By Eric Lindberg
Despite their status as the fastest-growing segment of the aging population in the United States, ethnic minority groups face significant health care disparities and remain at higher risk than the general population for serious illness such as diabetes and cancer.
The issue is especially pronounced in low income areas of Los Angeles with large populations of older adults. Highlighted by the economic downturn, critical questions have emerged in recent years about how best to support older minority adults, to promote sustainable aging, and to ensure that basic needs such as food, social support, and mental stimulation are being met.
“It really means we have double duty to do here, both in the arena of carrying out a lot of research to develop more effective interventions but also determining the public policy that is going to support these people,” said William Vega, executive director of the USC Edward R. Roybal Institute on Aging. “These policy issues are so dominant, no matter how we tinker with the existing delivery system, we’re tinkering at the edges.”
As a research entity within the USC School of Social Work, the institute is formally tasked with addressing those key questions through innovative translational research and training that focuses on improving and sustaining the health and mental health of aging minorities and their families.
For Marilyn Flynn, the school’s dean, the purpose of the institute is twofold: to develop a more responsive community environment for older adults, particularly members of underserved minority groups in Los Angeles, and to advance knowledge and promote understanding of the specific needs of those populations.
“Especially under the current budget constraints, our approach to not just maintaining services but promoting health among older people and disadvantaged minorities is, from my point of view, one of the most important issues of our time,” she said.
The multifaceted approach of the Roybal Institute includes a robust research agenda driven by a focus on three key areas: the development of new knowledge about the social issues that affect older adults, strategies to transfer that knowledge into practice among providers that serve older populations, and policy research that seeks ways to improve quality of life for underserved and aging groups.
Vega sees a particular need to focus on comprehensive improvements to the health care system, as older adults are finding it more difficult to sustain a healthy and happy lifestyle in the face of deteriorating sources of public support and poor access to long-term care. A critical focus of the institute is to bolster an environment in which older people can remain in their home and live safely and independently regardless of their financial resources, also known as “aging in place.”
“How do you create those conditions in the situation we’re in now with a collapsing social network of supply from the public side and a higher reliance on the personal social networks of individuals?” he said. “The official networks are weakening, but we don’t know the impact that is having on personal networks.”
Among recent research projects, Roybal Institute scholars completed a community pilot survey that examined the current living conditions and health status of older residents in select areas of East and South Los Angeles. Interviews with Latinos and African Americans between the ages of 60 and 100 revealed that more minority older adults were living on low incomes compared to a decade ago.
More than half of the residents interviewed had an annual household income below $15,000 and often faced health challenges due to their financial status. Those lower income levels were linked to poorer physical and mental health, as well as more restrictions on daily activities. Participants also had higher rates of obesity and serious psychological distress than the wider population of older African Americans and Latinos in Los Angeles County.
Roybal Institute researchers hope the report, which is being disseminated to local agencies and community groups, will offer guidance to policy makers and community leaders who are in a position to advocate and provide services for these underserved residents.
In addition to leading research projects on critical issues related to aging and low-income populations, the Roybal Institute works closely with local and national agencies on advocacy and education projects.
One major effort, known as Project HEAL, is a collaboration with AltaMed Health Services to train and empower new leaders to promote community health in underserved areas of Los Angeles and Orange counties. Institute scholars provide research information on health disparities and work with AltaMed and other organizations to develop policy initiatives.
Through the Lucille and Edward R. Roybal Foundation, the institute also coordinates financial assistance for master’s students at the School of Social Work who plan to pursue careers that serve older adults, particularly in the field of health care.
Beyond their focus on issues that affect low-income African American and Latino populations in local and regional communities, Roybal Institute leaders are also seeking to generate a global understanding of commonly shared solutions to issues of aging.
Flynn noted that both emerging and developed countries, particularly China and Mexico, are struggling to create effective strategies to address the needs of older adults.
“Everyone is trying to address the problem of healthy aging, or aging in place,” she said. “Everyone is trying to work on health care solutions and social solutions that prevent people from developing chronic problems such as cancer and heart disease.”
Vega and his colleagues have made a concerted effort in recent years to develop research opportunities and collaborations with peers in Latin America. Institute leaders plan to develop a cross-cultural research venture focused on the similarities and differences between China and Mexico in terms of aging and health-related disparities.
“The ability to support healthy aging in those countries is a massive challenge,” Vega said. “We have an opportunity to do some very interesting work within that arena.”
The institute itself has also undergone some organizational changes in recent years.
It was initially established by the late Congressman Edward R. Roybal at California State University, Los Angeles, to continue his legacy as a champion of causes related to aging and low-income minority populations.
As a cofounder of the House Select Committee on Aging, Roybal led an effort to expand housing services for older adults, restored low-cost health care for seniors, and played a key role in legislation outlawing age discrimination.
He also helped expand mental health care services in rural communities as well as health care support for people with Alzheimer’s disease. Roybal’s daughter, Congresswoman Lucille Roybal-Allard, became the first Mexican American woman elected to the House of Representatives following his retirement in 1992 and currently represents portions of downtown and East Los Angeles, including segments of Roybal’s former district.
The institute was ultimately relocated to the USC Davis School of Gerontology in 2007 before being shifted to the School of Social Work about three years ago. Flynn noted the Roybal Institute maintains a very strong connection with the School of Gerontology and a handful of scholars have joint appointments with both schools.
As the institute continues to expand, Vega and other scholars have their hands full with a wide array of new projects, including a study on cognitive functioning that focuses primarily on Alzheimer’s disease, an advocacy and training partnership designed to promote mental health care in low-income African American communities in Los Angeles, and the development of a new research center on minority aging in collaboration with the RAND Corporation.
“We’re also writing research proposals and we’re sponsoring big conferences,” Vega said. “We have a lot of work ahead of us.”