ETHNIC MINORITY PROFILES OF OLDER ADULTS IN THE UNITED STATES

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Ethnic Minority Profiles of Older Adults in the United States
Ilana P. Israel
Elon University












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Abstract
The purpose of this study is to understand the older ethnic minority populations in
the United States and how they are treated and viewed in comparison with the White
reference majority. The knowledge gained from these studies shows the major
discrepancies between the majority and minority elder populations in the United States.
The minority ethnicities are growing at a rate that will make them the majority in the near
future. When looking at the four major ethnic minorities in the United States; Hispanics,
Asians, African American and Native Americans one can determine that the elder
populations of these minorities are at risk for lower socioeconomic statuses,
institutionalized racism and unattainable access to adequate health care. The longevity of
these minority groups can have several factors including; cultural support, social
networking and positive views on aging. The population of elders in these minority
groups are growing and that is why it is important to address these issues now.










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Introduction
The United States has a large population of older adults. Older adults are
classified as adults aged 65 years and older (U.S. Census Bureau, 1995). This population
consists of many different ethnic groups and the aging between them can be seen in
similarities and differences. This paper will focus on the aging differences between
Hispanics, Asians, African Americans and Native Americans with Whites being the
reference group. Why is looking at the minority aging populations so important to look at
in the United States? In recent projections they suggest that by 2050, one in four people
age 65 and older in the United States will be of minority decent (U.S. Census Bureau,
1995). This shows why it is so important to see the differences and discrepancies now so
that by 2050 these issues can be changed to make aging within a minority group a
positive experience.
To look at the differences between the aging among minority groups it is
important to understand the age distribution within each group. Each ethnic group will be
described by a profile showing the different aspects of aging that they experience. The
differences between the aging populations of the ethnicities that will be looked at are:
what ethnicity is more at risk of being in poverty, the rapid growth of the minorities and
how that will effect the population and what are the leading causes of death within each
ethnic group. All minority ethnic groups experience discrepancies in care provided for
elders and it is important to address these issues as the population of minorities is
growing. The profiles along with the differences that will be compared will allow for a
greater understanding of the aging population in the United States and how aging in
different ethnic populations are affected in certain ways.
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Ethnicity Profiles
Hispanics
The Hispanic older population is growing at a rapid rate, in 2008 there was a
population of 2.7 million and it has been projected that the population of older Hispanics
will grow to 17 million by 2050 (Administration on Aging, 2010). The Hispanic
population in general is growing along with the older Hispanic population. 7.1% of the
population aged 65 plus in the United States are Hispanic making them the closest
minority population behind the majority population, Whites (U.S. Census Bureau, 2010).
Hispanics tend to live with family as they are aging where as other ethnicities such as
Whites tend to live in nursing homes around people who they are not related to. This is an
important factor because it has to do with culture but can also be an indicator of lower
socioeconomic status where Hispanics cannot as readily afford nursing homes. The
percent of Hispanic older persons living with other relatives is almost twice that of the
total older population (Administration on Aging, 2010).
Income impacts the life of older populations especially minority populations in
the United States. The income of the Hispanic population of adults 65 plus in 2008 had a
median income that was reported as being $33,418 (Administration on Aging, 2010). The
income of non-Hispanics whites was $46,720. This difference is a large gap, which
contributes to the high rate of poverty among the Hispanic older population. The poverty
rate in 2008 for Hispanics 65 plus was 19.3 percent, this is more than twice the percent of
the poverty for non-Hispanic Whites at 7.6 percent (Administration on Aging, 2010).
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With this lower income Hispanics especially the older population struggle with medical
expenses and in home or nursing home care.
Hispanics have lower death rates than Caucasians, which is odd because the
Hispanic population as a whole generally has a lower socioeconomic status (SES) than
Whites. This is seen as a paradox because normally lower SES is associated with higher
death rates. The Hispanic elder population is an exception to this normal projection. This
Hispanic Paradox has started many debates talking about why this is the case. Some
researchers say that it is attributed to migration effects: Hispanics who migrate to the
United States are more likely to be healthy (a selection effect), and the immigrants who
return to their home countries are the least healthy (often called, a salmon bias or return
migration effect). Other researchers argue that the effect is due to cultural factors such as
a stronger kinship and social support mechanisms in the Hispanic community (Kanada
& Adams, 2008). This goes along with the idea that people who have stronger social
communities and more support for positive aging, live longer. A positive outlook on
aging in a culture can extend the longevity of a persons life.
There are many aspects that come along with poverty especially in an older
population. These include: access to health care, access to healthy food and exposure to
negative environmental exposure. With regards to health care in 2007, about 7.5 percent
of Hispanic older persons reported that they have no usual source of medical care
(Administration on Aging, 2010). The major reason they say that they do not have
consistent health care is because of the cost and availability. In many lower
socioeconomic status (SES) areas there tend to be fewer health clinics and the ones that
are available often have mediocre care. In areas where people who have lower SES the
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access to emergency medical care is often not close by and without health insurance the
cost of being transported there is out of the question. The lack of treatment and health
care can been seen in the overall poorer health of Hispanic elders, but with that being said
they have a lower mortality than non-Hispanic whites do (Kanada & Adams, 2008).
Hispanics along with Asians are a minority population that has a longer life expectancy
than Whites, Native Americans and African Americans (Frances & Sue, 2005).
The top ten leading causes of death for the Hispanic population are: 1) Cancer, 2)
Heart Disease, 3) Unintentional Injuries, 4) Stroke, 5) Diabetes, 6) Chronic Liver Disease
and Cirrhosis, 7) Chronic Lower Respiratory Disease, 8) Influenza and Pneumonia, 9)
Homicide, and 10) Nephritis, Nephrotic Syndrom and Nephrosis (CDC, 2010).

