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Archived
June, 2007


Highlights in Minority Health
& Health Disparities
May, 2006
Older Americans Month, May 2006

 

May 2006 is Older Americans Month
The United States is on the brink of a longevity revolution.1  In 2004, there were 36.3 million Americans ages 65 and over, making up 12% of the population.  By 2050, the U.S. Census Bureau projects that number will have more than doubled to 86.7 million, making up 21% of the population at that time.2  The composition of America’s older population is also shifting.  In 2003, 82.5% of Americans aged 65 and over were non-Hispanic white; by 2050 non-Hispanic whites are projected to make up about 61.3% of the population.  The older Hispanic/Latino population is growing at the fastest rate: in 2003 only 5.7% of older adults were of Hispanic origin and by 2050 they will account for 17.5% of the older adult population.3
United States Population Ages 65+
by Race and Hispanic Origin,
2003 (estimated) & 2050 (projected)
graph version of data in table below
Non-Hispanic White African American Hispanic/Latino Asian American Other
  2003 2050
Non-Hispanic White 82.5% 61.3%
African American 8.4% 12.0%
Hispanic/Latino 5.7% 17.5%
Asian American 2.7% 7.8%
Other 1.1% 2.7%
Note: "Other" includes American Indians, Alaska Natives, Pacific Islanders & others.
Source:
Federal Interagency Forum on Aging Related Statistics, Older American 2004: Key indicators of Well-Being.

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It used to be accepted wisdom that disability and ill-health were just part of getting older. No longer. As America ages, we’ve learned that people can stay active and healthy well into older years – and the more active they stay, the healthier they will be.  Many chronic diseases can be prevented or postponed through healthy lifestyles, physical activity, getting recommended screenings and appropriate follow-up, and meaningful social engagement.4

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EXAMPLES OF IMPORTANT HEALTH DISPARITIES
 

Chronic Conditions

  red arrow In 2003, 25.5% of adults aged 65 and older reported their health as “fair or poor,” compared to only 5.6% of adults aged 18-44.5   Older adults also report more activity limitations due to chronic diseases than adults aged 18-44 (34.6% vs. 6.0%.6
  red arrow In 2001-2002, among people aged 65 years and older, non-Hispanic blacks reported higher levels of hypertension than non-Hispanic whites (66% compared with 49% for hypertension).3
  red arrow In 2002, 8.6 million Americans aged 60 years and older had diabetes (18.3%), 2.1 times more prevalent than among Americans aged 20 years and over (18.2 million, or 6.3%).7
In 2001-2002, among people aged 65 years and over, non-Hispanic blacks reported higher levels of diabetes than non-Hispanic whites (23% compared with 14%).  Hispanics also reported higher levels of diabetes than non-Hispanic whites (24% compared with 14%).3
  red arrow In 2003, 52% of adults 75 years and over reported a doctor's diagnosis of arthritis, compared to 7.8% of adults aged 18-44, 28.8% aged 45-64, and 46.2% aged 65-74.8
  red arrow Older women report more depressive symptoms than older men.  In 2002, 18% of women aged 65 years and older reported depressive symptoms compared with 11% of men.3
  red arrow In 2000, approximately 4.5 million Americans had Alzheimer's disease.  By 2050 the number of individuals with Alzheimer's could range from 11.3 million to 16 million.9  In 2002, Alzheimer’s disease accounted for 2.6% of deaths from white Americans, making it the 8th leading cause for this group.  It is not among the top ten causes of death for any other racial or ethnic group.16
  red arrow In 2002, 46% of people aged 65 years and over with family income below the poverty line reported having no natural teeth, compared with 27% of people above the poverty threshold.3
 

Cancer and Early Detection

  red arrow In 2003, Adults aged 75+ were 2.7 times more likely to have any type of cancer (21.6%) than persons aged 45-64.  Adults aged 65-74 were 2.3 times more likely to have any type of cancer (18.0%) than those aged 45-64 (7.9%).10 
  red arrow In 2000, 55% of women aged 65 years and older living below the poverty level reported having had a mammogram compared with 70% of older women living above the poverty level.  In 2000, 58% of women aged 65 years and older without a high school diploma reported having had a mammogram in the preceding 2 years compared with 72% of women who had a high school diploma and 74% of women who had some college education.3
  red arrow In 2003, Asian American women were least likely to have had a mammogram in the past two years (58.8%) compared with non-Hispanic whites, African Americans (both 70.4%), Hispanics/Latinas (66.1%), and American Indian/Alaska Natives (68.6%).11
 

