By Ronald Angel and Jacqueline Angel
Mega Doctor News
As National Hispanic Heritage Month comes to a close, it provides an occasion not only to recognize the contributions of Hispanic Americans to our society, but also a chance to contemplate what awaits the nation as Hispanics age along with rest of the population.
The Hispanic population’s rate of growth exceeds that of the general U.S. population by almost five times. One distinguishing feature of the Hispanic population is that although it suffers from high levels of poverty and low levels of health insurance coverage, Hispanics have similar or even longer life spans at birth and at age 65 than non-Hispanic whites. This presents a situation that raises several major issues that the nation will have to confront in the coming decades.
Given their higher fertility, a huge fraction of working-age individuals will be Hispanic in a few short years, but most retirees will be non-Hispanic and white. This means that in the relatively near future, two workers will be called upon to support each retiree. It is very likely that one of those two workers will be Hispanic, and if their productivity is undermined by low levels of education and poor health, the productivity of the labor force as a whole will suffer, and their ability to support a growing aging population will become more limited.
This reality makes the welfare of Hispanics a national concern because they will be called upon to pay for the needs of younger and older Americans from all groups.
Several experiments indicate that it is possible to assist older people who would otherwise need nursing home care to remain in their communities. In the case of Latinos, the range of community care options must be extended to include more affordable, accessible and culturally appropriate services.
Certain experimental programs have been very successful in meeting the needs of frail and disabled Latinos, such as the Program of All-Inclusive Care for the Elderly (PACE), a government-sponsored demonstration program designed to allow people age 55 and older who would otherwise be forced to enter a nursing home remain in the community. Since 1986, El Bienvivir, a PACE experiment in El Paso, has provided comprehensive community services that allow frail Latino elders to remain in their homes.
The program includes an interdisciplinary team consisting of primary care doctors, social workers, rehabilitative therapists, nurses and other health care professionals. Nonmedical supports include medication assistance, transportation, meals and recreational activities. The program is financed from various sources including Medicaid and provides a good blueprint as an example that works.
Serious challenges for community support remain, though. In 2010 approximately 500,000 individuals were on Medicaid home and community-based waiting lists in the 38 states that offered community options. Latinos are especially unlikely to use such options and to remain dependent on their families and local communities. Our research shows that even after they become incapacitated, low-income Latinos — and especially Mexican immigrants — do not turn to nonfamily sources of support.
The lower use of formal services reflects the lack of culturally tailored programs in addition to serious financial barriers. As younger Latina women, who have traditionally served as primary caregivers to aging parents, find it necessary to juggle work and family, the traditional expectations that parents should be taken care of at home is becoming increasingly unrealistic. In the future, programs that provide resources that help family caregivers must be developed.
It is clear that the social and demographic changes that transformed traditional ways of living during the past century will accelerate in the years ahead. Aging populations will add an age dimension to ethnic and racial distinctions, with younger age groups consisting disproportionately of minority group workers and the older age ranges consisting disproportionately of non-Hispanic white retirees. In this new world, we must avoid ethnic and racial group-based conflicts and create culturally and socially appropriate support systems for aging people.
Ronald Angel is a professor of sociology and at The University of Texas at Austin. Jacqueline Angel is a professor of sociology and public affairs at The University of Texas at Austin. Their most recent book is “Latinos in an Aging World.”