Working Toward Health Equity for LGBT Elders of Color

June 12, 2013

By Judy Evans

Over the next several decades, our country will grow increasingly older and more diverse. There are currently more than 40 million adults aged 65 and older in the U.S., a number that will more than double over the next four decades; by 2050, Latino, Black, Asian and Pacific Islander and American Indian and Alaska Native people will comprise more than 40% of this elder population. In addition, based on conservative estimates, the number of lesbian, gay, bisexual and transgender (LGBT) people over age 65 will grow to more than 3 million by 2050.

LGBT elders face a number of health and financial disparities as compared to elders as a whole, and LGBT elders of color—burdened by a lifetime of racial inequality and anti-LGBT discrimination—face even greater health and economic challenges. Despite this, LGBT elders of color are largely rendered silent in public policy discussions on aging.

A new policy report from SAGE (Services and Advocacy for GLBT Elders of Color) seeks to challenge that silence. Health Equity and LGBT Elders of Color explores 10 policy areas where health and wellness can be improved for LGBT elders of color (a population that encompasses multiple groups diverse across race, ethnicity, culture, language of origin and more. Some of these areas include:

  • Improving health access by enacting new amendments in the Older Americans Act (OAA):  The OAA is the country’s leading vehicle for delivering services to older people nationwide, providing more than $2 billion annually in nutrition and social services. SAGE recommends ensuring that the reauthorization of the OAA incorporates the amendments proposed in the “LGBT Elder Americans Act” and the “Improving Services and Activities for Diverse Elders Act,” both introduced by Senator Michael Bennet (D-CO) in 2012. These acts include amendments such as designating LGBT elders a population with greatest social and economic need, and requiring that OAA programs meet the cultural and linguistic needs of older Americans.
  • Engaging LGBT communities of color in health reform: The Affordable Care Act (ACA) provides numerous opportunities to address health disparities among LGBT elders of color. For example, as key healthcare reforms are implemented by states over the next few years, items such as health exchanges and establishment of new community health centers will need to ensure that they leave no community behind. State-level outreach, enrollment and education efforts tied to health reform should work with community advocates who are situated in marginalized communities to help lead these efforts.
  • Improved data collection on sexual orientation and gender identity: A pervasive challenge to addressing health disparities is the dearth in data about LGBT elders of color. Federal and state survey instruments in the health and aging fields rarely pose questions on sexual orientation or gender identity. Federal agencies must invest in better data collection and focused research on LGBT elders of color. Without this analysis, LGBT people of color are left without the research to quantify how health inequality plays out in their lives and without the stats to make data-driven arguments that are often required by government and private funders, among others.
  • Access to safe and necessary care for transgender elders: Arbitrary and discriminatory insurance coverage limits access to safe and competent care for low-income transgender elders, many of whom are people of color; many private insurance plans exclude coverage for medically necessary care related to gender transition, leading to significant mental and physical health complications. Discriminatory exclusions of medically necessary transition-related care should be eliminated from federally-funded health programs, such as ACA, Medicare, and veterans benefits.

Now is the time to draw the spotlight on these solutions. Health disparities are rising across marginalized populations yet few aging programs consider interventions that work effectively with these communities. Health reform efforts are moving at a rapid-fire pace across the country, at the potential expense of communities of color and LGBT people. The Older Americans Act is up for reauthorization and is primed for supporting LGBT elders. Social Security, Medicare and Medicaid are under scrutiny and in need of both strengthening and reform.

The recommendations in this report are a start to improving health equity for LGBT elders of color, and not all of the recommendations in the report specific to their needs. SAGE recognizes that LGBT elders of color benefit from policy improvements that address the barriers facing LGBT people and people of color. However, all of these recommendations are intended to strengthen this country’s health supports for the most vulnerable people—which will strengthen the health care system for all people.

To see all of the recommendations, download Health Equity and LGBT Elders of Color today. In addition, to raise awareness of these issues further, download and share the infographic, LGBT Health, Racial Disparities, and Aging—By the Numbers.  

Judy Evans is the Director of Marketing and Media Relations at SAGE (Services and Advocacy for GLBT Elders)

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