This chapter focuses on the following topics: demography, gender, age at diagnosis/onset of cardiovascular disease (CVD), Medicare usage, work and retirement, social support, social context and neighborhoods, ethnography of families, qualitative research, and social policy. These topics constitute some of the key areas that should be the focus of future research on the sociology of minority aging. The chapter provides a rich description of trends in the ethnic and racial composition of older cohorts to illustrate the dramatic changes that have taken place in the United States in the past century. The rising costs of health care and the increasing older minority population, additional reform will be needed to maintain the sus-tainability of the program. Additional work examining within-race group differences is key to understanding minority aging issues given the large amount of cultural diversity in the United States.
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Neurorehabilitation has become more of a global phenomenon and is not necessarily limited to industrialized or Westernized societies. Culture often connotes concepts of race and ethnicity when discussed in the context of health care disparities. Socioeconomic and other demographic variables make up the majority of the balance on discussion regarding culture in health care. Multicultural neurorehabilitation must emphasis “multiple”, and do so in a dynamic manner. In other words, at any given time, multiple cultures operate in each interaction and in each therapy delivered in the neurorehabilitation setting. Recently, there has been increased interest and research into the newly developing field of cultural neuroscience. Several models are available to conceptualize the influence of culture in human functioning. The most persuasive model is one that mirrors a dynamic, ecological system.
This chapter focuses on aging and health issues in all of America’s major minority populations including African Americans, Hispanics/Latinos, Asian Americans, as well as Native Americans. It addresses the issues of health inequality and health advantage/disadvantage. The chapter introduces relatively new areas of inquiry including long-term care, genetics, nutrition, health interventions, and health policy issues. In addition to possible genetic factors, the literature has emphasized the influence of poverty and socioeconomic status as well as stressors associated with minority group status. The system of long-term care services will need to be restructured to take into account issues affecting minority populations such as health care coverage, housing and income supports, as well as cultural issues as filial piety and trust. The field of minorities, aging, and health has been dominated by a health inequality perspective that has been illustrated by the application of cumulative disadvantage/cumulative inequality theory.
- Go to chapter: Does Health Care Quality Contribute to Disparities? An Examination of Aging and Minority Status Issues in America
Does Health Care Quality Contribute to Disparities? An Examination of Aging and Minority Status Issues in America
This chapter focuses on the changing health care policy climate. These changes can either reduce current barriers or create new challenges to health care. The Patient Protection and Affordable Care Act (ACA) has reformed the Medicare payment system and incorporated the voice of older minority adults in shaping the performance of their local health care delivery system. Health care access inequity and policy-based remedies have historic roots in U.S. civil rights legislation. The civil rights of older adults and their access to health care were resolved through Medicare. ACA policy creates an opportunity to reframe health disparities research as a consumer issue. However, the terms health disparities, older minorities, and barriers to care are not usually viewed as consumer issues. Standardization of health care practice creates research opportunities for social gerontologists to evaluate policy and its impact on health care access disparities.
This book provides a multidisciplinary compendium of research pertaining to aging among diverse racial and ethnic populations in the United States. It focuses on paramount public health, social, behavioral, and biological concerns as they relate to the needs of older minorities. The book is divided into four parts covering psychology, public health/biology, social work, and sociology of minority gang. The book focuses on the needs of four major race and ethnic groups: Asian/Pacific Islander, Hispanic/Latino, black/African American, and Native American. It also includes both inter- and intra-race and ethnic group research for insights regarding minority aging. The chapters focus on an array of subject areas that are recognized as being critical to understanding the well-being of minority elders. These include psychology (cognition, stress, mental health, personality, sexuality, religion, neuroscience, discrimination); medicine/nursing/public health (mortality and morbidity, disability, health disparities, long-term care, genetics, nutritional status, health interventions, physical functioning); social work (aging, caregiving, housing, social services, end-of-life care); and sociology (Medicare, socioeconomic status (SES), work and retirement, social networks, context/neighborhood, ethnography, gender, demographics).
This chapter provides a review of public policy and public programs related to important aspects of the welfare state in the United States, with particular attention to the impact of various policies and programs related to income support, health care, and housing on low-income and minority Americans. It focuses on the guiding principles that motivate the various parties in today’s welfare state debates and investigate how the basic structure of the way social welfare is guaranteed in the United States affects low-income and minority individuals. The chapter also focuses on the general features of our economic, political, and social systems that place minority Americans at serious risk of poverty and ill health throughout life, including its waning years. The welfare state represents a relatively late development in human social, economic, and political history. Social Security is particularly important for minority Americans.
- Go to chapter: Thinking Outside the Box: Tackling Health Inequities Through Forensic Social Work Practice
This chapter emphasizes the importance of improving health literacy. It describes the incorporation of cultural competence standards in forensic social work practice perspectives. The chapter also explains how to promote engagement of informal support networks in promoting health and well-being among diverse groups. Disadvantaged racial and ethnic minorities in the United States have long been overrepresented in the criminal justice systems. The elimination of health care disparities and ensuring the health care delivery system is responsive to minority groups is a social justice issue. The roles and function of forensic social workers that provide services to persons with these cultural norms can be expanded using a broader ecological framework and the applied social care model to develop intervention strategies and care plans with incarceration persons. Identifying and incorporating culturally appropriate practice approaches are challenging, yet necessary undertakings for forensic social workers.
Nonprofit, for-profit, and hybrid organizations with the greatest impact in areas such as education, health care, and social service delivery could also create new social industries and spur economic development. Angel investors are often the first professional lenders who provide financial support to a growing business. Launched in the United Kingdom, social impact bonds (SIBs) raise funds from nongovernment investors, that is, trusts and foundations, high-net-worth individuals, and so forth, to pay for preventive services. Greater levels of funding will be directed to organizations next-generation nonprofits (next-gens) that can prove impact and take operations to scale. This chapter discusses two very different innovations that are also sustainable business models, the retail-based convenient care clinics (CCCs) and the Apple iPad2. CCCs operate under different names, including Minute Clinic, Redi-Clinic, Take Care Health Systems, and Quick Quality Care. The Disrupter-o-Meter is an excellent, low-cost place to begin determining an innovative idea’s feasibility.
This chapter focuses on how nonprofit leaders can become nonprofit advocates. It provides an overview of the legal guidelines that govern nonprofit lobbying. The chapter details the process of developing a policy agenda, learning the legislative landscape, and executing the agenda. It reviews the tactics of effective lobbying, such as working in coalitions, meeting with lawmakers, and cultivating relationships with legislative allies. The chapter then presents case studies that describe the advocacy process that went into the expansion of the role of nurse practitioners as primary care providers and the expansion of the retail-based convenient care clinic model. It explores case study that discusses an assessment process on which advocacy for college access and success systems change can be built. The chapter examines how nonprofits can shape legislation by lobbying elected officials in ways that are in keeping with the Internal Revenue Service’s (IRS) definitions and requirements.
Career opportunities are projected to grow faster for nursing than all other occupations through 2026. The advantage of a career framework with multiple stages is that one doesn’t start out expecting to be fully developed at the beginning. Mentoring is needed throughout a career, not just at the start. This chapter provides an overview of the career model that the author has fleshed out over time, greatly influenced by Dalton, Thompson, and Price’s classic article (1977) on stages of a professional career and subsequent work. There are five career stages whereby the individual moves from: (a) becoming prepared, to (b) demonstrating the ability to work independently and interdependently in achieving professional goals, then (c) developing others and the home institution, then (d) advancing the profession and healthcare, and eventually (e) daring to be a truth teller. Exerting leadership presupposes complete career development, going through all five career stages.