Asians
The elder population of Asians in the United States makes up 3.6% of the total
American population that are over the age of 65. Many older adults in the Asian
population were born in other countries. There have been some positive health benefits
that are associated with migration. The Asian population tends to have lower rates of
infant mortality and adult mortality than people who are born in their native cultures
(Frances & Sue, 2005). The Asian population now has a longer life expectancy than
Whites, African Americans and Native Americans. In 2001 the average life expectancy at
birth for the Asian population was 81.5 years. Asians have a much lower death rate than
Whites for three leading causes, death of heart disease, cancer and stroke. Those three
leading causes make up 60% of all the deaths among all ethnicities in the United States
(Frances & Sue, 2005).
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In a recent study focusing on the negative stereotypes of aging in minorities it
found that the Asian culture tends to have positive views on aging. They have found a
strong correlation between their positive views on aging and their longevity and they
have fewer problems that are associated with aging (Fances & Sue, 2005). In the Asian
culture the younger generations are taught to have respect towards and honor the older
adults. It is an important part of their culture that the younger generations especially the
first-born son or daughter understands the need to take care of their aging parents
(Frances & Sue, 2005).
The older adult Asian population aged 65 plus in 2008 was reported to have a
median household income of $48,859. This is compared to all other households, which is
$44,188. However the household income is high they still have a poverty rate of 12.1%
compared to 9.7% for Whites (Administration on Aging, 2010). Out of the minority
populations in the United States the Asian population has the lowest poverty level and
that can be seen as a positive correlation to longevity.
The aging Asian population is one of the only minority ethnic groups that more
often than not engages in preventative health practices. These practices include diet,
exercise, not smoking and taking advantage of screening tests. However on the contrary
the Asian population is known to be less willing to seek medical treatment for socially
stigmatized problems (Spivack, 2005). Many of todays Asian elder population are
foreign-born and some still are unfamiliar with English along with not understanding the
health care system. This causes problems for elder Asians when they are trying to
communicate with doctors and or are seeking medical attention (Spivack, 2005). The
Asian American population comes from all over the world and they speak all different
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languages and different dialects which can cause problems when providing medical care
to the elderly. There are three other factors that have been recognized along with
language barriers as being contributors to poor health outcomes; cultural barriers, stigma
associated with certain conditions and the lack of health insurance (CDC, 2010). Asian
American women have the highest life expectancy of any other minority group in the
United States.
There are lots of language barriers that are associated with the Asian population
and this is one reason why they experience institutionalized racism the most.
Institutionalized racism can be seen across the board when looking at the treatment of
minority populations in the United States especially when it is a minority person with a
low socioeconomic status. For example, a study was done that looked at treatment for
elderly minority patients that had cancer and were in pain, this study found inconsistent
treatment options for these patients. Asians and Hispanics were 1.4 times less likely to
receive medication than their White counterparts despite symptomatic complaints and or
evidence of chronic pain (Administration on Aging, 2010). This is only one of many
examples of institutional racism that occurs in the United States medical system.
The top ten leading causes of death in the Asian elder population are: 1) Cancer,
2) Heart disease, 3) Stroke, 4) Unintentional Injuries, 5) Diabetes, 6) Influenza and
Pneumonia, 7) Chronic Lower Respiratory Disease, 8) Suicide, 9) Nephritis, Nephrotic
Syndrome, and Nephrosis, and 10) Alzheimers Disease (CDC, 2010).

