Issue Category: Age-Friendly Public Health

Public Health’s Role in Supporting Family Caregivers

According to a September 2022 report by the National Alliance for Caregiving (NAC) and  the National Association of Chronic Disease Directors, Chronic Disease Family Caregiving Through a Public Health Lens, there are 53 million family caregivers in America-that’s nearly one i five families. Furthermore, the number of caregivers will continue to rise as people aged 65 or older are expected to almost double by the year 2060. At that time, the nation will have reached a milestone of one in four people responsible for providing care for a family member with a chronic disease, serious illness, or a disability.

The report, which was supported by a grant from the John A. Hartford Foundation, found that caregivers are taking on caregiving responsibilities for adults with increasingly complex needs due to raising rates of chronic disease, Alzheimer’s Disease and other types of memory and dementia issues.

Caregivers in Need

Providing care for an ill family member is a demanding task often made more complicated by geographically dispersed families and the need for two wage-earners.

Source: Caregiving for Family and Friends – A Public Health Issue

According to a NAC and National Association of Chronic Disease Directors Roundtable, in 2020,23 percent of caregivers reported worsening health due to caregiving. Of those caregivers, 60 percent reported difficulty when addressing their own health needs. TFAH has recommended establishing a comprehensive paid family and medical leave policy that ensures paid time off to address family health or caregiving needs for all employees.

Equity in Caregiving

Of the nation’s 53 million family caregivers, an estimated 61 percent are Non-Hispanic white, 17 percent are Hispanic, 14 percent are African American, and 5 percent are Asian American and/or Pacific Islander. As the need for care grows, the need for caregiver systems that are integrated into the community, and culturally and language appropriate is critical. Innovations in technology, such as telemedicine and translation tools, can assist in allowing both long-distance and non-English speaking caregivers have the support they need from public health programs and their communities. Culturally designed approaches and relationship building within communities will enable greater understanding of, support for, and interaction with the nation’s caregivers.

How Can the Public Health System Support Caregivers?

Support for the nation’s caregivers is a public health issue especially in light of demographic changes that will make the need for family caregiving even greater in the future. The public health system has  a critical role to play in supporting family caregivers and their ability to provide care through care coordination and assistance integrating home care with more formal healthcare services. Public health systems should work to create family caregiving support infrastructure and should team with other entities that can have a role in supporting caregivers including healthcare systems and providers, insurers, community-based organizations, faith-based organizations, and employers.

Conclusion

Caregivers are a vital part of the nation’s healthcare system and need the support of the public health sector. Policies should support the nation’s existing and growing number of caregivers to allow them to provide care while protecting their own health, well-being, and financial security.

Additional TFAH Age-Friendly Public Health Systems initiative Resources on Family Caregiving

Michigan Conference Seeks to Advance an Interconnected, Age-friendly Public Health System

Michigan is a leader in the movement to create a more age-friendly public health system by creating partnerships throughout the health and public health sectors within the state. In October 2022, over 120 aging and health leaders and innovators gathered at Michigan State University for the state’s first-ever Strategically Partnering for Age-Friendly Health in Michigan Conference to collaborate on a shared vision to advance age-friendly policies and practices across the state.

The conference, jointly hosted by The Michigan Health Endowment Fund, Michigan Public Health Institute, and Trust for America’s Health, emphasized the need for age-friendly policies to benefit everyone, not just older adults, due to their focus on the social conditions that support optimal health.

One of the key themes of the conference was the importance of integrating age-friendly principles into the ecosystem of society and information sharing across care delivery, between hospitals and home care providers, for example. Dr. Aaron Guest, a national leader in aging and public health, spoke on the connections between social determinants of health and healthy aging, and the importance of creating an age-friendly environment that addresses the social and economic factors that promote good health and well-being.

Structural racism and health disparities were also discussed as significant obstacles to ensuring equitable access to care and culturally responsive, age-friendly care. Black older adults in Michigan experience lower rates of health insurance coverage and greater rates of chronic health conditions compared to their white counterparts. Furthermore, the Detroit Area Agency on Aging found that the death rate of Detroit adults in their 50s is 122 percent higher than the rest of the state.

Overall, the conference sought to chart the course for an age-friendly future within the state, acknowledging the challenges ahead but also the progress made, especially in light of the COVID-19 pandemic. The pandemic’s disproportionate impact on communities of color and older adults illustrates the importance of addressing the upstream social determinants of health and integrating age-friendly policies into public health systems.

TFAH is proudly committed to a continued partnership with the Michigan Public Health Institute and will continue to help support Michigan’s Age Friendly Public Health System initiative in the future.

