Key Takeaways

  • It’s time to change the public discourse on aging and the public and private systems that have been exposed for what they are—ageist and racist.

  • The pandemic showed us that systemic barriers make it nearly impossible for all to age well.

  • We’re changing this narrative by empowering individuals with trusted information, supporting community-based organizations that serve older adults, and advocating for representative change in federal policy.

We’re living in unprecedented times. The pandemic and racial reckoning have changed our landscape forever, exposing long-standing disparities and demanding bold new approaches.

One-third of all COVID-19 deaths have been in nursing homes, and 80% of pandemic deaths have been among people aged 65+, disproportionally among people of color.

This is not business as usual.

It’s time to change the public discourse on aging and the public and private systems that have been exposed for what they are—ageist and racist.

COVID-19 has been a wake-up call for the nation—and for the aging services network. No longer should we accept incremental change. No longer should we be satisfied with nibbling at the edges of major societal challenges and barriers to ensuring equity in aging.

The pandemic showed us that systemic barriers make it nearly impossible for all to age well. In particular, women, people of color, LBGTQ+, low-income, and rural older adults are victims of a broken system.

These populations are more likely to experience declining health at an earlier age, face higher rates of social isolation, and live near or below poverty. They lack culturally responsive services and are at greater risk of premature death because the system that was created to support them failed.

At NCOA, we’re working to change this narrative by empowering individuals with trusted information, supporting community-based organizations that serve older adults, and advocating for representative change in federal policy.

How we define equity

To achieve aging well for all, we must first define equity. This requires collaborating with all sectors—public, private, nonprofit, community-based organizations, and individuals. We must learn how and why certain communities feel left out of the conversation and what it means to them to be included.

Access also is critical. The reality is that many disadvantaged communities still don’t have access to culturally responsive care. Too many also lack the wraparound supports they need to get care—things like accessible and affordable transportation and paid leave. As a result, millions are not even in our health system until a crisis happens and they appear in the emergency room without any medical IT journey behind them.

Another place where equity needs to be baked in is telehealth. While this technology may solve some issues related to access, it remains a barrier for those behind the digital divide who lack broadband and the digital literacy required to use it.

The importance of holistic data

We’re strong supporters of a holistic approach to defining and collecting data. Where individuals live, learn, work, and play clearly affects their health and quality of life, risks, and outcomes. These social determinants of health are not yet baked into our health systems.

Today’s health systems are too often built in silos based on what payers want or need to know—not on the true consumer experience. And while data collection is key, its standardization and utilization are even more important.  

Perhaps relying on the U.S. Census for guidance, we need standard data that shows where there are overlaps of race, ethnicity, language, gender, and other demographics, which are at the root of cumulative disadvantage. Standard demographics must be written broadly and capture a wide range of responses. For example, including an “Other” category to ensure all respondents feel they are being seen and included.

It’s not until we garner a real understanding of the inequities in care that we can collectively build solutions to address these systemic failures.

No matter the demographic group affected, NCOA believes we must address disparities to ensure all can age well. This means strengthening and targeting our policies to ensure demographic groups can enjoy the benefits of aging with the health and economic security needed to live with purpose and dignity.

If we want our nation on track to be among the leading countries experiencing longevity gains, we have much work to do to ensure all have the opportunity to age well.