast Asia Resource Action Center

The Diverse Elders Coalition seeks a world where everyone can live full and active lives as they age and represents a growing majority of older adults throughout the country, including the poor and low-income. For more information: www.diverseelders.org

There are more than 2.7 million lesbian, gay, bisexual, transgender and queer or questioning (LGBTQ) adults aged 50 or older in the U.S., and 1.1 million who are 65 and older, with about 20% of LGBTQ older adults being people of color, according to a Gallup Poll. LGBTQ older adults face many difficult issues in many areas of their life. A report from the Movement Advancement Project (MAP) revealed that more than half of LGBTQ older people are very concerned about having enough money to live on, and one in three are very concerned about being lonely and growing old alone. Many may have experienced employment discrimination in their career, resulting in lower retirement savings and Social Security income. In the landmark Aging with Pride study, 27% of respondents reported not being hired, 26% not being promoted and 18% reported being fired for their sexual orientation or gender identity.

Transgender older adults have particularly difficult issues, according to the MAP report. They may have specific medical needs, including medically necessary transition-related care. When transgender elders are forced back into the closet due to discrimination, their health suffers. Older adults who transition later in life face added health challenges in accessing care and support. They may also have faced discrimination in housing employment. Some, alienated from families, experience social isolation.

Though protected by legislation that in some cases may be at risk, including the Affordable Care Act, the picture painted about older Americans of all racial and ethnic groups is one that is reflected in American society. Huge disparities exist in income, access to healthcare and resources for minorities. Because of this, organizations such as CJE are even more important. Funding from individuals, grants and foundations become vital to provide services to those who may be marginalized.

 

Russian-Speaking and Needing Help: Assistance for Immigrants and Survivors

CJE serves several thousand clients who either do not speak English or speak English as a second language (ESL). Most of these individuals are from the 15 countries that were part of the USSR, often referred to as Former Soviet Union (FSU). From Russia, Ukraine, Belarus, Lithuania, Latvia and other places, these people have come to the U.S. for a variety of reasons—80% of these immigrants are Jewish and include Holocaust Survivors, who are estimated to number about 6,000 in the Chicago area.

These FSU individuals may find their way to CJE’s doorstep in need of assistance or resources. This often requires a Russian-speaking staff member, a sensitive ear and an understanding of cultural norms. Fortunately, CJE employs many Resource Specialists (some Russian-speaking) who are culturally-competent, that is, familiar with FSU clients’ communication styles, expectations and behaviors. Christie Norrick, Manager of Consumer Assistance, says the majority of these clients live below 200% of the poverty level and struggle financially. CJE helps this cohort mostly with programs like Subsidized Housing, Holocaust Community Services, Consumer Assistance (CA) and Lieberman Center for Health and Rehabilitation.

CJE CA staff is so knowledgeable on FSU matters that Norrick and Resource Specialist Yelena Abramova gave a presentation at the AgeOptions Diversity Conference held in May. The presentation was all about these FSU individuals—their statistics, lifestyles and families. It also informed about the barriers and challenges to providing resources and services and recommended inclusive practices. Norrick urged sensitivity to language issues and to cultural norms when serving diverse older adults.

Below is a list of resources for FSU persons.

  • CJE SeniorLife and Holocaust Community Services (referrals to dentists, etc. with Russian-speaking staff)
  • Jewish Child and Family Services programs:
    • HIAS Chicago for immigration and citizenship assistance (312.357.4666)
    • Jewish Vocational Services for employment assistance (773.743.5368)
    • Ezra Russian Senior Center (773.275.0866)

CJE provides a welcoming environment for people from all backgrounds and national origins. Please be sure to contact our Consumer Assistance Department (773.508.1000) or Holocaust Community Services (773.508.1004) for more information.

References for this article can be found here.