Aging and Health: Addressing Health Disparities Among Older Adults

Advances in public health and medicine have contributed to an increase in the life expectancy of people in the United States. Currently, adults aged 65 and older represent 16% of the nation’s population. The US Census Bureau projects that by 2034, the aging population will outnumber kids for the first time in history. According to the Centers for Disease Control and Prevention (CDC), nearly 1 in 4 older adults are members of a racial or ethnic minority group. Although life expectancy has increased, notable disparities remain. Older adults are disproportionally affected by chronic conditions, such as diabetes, arthritis and heart disease; 80% have at least one chronic illness, and nearly 70% of Medicare beneficiaries have two or more. This rapid increase in life expectancy comes with a greater responsibility to ensure that people experience these additional years of life in good health. From a health equity lens, it is imperative to recognize the diversity within the aging population and address the factors contributing to and sustaining disparities among older adults.

The National Institute of Aging (NIA) reports that environmental, social, cultural, biological and behavioral factors can affect older adults’ health and quality of life. For example, despite living longer, older women are more likely to report depressive symptoms or limitations in physical function, live alone and live in poverty at a disproportionately high rate. Moreover, African Americans suffer disproportionately from hypertension and prostate cancer, and Hispanics suffer more from diabetes.

Research findings from the NIA also indicate that there is a correlation between disease risk, diagnosis, progression, response to treatment, caregiving, access to care, overall quality of life and variables such as race, ethnicity, gender, socioeconomic status, age, education, occupation, country of origin and possibly other lifetime and lifestyle differences.

In North Dakota, the number of adults ages 65 and older is expected to grow by 52% by 2025 (North Dakota Compass). Data from 2019 indicates one in three older adults (age 65 and older) had one or more disabilities (33.2%), about the same as the national average of 33.5%. From 2015-2019, disability rates among American Indian older adults were higher than for White (non-Hispanic) older adults in North Dakota (46.5% and 33.0%, respectively).

Understanding the need to adapt to this demographic shift and improve aging health, the HHS Adult and Aging Services Section “administers programs and services to enhance the ability of older adults and adults with physical disabilities to live safely and productively in the least restrictive, appropriate setting. They work with partners to ensure that the aging population maintain independence and remain in their own homes and communities.” Additionally, this section protects the health, safety, welfare and rights of residents of long-term care settings and vulnerable adults in the community.

For example, the HHS Family Caregiver Support Program provides support services to help informal (unpaid) caregivers of older adults as well as grandparents/relative caregivers caring for children. This program offers information about local community services and support. A trained caregiver coordinator helps caregivers assess needs and access support services. The Family Caregiver Support Program provides counseling, support groups and training services to meet caregivers’ individual needs for assistance. The program ensures that respite care is available for temporary relief to caregivers who provide 24-hour care. In addition, the programs assist with the cost of incontinence supplies and assistive devices such as a shower bench or safety rails.

As part of the state’s effort to support aging adults who prefer to age in place and stay in their own homes as they get older, North Dakota’s Home and Community-Based Services (HCBS) are provided in the individual’s home with homemaker services (housecleaning, laundry or meal preparation) or personal care (assisting with a bath, etc.) or are community-based, such as non-medical transportation assistance and home-delivered meals.

Older adults experience unique social, physical and economic challenges that may differ from other age groups. Services like these that focus on individual needs and personal care not only minimize the financial burdens that contribute to health disparities but also reduce significant barriers that negatively impact the quality of life of older persons. Also, the North Dakota Adult and Aging Services Section programs illustrate the importance of collaboration across different sectors in the health field to aid a healthier experience for the older generation. As the life expectancy of older adults in America, and in North Dakota, continues to increase, it is critical to foster preventative care and implement comprehensive interventions to address the complex and interrelated factors associated with health disparities among the aging population.


Interested in this topic? Check out these resources:
North Dakota Adult and Aging Services
U.S. Department of Health and Human Services, Aging Population Resources
Eldercare Locator – Help is Here