Preventive Measures

  red arrow In 2001-2002, men aged 65 years and over were more likely than women in the same age group to report engaging in regular leisure time physical activity (26% and 18%, respectively).  Older non-Hispanic white adults report higher levels of physical activity than non-Hispanic black adults or Hispanics (23% compared with 14% for Hispanics and 13% for non-Hispanic blacks).3
  red arrow In 2002, 66% of people aged 65 years and older reported receiving a flu shot in the past 12 months; 69% of non-Hispanic whites reported receiving a flu shot compared with 50% of non-Hispanic blacks and 49% of Hispanics.  Despite recent increases in pneumonia vaccination rates for all groups, non-Hispanic whites were more likely to have received a pneumonia vaccination (60%) compared with non-Hispanic blacks (37%) or Hispanics (27%).3

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PROMISING INTERVENTION STRATEGIES
Research has shown that poor mental and physical health and loss of independence are not inevitable consequences of aging. The following strategies have proven effective in improving the health of older adults:
  red arrow Healthy lifestyles. Research has shown that healthy lifestyle behaviors, such as being physically active, eating a healthy diet, and not smoking, are more influential than genetic factors in helping older people avoid the deterioration traditionally associated with aging.
  red arrow Early detection of diseases. Screening to detect chronic diseases early in their course, when they are most treatable, can save many lives; however, many older adults have not had all of the recommended screenings covered by Medicare.
  red arrow Immunizations. About 36,000 people aged 65 or older die each year of influenza and invasive Pneumococcal disease.  Immunizations can reduce a person’s risk for hospitalization and death from these diseases.
  red arrow Injury prevention. Falls are the most common cause of injuries to older adults. More than one-third of adults aged 65 or older fall each year, and of those who fall, 20% - 30% suffer moderate to severe injuries that decrease mobility and independence.
  red arrow Self-management techniques. Programs to teach older adults self-management techniques can reduce both the pain and costs of chronic disease.  For example, people with arthritis can learn practical skills such as how to manage their pain, how to deal with fatigue and stress, and how to develop a personal exercise program.12
However, these preventive measures are not reaching many individuals belonging to a racial or ethnic minority group. While much is known about how to prevent disease and preserve function among older adults, significant disparities exist both in the incidence and prevalence of diseases and conditions, and the extent to which effective preventive measures reach these individuals.13

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Older Adult Health - Programs and Accomplishments
Centers for Disease Control and Prevention (CDC)
The dramatic aging of the U.S. population, coupled with the growing proportion of racial and ethnic minority groups, compels an enhanced emphasis on addressing the health-related needs of older adults, with tailored strategies for individuals within these groups.  The Centers for Disease Control and Prevention (CDC), together with its sister federal agencies (e.g., Administration on Aging, National Institute on Aging), are working to ensure that proven prevention strategies to promote health and preserve independence in older people are more broadly applied.13
CDC’s scientific and programmatic expertise is readily applied to target major health issues among older Americans. CDC supports programs in states targeting cardiovascular disease, diabetes, cancer, arthritis, injuries, and influenza and Pneumococcal disease. Within these and other CDC programs, efforts are focused on promoting healthy lifestyles, adult immunization, chronic disease self-management, and injury prevention.13
In addition to targeting disease prevention and health promotion efforts, CDC provides public health leadership and coordinates with the aging services network and national health and aging organizations to promote health and independence among older adults.  Examples of current efforts include:
   
blue sphere
Providing grants to states through CDC’s SENIOR Grant Program for health promotion efforts targeted to older adults.
   
blue sphere
Supporting the translation and dissemination of evidence-based practices to communities through the Health Aging Research Network of CDC’s Prevention Research Centers program.
   
blue sphere
Monitoring the health trends of older adults through The State of Aging and Health in America report series, with a special emphasis in the 2006 edition on health disparities.
   
blue sphere
Developing and building on recently-established public health priorities for addressing end-of-life issues.
   