African Americans
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The African American older adult population represents around 8% of the entire
African American population. The older adult population of African Americans is 8.6%
of the total American population aged 65 plus. By 2050 it is estimated that the elder
African American population could quadruple representing to 15% of the entire African
American population (Cowgill, 1988). The research done by Kaneda and Adams found
that African American elderly have the worst outcome of mortality age and health. The
United States classifies older adults as being 65 and older, but some researchers are
suggesting that the classification of different ethnic groups and the age in which they are
considered older adults should be different based on their life expectancy. African
American have a shorter life expectancy and more health disparities so researchers are
saying that they should be classified as older adults at the age of 55 (Kaneda & Adams,
2008).
The socioeconomic status (SES) of African American older adults is staggeringly
low compared to the White population. Many older African Americans are unemployed
and there are lots of factors that contribute to this. Including: discrimination in hiring and
pay rates, inadequate education and previous work history of low paying jobs (Kaneda &
Adams, 2008). All of these factors have effects of the poverty of older African American
adults. With lower paying jobs the benefits that are for retirement are less substantial and
most people who are working the lower paying jobs will continue to work longer than
someone who has a higher paying job with better benefits for retirement. High levels of
discrimination are found in the United States in wage discrepancies. A person who is a
minority tends to be paid a lower wage than someone who is of the majority population
working the same job. It tends to be a trend that a lot of lower income jobs include high
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levels of manual labor and the tolls of that labor can be seen in the older African
American adult population. These lower income jobs do not have good healthcare
packages and therefore health related problems associated with work tend to arise and go
untreated leading to poorer health as they age.
The African American culture shows the importance of the elder population.
Studies have shown mental health benefits for African Americans of collective activities
such as church going, family gatherings, and church-based social services (Spivack,
2005). These are all examples of supportive networks for the aging population and it
allows for a greater sense of importance and acceptance within the community. Along
with a lower SES African Americans tend to live in areas around the country that have
poor healthcare options. Even in the areas where healthcare may be good the African
American older adults tend to see discrimination aspects and institutionalized racism as
mentioned above with the Hispanic population. When looking at age profiling it has been
shown that African Americans 85 and older have lower rates of heart disease than Whites
(Frances & Sue, 2005).
The top ten leading causes of death in African American elders are: 1) Heart
Disease, 2) Cancer, 3) Stroke, 4) Unintentional injuries, 5) Diabetes, 6) Nephritis,
Nephrotic Syndrome, and Nephrosis (Kidney Diseases), 7) Chronic Lower Respiratory
Disease, 8) Homicide, 9) Septicemia, and 10) HIV/AIDS (CDC, 2012).

