The effects of poverty hurt low-income older adults. They struggle to make ends meet, wondering whether to cut pills or pay for groceries or their rising rent. They make these difficult decisions in a larger world that devalues and ignores older people, making it difficult to age in their communities and get the supports they need. Many low-income older adults also experience barriers because of the impacts of discrimination based on other identities, like race, gender, and sexual orientation.
To advance equity in aging, laws and policies must address not only the structural ageism embedded in our systems, but also the other types of discrimination that intersect with age and compound harmful inequities. The structural inequities facing low-income older adults require a broad set of solutions grounded in law and policy.
In this “At a Glance” and in the complete paper, Justice in Aging recommends focusing on five key areas to advance equity for older adults, especially those experiencing intersectional inequities.
Older adults who face intersectional discrimination have more pronounced long-term care needs as they age. Institutional bias in long-term care often forces older adults and people with disabilities into institutions, rather than enabling them to age at home, an option many prefer. Those who face structural inequities based on intersecting identities are more likely to be institutionalized.
Universal programs are essential to advancing equity for low-income older adults. However, barriers and challenges persist in who is eligible and who can access these programs, so they suffer from under-enrollment and are so outdated that they fail to meet people’s basic needs.
Policies and laws must enhance and strengthen safety net programs by streamlining and broadening eligibility with a focus on equity. Program updates should incorporate improvements that best increase access for marginalized older adults. Improving safety net programs should also incorporate targeted solutions, such as California’s efforts to ensure undocumented older adults are not excluded by providing Medicaid and Supplemental Nutrition Assistance Program benefits to this group. Program policies for older adults who are Limited English Proficient should not only require translation and interpretation but provide culturally competent services and care. Finally, all policies and programs must be reviewed to ensure they are not implemented in a way that results in disproportionately negative impacts on communities of color and other marginalized groups of older adults.
Anti-discrimination laws and policies are critical to advancing equity for older adults.
Just like safety net programs, anti-discrimination laws and policies must be updated to better advance equity for low-income older adults. For example, older workers who are discriminated against because of their age and other identities need better protections that account for how discrimination in the workplace has evolved. Incorporating legal theories such as disparate impact theory and intersectional discrimination into anti-discrimination protections would better recognize how inequities compound throughout the lifespan.
To improve equity data, including an intersectional framework that includes age is necessary to appreciate the compounding impacts of discrimination over the course of one’s lifetime. Data must also be disaggregated so that disparities within communities are evident, and it must also be transparent, so advocates can hold policymakers accountable.
Advancing equity for low-income older adults requires tailored outreach strategies that are mindful of how older adults in particular communities receive information.
Policymakers and others should incorporate lessons learned from the COVID-19 pandemic on how older adults receive information. This includes a preference for in-person communication, the importance of trusted messengers such as caregivers, not relying solely on technology, as well as focusing outreach on community gathering places and considering media types most likely to reach a diverse group of older adults.
Low-income older adults persevere while facing significant barriers based on their age and other identities that compound the impacts of systemic discrimination. Law and policy can play a key role in advancing equity for older adults.
For a more detailed discussion of these recommendations and why aging and equity are connected, read the complete paper, Fulfilling the Promise of Equity for Older Adults—Opportunities in Law and Policy.