A new report from UMass Boston identifies aging equity among Boston residents

The number of Boston residents aged 60 and older has increased by more than one-third in the last eight years and more than half of older residents are persons of color. However the experiences of these older residents differ substantially depending on race, ethnicity and gender, and challenges their abilities to thrive.

A new report, “Aging Strong for All: Examining Aging Equity in the City of Boston,” by researchers at the University of Massachusetts Boston, documents disparities across three dimensions that impact quality of life — economic security, health, social engagement — and identifies opportunities for stakeholders to ensure an environment in which “aging strong” is possible for all Boston residents.

“It has never been more critical to strategically pursue greater equity in the aging experience of Boston residents,” says Jan Mutchler, PhD, director of the Center for Social and Demographic Research on Aging at UMass Boston, a professor in the Department of Gerontology and one of the study’s authors. “The numbers of older adults are increasing and stakeholders share a growing recognition of the powerful ways in which inequity, racism, and discrimination shape health outcomes and the aging experience, amplifying the need to examine and remediate disparities in aging.”

The report identifies substantial disparities across racial and ethnic groups, such as:

Economic security

• Poverty rates are especially high among Asian Americans and Latinos, and more than one-third of these residents age 60 or older live in households with incomes below the federal poverty line.
• Sizable gaps differentiate racial groups. For example, while a similar share of non-Hispanic White, Black and Native American people aged 66 or older receive Social Security benefits, percentages receiving Social Security are considerably lower for Latinos and Asian Americans.
• Housing costs in Boston place a heavy burden on older residents and half or more of renters age 60 or older pay more than 30% of their incomes for housing. Fewer homeowners bear such a heavy cost burden for housing, but older Black, Latino and Native American homeowners are at amplified risk for being cost-burdened.

Health

• Racial disparities in health and disability are substantial among older Boston residents, with older Blacks, Latinos and Native Americans having an especially high risk of health challenges and disability.
• Levels of depression and anxiety reported by older people in Massachusetts at this time are high relative to national standards.
• Boston residents are fortunate to live in a state where insurance coverage is virtually universal for older people; however, persons of color are far more likely than non-Hispanic Whites to rely on Medicare only, or Medicare in combination with MassHealth, which may have implications for out-of-pocket expenses, options for obtaining care, and quality of care.
• Higher rates of disability and needs for assistance among older persons of color also yield disparities regarding younger family members providing care for disabled or frail older relatives. Although most caregiving is provided informally, alternatives to family care may be few if the care recipient does not speak English well or culturally appropriate services are unavailable.

Social engagement

• In Boston, persons of color are less likely than their non-Hispanic White counterparts to live alone, and a large share live in multigenerational households. Though the researchers lack data on the level of support provided within and across households, multigenerational settings may promote a level of social engagement that benefits participants, a disproportionate share of whom are persons of color.
• Community strengths in terms of mutual support, resilience, and cultural cohesion offset or buffer aspects of disadvantage for some people. Yet access to information may be challenging for older communities of color, many of whom have limited knowledge of English. In addition, a larger share of older persons of color do not have access to digital technology.

“The topicality of our report is heightened when viewed during the current Covid-19 crisis,” said Mutchler.  “It is not just age, but the social determinants of health over the course of one’s life that has had such a devastating impact here in Boston and across the U.S.”

Congested living situations, pre-existing health conditions or lack of resources to keep oneself safe are factors that have impacted an increased risk of infection.

“People do not ‘age out’ of inequalities that exist earlier in life,” said Mutchler. “Instead, disparities can become exacerbated in older age. Our report uses an intersectional approach to address aging equity which provides a more nuanced view of the challenges and opportunities encountered by sub-population groups.”

The report suggests a multi-faceted approach for stakeholders to respond to issues outlined in the report by promoting “aging equity,” ensuring that people have the access and support that they need according to their personal situation. Creating safer environments, providing equal access to healthcare, and disseminating knowledge of community supports and services in a variety of languages needed are some of the features that encourage aging well. Researchers also point out that, with Boston’s many distinct neighborhoods, stakeholders will need to see that each receives healthy aging assets equitably.

“The disparities we identify make clear that for Boston to adequately meet the needs of its older population, it must redouble efforts to understand and respond to the full range of needs, the different languages, and neighborhood differences in assets,” said Mutchler.

Six institutes at UMass Boston — The Center for Demographic Research on Aging, The Institute for Asian American Studies, The Institute for New England Native American Studies, The Mauricio Gaston Institute for Latino Community Development and Public Policy, The William Monroe Trotter Institute for the Study of Black Culture, and The Center for Women in Politics and Public Policy — contributed to the report using data from the Boston Public Health Commission, the U.S. Census Bureau and other sources.