blue sphere
Collaborating with the Alzheimer’s Association on a multi-faceted approach to protect and promote brain health that includes the development of a public health action plan and community demonstration projects.13
  red arrow CDC’s Racial and Ethnic Approaches to Community Health (REACH) 2010
REACH 2010 is one of the cornerstones of CDC’s efforts to eliminate racial and ethnic disparities in health. Launched in 1999, REACH 2010 is designed to eliminate disparities in the following six priority areas: cardiovascular disease, immunizations, breast and cervical cancer screening and management, diabetes, HIV/AIDS, and infant mortality.  Currently, REACH 2010 efforts are focused on reaching African Americans, American Indians, Alaska Natives, Asian Americans, Hispanics, and Pacific Islanders.  Among the community-based projects funded by REACH 2010 are efforts specifically focusing on addressing health disparities among racial and ethnic minority populations.13,14

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What Individuals & Communities Can Do to Promote Healthy Aging
Much of the illness, disability, and death associated with chronic disease is avoidable through known prevention measures. Key measures include practicing a healthy lifestyle (e.g., regular physical activity, healthy eating, and avoiding tobacco use) and the use of early detection practices (e.g., screening for breast, cervical, and colorectal cancers, diabetes and its complications, and depression).1
Broader use of clinical preventive services is one of the keys to preserving and extending the health of older Americans.  Because research has shown that older adults are motivated by health care providers’ recommendations for screening and immunization, better educating seniors on recommended preventive measures is essential.  Community organizations can promote and facilitate access to preventive measures by hosting health fairs and “Immunization Days” where older people live and congregate and by widely publicizing the benefits and local availability of immunization and screening services.15 
The current gap between life expectancy and healthy years of life can be narrowed.  Research shows that simple behavioral changes can improve the health conditions of older adults.  These improvements in health can be achieved through a combination of practicing healthful behaviors, effectively identifying disease, modifying health risks, and managing chronic conditions.  An important way to promote health behaviors among older adults is to improve patient-provider communication and to provide time for counseling and referral regarding lifestyle modifications, so that older adults can adopt and maintain these behaviors.15 

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FOR MORE INFORMATION
United States Department of Health and Human Services (HHS)
    HHS’ Office of Minority Health Resource Center (OMHRC)
      Health Information for Older Americans
  Centers for Disease Control and Prevention (CDC)
  blue sphere National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP)
      Healthy Aging
      The State of Aging and Health in America 2004
  blue sphere National Center for Health Statistics (NCHS)
      Older Persons’ Health
  Administration on Aging (AoA)
 

Agency for Healthcare Quality and Research (AHRQ)

    Improving the Health and Health Care of Older Americans: A Report of the AHRQ Task Force on Aging
  Centers for Medicare and Medicaid Services (CMS)
    Medicare
      New Medicare Prescription Drug Coverage
    Medicaid
  Environmental Protection Agency (EPA)
    Aging Initiatives
  Federal Interagency Forum on Aging-Related Statistics
    Older Americans 2004: Key Indicators of Well-Being
  Food and Drug Administration (FDA)
    Growing Older, Eating Better
    Medicines and You: A Guide for Older Adults
  Health Resources and Services Administration (HRSA)
  United States Department of Agriculture (USDA)
  blue sphere Food and Nutrition Information Center (FNIC)
      Aging
  U.S. Census Bureau
    Older (55+) Population
    Elderly (65+) Population

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SOURCES
1. Centers for Disease Control and Prevention (CDC), Healthy Aging for Older Adults, 2005
2. U.S. Census Bureau, Facts for Features, Older Americans Month Celebrated in May, 2005
3. Federal Interagency Forum on Aging Related Statistics, Older American 2004: Key Indicators of Well-Being
4. CDC, The State of the CDC, Fiscal year 2004, p. 32
5. CDC, National Center for Health Statistics (NCHS), Health, United States, 2005, table 60
6. CDC, National Center for Health Statistics (NCHS), Health, United States, 2005, table 58
7. CDC, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Diabetes Public Health Resource, National Diabetes Fact Sheet, 2005
8. CDC, NCHS, Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2003, table 8
9. LE Hebert, PA Scherr, JL Bienias, DA Bennett, DA Evans, Alzheimer Disease in the US Population, Archives of Neurology, 2003, 60(8): 1119-1122
10. CDC, NCHS, Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2003, table 6
11. American Cancer Society (ACS), Cancer Prevention & Early Detection Fact & Figures 2006
12. CDC, Healthy Aging: Preventing Disease and Improving Quality of Life Among Older Adults, 2006
13. CDC/NCCDPH/Healthy Aging Group
14. CDC, Racial and Ethnic Approaches to Community Health (REACH 2010): Addressing Disparities in Health, 2006
15. CDC, The State of Aging and Health in America 2004
16. CDC, NCHS, Health United States, 2005, Table 31

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