100th Dissertation Celebrated by UMass Boston’s Gerontology Program

One in Five Gerontology PhDs are earned at UMass Boston

Krystal Kittle, PhD

The Gerontology program at UMass Boston (UMB) has recognized a significant milestone: its 100th dissertation defense. With the COVID-19 pandemic still requiring most academic work conducted remotely, Krystal Kittle defended her dissertation over Zoom. Her thesis advisor, Professor Kathrin Boerner, attended the online event as well other committee members, faculty, fellow students, and staff to show their support and celebrate her accomplishment.

Established in 1989, the UMass Boston Department of Gerontology is one of the world’s oldest and most recognized programs studying aging across the lifespan. Globally renowned for its multi-disciplinary curriculum, exemplary research and accomplished faculty, one in five gerontologists with a doctorate earned their degree at UMass Boston. The program is also home to the Journal on Aging & Social Policy and Research on Aging, both peer-reviewed journals edited, respectively, by UMass Boston faculty Edward Alan Miller, PhD, professor and doctoral program director for the department and Jeffrey Burr, PhD, professor and chair of the department.

“Doctoral education takes a commitment to the field and a willingness to sacrifice,” says Burr. “Our alumni exemplify dedication, perseverance, and passion for research that makes a difference in society. As we mark this milestone, we celebrate the hard work of our graduates, and the impact they make in the world.”

Jeffrey Burr, PhD

UMass Boston gerontology alumni have been major contributors to the strong international reputation of the program. They live and work across the globe, including in Canada, China, Germany, Israel, South Korea, Singapore, Switzerland, Saudi Arabia, Taiwan, Thailand, and across the U.S. Alumni work in a variety of healthcare settings, for local, state, and federal agencies, not-for-profits that address aging issues and as faculty, researchers and administrators in universities.

“Between the first dissertation defense and the 100th, our students have produced many innovative, cutting-edge research projects and publications in scholarly journals,” says Miller. “They add significantly to the knowledge base on aging, while informing practices and policies that impact older adults, their families and communities.”

Kittle, from California, was the first person in her family to go to college and the only one to earn an advanced degree. She chose to attend UMass Boston’s gerontology program because of its high graduation rate which, she reasoned, meant a supportive and patient faculty. Kittle said she was impressed with the collegiality among the program’s tightknit community of students and faculty.

“The endurance required for a doctorate is considerable,” she says. “The UMB faculty saw something in me that inspired me to keep going.”

Kittle’s dissertation centered on the healthcare of older LGBT adults and “The Role of Minority Stress, Sociodemographic Characteristics and Social Resources.”

“I was a little nervous, but more excited to share what I had worked so diligently on for so long,” she says.

Edward Alan Miller

Edward A. Miller, PhD

Kittle joins an engaged and respected group of professionals. In a recent survey, nearly three-quarters of the program’s 100 doctorates shared how their degree had shaped and supported their career goals.

“My multidisciplinary training from UMB prepared me to be an effective collaborator—one that weaves together the expertise and perspective of colleagues towards a shared purpose,” noted one alum. “[My training] helped me develop extensive knowledge and hands-on skills in conducting qualitative and quantitative research studies that makes a real impact on the care and life of vulnerable and frail elders,” wrote another alum.

Identifying their current professional roles, alumni reflect the wide range of career opportunities available to gerontologists. These prospects are anticipated to increase as older populations are expected to outnumber younger populations in most countries. According to the U.S. Census Bureau, one in every five residents will be retirement age by 2030. By 2034, there will be 77 million Americans 65 years and older and 76.5 million Americans under the age of 18.

“One highlight of faculty life is maintaining relationships with our graduates as they progress in their careers,” says Burr. “We see them at conferences, collaborate on research and welcome their return to campus as guest lecturers.”

After she successfully defended her thesis, Kittle was told she had earned the program’s 100th doctorate. She said it gave her a strong “sense of pride for the program. It felt as if I had come full circle. It was a testament to the commitment that the faculty makes for their students.”

