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Socioeconomic Status and Health Disparities Among Older Adults

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2005 American Lung Association's publication on air pollution did not include this population ... Source: American Lung Association. Cost to society ... – PowerPoint PPT presentation

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Title: Socioeconomic Status and Health Disparities Among Older Adults


1
Socioeconomic Status and Health Disparities Among
Older Adults
  • Lovell A. Jones, PhD
  • Director, Center for Research on Minority Health
  • Director, Reproductive Biology Program
  • University of Texas M.D. Anderson Cancer Center
  • Houston, Texas

2
What do we know and not know about environmental
health disparities among older adults?
3
We dont know much!
  • Insufficient research on geriatric environmental
    health issues in the US
  • No known studies on environmental health
    disparities for the elderly of minority or
    medically underserved populations
  • 2005 American Lung Associations publication on
    air pollution did not include this population

4
Whats the problem?
  • Younger people are often easier to study than
    older people
  • Aggregated data
  • Everyone over age 65 is often put in the same
    category regardless of health status
  • Seniors are often grouped in the susceptible
    population category
  • Minority seniors are often ignored in studies

5
What we know
  • Overall, elderly population face greater health
    risks from environmental pollution because
  • Chronic diseases can be exacerbated by
    environmental contaminants
  • Older bodies have less energy/immunity to combat
    environmental hazards
  • Some pollutants could accelerate aging
  • Older people have collected more toxins in
    their bodies than younger people
  • Seniors are more likely to have been exposed to
    toxic chemicals that were previously unregulated

6
For example
  • Asthma in the US
  • Poverty is a strong risk factor for asthma
    mortality
  • Majority of the 5000 asthma-related deaths per
    year are among those age 65 and older

Source American Lung Association
7
Cost to society
  • Strong link between air pollution and increased
    health care cost for older adults
  • For every 10 mcg/m3 drop in air pollution
  • Medicare will save 76 per person for inpatient
    care
  • 100 per person for outpatient care

8
Outdoor air
  • Few studies of link between outdoor air
    pollution and the health of minority elderly in
    the US
  • European study seniors exposed to air
    pollutants for 2 hours showed adverse changes in
    electrocardiogram
  • Korean study Rising concentration of
    particulates, CO, SO2, NO2, and O3 resulted in
    increased stroke death

9
Outdoor air and disparities
  • African-Americans are more likely than Whites to
  • Live in households with incomes below the federal
    poverty line
  • Have children 5 years of age or younger
  • Live closer to the nearest industrial emission
    source
  • Live within 2 miles of multiple industrial
    emission source
  • Nationwide, 65 of blacks and 80 of Hispanics
    live in counties that do not meet federal air
    pollution standards, compared to 58 of whites.
  • No known studies on Asian-Americans and American
    Indians exposure to air pollution
  • In general, living in proximity to the sources of
    air pollution lowers environmental quality and
    worsens ones health.

10
Why not relocate?
  • Not aware of the adverse health effects of
    polluted air
  • Acclimated to the polluted air
  • Difficult to sell home
  • Home prices in area are more affordable
  • Uncertain employment opportunities leading to
    unstable income
  • Older, retired adults can not afford to move out
    of the area

11
Indoor air
  • Few indoor air quality studies on older adults
    none focused on the health of geriatric
    minorities
  • Elders stay indoors more than younger people.
    Increased risk of exposure to indoor air
    pollutants.
  • Smoking and second-hand smoke contribute to all
    major causes of death among the elderly

12
How do we fill the knowledge gap?
  • RESEARCH!
  • Community-based participatory research
  • Community empowerment and inclusiveness
  • Must involve the community at every level of
    research

How?
13
Houston
  • is the oil refining and chemical manufacturing
    center of the U.S.
  • is one of the most polluted city in the nation
  • 120 petrochemical industries
  • 11 superfund sites
  • 45 hazardous waste sites
  • has one of the largest medicals center in the
    world
  • has produced no research exploring link between
    air toxics and cancer in Houston
  • has grass-roots groups doing independent
    air-quality research

14
Addressing environmental issues in Houston
  • 1991 The Mickey Leland National Urban Air
    Toxic Research Center
  • 2001 NIEHS Baylor College of Medicines
    meeting on environmental health
  • 2002 EPA-Region 6 Texas Southern
    Universitys Environmental Justice Listening
    Session
  • 2004 IOM Center for Research on Minority
    Healths environmental health workshop

15
Expanding the definition of Environmental Health
Built
Social
Natural
16
Listening is key to understanding
  • Agenda planning based on results from
  • Four community focus groups
  • One professional focus group
  • Advisory panel

17
Common Environmental Health Concerns in Houston
18
Northeast Houston
19
Northwest Houston
20
Southwest Houston
21
Southeast Houston
22
Guiding principles
  • Coordinate efforts in improving the collection of
    health information for minority communities.
  • Research related to health disparities should
    engender three principles
  • improve the science base,
  • involve the affected populations,
  • and communicate the findings to all stakeholders
  • Exercise caution on behalf of the affected
    communities, particularly those that have the
    least access to medical, political, and economic
    resources, taking reasonable measures to
    safeguard against or minimize adverse health
    outcomes.

23
Recommendations
  • Recognize that low-income groups, which include a
    disproportionate number of ethnic and racial
    minorities, constitute a susceptible segment of
    society that deserves special attention and
    protection.
  • Advocate for clear state and federal industrial
    emission guidelines and develop enforceable
    standards.
  • Encourage research focusing on the specific
    health effects of toxic air exposure.
  • Examine air quality and pollution in the context
    of health disparities to include the
    interrelationships among race (disaggregate
    data), age, and poverty. Be inclusive of smaller
    ethnic groups such as Asian Americans and
    American Indians.
  • Train minority researchers in the area of
    environmental health disparities using the
    community-based participatory research model.
  • Design research projects that are culturally
    competent and linguistically appropriate when
    working with ethnic minority groups. Special
    considerations may be necessary to accommodate
    cognitive needs of the elderly population.
  • Educate the community, especially the elderly, on
    the ill effects of air pollution.

24
"If you want to change the world, be that
change. Gandhi
25
Remember. No matter how hard you work. No
matter how right you are.
Sometimes the Dragon wins However, the object
is not to be eaten so that you can fight on
another day
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