Black Aging Older Black Woman
Racism, discrimination, and systemic barriers can create unique challenges that can make aging more difficult and expensive for Black people.
By Andrea Plaid
The cost of aging while Black in Detroit is too many of us don’t make to 60 years old.
The latest census data, from July 2022, states that Black people make up 77.9 percent of the city’s population. Out of that, said Statistical Atlas, 30.8 percent of us—or 205,032–are aged 45 and older. Broken down even further, even though 20.5 percent of us—or 42,032–are between the ages of 45 and 64, that drops by half for people aged 65 and older.
According to a 2020 study commissioned by the Detroit Area Agency on Aging titled “Dying Before Their Time III,” (DBTT-3) the death rate for people aged 50 to 59 in the Detroit area is 122 percent higher than the rest of the state. Comparatively, the death rate for Detroiters aged 60 to 74 is 48 percent higher than the rest of the state.
To put a finer point on this, we Black folks are disproportionately represented in the death rate as there are more of us in the city.
The real is aging is an inevitable part of life, but for Black people, it can come at a steep cost. Racism, discrimination, and systemic barriers can create unique challenges that can make aging more difficult and expensive for Black folks.
One of the biggest challenges faced by Black individuals as we age is health disparities. According to the Centers for Disease Control and Prevention (CDC), Black people are more likely to suffer from chronic conditions like diabetes, heart disease and hypertension than white people. We are also more likely to die from these conditions at a younger age.
The DBTT-3 bears that out. Eighty-nine percent of older adults in the city has at least one chronic condition, and 39 percent have three or more conditions, including the ones previously mentioned along with arthritis and stroke.
These health disparities can be attributed to a variety of factors, including genetics, lifestyle factors and access to healthcare. We are more likely to live in neighborhoods with limited access to healthcare facilities, which can make it more difficult to manage chronic conditions. In Detroit, 54.5 of older adults live in federally designated medically underserved areas (MUAs) compare to 16.5 percent of the rest of Michigan, according to the DBTT-3.
We are also more likely to experience discrimination in healthcare settings, which can lead to mistrust and avoidance of medical care. Studies have shown that non-Black medical professionals don’t take our concerns seriously due to stereotypes about our pain thresholds and even our skin.
Managing chronic conditions can be expensive, especially as individuals age and require more frequent medical attention. We are more likely to have lower incomes and less access to insurance, which can make it more difficult to afford the care they need. As a result, we may be forced to prioritize their health needs and make difficult choices about which medications or treatments they can afford.
The flip of that is we put off treatments for treatable conditions until they become so bad that we end up in the hospital, which ends up costing us more. Those conditions, which the DBTT-3 calls Ambulatory Care Sensitive Conditions(ACSCs), hospitalize 60 percent of Detroiters. They include heart disease, kidney disease, diabetes and stroke. Furthermore, 27 percent of Detroit residents die from ACSCs.
We more than likely don’t have access to care due a lack of health professionals or lack access to primary care services. Ninety-four percent of older people in Detroit live in such places, called health professional shortage areas (HPSAs), as much as MUAs, according to DBTT-3.
Another challenge we face as we age is social isolation. Black people are more likely to live alone and to have smaller social networks than white individuals. This can be attributed to a variety of factors, including historical and ongoing segregation, economic inequality, and discrimination.
Social isolation can have serious consequences for an individual’s mental and physical health. It can lead to increased rates of depression, anxiety and cognitive decline. It can also increase the risk of chronic conditions like heart disease and hypertension. This is especially true for older Black men.
One of the reasons for social isolation is the lack of representation in mainstream media. The vast majority of images and stories shown in the media do not reflect the experiences of Black individuals, particularly older Black people, which can make them feel invisible and unimportant. This can lead to feelings of social exclusion and isolation.
Economic insecurity is another major challenge faced we face as we get older. We are more likely to experience poverty and financial hardship than white individuals. We are also more likely to have lower incomes and less access to retirement savings, which can make it more difficult to retire comfortably.
This economic insecurity can have serious consequences for an individual’s physical and mental health. It can lead to increased rates of chronic conditions, depression and anxiety. It can also make it more difficult to afford the care and services needed to maintain good health.
One of the reasons for economic insecurity is the lack of access to job opportunities and education. We Black folks are more likely to live in neighborhoods with limited access to good jobs and quality education. This can make it more difficult to build a stable career and to earn a livable wage.
Finally, caregiving is another major cost of aging as a Black person. We are more likely to be caregivers for our family members than white people, especially Black women. This can be attributed to a variety of factors, including cultural norms, historical and ongoing segregation, and economic inequality.
Caregiving can be a full-time job, and it can be expensive. Caregivers may have to take time off work or reduce their hours to provide care for their loved ones. They may also have to pay for medical expenses, home modifications and other services to help their loved ones maintain their independence.
The DBTT-3 made the following recommendations:
- Develop and implement programs, services and approaches to eliminate the continually widening gap in health and social disparities.
- Provide more non-Medicaid funding for home- and community-based services and programs.
- Provide more funding and support for informal care, kinship care and grandparents rearing grandchildren.
- Incorporate the elements of social determinants of health in the allocation of federal and state resources.
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