In April, Kittle begins work as a postdoc research fellow in the Social and Behavioral Health Program at the University of Nevada, Las Vegas School of Public Health. The focus of her work is Alzheimer’s disease and related dementias among LGBTQ middle-aged and older adults.

Elder Index at Work: Helping Boston’s Age-Friendly Plan Take Aim at Economic Insecurity

This article is one in a series of stories about how people across the country are using the Elder Index to understand the true cost of living for older adults and its economic implications. If you know someone who would like to receive information about these stories, send us a note at gerontologyinstitute@umb.edu.

Go to any city across America and you will find older adults struggling to make ends meet. Go to Boston and you will see some of the most serious elder economic insecurity problems in the nation.

This is not news at Boston’s Age Strong Commission, which first launched an ambitious age-friendly plan in 2017. The commission is now developing a Step 2 blueprint with a focus on the problem of economic security among older residents. A critical tool for that job: The Elder Index. Continue reading

How Massachusetts Can Become a Living Laboratory for Aging

Reposted from The Boston Globe 

Let’s measure what’s going on in cities and towns so we can identify how a community’s aging circumstances change over time.

Historically speaking, population aging is new and presents a growing, largely untapped resource. Aging is something we all have in common, and we can leverage that collective reality to create moon-landing levels of advancements. We need a mindset that sees the older population as a solution and opportunity, not a burden or cause for panic.
One of the keys to seizing this opportunity is to measure what’s going on in our cities and towns and identify how a given community’s aging circumstances change over time. This goes far beyond simple head counts of how many are over 65. It requires granular information on a community-by-community level to really be effective.
My research team at the Gerontology Institute in the McCormack Graduate School of Policy and Global Studies at the University of Massachusetts Boston has been creating such tools for nearly a decade, with support from the Tufts Health Plan Foundation. We started in Massachusetts, collecting detailed data, most recently in 2018, about older adults living in every one of the Commonwealth’s 351 cities and towns, and we then produced similar information for Rhode Island, New Hampshire, and Connecticut. All this information can be found in our Healthy Aging Data Reports, available at healthyagingdatareports.org.

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Nursing Home Reimbursement: A case study

The current financing structure of Pennsylvania nursing homes is not sustainable

Nursing homes play a critical role delivering long-term services and supports (LTSS) to older adults and individuals under the age of 65 with disabilities. Despite this, these facilities face serious threats to their financial viability. A new report documents the increasingly important role nursing homes play in Pennsylvania, the key demand and supply factors affecting nursing home performance, and highlight implications for the financial viability of nursing homes going forward.

Edward Alan Miller

Editor-in-chief Edward A. Miller

Using data from a variety of sources, the researchers demonstrate that the demand for nursing home care is expected to increase, but the reimbursement level from Medicaid — the growing source of payment for nursing home residents — is causing a financial strain on these institutions. The report, “The Case for Funding: What is Happening to Pennsylvania’s Nursing Homes,” was written by researchers with the LeadingAge LTSS Center @ UMass Boston and funded by The Jewish Healthcare Foundation.

Data between 2010 and 2018 indicate that nursing homes are serving lower income individuals with more challenging diagnoses, including more severe cognitive impairment and psychiatric illness, as length of stay and occupancy has declined. Coupled with Medicaid as a payment source for increasing numbers of residents, the researchers expect to see more nursing homes face financial challenges in the coming years.

“The current financing structure supporting nursing home care in Pennsylvania is not sustainable,” says Edward Alan Miller, PhD, one of the report’s authors and Professor of Gerontology at UMass Boston. “Unless the reimbursement rates paid by the Medicaid program are brought more in alignment with the costs of providing high quality care in a safe manner, providers will face increasing challenges caring for Pennsylvania’s most vulnerable residents.”

