Americans are living longer and healthier lives. As the population of Black adults age 65+ continues to grow, addressing the unique challenges they face is essential for promoting health and economic well-being.

At NCOA, we are working to build a society where every one of us has the resources to age with health and financial security. We are doing this in partnership with national and local organizations that are committed to empowering older adults with the best solutions.     

Honoring our elders in the Black community involves providing resources and best practices to professionals and advocating for policies and programs that promote economic stability. With a focus on strengthening the direct care workforce, promoting social safety net initiatives, and increasing benefits access and enrollment, NCOA’s Center for Economic Well-Being has outlined actions to support Black older adults.

Understanding the barriers that Black older adults face and identifying opportunities for improvement are critical for everyone's well-being.

Historical barriers

The Black population has faced barriers that have contributed to wealth and health gaps. Historical segregation, discriminatory housing policies, and unequal access to education and employment have resulted in economic disadvantages that persist today. Aging, along with increasing costs of living and medical expenses, only worsens these challenges. 

Economic barriers

Many Black adults age 65+ don’t have adequate retirement savings and live in poverty. They are more likely to live on fixed incomes, often relying solely on Social Security or safety net programs, which are frequently inadequate to cover living expenses.

In 2022, white families had about $260,000 more in average retirement savings than Black families.¹ Black older adults have fewer assets than whites and are less likely to own their own business or be homeowners. Black adults age 65+ on average have $159,200 compared to $647,300 for white older adults, which worsens issues related to housing stability, access to health care, and overall quality of life.²

Quality health care

The lack of access to quality health care has a disproportionate impact on Black older adults. When compared to whites, Black adults are less likely to have public health insurance coverage and more likely to receive care in nonoptimal settings (such as emergency rooms) and lack continuity in health care.³ They often experience higher rates of chronic conditions, such as hypertension and diabetes,^4,5 yet encounter obstacles in accessing timely and quality care.

Lack of insurance coverage and the availability of providers in their communities further complicate their health care experience. And mental health stigma within the community can prevent people from seeking necessary support, leading to untreated issues such as depression and anxiety.

Cultural competency in care

Health care systems often lack culturally competent care models that address the unique needs of diverse older adult populations. Black older adults often report experiencing pain levels of five and higher, as well as higher levels of insomnia, depression, and inferior memory.⁶ Yet they are at increased risk of being undertreated for pain and experiencing ineffective communication.

Many older Black adults mistrust the health care system because of a history of mistreatment and exploitation. These factors can result in misdiagnoses, inadequate treatment plans, and general distrust of the health care system.

How can we address these barriers and advance positive and lasting change? We can take positive actions to make a difference.

Drive policy advocacy and reform

Advocating for policies that improve the lives of Black older adults is vital. This includes pushing for reforms in health care access, affordable housing, and Social Security benefits, ensuring that these policies are tailored to meet the specific needs of this population. Policymakers should prioritize funding for programs that ensure resources are allocated where they are most needed. 

Support and expand community-based programs

Community organizations, such as Benefits Enrollment Centers, SNAP enrollment sites, and the National Institute of Senior Centers play a crucial role in bridging gaps and addressing the needs of older adults. Human-centered programs provide resources and services tailored to unique needs. Programs focused on financial literacy, health education, transportation, meal delivery, and benefits enrollment support all improve access to essential services that strengthen economic security and overall well-being.  

Leverage technology to increase accessiblity

The rise of telehealth offers new avenues for older adults to access health care services without  transportation and mobility barriers. By investing in technology, health care systems can enhance access to care, particularly for those in rural or underserved areas.  

Raise awareness

Increasing awareness about the unique challenges faced by Black older adults can combat biases and promote more inclusive policies and practices. Developing health care initiatives that prioritize cultural competence can improve quality of care. Training providers to understand the historical and cultural contexts impacting their patients can lead to better health outcomes and increased trust in the health care system.  

Invest in research and data collection

Investing in research focused on the health and economic challenges faced by Black older adults can inform policies and programs aimed at addressing issues related to poverty, income, retirement planning, housing, and more. Gathering disaggregated data will help stakeholders understand the specific needs of this demographic and develop targeted interventions. 

We can make a difference

Advancing health and economic well-being for Black older adults is a multifaceted challenge that requires collaborative efforts from policymakers, community organizations, and health care providers. While barriers persist, there are opportunities to create meaningful change. We can create the conditions for all to age well, now and into the future.  

Sources

1. Urban Institute. Nine Charts about Wealth Inequality in America. April 24, 2024. Found on the internet at https://apps.urban.org/features/wealth-inequality-charts/

2. Richard W. Johnson. Policy Options to Reduce the Black-White Gap in Retirement Security. Journal of Elder Policy. Spring 2021. Found on the internet at https://www.journalofelderpolicy.org/johnson.html

3. National Academies. Panel on Race, Ethnicity and Health in Later Life. 2004. Found on the internet at https://nap.nationalacademies.org/initiative/panel-on-race-ethnicity-and-health-in-later-life 

4. Centers for Disease Control and Prevention. Quickstats: Age-Adjusted Percentage of Adults with Hypertension, by Sex and Race and Ethnicity, United States, August 2021-August 2023. Morbidity and Mortality Weekly Report. Dec. 5, 2024. Found on the internet at https://www.cdc.gov/mmwr/volumes/73/wr/mm7348a5.htm

5. U.S. Department of Health and Human Services, Office of Minority Health. Diabetes and Black/African Americans. Found on the internet at https://minorityhealth.hhs.gov/diabetes-and-blackafrican-americans

6. Bazargan, M, et al. Pain in Community-Dwelling Elderly African Americans. Journal of Aging and Health. April 2016. Found on the internet at https://journals.sagepub.com/doi/abs/10.1177/0898264315592600