Polls finds inequity in community support for older adults

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WASHINGTON, DC, United States (AP) - Many Americans believe their communities are doing a good job meeting the needs of older adults, but white people may be better equipped than people of colour to age within their communities, according to a new survey from The Associated Press (AP)-NORC Center for Public Affairs Research.The poll finds more Americans think their area is doing well, rather than poorly, in providing access to resources and services for aging adults, including health care, healthy food, transportation, and at-home support.But white people are more likely than people of colour to say their community does well in offering health care for older adults generally, as well as urgent care, primary care and physical therapy specifically. White Americans also are more positive than non-white Americans in rating their communities' access to grocery stores, outdoor spaces, libraries, and other amenities.The poll finds community assessments also differ by household income, with Americans in lower-income households more likely than those earning higher incomes to say their communities are lacking across many resources and services.Overall, 46 per cent of Americans say their area is doing a good job providing access to health care for older adults, in contrast to 15 per cent saying it does a poor job. Fifty-two per cent of white people say their community does a good job, in contrast to 37 per cent of people of colour. Many people of colour say either a poor job, neither, or they don't know. Uncertainty was an issue for many of the resources asked about in the poll.Sarah Szanton, a professor at Johns Hopkins University's nursing school, described ageing as "the sum of people's life experiences across the course of their life"."There's certainly some randomness, there's certainly some genetics involved but, in general, ageing is a health equity matter," she said.The poll finds just 34 per cent of Americans say their communities do a good job offering in-home support services for older adults, in contrast to 14 per cent who say it does a bad job. Another 31 per cent say they don't know. White people are somewhat more likely than people of colour to say they have good access to in-home services - 37 per cent (whites) to 27 per cent (people of colour).The new findings follow an AP-NORC polling earlier this year that found a majority of Americans want the federal government to help Americans age in their own homes, which continues to be the option most prefer.Dan Carrow has lived in New York City for more than 30 years, and he knows he wants to continue to live as close to a major city as possible as he gets older. But, in his Washington Heights neighbourhood, he feels the onus is on people to do research for themselves to get health care and plan for the future."Because I live in New York, I have access to good health care. But you have to do all the research yourself," said Carrow, who says he feels lucky to have family members in the health-care industry. "I think, if I didn't have my family background and my education I would be in bad shape."Carrow, an African American man, knows his neighbourhood features world-class Columbia University - "the best medical care you can get" - but doesn't think there is enough outreach to, or understanding of the predominantly non-white neighbourhood."I think what the medical profession has to start working on is building trust with individual people," Carrow said. "Because people basically don't trust doctors, especially people of colour because of the past - our relationship we've had with them over the past century. So that's how come many times people don't go to a doctor till they're like, you know, dancing around the doorway of death."Szanton compared funding for ageing-in-community initiatives to funding for schools - localised and therefore disparate. Instead, she thinks initiatives should be statewide "so that the people in the more low-income counties and cities don't have fewer resources to be able to support ageing-in-community initiatives".She pointed to decades of disinvestment in, specifically, majority African American neighbourhoods as an illustration of the problem."That snowballs, where the lack of wealth leads to more lack of wealth," she said. "Then because community resources for ageing are usually neighbourhood- or city- or county-based, those resources are also less."Jacqueline Angel, a professor of health, social policy, and sociology at the University of Texas, said demographics factor into a person's "physical, mental, social, and even spiritual and emotional well-being". And, because disadvantages accumulate over time, Angel said, they are too wide for ageing programmes - Medicare, Medicaid, and social security - to fully close the gap."One has to provide the resources that will be able to curb the disparities in health, income, and overall quality of life," she said. "It's more critical now than ever to be able to do that, given the pace of our ageing racial minority population."

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