Data on professional and support staff in nursing homes also indicate a concerning trend:

  • Even as patients are presenting with more challenging diagnoses, overall staff hours among direct care workers have remained relatively unchanged over the last ten years and RN hours have declined slightly.
  • Compensation for direct care workers has remained relatively flat, increasing by only 1.9% per year from 2012 to 2019. When adjusted for the medical consumer price index, real wages have declined an average of .78% annually during the time examined.
  • While certain individual quality metrics have improved — such as declines in the numbers of bed sores — overall aggregated quality scores have not.Marc Cohen, PhD

“The growing gap between what facilities need, as reflected in charges, and the Medicaid reimbursement rate has come at a time when nursing homes are being asked to care for an increasingly complex and frail mix of residents,” says Marc Cohen, PhD, one of the report’s authors and Co-Director of the LeadingAge LTSS Center @ UMass Boston. “The result has been increased cost shifting to individuals and families who must pay for care privately or take on additional caregiving responsibilities. Nursing home services represent a critical component in Pennsylvania’s continuum of care. Our study demonstrates that more needs to be done to support them.”

New Report Ranks Elder Economic Insecurity in 100 Largest U.S. Metro Areas

Jan MutchlerOlder adults in every one of America’s large metropolitan areas face serious challenges affording their local cost of living. But the scale of economic insecurity varies dramatically, depending on what city those older adults call home.

A new report by University of Massachusetts Boston professor Jan Mutchler and graduate assistant Yang Li uses the Elder Index™ to analyze the cost of a no-frills elder budget in each of the nation’s 384 metropolitan statistical areas (MSAs), where 83 percent of older Americans live. They also tracked income levels of older adults in the 100 largest metro areas to determine what percentage of elders in those cities had insufficient income to afford their local cost of living without help.

They found a wide range of elder economic insecurity levels among both older individuals and couples living in the larger metro areas. More than 67 percent of older individuals in the Texas metro area covering McAllen, Edinburg and Mission did not have enough income to meet local expenses on their own, the highest rate among the 100 largest MSAs. Continue reading

How do we build a culture of person-centered care for older adults?

A new report shows that whether care preferences for older adults are considered is heavily influenced by race, income, and other variables.

 “When thinking about your experiences with the healthcare system over the past year, how often were your preferences for care taken into account?”

This question was posed in a healthcare study to approximately 20,000 people over the age of 50 and living across the U.S. The University of Michigan Health and Retirement Study (HRS) is a longitudinal panel study surveying a representative sample of Americans. This ongoing study provides valuable data that researchers are using to address important questions about the challenges and opportunities of aging. The HRS is one of the first to explore the issue of person-centered care. Marc Cohen, PhD

In one of the first studies to examine this new data, three researchers analyzed responses to the question of healthcare preferences in a recent report on person-centered care. The researchers — Marc Cohen Ph.D., Ann Hwang M.D., and Jane Tavares Ph.D.— wanted to understand how aging adults experience care, if their preferences are acknowledged, and whether their experiences vary by race and ethnicity, wealth and income, and/or insurance status.

“The delivery of person-centered care — defined as care that is guided by individuals’ preferences, needs, and values — is an important factor in high-quality healthcare systems,” says Hwang.

Despite the healthcare industry’s assertions that it is becoming more patient-centered, the researchers found that one-third of all older adults (age 50 and over) said their care preferences were “never” or only “sometimes” considered.

Using 2016 HRS data — the most recent data available — the survey revealed stark disparities based on race and ethnicity. While 8% of White respondents said their needs and preferences were  never considered, 16% of Black and 27% of Hispanic respondents gave that answer. The researchers also found that, across all service settings, people who felt that the health system never took account of their care preferences were more likely to forego medical care. They visited a doctor fewer times and were less likely to use home care and outpatient surgery services. The largest impact was on use of prescription medications: they were 39% less likely to use prescription medications. Continue reading

“Older Adults and COVID-19: Implications for Aging Policy and Practice”

New webinar explores the impact of the pandemic on older adults

View the full slide set here, and a video recording from the 2.5 hour webinar is available here.

