The American Geriatrics Society (AGS) has consistently advocated for a healthcare system that meets the needs of older adults, including addressing impacts of ageism in healthcare. The intersection of structural racism and ageism compounds the disadvantage experienced by historically marginalized communities. Structural racism and ageism have long been ingrained in all aspects of US society, including healthcare. This intersection exacerbates disparities in social determinants of health, including poor access to healthcare and poor outcomes. These deeply rooted societal injustices have been brought to the forefront of the collective public consciousness at different points throughout history. The COVID‐19 pandemic laid bare and exacerbated existing inequities inflicted on historically marginalized communities. Ageist rhetoric and policies during the COVID‐19 pandemic further marginalized older adults. Although the detrimental impact of structural racism on health has been well‐documented in the literature, generative research on the intersection of structural racism and ageism is limited. The AGS is working to identify and dismantle the healthcare structures that create and perpetuate these combined injustices and, in so doing, create a more just US healthcare system. This paper is intended to provide an overview of important frameworks and guide future efforts to both identify and eliminate bias within healthcare delivery systems and health professions training with a particular focus on the intersection of structural racism and ageism.
A ging is closely linked to a broad array of risk factors that are associated with chronic disease and declining health. With increasing age, most individuals will have a growing and sustained need for a variety of prescription drug therapies. In a survey of noninstitutionalized adults, 94% of women age 65 years or older had taken at least one medication in the preceding week, and 57%
Our work with older adults, particularly those with limited incomes, has provided significant insight into the complexities of Medicare and the U.S. healthcare system. This article provides a brief history and overview of Medicare; describes the array of insurance choices Medicare beneficiaries face; and considers the effect of income, race, and health literacy on an individual's ability to navigate Medicare. We discuss how health is more than healthcare service delivery and that it takes community efforts to ensure that older adults not only understand their insurance, but also have access to other important resources that influence their health such as safe, affordable housing; food security; and transportation. J Am Geriatr Soc 66:25-32, 2018.
This article is a reflection of some of the changes we have witnessed in pharmacy over the years, including the rise in medication use and prices and the transformation of how medicines are paid for in the United States, with growing concern over pricing transparency. We discuss the complex Medicare Part D prescription drug benefit, how enrollees can save by comparing plans annually, and the influence of preferred pharmacies. We review options for medication assistance other than Part D and share our belief that, although Medicare Part D has dramatically improved access to medicines, more needs to be done to decrease Medicare's and individuals' out-of-pocket spending and, as importantly, to ensure that medicines are doing more good than harm. J Am Geriatr Soc 66:33-40, 2018.
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