This chapter highlights some of the current health programs and policies in place and changes in demographic trends for older adults living within American society. In addition, substantial changes within the social, political, and cultural expectations of communities over the past century pose challenges for policies and programs serving older adults. The chapter presents several issues emerge as realities within the context of policy development and program planning for older adults. These issues include changes in living arrangements, education levels, economic well-being, and rural population settings; trends in morbidity and mortality; and changes within the social, political, and cultural expectations of communities. Despite the availability of programs and services resulting from health policies, many programs have focused upon “medically necessary” services and have lacked a health promotion, health education, or community-based focus.
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- Go to chapter: Background and Demographic Profile of People Growing Older and/or People With Disabilities
This chapter provides a backdrop to our current social security program and an overview of some models for social security programs in Europe and Canada. It explores the genesis of the social program in the United States. The chapter also explores contents of the original social security act (SSA) and compares the titles and programs mandated through the current SSA. It offers some guidelines for the current administration of the program, examines the debate around current proposals for revision, and reviews why these proposals are current issues for consideration. The chapter then presents the current social security system, which provides for older adults, but has also grown to cover dependent women and children. Although many people have argued for their vision to privatize the system, the reality is that there is much more political support to maintain the program as a safety net program rather than a means-tested program.