scholarly journals Rural America’s Hospitals are Not Prepared to Protect Older Adults From a Surge in COVID-19 Cases

2020 ◽  
Vol 6 ◽  
pp. 233372142093616 ◽  
Author(s):  
Natalie M. Davoodi ◽  
Margaret Healy ◽  
Elizabeth M. Goldberg
Keyword(s):  
United States ◽  
Older Adults ◽  
Rural Communities ◽  
Older Adult ◽  
The United States ◽  
Rural America ◽  
Health News ◽  
Medical Supplies ◽  
Poor Outcomes ◽  
The U.S

Rural communities with predominantly older adult populations could be especially vulnerable to poor outcomes from COVID-19 due to lacking intensive care unit (ICU) capacity. Our objective is to describe the scope of the problem by summarizing population totals of older adults in rural America and their community’s ICU bed availability. We performed a review of peer-reviewed literature, in addition to hand searching non–peer-reviewed and governmental/non-governmental agency reports, using the Kaiser Health News data report to assess the number of ICU beds in 10 predominantly rural states with the highest older adult populations. We found that while 19% of the U.S. population lives in rural counties, these counties contain only 1% of the ICU beds in the United States. Counties particularly at risk for inadequate ICU capacity include Crittenden, Arkansas; Cass, Minnesota; and Sagadahoc, Maine. Solutions include building new delivery systems, reopening previously closed rural hospitals, and calling on local businesses to create medical supplies. In summary, the 10 million older adults in rural communities in the United States may face challenges with obtaining critical care treatment due to the increased need of ICU beds during the COVID-19 pandemic.

Engaging Vital Older Adults in Intergenerational Service-Learning

2018 ◽  
pp. 266-287
Author(s):  
Reneé A. Zucchero
Keyword(s):  
United States ◽  
Older Adults ◽  
Service Learning ◽  
Older Adult ◽  
Undergraduate Students ◽  
The United States ◽  
Life Review ◽  
Future Research ◽  
Negative Stereotypes ◽  
Adult Volunteers

The population of older adults within the United States is growing rapidly, which calls for increased understanding of that population. However, ageism is pervasive and one of the most engrained forms of prejudice. Intergenerational service-learning may be one way to reduce negative stereotypes and ageism. The Co-Mentoring Project is an intergenerational service-learning project that matches undergraduate students and vital older adult volunteers. Students meet with their partners at least four times over the course of the semester to conduct a life review and gather information to begin the older adults' memoirs. This chapter provides a rationale for intergenerational service-learning and information about its theoretical underpinnings. The chapter also offers information about service-learning best practices, including structured reflection, and how the Project's methodology is consistent with them. The multi-modal assessment conducted for the Project and its outcomes are discussed. Finally, directions for future research are described.

Infant Health, Women's Fertility, and Rural Electrification in the United States, 1930–1960

2018 ◽  
Vol 78 (1) ◽  
pp. 118-154 ◽  
Author(s):  
Joshua Lewis
Keyword(s):  
United States ◽  
Rural Communities ◽  
Infant Mortality ◽  
Infant Health ◽  
The United States ◽  
Rural Electrification ◽  
Rural Counties ◽  
Electricity Access ◽  
The U.S

From 1930 to 1960 rural communities, mainly in the U.S. South and Southwest, gained access to electricity. In addition to lights, the benefits included easier clothes washing, refrigeration, and pumped water. This article uses differences in the timing of electricity access across rural counties to study the effects on infant mortality and fertility. Rural electrification led to substantial reductions in infant mortality but had little effect on women's fertility. The increase in electricity access between 1930 and 1960 can account for 15 to 19 percent of the decline in rural infant mortality during this period.

scholarly journals Dementia Care in Diverse Older Adults in the U.S. Deep South and the Rest of the United States

2021 ◽  
pp. 1-13
Author(s):  
Maria Pisu ◽  
Roy C. Martin ◽  
Liang Shan ◽  
Giovanna Pilonieta ◽  
Richard E. Kennedy ◽  
...  
Keyword(s):  
United States ◽  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Drug Use ◽  
Ethnic Groups ◽  
The United States ◽  
Deep South ◽  
Racial Ethnic ◽  
The U.S