Edward Alan Miller, Gerontology Department Professor and Editor-in-Chief of the Journal of Aging & Social Policy (JASP), led the webinar “Older Adults and COVID-19: Implications for Aging Policy and Practice” based on a JASP special issue and book of the same title. The February webinar drew more than 500 registrants from around world to learn about the ramifications of the pandemic for older adults and their families, caregivers, and communities.

Edward Alan Miller

Editor-in-chief Edward A. Miller

“We are extremely gratified with how the webinar turned out, drawing participants and viewers from throughout the United States and globally,” said Miller. “It illustrates how the problems and issues brought to the fore by the pandemic will continue to reverberate well beyond the present day to the years to come.”

The ongoing COVID-19 pandemic has prompted an outpouring of scholarly work on the effect of the pandemic on various populations. Older adults – as well as their formal and informal caregivers – have received a disproportionate share of the pandemic’s impacts. Direct exposure to the virus led to a higher rate of hospitalization and death among older populations, particularly in nursing homes and other congregate living environments. This reality prompted mandates meant to mitigate the virus’ effects on older adults and which, in turn, led to unintended consequences, such as increased social isolation, enhanced economic risk, delays in receiving medical treatment and other supports, and latent ageism.

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Boston’s Older Population: Increasing in Racial Diversity, but Quality of Life is Shaped by Racism, Discrimination

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. Jan Mutchler

“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.

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Elder Index at Work: Helping Improve Access to Medicare Savings Programs in Massachusetts

multigeneration portraitThis article is one in a series of stories about how people across the country are using the Elder Index to understand the true cost of living for older adults and its economic implications. If you know someone who would like to receive information about these stories, send us a note at gerontologyinstitute@umb.edu.

The cost of health care is one of the most common economic problems facing older adults across America. In more serious cases, it can lead to a bleak choice between paying for medicine or affording other basic needs.

These are familiar facts of elder life to the Massachusetts Senior Action Council, a grass roots organization focused on public policy and community issues affecting the health and well-being of older adults.

Research on policy options to address the problem led the council to focus on Medicare Savings Programs, which help qualified beneficiaries with health costs. Though the programs are run by the federal government, states have the ability to change eligibility standards for their older adults.

The council launched a campaign to make the Medicare Savings Programs available to more Massachusetts elders. It took years but finally paid off when Gov. Charlie Baker signed the state’s 2020 budget, which included a policy that now offers an estimated 40,000 older adults access to more than $150 million in new annual benefits.

A key resource in the successful effort: The University of Massachusetts Boston’s Elder Index, a free online tool that provides realistic and detailed cost of living data for older adults living in every U.S. state and county. Continue reading

Transforming the Future of Aging

Bei Wu works toward improving health status through research and policy

If the world of academic gerontology had a rock star, it would be Bei Wu, MS ‘97, PhD ’00.

Recognized for her extensive research and pursued by top tier universities, Wu has become an international leader in the field since graduating from the University of Massachusetts Boston’s Department of Gerontology. Add the years in policy work before earning her doctorate and Wu chuckles that, having spent more than half of her life in the field of gerontology, she herself is now experiencing the aging process.

“I’ve become my own study subject,” Wu says.

Today, Wu is the Director of Global Health and Aging Research at the Rory Meyers College of Nursing, and Director for Research at the Hartford Institute for Geriatric Nursing at New York University (NYU) and the inaugural co-director of NYU’s Aging Incubator, a university-wide aging initiative.

Given her considerable success in gerontology, it’s fitting she credits her grandmother — with whom she was extremely close — for nudging her into the field. Born in Shanghai, Wu’s parents left her and her brother in their grandparents’ care when the two were young. After college, Wu accepted a research position with the Shanghai Commission on Aging only after prompting by her grandmother.

“At the time, very few people thought aging would be a challenging issue in the future,” Wu says.

But writing policy briefs and launching studies on intergenerational support with the United Nations Population Fund convinced Wu to pursue graduate studies. With no options available in China, she chose UMass Boston.

“UMass Boston has had a significant impact on my career,” Wu says. “The gerontology program has a critical mass of excellent faculty.” Continue reading