Starting a Conversation: How We Can Reduce Health Disparities Among Older Adults
By Heather Plakosh, MA (Doctoral Candidate in Counseling Psychology, Chatham University) & Jennifer Q. Morse, PhD (Associate Professor of Psychology, Chatham University)
Achieving Optimal Health is Not a One-Size-Fits-All Effort
The “melting pot” of America is becoming more diverse and “older” with each passing decade. At present, older Americans (aged 65 and up) account for 14.1% of the population and are expected to nearly double over the next 30 years. With this growth, we will witness an increase in diversity among older adults. Often, we recognize diversity simply in terms of racial and ethnic differences; however, diversity is so much more than that. It also applies to all that affects a person individually, socially, and environmentally. Given the broad scope of diversity, especially among older adults, optimal health will only be achieved when we provide equal healthcare to every individual and disparities cease to exist.
Healthy People 2020 defines health disparities as:
“a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage. Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion.”
In other words, health disparities occur because some groups have worse health simply because they are members of a disadvantaged group. Health disparities affect the prevention or development of injury, disability, or illness, as well as negative health consequences and death. This is simply not acceptable.
So, what does this mean in terms of promoting, achieving, and sustaining optimal health and well-being as people age?
It means we must pay closer attention to who a person is in addition what they require for preventing poor health and maintaining good health.
It’s Time to Start TALKING. Really Talking.
Reducing health disparities among older adults overall is a massive undertaking and managed healthcare significantly reduces time spent with patients. However, there are still small steps that providers and older adults themselves can take. Providers and older adults can talk to each other about barriers to receiving care, barriers to achieving healthier lifestyles, and their own values and beliefs.
We should all advocate for ourselves and be active participants in the healthcare decision-making process. If you’re an older adult receiving care – speak up. Ask questions. Let your doctor know when it is hard for you to get to a particular clinic and why. Ask if there are others locations or resources to help you get to an appointment. Ask for several treatment plans. Ask about lifestyle changes that go along with a treatment plan and ask for help to make healthy lifestyle changes. Make sure your provider knows your values and preferences for treatment. Let your voice be heard!
A Few Relevant Talking Points for Providers:
Barriers to adequate care
Two of the most common barriers are transportation and cost. However, other barriers may include geographic location.
What resources are available?
Where can these resources be located?
Can small adjustments or accommodations be made?
It is important to assess how your client lives their life.
Do they engage in pleasurable activities, hobbies, or interests?
Do they live in a safe, healthy environment?
Are they isolated or part of a larger community?
These are simple, yet powerful determinants of health and well-being.
Beliefs and values related to illness and treatment.
How does your client view their illness?
What do they think about the treatments for the illness?
Are there negative viewpoints or beliefs?
Do they have enough information to make an informed decision?
Perhaps they had a past negative experience with their care. Perhaps they hold firm religious, spiritual, or cultural beliefs that influence their decisions about healthcare.
Keep in mind, the above list is only a snapshot of how we can begin to reduce health disparities among older adults. The general theme here is it is important to recognize diversity and uniqueness in our older clients, and to ask about barriers, lifestyle, and values or beliefs in order to reduce or eliminate health disparities. Asking about these topics allows us to understand context and provide more support to our clients. It also encourages older adults to be more involved in their care, and helps to address disparities consistently, one person at a time.
Heather Plakosh, MA, is a third year doctoral student of Counseling Psychology at Chatham University, where she also obtained her Master of Arts in Psychology. Her training background includes neuropsychological and psychological assessment and individual and group Interpersonal Psychotherapy (IPT) with individuals across the adult lifespan. Heather is currently receiving advanced training in psychotherapy with older adults at a geriatric primary care clinic. Heather is extremely passionate about working with older adults and plans to specialize in geropsychology. Her main research interests include late-life mood disorders, the impact of comorbid health conditions on mental health, and health disparities among older adults.
Jennifer Q. Morse, PhD, is an Assistant Professor of Counseling Psychology at Chatham University. Dr. Morse graduated from Bryn Mawr College with a degree in psychology and completed her doctoral studies at Duke University. Dr. Morse’s research interests focus on Axis I and II disorders across the lifespan, with particular interests in late-life depression and the personality and interpersonal factors that predict depression, treatment course, and recurrence or relapse, assessment of attachment and interpersonal relationships across the lifespan and their relation to psychopathology, and personality disorders across the lifespan especially borderline personality disorder.
For more information on aging issues, visit APA’s Office on Aging website.
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