Background: Use of specialists and recommended drugs has beneficial effects for older adults living with Alzheimer’s disease and related dementia (ADRD). Gaps in care may exist for minorities, e.g., Blacks, and especially in the United States (U.S.) Deep South (DS), a poor U.S. region with rising ADRD cases and minority overrepresentation. Currently, we have little understanding of ADRD care utilization in diverse populations in this region and elsewhere in the U.S. (non-DS), and the factors that adversely impact it. Objective: To examine utilization of specialists and ADRD drugs (outcomes) in racial/ethnic groups of older adults with ADRD and the personal or context-level factors affecting these outcomes in DS and non-DS. Methods: We obtained outcomes and personal-level covariates from claims for 127,512 Medicare beneficiaries with ADRD in 2013–2015, and combined county-level data in exploratory factor analysis to define context-level covariates. Adjusted analyses tested significant association of outcomes with Black/White race and other factors in DS and non-DS. Results: Across racial/ethnic groups, 33%–43% in DS and 43%–50% in non-DS used specialists; 47%–55% in DS and 41%–48% in non-DS used ADRD drugs. In adjusted analyses, differences between Blacks and Whites were not significant. Vascular dementia, comorbidities, poverty, and context-level factor “Availability of Medical Resources” were associated with specialist use; Alzheimer’s disease and senile dementia, comorbidities, and specialist use were associated with drug use. In non-DS only, other individual, context-level covariates were associated with the outcomes. Conclusion: We did not observe significant gaps in ADRD care in DS and non-DS; however, research should further examine determinants of low specialist and drug use in these regions.

scholarly journals Where to Retire? Experiences of Older African Immigrants in the United States

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 455-455
Author(s):  
Manka Nkimbeng ◽  
Alvine Akumbom ◽  
Marianne Granbom ◽  
Sarah Szanton ◽  
Tetyana Shippee ◽  
...  
Keyword(s):  
United States ◽  
Older Adults ◽  
African Immigrants ◽  
The United States ◽  
Political Climate ◽  
Structured Interviews ◽  
Family Responsibilities ◽  
Sociocultural Environment ◽  
Decision Making Factors ◽  
The U.S

Abstract The needs and conceptualization of age-friendliness likely vary for immigrant older adults compared to native-born older adults. For example, Hispanic immigrant older adults often return to their home country following the development of ill health. Doubling in size since the 1970’s, the aging needs of African immigrants are not fully understood. This qualitative study examined experiences of aging and retirement planning for African immigrant older adults in the United States (U.S.). Specifically, it explored the factors, processes, and ultimate decision of where these older adults planned to retire. We analyzed semi-structured interviews with 15 older African immigrants in the Baltimore-Washington Metropolitan area. Data were analyzed using thematic analyses in NVivo. The majority of participants were women, with a mean age of 64. We identified three overarching themes with ten sub-themes. The themes included: 1) cultural identity: indicating participant’s comfort with the U.S. society and culture; 2) decision making: factors that impact participants' choice of retirement location, and 3) decision made: the final choice of where participants would like to retire. Age-friendliness for immigrant older adults in the U.S. is complex and it includes the traditional domains such as physical and sociocultural environment (e.g. housing, transportation, and income). However, immigrant age-friendliness also needs to include wider contextual aspects such as political climate in their country of origin, immigrant status, family responsibilities, and acculturation in the U.S. More research is needed understand and facilitate age-friendly environments for transnational immigrant older adults.

scholarly journals 149 Falls in the United States: Magnitude, Risk, Disparities, and Solutions

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv34-iv39
Author(s):  
Matthew Lee Smith ◽  
Edgar Vieira ◽  
Angelica Herrera-Venson ◽  
Kathleen Cameron
Keyword(s):  
United States ◽  
Older Adults ◽  
Older Adult ◽  
Fall Prevention ◽  
Prevention Programs ◽  
The United States ◽  
Incidence Rates ◽  
Gis Mapping ◽  
Isolated Populations ◽  
National Network

