I said in a previous blog that the only two things we can be certain of in life is death and taxes. Last time we spoke on the life expectancy of men and women. We found that biopolitics of gender assignment from birth plays a role in health outcomes. Indeed, individuals assigned female at birth live longer. Spanning away from the morbid side of this data one wonders what habits and routines are
What life do you expect to have as an elderly person?
Is there a barrier to positive health outcomes for gerontic individuals?
What mechanism must a modern society have in place to ensure equity and equality in geriatric health care?
“The language of the dependent, weak, vulnerable, frail, and sick older people was readily circumscribed within well-established cultural definitions of welfare dependency, (Jocelyn Angus and Patricia Reeve p. 143).
In the reading quoted above, “Ageism: A Threat to ‘Aging Well’ in the 21st Century,” authors Angus and Reeve explore the harms that stereotypes have played in creating false representations for demographic of elderly people. This begs the almost paradoxical rhetorical inquiry: Is seeking assistance at an old age considered a resignation of self-reliance?
There are of course many considerations for what aging well suggests. First may be the environment which one is established in. Another is one’s feeling of self-worth in the context of social status or role within a community.
Janet Currie points out some prevailing phenomena in their article, “Inequality in mortality over the life course: why things are not as bad as you think,” published in Contemporary Economic Policy, one such issue has to do with the able-bodied. How does a person’s well-being shift with the ability to leave distressed areas?
We find staggeringly sharp contrasts in mortality as we segment age groups, with race, against poverty. The idea of geriatric well-being or care sheds a light on the inequality that exists from a racial lens. Though mortality increases as one gets older by-in-large, it is clear from the data, that Black males experience higher mortality rates. Comparatively these departures from normalized trends are more pronounced as the level of poverty increases.
What solutions best address these disparities?
The United States government has tax credit-based programs, food access programs, etc, that help adjust for the aspects of health easiest addressable by access to capital. According to Currie, the Affordable Care Act and expansions to Medicaid is intended to provide access to health care by offering public insurance. Studies have shown improvements to child mortality rates with these implementations (Currie p. 18).
We can also dissect other types of data based on age / race as two control vectors. Consider air quality, or tobacco use. Many countries are focused on outcomes of children with policies that target these two topics.
“…even in times of increasing economic inequality, increase in health inequality…depend on public policy,” (Currie p. 22)
Finally, holding all things even, ceteris parabus, author Dale Dannefer ties all these ideas together. Dannefer talks about the economics of getting older, pointing out that, money health and status are inextricably linked. The concept known as cumulative advantage/disadvantage (CAD), explains some traps in over simplifying policy solutions. What is fair does not always connect with what is practical or preventable in reality. Meaning, it is a lot more realistic to age-well if one’s social-economic status was prosperous during one’s heyday. So, while aging-poor, as “’[t]he old grow poor,’” as Robert N. Butler once said, it is critical that policy makers address poverty at both ends of the average life cycle (Dannerfer p. S329).
To say it more plainly, aging poor results in shorter lives. For some the benefit of public assistance is a matter of life and death within the span of three years. If policymakers share in the concerns of gerontological scholars, they will not only expand health programs for the elderly, but they would also invest heavily in the upward mobility of those in poverty while they are in their prime. The strongest investment should be made for those who have the able-body, and social incentive to reap the benefit of governmental assistance.