Hi there and welcome back to Aging Together! February is Black History Month in the United States! February is also American Heart Month. This month’s posts will be split between the two topics with our first two guest speakers! In today’s post, I’m taking a dive into the history of aging in Black America, its implications on current day aging, and an outlook for the future as we work collectively to address social determinants of health.
The history of caregiving and elder care in Black America is a complex and multifaceted one. Historically, Black Americans have had to navigate systemic racism and discrimination that has impacted their access to healthcare and other resources. This has made it difficult for them to receive adequate care as they age.
The History
During slavery, enslaved Black Americans were forced to take care of their own elderly without any support from their owners. After slavery, Black Americans were often excluded from government programs and resources for the elderly, and had to rely on family and community support.
1965: The Older Americans Act (OAA)
In 1965, the Older Americans Act (OAA) was the first federal law aimed at providing funding for comprehensive services for older adults. Funded services included meals, transportation, in-home services, legal services, and caregiver support. This initiative created the National Aging Network which includes the Administration on Aging at the federal level, State Units on Aging at the state level, and Area Agencies on Aging at the local level. The OAA has been amended several times over the years to increase funding for services that benefit minority populations, including Black Americans.
1970: The National Caucus & Center on Black Aging (NCBA)
In 1970, the National Caucus & Center on Black Aging (NCBA) was founded to ensure that particular concerns of elderly minorities would be addressed in the then-upcoming 1971 White House Conference on Aging. Since then, NCBA has helped protect and improve the quality of life for elderly populations through their services. Their services include employment assistance, health and wellness, and affordable housing. According to their website, NCBA is the only national organization devoted to minority and low-income aging.
Current Day
In the 20th century, the Civil Rights movement led to some improvements in access to healthcare and social services for Black Americans. However, disparities in access to care and quality of care continue to exist today.
A 2021 study examining racism in healthcare as it relates to older African American adults found that they are less likely to have their chronic illness sufficiently managed and are more likely to die from chronic illnesses that are otherwise well-controlled in non-BIPOC communities. They also found that older adults continue to suffer from poorer healthcare outcomes throughout the lifespan to end-of-life. Further tying this topic into American Heart Month, the study also found that African Americans aged 18-49 are twice as likely to die from heart disease than non-Hispanic Whites.
Similarly, a 2022 Report from the Nursing Home Abuse Justice Team suggests that “elderly nursing home residents of color do not always receive the same level of care as white residents.” The same report also highlighted a paper published by the National Institute of Health (NIH) that stated, “African Americans [are] more likely to live in nursing homes with lower cleanliness and maintenance ratings.” It further elaborated that the study found non-white residents to be up to 40% less likely to be socially engaged, and elderly African American cancer patients are 63% more likely to be left untreated for pain.
These inequalities only worsened during the COVID-19 pandemic. A study conducted at the University of Chicago found a consistent relationship between race and COVID-19, where nursing homes with the least amount of white residents were more than twice as likely to have cases and deaths compared to facilities with mostly white residents. The study further states that “nursing homes that service more residents of color reported lower nurse-to-patient ratios, higher deficiencies, and lower levels of care, putting residents at an increased risk for nursing home abuse and neglect.
Aside from general healthcare disparities, Black Americans are disproportionately impacted by other social determinants of health. Two of these include poverty and lack of access to affordable housing. According to the NAACP, Black families generally have lower incomes than white families, making it more difficult to save for retirement. Per the Federal Reserve 2019 Survey of Consumer Finances, the median wealth of white families was at just above $188,000 compared to the median wealth of black families at barely $24,000. This disables Black Americans from being able to participate in employer-sponsored retirement accounts, stocks, or mutual funds that they could potentially take advantage of with stock market growth. All of this put together makes it incredibly difficult for Black families to provide adequate care for their elderly loved ones.
In recent years, there has been an increase in awareness of the unique challenges faced by Black Americans in accessing elder care. Efforts are being made to address these issues through policy and community-based initiatives.
Community-Based Programs
Many community-based programs, including many faith-based organizations, address the specific needs of Black older adults and their caregivers. These programs often provide a range of services, including home-delivered meals, housing, transportation, and caregiver support. Community-based programs will differ in different geographic locations. Since I am based in Chicago, here are some local resources.
The Chicago Department of Family & Support Services (DFSS)
The Chicago Department of Family and Support Services (DFSS) offers a variety of programs and services for older adults in Chicago, including Meals on Wheels, which delivers meals to older adults who are unable to leave their homes, and senior centers that provide social and recreational activities for older adults. Their webpage outlines 17 services for seniors and caregivers! I encourage you to take a look to see if you find something useful for you or a loved one!
The Illinois Department of Aging’s Community Care Program
In 1979, the Illinois Department on Aging established The Community Care Program which provides in-home services such as housekeeping, personal care, and homemaker services to older adults and individuals with disabilities. This program is one of the waivers for home and community-based services under Medicaid.
The Cook County Department of Public Health
The Cook County Department of Public Health also offers a number of programs that support older adults in Chicago, including the Health Fairs which provides health screenings, information, and resources to older adults in the city. They regularly update their events schedule on their website.
The Westside Health Authority (WHA)
The Westside Health Authority (WHA) offers a variety of programs and services for older adults in Chicago’s Austin neighborhood. Their support services offerings include health screenings, case management, and support groups for families.
It’s worth checking out these organizations’ websites for more information about the specific services and programs they offer to the black community. You can also check with the city government or local non-profit organizations for more information on specific programs and resources available in Chicago for black older adults and their caregivers.
The Future
According to the NAACP, after a lifetime of racial and health inequities, Black seniors are at risk of spending their last years with declining health, little income, and virtually no savings. It is important to note that while efforts are ongoing, there is still a long way to go to address the disparities and inequalities in elder care for Black Americans.
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At Caregiver Consulting & Healthy Solutions, we are dedicated to helping you navigate aging together. This blog page is for everyone: whether you are an older adult looking to age in place, a caregiver seeking support and guidance, a young or middle-aged adult planning for the future, or simply someone interested in learning more about the aging process. I hope you’ll join me on this journey. Let’s navigate aging together.