Abstract In the United States, falls incidence rates remain steady among older adults (those age 65 years and older), which highlights the need for effective interventions to prevent falls and manage fall-related risks. Falls are the leading cause of unintentional injury and injury-related disability and deaths among older adults (29,668 deaths, 61.6/100,000, in the US in 2016), and the rate of fall-related deaths among older adults increased 31% from 2007 to 2016. In the United States, an older adult goes to an emergency room due to a fall every 11 seconds (3 million visits per year), and an older adult dies from a fall-related injury every 19 minutes. In response to this issue, the Administration for Community Living (ACL) and other governmental agencies have dedicated large sums of funding to initiate and support fall prevention and management efforts in clinical and community settings. As part of the solution, ACL supported 40 grantees to deliver eight evidence-based fall prevention programs (e.g., A Matter of Balance, Stepping On, Tai Chi, Otago Exercise Program) from 2010-2016. During that time, this ongoing initiative has reached 45,812 participants in 22 states by delivering 3,755 workshops. The majority of workshops were delivered in senior centers (26%), residential facilities (20%), healthcare organizations (13%), and faith-based organizations (9%). This presentation will use geographic information system (GIS) mapping to geospatially depict the dissemination of these programs as well as highlights their impact on fall-related outcomes. Additionally, models of clinical and community collaboration for fall prevention will be described, which shows the importance of leveraged resources, seamless referral systems, and timely feedback channels. Further, policy initiatives and a national network of state-based fall prevention coalitions will be described to coordinate and integrate efforts across clinical, community, corporate, and academic settings. Lastly, strategies will be shared to diversify the delivery infrastructure for fall prevention programs and incorporate technological options for isolated populations and those without access to preventive services.

scholarly journals Back in the Saddle Again: Ethics, Visibility, and Aging on Screen

2015 ◽  
Vol 36 (1) ◽  
pp. 11-19 ◽  
Author(s):  
Maruta Z. Vitols ◽  
Caitrin Lynch
Keyword(s):  
United States ◽  
Older Adults ◽  
Mass Media ◽  
The United States ◽  
Subjective Experiences ◽  
The U.S

This paper engages with filmic portrayals of older adults in the U.S. in order to ask questions about the impacts of mass media on reproducing, critiquing, or interrogating mainstream values and assumptions about aging. The study considers the recent Hollywood works The Expendables (2010) and R.E.D. (2010), as well as the independent documentary Young@Heart (2007). We forefront questions of visibility, invisibility, and recognition both in terms of what experiences and realities are rendered visible or invisible by mass media, but also in terms of the subjective experiences of many older adults in the United States.

scholarly journals Social Isolation and COVID-19 Mitigation: Perspectives of Key Informants in the United States and Japan

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 441-441
Author(s):  
Emily Ihara ◽  
Megumi Inoue ◽  
Cortney Hughes Rinker ◽  
Naoru Koizumi
Keyword(s):  
United States ◽  
Older Adults ◽  
Social Isolation ◽  
Older Adult ◽  
Adult Population ◽  
The United States ◽  
Mitigation Measures ◽  
Adult Care ◽  
Key Informant ◽  
The Many

Abstract The deleterious health effects of social isolation and loneliness among older adults have been well-established and were exacerbated by the forced separation for those at health risk of contracting the COVID-19 virus. Both the United States and Japan are experiencing phenomenal growth of the older adult population; Japan is considered a “super-aged” society, with the highest proportion of people aged 65 and older in the world. This study examined how COVID-19 and mitigation measures may have affected services for older adults. We conducted key informant interviews with specialists in aging and older adult care in both Japan (n=5) and the United States (n=14). All interviews were conducted over Zoom and lasted 30-60 minutes. The research team transcribed and checked the interviews for accuracy and conducted multiple coding sessions to identify, sort, and consolidate the codes using Atlas.ti. Key themes in both countries that emerged included the many cracks in the system of programs and services for older adults, the inaccessibility to technology and the internet, and the particular difficulties of socioeconomic inequities, especially for those living alone. Older adults were motivated to become more technologically proficient and local communities came forward to help provide support. One key informant from the U.S. noted that their organization experienced a 600% increase in interest among volunteers as a result of the pandemic. Despite the many challenges of the pandemic, many silver linings emerged. One participant poetically stated, “I think that's human nature – when you have no other choice, you find a way.”