This article is based on the Age-Friendly Conference Envisions as Interconnected Michigan blog, published by the Michigan Health Endowment Fund.

Read more on TFAH’s Age Friendly Public Health Systems and Age Friendly Public Health Systems Initiative Page.

Subscribe to TFAH’s Age Friendly Public Health Newsletter.

Trust for America’s Health Celebrates Older Americans Month

The month of May provides America with the opportunity to celebrate our families, neighbors, colleagues, and friends as we all age.  It is an opportunity to recognize and share the collective wisdom and rich history afforded by older age.  It is also a time to reflect on how we, as a nation, view ourselves as we age, and to reflect on how well we are working to create supportive environments for equitable health and well-being across the lifespan.

Trust for America’s Health (TFAH), as a non-profit public health policy, research, and advocacy organization committed to ensuring healthy environments for all individuals and communities, prioritizes the roles of the public health sector in creating such supportive environments.  We have seen the significant toll that the COVID-19 pandemic has taken on not just the health, but also the social and economic well-being of older adults.  We commend the public health sector for actively addressing these challenges and working across sectors to collaboratively and equitably support our nation’s older adults, their families, and caregivers.

Older Americans Month offers us the opportunity to examine the public health practices that can be expanded to include older adults beyond the COVID-19 pandemic.  We must continue to elevate healthy aging as a core public health function, from collecting robust data on older adult health, to embedding multi-sector partnerships, to prioritizing and advancing health equity, to exploring how the social determinants of health can be framed with an aging lens.  And public health departments can continue to collaborate with America’s aging services network to support and build opportunities and options for more older adults to age in the communities and spaces of their choice.

TFAH will continue to explore new opportunities with state and local health departments to embed healthy aging within public health practice, to develop resources to support this engagement, and to advocate for policy changes to ensure appropriate authority and funding for these efforts.  For more information on TFAH’s Age-Friendly Public Health Systems initiative, please visit www.afphs.org.

TFAH Applauds Introduction of the Protecting the Health of America’s Older Adults Act

(Washington, DC – December 16) – Trust for America’s Health, a non-partisan, nonprofit public health policy, research and advocacy organization, applauds the introduction of the bipartisan Protecting the Health of America’s Older Adults Act by Representatives Lois Frankel (CA-44), Gus Bilirakis (FL-12) and Debbie Dingell (MI-12). The bill would enable state and local public health departments to better meet the needs of older adults via innovative new strategies.

If enacted, the bill would create a Healthy Aging grant program at CDC to provide grants to health departments to help states and local communities coordinate multi-sector efforts to promote the health of older adults and develop aging expertise. The grant program would allow state and local health departments to apply an aging lens to all of their work, including efforts to reduce healthcare costs and improve health equity. The COVID-19 pandemic has demonstrated the importance of public health’s role in the aging sector, and this new program will help ensure that health departments have the resources they need to make a meaningful impact for seniors.

The President and CEO of Trust for America’s Health, Dr. J. Nadine Gracia, congratulates Representatives Frankel, Bilirakis, and Dingell on the introduction of the bill, stating:

“The last year underscored how important it is for public health to be at the table when it comes to promoting the health of older adults. Health departments have been critical to addressing the needs of older adults during the pandemic; their active engagement in many other issues faced by the aging population, including transportation and housing access, chronic disease, and mental health, will promote better aging outcomes and benefit our entire society. This new grant program would be a step in the right direction to ensure that state and local health departments have the resources to do exactly that.”

In addition to TFAH, original endorsing organizations include:

  • Alliance for Aging Research
  • American Association on Health and Disability
  • American Lung Association
  • American Muslim Health Professionals
  • American Public Health Association
  • American Psychological Association
  • Association of Schools and Programs of Public Health
  • Association of State Public Health Nutritionists
  • Association of State and Territorial Health Officials
  • Authority Health
  • Catholic Health Association of the United States
  • Center for Advocacy for the Rights and Interests of the Elderly (CARIE)
  • Ceres Community Project
  • Christian Council of Delmarva
  • Coalition of National Health Education Organizations
  • Common Threads
  • Elder Options
  • Equality California
  • FLIPANY
  • Florida Public Health Association
  • The Gerontological Society of America
  • Hartsfield Health Systems Consulting, LLC
  • Lakeshore Foundation
  • Long Beach Gray Panthers
  • Maine Council on Aging
  • Maine Public Health Association
  • Mel Leaman Free Clinic
  • MindWise Innovations
  • National Association of Nutrition and Aging Services Programs
  • National Network of Public Health Institutes
  • National Recreation and Park Association
  • National Senior Games Association
  • Peggy Lillis Foundation
  • The Praxis Project
  • Prevent Blindness
  • Silver State Equality-Nevada
  • Society for Public Health Education
  • Society for Women’s Health Research
  • Tennessee Justice Center
  • Urban Health Partnerships
  • Valley AIDS Council
  • WARM, Inc.
  • Washington State Public Health Association
  • We All Rise

TFAH has prepared a fact sheet on the legislation.

