Michigan coalition works to address health disparities for older adults

A broad coalition of Michigan organizations has come together to address health disparities that affect Michigan's rapidly growing population of older adults.
This article is part of State of Health, a series about how Michigan communities are rising to address health challenges. It is made possible with funding from the Michigan Health Endowment Fund.

A broad coalition of Michigan organizations has come together to address health disparities that affect Michigan's rapidly growing population of older adults. That coalition, known as the Inclusive Health Care (IHC) Taskforce, was convened by AARP Michigan, the Michigan Public Health Institute (MPHI), and the Detroit Area Agency on Aging (DAAA) in 2023 and will continue through 2025.

With the goal of empowering the Metro Detroit region to re-imagine how citizens can better prepare for growing older, the IHC Taskforce seeks to reshape health care and bridge the digital divide. The taskforce emphasizes addressing social determinants of health, or non-medical factors that contribute to health outcomes.

The IHC Taskforce is collaborating with public and private sector organizations and agencies, as well as gathering feedback from older adults living in Detroit. Collaborators include Michigan State University, the University of Michigan, Wayne State University, St. Patrick's Senior Center, GenesisHOPE, and United Way of Southeast Michigan.

"No one entity is capable of addressing the social determinants of health and the barriers to care that our community faces. If we collectively create that energy, the relationships, we can have a sustainable model to address our community concerns," says Ronald Taylor, DAAA executive director. "We are a convener, a facilitator, and a unifier of organizations and resources to bring entities together to talk about the barriers to care that may be impacting our older adult community [and] the health-related social needs that can be addressed."
Nick HagenRonald Taylor.
Five pillars support equitable health care 

The IHC Taskforce has five key subcommittees, focusing on health, education, economics, community, and built environment. Woven throughout each is the goal of combating the digital divide. The taskforce also takes a racial equity-focused approach to older adults' health, prompted by statistics like those found in the DAAA's "Dying Before Their Time III" report. The report found that in Detroit, where nearly 80% of the population is Black, the death rate for people ages 50 to 59 is 122% higher than those of the same age in the rest of Michigan. The death rate for people ages 60 to 74 is 48% higher.

"People aren't getting the kind of access that they need in terms of quality and affordability," says Paula Cunningham, state director, AARP Michigan. "Racial and ethnic minorities in Michigan being more likely to experience chronic conditions is a result of not having access, of not being able to get the kind of treatment that they really need."
Roxanne FrithPaula Cunningham.
Dr. Fayana Richards, MPHI senior health equity consultant in the Center for Health Equity Practice, is a medical anthropologist with expertise in gerontology. She works primarily with older Black women, grandmothers who are raising their grandchildren in Detroit.

"I'm really excited that a project like this exists for a few reasons," she says. "One is that ageism is really prominent in our society. And the thing about aging is that all of us do it. We age every single day. There is an overemphasis on youth culture that leads into assumptions about the possibilities and capabilities of older adults and how older adults should navigate spaces."

The IHC Taskforce has also been hosting in-person forums addressing social determinants of health. Dialogue with community members is informing the taskforce's training core and toolkit, and the taskforce has developed a summary report on feedback it's received.

"The DAAA has also done a lot of tabling at senior events to ask what are the nontraditional populations that aren't necessarily served when it comes to digital equity and digital inclusion," Richards says. "That way we can provide and develop deliverables that have the most reach."

Richards facilitates the IHC Taskforce education subcommittee, which is developing a retirement toolkit and a senior training core around digital literacy for older adults, with the goal that those who complete the training will teach others.

"We've been working to get a sense of what's already there because we don't want to duplicate existing resources," she says. "We've been trying to create a list of those existing digital resources and, using that, then ask partner organizations, 'What is missing? What do older adults say that they need to know?'"
Detroit Area Agency on AgingThe Inclusive Health Care Taskforce hosted an information and resource fair on June 13.
On June 13, DAAA hosted the IHC Taskforce Information and Resource Fair. Industry leaders presented on topics like social determinants of health, economics and retirement planning, technology challenges impacting older adults, creating age-friendly environments, and expanding community resources. Anne Holmes Davis, DAAA vice president of planning, describes the fair as "a great opportunity" to communicate the taskforce's accomplishments so far to older adults, caregivers, and potential taskforce partners.

"If we don't take the moment to try to find ways to collaborate with partners who have aging as their top priorities, we'll be doing our communities a disservice," adds Caira Boggs, MPHI director of Detroit Health Innovations and Center for Health Equity Practice. "Being a part of a project like this really helps us as we're trying to help others to meet their goals and their needs as they move the needle around public health as it relates to our aging population."
Steve KossCaira Boggs.
Health care access impacts health care costs

Taskforce members see their work as having broad positive implications for Michiganders of all ages. When older adults are unable to take care of their own health due to affordability or accessibility issues, emergency room visits increase, straining the health care system, impacting the economy, and driving up health care costs for everyone.

The U.S. Census Bureau has projected that by 2030, one of every five Michiganders will be over the age of 65. Another study found that reducing health disparities could save the U.S. economy approximately $230 billion in direct medical care costs and $1 trillion in indirect costs over a decade.

"Drop the mic right there. Everybody should be involved and engaged. It's going to impact you now or later. But it's going to impact all of us if we don't do something about this. And now's the time," Cunningham says. "That aging population — we want them to stay healthy. They contribute to our economy in ways that no one else does. Whatever we can do to make certain they have choices as they age, that's what we want to do."

The IHC Taskforce is working on other solutions, such as creating better ways of communicating health-related information and resources to older adults. Cunningham is especially excited about a proposal to create a hotline, similar to United Way’s 211, that would connect older adults with transportation to health care appointments, help finding affordable medications, and other community resources that support their health.

"We've learned that people, particularly older adults, don't follow up with their health care because they don't have transportation or they think they can't afford it — for reasons that are fixable, that are preventable," Cunningham says. "If we can alleviate those reasons, then perhaps more people will follow up."

Cunningham notes that AARP staff often hear from medical doctors who are not just practicing medicine, but also helping people find transportation, affordable medications, and healthy food. 

"Those are things that medical staff were not trained to do, but they're having to do," she says.

Taylor says "it really takes all of us" to improve the health outlook for Michigan's older adults.

"By leveraging and leaning upon one another, it can give us the energy to really move forward to have some generative thoughts, some generative conversations, discussions, and the creation of ideas," he says. "... If we can all collectively come together and talk about these issues and talk about how our respective spaces can contribute and develop solutions, that's how we will truly begin to make some inroads to addressing some of the issues that are before us."

Estelle Slootmaker is a working writer focusing on journalism, book editing, communications, poetry, and children's books. You can contact her at [email protected] or www.constellations.biz.

Ronald Taylor photo by Nick Hagen. Paula Cunningham photo by Roxanne Frith. Caira Boggs photo by Steve Koss. Resource fair photos courtesy of DAAA.
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