By Eric Lindberg
The trend is clear: The United States and Mexico are getting old.
An estimated 72.1 million older adults will be living in the United States by 2030, more than twice as many as in 2000. The proportion of older adults is expected to triple in Mexico by 2050, driven by falling birth rates and smaller family sizes.
As the two countries begin to grapple with issues such as changing social support structures, chronic diseases, and other challenges to the health and well-being of older populations, a unique partnership led by scholars at the USC Edward R. Roybal Institute on Aging and Mexico’s Instituto Nacional de Geriatría is embracing an international approach to the problems of aging.
“We’re in the early stages of trying to develop an overall structure and philosophy that’s going to underlie how we support global research on aging in Latin America. We are entrepreneurs at this point,” said William Vega, executive director of the Roybal Institute, provost professor, and the Cleofas and Victor Ramirez Professor of Practice, Policy, Research and Advocacy for the Latino Population.
Although there are clear differences between the two countries, Vega said Mexico and the United States are both in the process of developing and deploying support systems related to aging.
Mexico is quickly approaching a population replacement birth rate, whereas recent estimates suggest the United States is hovering below replacement level. Mexico is just starting to envision a nationwide system for aging services. The United States has structures in place that will need to be adjusted to adapt to its growing population of older adults.
“What we have in common is this fluid migration of people across the border,” said María Aranda, associate professor and associate director of clinical and behavioral intervention research at the Roybal Institute. “Those people are getting older, whether here in the United States or in Mexico, so we have a joint interest in understanding how people age successfully in both countries.”
To begin exploring that joint interest, the Roybal Institute and researchers in Mexico formed the Global Research Network on Aging and Health. In addition to holding conferences and workshops in both countries, the network is developing binational research projects and promoting evidence-based research.
For instance, the partnership is beginning to take advantage of a large-scale data collection effort conducted in Mexico during the past decade that is similar to the Health and Retirement Study in the United States, a biannual survey conducted nationwide with approximately 20,000 Americans older than 50.
That information can be used to compare the aging experience in both countries, such as how individuals of Mexican origin living in the United States manage challenges in late life versus individuals who stay in Mexico or travel frequently between the two countries. Are support programs for older adults created in the United States applicable in Mexican contexts?
“If so, what sociocultural adaptations and systematic and organizational changes would have to be made for there to be a significant adoption of these evidence-based practices in health and mental health settings?” Aranda said. “Are there interventions and services occurring in Mexico that we could learn from? I always see our learning as bidirectional.”
Aranda recently coauthored a book chapter on falls and fall-related injuries among older adults in Mexico with Luis Miguel Gutiérrez Robledo, director general of the Instituto Nacional de Geriatría, and Mariana López-Ortega, a researcher with the Instituto Nacional de Geriatría and former postdoctoral scholar at the Roybal Institute.
The research, published in Challenges of Latino Aging in the Americas, which was coedited by Vega, showed that more than one third of adults older than 60 experience a fall each year.
“They have almost the same rate of falls, about one out of three, as Mexican-origin older adults living in the United States,” Aranda said.
The authors called for early detection of older adults at risk of being injured in a fall and increased funding for services to decrease falls, injuries, and death. Their recommendations include promoting a global research agenda on falls and fall-related injuries, launching a public education and awareness campaign focused on preventable risk factors, and developing best practices for fall prevention and treatment.
As Mexico begins considering how to implement these types of services for older adults, particularly in lower-income and rural areas of the country in comparison to urban centers, which tend to have more health and social care programs, Vega said scholars at the Roybal Institute can offer valuable guidance in terms of the science behind research and practice.
“They have very little going on in terms of developing evidence-based interventions,” he said. “That’s something they really need because they are in the process of developing their national delivery system for services in aging. They are talking about building 10,000 aging centers around the country.”
However, lessons learned in Mexico can prove just as valuable for researchers in the United States, he said, particularly in terms of deploying interventions in a wide range of contexts. For example, a program delivered in urban Los Angeles likely would need to be adapted before it can be used to support farm workers just a few hours north in California’s Central Valley.
Conducting research in Mexico also tends to be cheaper, Vega noted, describing a recent large-scale trial involving USC School of Social Work researchers that tested whether supplementary income in the form of a monthly stipend from the government would improve or harm health. The researchers, curious whether recipients of the stipend might spend it on tobacco or alcohol, tested the approach in one town in the state of Yucatán and used another town as a control.
They found the intervention actually improved health and did not increase the use of substances such as cigarettes or alcohol.
“It was cheap and effective,” Vega said. “You can carry out experiments in places in Mexico that you couldn’t do in the United States because it’s too expensive. It’s very difficult to pull those things off here. Just getting the alignment of all the bureaucracies to do something like that is difficult.”
Naturally there are political considerations in both countries that influence the emerging research partnership. For instance, the United States is facing challenges related to its entrenched infrastructure and programs, such as Social Security and Medicare.
Mexico has not been considered an undeveloped country for years and boasts a strong democratic political system. Nonetheless, the national budget and funding priorities are significantly affected every six years, each time a new president is elected. Fortunately, Vega said, the Instituto Nacional de Geriatría has benefited from stable leadership.
“They have major university capabilities and are really developing first-class research,” he said of Mexico and other Latin American democracies, such as Chile and Colombia. “They now have capacity that is self-sustaining. That doesn’t mean there won’t be fluctuations, but the capacity is there.”
In the coming years, Vega is hopeful the research network will continue to expand. Since its formation five years ago, the network has branched out to other major research centers specializing in aging issues and demography.
A conference in 2014 held in Mexico City gathered leading scholars from the United States, Mexico and China to discuss potential joint research programs focused on social support for older adults. Another multinational conference is slated for fall 2015 to continue an increasingly global dialogue about issues related to successful aging.
Vega hopes to open the network to other Latin American countries as well, in line with a broader emphasis by USC on increased academic and research collaboration with colleagues in Central and South America.
“Now we are developing a true network, not just the two polarities between Mexico and USC, but further integration into larger networks of research,” Vega said.
“We’re looking at a much larger platform for exchange of scholarly ideas.”
Developing more cohesiveness at the university level in terms of how USC approaches global research will be needed, he added. Support can be segmented and inconsistent at times, but Vega said he is confident that the entrepreneurial approach will lead to better integration and visibility of programs such as the Global Research Network on Aging and Health.
“It is an exciting time and now is the moment for it to happen,” he said. “Right now there is a super arc of growth at USC in program capacity and we don’t want to leave this behind.”
“In the end, the goal is to improve the quality of life for aging people. It’s not to put USC or Mexico in the spotlight, it’s to get something done.”