Native Americans

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The Native American older adult population is growing because the Native
American population is increasing. The Native American elder population was 232,042
in 2009 and is expected to grow to 918,000 by 2050 (Administration on Aging, 2010).
Native American elders aged 65 plus make up 0.5% of the entire population of people
aged 65 plus in the United States. This is the smallest minority population in the United
States, but the number of Native Americans is increasing (Administration on Aging,
2010).
Many Native American still choose to live on reservations and in communities
where they are reserved from the greater surrounding community. This is causing the
access to western medical treatment to become a problem. Many communities are now
receiving aid from different organization around the country including National Research
Center on Native American Aging. The major concern when it comes to health care that
is provided is that the doctors and nurses must have knowledge of the Native American
traditions so they do not over step traditional rituals and practices. Some Native
American elders refuse to go to Western doctors because they do not respect and
understand the Native American culture enough to provide satisfactory care.
Native Americans who are 75 and older have lower death rates than Whites for
four of the leading causes of death, including cancer, heart disease, cerebrovascular
diseases, and chronic pulmonary disease (Frances & Sue, 2005). Cultural differences play
a large role in Native American aging. Unlike other cultures Native Americans see the
elders as being the heart and soul of the family and with that notion elders tend to have
more positive views on aging. (Lyons, 1978; Red Horse, 1980) The passing on of
tradition is very important and Native American elders tend to live in three-generation
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households where they can pass on culture and tradition to their grandchildren (Barresi,
1987).
The supportive and family oriented care of the Native American elder population
is the most common view of the elder population, however in the last few years there has
been a large increase in the number of elders who are suffering from elder abuse. The
abuse that has been noted tends to come from the person providing care. In the past the
community and the leaders were able to intervene and take charge, but new laws and
regulations have caused them to have to take a more indirect approach to helping those
elders. There are seven categories to consider when looking into elder abuse. These
include: Physical abuse, sexual abuse, physiological/emotional abuse, neglect,
exploitation, self-neglect and isolation (CDC, 2010). The statistics of elder abuse in the
Native American community have not yet been researched to a level that can be shown
numerically, but it is an important aspect to look at when talking about Native American
elders.
When reviewing the information on Native American older adults it is highly
evident that there is a limited number of resources and small amounts of information.
Neal Krause a sociologist at the University of Michigan who focuses on aging, states that
the reason you cant find a lot of information on Native American aging is because the
research is not being done and the information that is gathered is not directly focusing on
the aging population (Krause, 2012).
The top ten leading causes of death among the Native American elder population
are: 1) Heart Disease, 2) Cancer, 3) Unintentional Injuries, 4) Diabetes, 5) Chronic Liver
Disease and Cirrhosis, 6) Chronic Lower Respiratory Diseases, 7) Stroke, 8) Suicide, 9)
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Influenza and Pneumonia, and 10) Nephritis, Nephrotic Syndrom and Nephrosis (CDC,
2010). These top ten deaths are very similar to the top ten leading causes of death for the
Hispanic elder population.

Major Comparisons
The aging population of minorities can all be seen as disadvantaged in most
categories compared to the White elder population. The percentage of people over the age
of 65 broken down by ethnicity shows the major impact that the White majority culture
has over the minorities. The minority populations are all growing which causes their elder
population to also be growing. The four ethnic minorities discussed all experience lower
socioeconomic statuses in their older adult years. The locations of these elder populations
prove to have issues with a healthy environment to aging and access to routine affordable
healthcare.
The elder White adult population makes up 84.8% of the total population in the
United States that is aged 65 plus (Administration on Aging, 2010). The top ten leading
causes of death for the White aging population are: 1) Heart Disease, 2) Cancer, 3)
Chronic Lower Respiratory Disease, 4) Stroke, 5) Unintentional Injuries, 6) Alzheimers
Disease, 7) Diabetes, 8) Influenza and Pneumonia, 9) Nephritis, Nephrotic Syndrome,
and Nephrosis, and 10) Suicide (CDC, 2010) It is important to show these to compare
them with the minority populations. The top two causes of death are the same across all
minority populations along with Whites, the order is the only aspect that changes. The
two leading causes of death across all elders in the United States are Heart Disease and
Cancer.
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The Asian population along with the Hispanic population has the highest
longevity statistics. They tend to live longer than all of the minority groups along with
Whites. All four-minority cultures have stronger connections with their family members
and tend to attach a sense of wisdom and honor on their elder population. The positive
view on aging that these minority cultures have can prove to provide a healthier and
longer life. Given that families are very important in these minority cultures it is seen that
they tend to live in multigenerational households more than their White counterparts.
This is because of two factors; sense of family connection and lower income to pay for
assisted living elsewhere. The fact that the minority populations are effected more by
lower socioeconomic status than their White counterparts tends to be in close correlation
with inadequate health care options and institutionalized racism.

Conclusion
In conclusion, the growth of the minority population in the United States is
causing the need for more awareness of the heath disparities between the hegemonic
population and the minorities. As stated above in the minority elder profiles the elder
population is growing in all minorities and the need for good health care, economic
support and education on aging is increasing in importance. Soon the minority ethnic
populations will become the majority and the need for improving their health and well
being along with their socioeconomic statuses becomes important for the health standings
and the economy of the United States. The Hispanic elder population is seen as being the
most healthy minority elder population across the board. The standards that the White
population upholds in regards to medical care and treatment for elders needs to be
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provided also to the minority population. Rural and affordable health care is needed for
most minority groups especially Native Americans and would increase their life
expectancies dramatically. The treatment overall of the minority elder population is an
important aspect in this changing population.






































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