HPA 444

aging demographics Poverty and Older Adults

"Over 25 million Americans aged 60+ are economically insecure—living at or below 250% of the federal poverty level (FPL) ($29,425 per year for a single person)" (National Council on Aging, 2016). Poverty impacts housing options, healthcare, nutrition and transportation, all areas we will discuss this semester. For older adults who are above the poverty level, one major adverse life event can change today's realities into tomorrow's troubles.

These trends have directly impacted the Old Age-Dependency Ratio. So what is the Old Age-Dependency Ratio?

"the dependency ratio is the total number of people too young or old to work, divided by those of working age (15-64 years old). The dependency ratio measures the burden caused by non-working people on a nation's working-age population. The higher the dependency ratio, the greater the burden. Non-working dependents are defined as those up to and including age 14, and people aged 65 and older" ("What is"). Dependency ratios are an important consideration in aging policy as the ratios indicate the population breakdown, shedding light on potential challenges of dependent care. As you can see from the AARP (n.d.) graphic below, we are seeing a dramatic shift in the ratio with older adults are becoming a larger percentage of the U.S. dependency ratio, while the percentage of children is falling. This disparity has negative consequences for Social Security because there will be fewer younger people available to take care of seniors.

Generally, two factors are considered to impact the aging of the population:

1. Increased Life Expectancy 2. Decreasing Birthrates

Today, _____ states still have certificate of need regulations.

36

The "oldest old" (_____ years and older) are the most rapidly growing age group among those over 65. This is of particular interest to communities, providers and government officials as the oldest old are the group that requires the largest number of services to remain viable in their homes and communities.

85

the list below provides a sense of the many areas in the U.S. that are guided by public policies.

Education Economic and commerce Housing Labor and employment Transportation Health National defense and security Environmental Agriculture and food Energy International and foreign Aging Public safety Immigration

aging demographics Education Attainment Among Older Adults

Educational attainment is increasing. You may ask, why is this important? Studies continue to find, there is a close association between educational attainment, health status and income.

aging demographics Health Status

Majority of older adults have at least one chronic condition. Keep in mind, the conditions listed below can have a major impact on the daily lives and activities of older adults. Most common chronic conditions: Arthritis Hypertension Heart disease Diabetes Cancer Likewise, the majority of older adults experience some form of limitations in ADLs and IADLs. While many Americans assume the majority of older adults reside in nursing homes, this is incorrect. The majority of older adults live in the community; with less than 5% of older adults live in institutional settings.

Similar to allocative policy, there are many examples of regulatory policy within the timeline but for demonstrative purposes, let's select the Patient Safety and Quality Improvement Act of 2005 for our analysis. This Act established patient safety organizations (PSO) which are certified under the Department of Health and Human Services (HHS) to collect and analyze patient safety data with the ultimate goal of improving the safety and delivery of healthcare. Furthermore, a portion of the Act stipulates that the secretary of HHS maintain patient safety databases and develop a national standard for the exchange of data in electronic form. Going back to our original definitions, we can see this Act is regulatory in nature. For example, it meets public goals or aims (patient safety) by the regulation of specific organizations (patient safety organizations). In this case the regulation is overseen by the secretary of HHS.

Now that we've established how this Act is an adequate example of regulatory policy, let's take it one step further and classify which type of regulation it would be considered. As a reminder, regulatory policy is subcategorized into one of the following five types of regulation: Market-entry regulations Price-setting regulations Quality control regulations Market-preserving regulations Social regulations

aging demegraphics Racial and Ethnic Diversity:

The aging population is becoming more diverse. The percentage of racial and ethnic minority elders will increase as projected. 2010: 16% 2030: 28%

So why is health policy important?

Well, for one, the goals of all health policies are to improve upon some aspects of individual, community, or population health. This could be increasing access to health services, refining how services are delivered to increase efficiency or quality outcomes, or altering payment structures to lower costs within the system. But beyond that, health policy is of growing significance to the economy of our nation. Longest (2016) describes heath as being equally integral to both the social and financial interests of all nations, including the United States. It is vital that not only individuals stay healthy, but that our economies remain healthy too.

There are two main types of public policy:

allocative and regulatory.

Regulatory policies

are policies that are created to meet public goals or aims by managing or controlling distinct groups of individuals or organizations. Chiefly, this influence occurs through regulation of some sector or industry.

Allocative policies

are policies that are designed to meet public goals or aims by providing net benefits to distinct groups of individuals or organizations. Most often these benefits are in the form subsidies, which are a type of federal funding to support and promote public policy in some sector or industry.

Public policy is a form of policy that stems from the decisions made within the

executive, legislative, and judicial branches of government. These decisions come in several forms and are assembled and implemented by governments at the local, state, and federal levels.

policies are created in both the private and public sectors. On the public side, policymaking happens within the ____________ ____________ ____________. On the private side, policymaking happens within _____________ ____________ _____________and other types of organizations

federal, state, and local government corporations, firms, businesses

Health Policy is a

governmental guideline that is intended to influence or guide the behaviors or decisions of others pertaining to physical or mental health and well-being, or the pursuit of either. health policies are created to protect or advance the health of a population.

Public policy is a

governmental guideline that is intended to influence or guide the behaviors or decisions of others.

Policy is a

guideline that is intended to influence or guide the behaviors or decisions of others.

The most obvious example of allocative health policy is Medicare and Medicaid. These federal programs provide health insurance coverage to the elderly and poor; however, these benefits are not "free." The government takes revenue from taxpayers and redistributes it to individuals who qualify for one of these programs.

mental health is considered to be one of the most severely underfunded allocative policy areas within healthcare.

One similarity between allocative and regulatory policy is that both are established by the government to achieve

public goals or objectives.

Allocative policies achieve the aim of providing benefits to groups of people through

redistribution, meaning that goods and services are reallocated from one group to another

Certificate of Need

regulation that restricts the building of new or expansion of existing health care facilities such as hospitals, nursing homes, or long-term care and mental health centers before the prior approval of state government. These laws are aimed at reducing overall health expenditures in the form of overbuilding or overbuying of health equipment. The overarching idea behind CON is that approval for such projects are granted only if there is a proven, genuine need for that service within the community.

significant health policies include

the formation of Medicare, Medicaid, and CHIP as well as the passing of the Health Portability and Accountability Act (HIPAA) and the Patient Protection and Affordable Care Act (ACA).