Pathways to Change in Rural America

2020 ◽  
pp. 43-58
Author(s):  
Alonzo L. Plough
Keyword(s):  
United States ◽  
Rural Communities ◽  
Well Being ◽  
The United States ◽  
Poor Health ◽  
Rural Populations ◽  
Rural America ◽  
Rural Living ◽  
Local Resources ◽  
Health And Well Being

This chapter explores the reputation and reality of the nation's less populated regions, which one in every five people in the United States call home. Too often, the rural designation implies an environment in which poor health and diminished opportunities are the norm. Though the chapter contributors acknowledge the enduring economic, social, and educational inequities that pervade these regions, they are equally invested in capitalizing on the inherent strengths of the rural heritage. Using examples from several Southern, rural communities that are among the poorest in the country, yet also offer pockets of hope, the contributors show that it is possible to reshape the narrative of rural living. To enhance health and well-being in rural America, policymakers and advocates must build on the unique challenges, strengths, and opportunities in rural populations. Changes that leverage local resources and strengths to better serve residents are vital, and some of them are surprisingly simple and often community-driven.

scholarly journals Designing Policy Solutions to Build a Healthier Rural America

2020 ◽  
Vol 48 (3) ◽  
pp. 491-505 ◽  
Author(s):  
Sameer Vohra ◽  
Carolyn Pointer ◽  
Amanda Fogleman ◽  
Thomas Albers ◽  
Anish Patel ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Health Policy ◽  
Rural Communities ◽  
The United States ◽  
Rural America ◽  
Current State ◽  
New Energy ◽  
National Model ◽  
Policy Solutions

Disparities exist in the health, livelihood, and opportunities for the 46-60 million people living in America’s rural communities. Rural communities across the United States need a new energy and focus concentrated around health and health care that allows for the designing capturing, and spreading of existing and new innovations. This paper aims to provide a framework for policy solutions to build a healthier rural America describing both the current state of rural health policy and the policies and practices in states that could be used as a national model for positive change.

scholarly journals Awareness and Use of Nutrition Information Predict Measured and Self-Rated Diet Quality of Older Adults in the United States (P18-046-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Anna Vaudin ◽  
Edwina Wambogo ◽  
Alanna Moshfegh ◽  
Nadine Sahyoun
Keyword(s):  
United States ◽  
Older Adults ◽  
Socioeconomic Status ◽  
Older Adult ◽  
Diet Quality ◽  
The United States ◽  
Healthy Eating Index ◽  
Nutrition Information ◽  
Ratio Method

Abstract Objectives This study aimed to investigate: 1) the diet quality of older adults, using the Healthy Eating Index 2015 (HEI-2015) and self-rated diet quality, 2) characteristics associated with reported awareness and use of nutrition information, 3) factors associated with HEI-2015 score and self-rated diet quality, including the relationship with awareness and use of nutrition information. Methods A cross-sectional analysis of 24-hour recall and questionnaire data from the National Health and Nutrition Examination Survey 2009–2014, including 4493 subjects, aged 60 years and older. The population ratio method was used in SAS 9.4 to calculate mean HEI scores. Data was stratified by gender, then t-tests and ANOVA were used to compare means and chi-squares were used to compare proportions. Logistic and linear regression were used to test for associations with diet quality, controlling for potential covariates. Results The mean total HEI score for men was significantly lower than for women (63.7 ± 0.8 vs. 66.6 ± 0.8 respectively, P < 0.0001). Compared to men, more women reported nutrition awareness (53.7% vs. 41.1%, P < 0.0001), and use of nutrition information (19.3% vs. 9.2%, P < 0.0001). Nutrition awareness was also associated with race, age, education, socioeconomic status, and food security. In bivariate analyses, nutrition awareness and use of nutrition information were significantly associated with both HEI score and self-rated diet quality in both men and women. In multivariate analyses, nutrition awareness remained a significant predictor of HEI for women but not men, and remained a significant predictor of self-reported diet quality in men but not women. Conclusions Nutrition awareness and use of nutrition information are significantly related to diet quality in older adults, even when controlling for other factors. There are differences in these relationships for older adult men versus women. Gaps in awareness, indicating need for nutrition education, exist in men, non-whites, those participating in nutrition assistance programs, and those with lower education and socioeconomic status. Closing these gaps may lead to improved diet quality in segments of the older adult population. Funding Sources Agricultural Research Service, United States Department of Agriculture.

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