 

Age-Friendly Public Health

Older adults are the fastest growing demographic of the U.S. population. This year, 10,000 Americans will reach age 65 on a daily basis.

Public Health departments and systems can make important contributions to the health and productivity of older Americans. Trust for America’s Health and The John A. Hartford Foundation are partnering with state and local health departments to help them implement a public health framework within their department activities to support the health and well-being of their older adult residents. Learn more about the initiative at Age-Friendly Public Health Systems – Trust for America’s Health.

Healthy aging initiatives should involve multiple sectors of a community and should implement evidence-based programs to reduce social isolation and risk factors for illness and injury among the older adult population.

New Report: U.S. Must Prioritize COVID-19 Vaccines for People Who Are Homebound

Experts provide strategies to ensure equitable vaccine distribution for homebound people

(Washington, DC – May 3, 2021) – At least 2 million older adults are homebound a number that increases when including younger people who are homebound due to illness or disability.  Ensuring that this population group receives the COVID-19 vaccination requires focused attention, collaboration and resources according to a policy brief released today by Trust for America’s Health (TFAH).

The brief, Ensuring Access to COVID-19 Vaccines for Older Adults and People with Disabilities Who are Homebound, recommends actions that federal, state, and local government, state and local health agencies, the healthcare sector and community partners should take to ensure that people who are homebound are vaccinated.

According to the report, all parties involved in the COVID-19 vaccination effort have a responsibility to ensure people who are homebound are vaccinated, which means redirecting or creating the infrastructure, workforce, and funding support to bring the vaccination process to them.  Adding to the importance of equity in vaccine access is the fact that people who are homebound often have underlying health conditions that put them at heighten risk if they were infected by the COVID-19 virus.  In addition, the processes created or improved to meet the challenge of this pandemic will strengthen the nation’s public health infrastructure for the growing segment of the population who are homebound and help better safeguard their health during future public health emergencies.

“Ensuring that every person is vaccinated against the COVID-19 virus is not only a matter of health equity, its critical to ending the pandemic, said John Auerbach, President and CEO of TFAH. “But millions of people in the U.S. cannot travel to a vaccination site. Government and community partners must work together to protect the health of the homebound population by bringing the vaccine to them.”

Among the report’s recommendations are:

  • Prioritize the administration of COVID-19 vaccination for people who are homebound and their caregivers (both paid and unpaid) by providing sufficient vaccines and the resources needed to administer them in the shortest time possible.
  • Develop a standardized operational definition of “people who are homebound” in order to identify this population and prioritize their vaccination.
  • Ensure that the COVID-19 vaccine is equitably available across the homebound population and that no subset of the population is less served due to race, ethnicity, SES status or where they live. Use data to identify pockets of under-vaccination.
  • Develop and actively promote multiple communications channels for vaccine appointments scheduling, including use of channels that minimize reliance on computers and internet access.
  • Leverage partnerships and establish new ones with public and private sector organizations that already serve the homebound population to ensure equitable and efficient vaccine administration.
  • Ensure, to the degree possible, that in-home vaccination teams include people who are trusted by those being vaccinated and who represent the diversity of the population they serve.
  • Government agencies and private payors should ensure that all costs associated with in-home vaccinations are covered including administrative expenses, travel time and transportation costs, and observation time.

The report is an outgrowth of two national expert convenings hosted by Trust for America’s Health.  Funding for the report and convenings was provided by The John A. Hartford Foundation and the Cambia Health Foundation.

“Older adults and those with disabilities who are homebound have been the forgotten faces of this pandemic,” said Terry Fulmer, PhD, RN, FAAN, President of The John A. Hartford Foundation. “We now know about cutting-edge solutions, as well as failed strategies we can learn from, to ensure that everyone has equitable access to vaccinations going forward.”

“We are committed to ensuring equitable vaccine access for all, including homebound older adults and people with disabilities who may face obstacles scheduling online appointments or getting to vaccination sites,” said Peggy Maguire, President, Cambia Health Foundation. “We funded the Trust for America’s Health national grant with thought leaders from other parts of the country so that we could share learnings and best practices that will help homebound people and their caregivers in our four states access the COVID-19 vaccine and achieve health equity.