How someone ages depends, in large part, on where they live, according to a new report published by AARP Pennsylvania and Drexel University.
In Pennsylvania, health disparities within the older population break down along economic lines in many of the state’s rural communities; while, in cities like Philadelphia, racial and ethnic minorities faced increased barriers to care, researchers found.
COVID-19 spurred a sudden shift online, which exacerbated existing issues for seniors lacking internet access or digital skills.
“This report reveals a very critical story about Pennsylvania, and, in a way, Pennsylvania looks like the rest of the nation,” Drexel professor Laura Gitlin said during a virtual press briefing Thursday. “The state is rapidly aging.”
“Not everyone is aging well or able to live as long as others,” she added.
“You see a stark difference in life expectancy,” said David Saunders, who heads the state’s Office of Health Equity. “In some cases, you can see a 20-year difference really just miles away from various communities.”
Right now, more older Pennsylvanians are white and live in rural counties, according to the study. Racial minorities make up just 12% of the state’s over-50 population.
However, there’s expected to be a growth in the senior population in Southeastern Pennsylvania, which is younger and more diverse than other regions of the state, over the next 20 years.
Projections indicate that the number of Philadelphians over the age of 64 will jump nearly 73% by 2040.
A significant portion of those older people will be Black and Latino, groups that tend to have higher levels of poverty, more health problems and tenuous housing situations, Gitlin said.
Preparing for that population’s healthcare needs will be crucial, those involved in the report said.
More than 90% of registered nurses and physician assistants in Pennsylvania are white, according to the most recent data.
Gitlin said it’s important that health professionals are trained in acknowledging the values, preferences and personal goals of patients, particularly as the older population in Philadelphia and elsewhere becomes more diverse.
The study noted that the commonwealth is heading for a “significant shortage of direct care workers,” such as home health aides and nursing home employees.
Pennsylvania, according to the report, will need about 91,000 additional direct care workers over the next five years. Pay for the positions is low, averaging under $21,000, and turnover is high. More than a third of the workforce is Black or Latino.
One of the study’s recommendations is that direct care employees are offered pay raises and more non-wage benefits.
The report, called “Disrupting Disparities in Pennsylvania,” also calls for increased efforts to enhance diversity in the healthcare sector.
Digital divide a barrier to health
Being active online can help older people stay connected to relatives and friends and, during the pandemic, consult with their doctors.
Telehealth should remain important post-COVID-19, especially for seniors who cannot travel or live far away from medical care, the Drexel and AARP researchers said.
Broadening access and offering digital literacy programs should be a priority, the study’s authors argued.
Philadelphia is one of eight counties in the state where more than 8% of people do not have broadband internet access. Across the commonwealth, 64% of residents ages 75 to 84 and 47% over those over 85 have a reliable internet connection, according to the report.
“This was compounded by COVID because many of the community agencies — senior centers, adult day services, libraries — that have had to close because of COVID are the places that older adults turn to use computers if they do not have broadband in their home,” Gitland said.
Social isolation among seniors can lead to depression and physical ailments, and some data links it with a higher mortality rate, the report said.
A metric that measures isolation based on a number of factors, including living arrangements and finances, found that older Philadelphians were at higher risk of loneliness than seniors living in any other area of the commonwealth.
“The critical take-home message from this report is that it shows that where an older adult lives, their age bracket and ethnic group are all critical in terms of determining how they’re going to age,” Gitlin said.