The gendered inequality of women illuminates how the personal is political. Women and children share vital stakes in Social Security, Medicare, Medicaid, Supplemental Security Income (SSI), the ...Affordable Care Act (ACA), and long-term services and supports (LTSS). Featured concepts
include feminism, the relations of ruling, social reproduction, caregiving, and women's cumulative life-course advantage/disadvantage. Women's strengths in witnessing and resistance are tagged for combating the extreme War on Women.
This commentary argues that precarity and inequity across the life course and aging has accelerated via the COVID-19 pandemic. President Biden's vaccination efforts, $1.9 trillion American Rescue ...Plan Act, and Build Back Better framework reflect a paradigm shift to restore faith and trust in government that boldly confronts entrenched austerity ideologues. We offer emancipatory sciences as a conceptual framework to analyze and promote social structural change and epic theory development. Emancipatory sciences aim to advance knowledge and the realization of dignity, access, equity, respect, healing, social justice, and social change through individual and collective agency and social institutions. Epic theory development moves beyond isolated incidents as single events and, instead, grasps and advances theory through attempts to change the world itself by demanding attention to inequality, power, and action. Gerontology with an emancipatory science lens offers a framework and vocabulary to understand the individual and collective consequences of the institutional and policy forces that shape aging and generations within and across the life course. It locates an ethical and moral philosophy engaged in the Biden Administration's approach, which proposes redistributing - from bottom-up - material and symbolic resources via family, public, community, and environmental benefits.
The United States' policy for elders is marked by legitimacy crises of the state; capitalism (the Great Recession/Depression, vanishing middle class, and the now dominant super-rich); and challenges ...to democracy, via voter disenfranchisement, intimidation, racial and ethnic profiling,
and billionaire campaign financing. One place to begin thinking about reform is by exhuming basic economic and health security as imperative priorities, along with objectives of the 1965 Older Americans Act, including food security, housing security, functional security, and support for economically
disadvantaged elders. Reforms must occur within a policy structure that places the public interest of our people above those of markets and profit-making interests.
This article focuses on precarity as it relates to the right to work and the right to retire. The evolution of corporate control over the labor market has contributed to workers' loss of opportunity ...and economic security. As individual and structural labor market disadvantage grows
with age, the aforesaid losses are borne disproportionately by marginalized populations, including older adults. Social insurance is the bedrock to protect people's working and retirement years, but such programs, especially in Ame rica, must be expanded and made financially secure.
This groundbreaking book provides comprehensive treatment of the political economy of aging by a scholar widely credited as the founder and key thinker of this field in the US and internationally. ...The body of work presented in this volume, in developing this critical perspective, aims to contribute to the understanding of old age and aging in the context of problems and issues of the larger social order in the world′s most advanced capitalist nation, the U.S.A.. Since Estes′ first writing on the political economy of aging in 1979, there has been growing recognition and incorporation of her critical perspective as one of the major paradigms in the field of aging.
Objective The authors evaluated whether the integration of mental health into primary care overcomes ethnic disparities in access to and participation in mental health (MH) and substance abuse (SA) ...treatment. Methods The authors conducted site-specific analysis of a multisite clinical trial to compare participation of black and white elderly in an integrated model of care (all MH/SA services are provided at primary care clinics) versus an enhanced referral model of care (all MH/SA services are provided at specialized MH clinics). In all, 183 elderly (56% black) diagnosed with depression (82%), anxiety (32%), and/or problem drinking (22%) were randomized. Results Blacks in the integrated arm were significantly more likely to have at least one MH/SA visit (77.5%) relative to blacks in the enhanced referral arm (22%; adjusted odds ratio OR: 14.13; confidence interval CI: 4.76–41.95, Wald χ2 : 22.75, df = 1, p <0.0001). There was no statistically significant difference between whites in the integrated treatment arm (66.6%) and whites in the enhanced referral arm (46.9%, adjusted OR: 2.98; CI: 0.98–9.06, Wald χ2 : 3.72, df = 1, p = 0.05). In the enhanced referral arm, blacks had a significantly smaller number of overall MH/SA visits (mean SD: 2.08 5.28) relative to whites (mean SD: 5.31 7.76, adjusted incident rate ratio IRR: 2.87; CI: 1.06–7.73, Wald χ2 : 4.37, df = 1, p = 0.03). In the integrated arm, there was no statistically significant difference between blacks (mean SD: 3.22 3.71) and whites (mean SD: 2.75 4.29, adjusted IRR: 0.58; CI: 0.25–1.33, Wald χ2 : 1.64, df = 1, p = 0.20). For both groups, time between baseline evaluation to first MH/SA visit was significantly shorter in the integrated treatment arm (for blacks: mean days SD: 31.06 28.66; for whites: mean days SD: 22.18 33.88) than in the enhanced referral arm (mean SD: 62.45 43.53, adjusted hazard ratio HR: 7.82; CI: 3.65–16.75, Wald χ2 : 28.02, df = 1, p <0.0001; mean SD: 63.46 32.41, adjusted HR: 2.48; CI: 1.20–5.13, Wald χ2 : 6.02, df = 1, p = 0.01, respectively). Conclusion An integrated model of care is particularly effective in improving access to and participation in MH/SA treatment among black primary care patients.
Local Long-Term Care Ombudsman Programs (LLTCOPs) protect the health, safety, welfare, and rights of residents in long-term care (LTC) facilities. This study examines the (a) existing resources ...available to LLTCOPs in Georgia, California, and New York, (b) relationship of resources to LLTCOP’s reported effectiveness in meeting its federal mandates, and (c) state-specific mediating factors influencing LLTCOPs’ resources and reported effectiveness. Quantitative and qualitative data from the National Ombudsman Reporting System (NORS) and a telephone survey of LLTCOPs in Georgia, California, and New York were collected and analyzed. Resource adequacy, as measured by beds per full-time equivalent staff (beds/FTE), is inconsistently associated with effectiveness in meeting federal mandates across and within the states studied. Analysis of alternate resource measures suggests a threshold of LLTCOP size, under which program effectiveness may be lower. LLTCOPs report the changing LTC environment and additional state mandates as factors influencing resource adequacy.
This project is based on the results of telephone surveys with 52 local, state, and national informed respondents including policymakers, county leaders, planners, and advocates in mental health and ...aging with a particular focus on the states of California and Florida. This article addresses challenges to access to mental health services for diverse older adults including barriers related to race and ethnicity, socioeconomic status, location, age, gender, immigrant status, language, sexual orientation, and diagnosis. The article also highlights broad themes that emerged including (1) the importance of outreach and transportation tailored to diverse elders, and (2) recruitment of diverse staff and training related to diversity. The article concludes with policy and practice recommendations to reduce these disparities in access to mental health services for diverse populations of older adults.
The authors describe the economic meltdown of the Great Recession as an opportunity to reframe the politics of aging. They point to the past thirty years, which they describe as characterized by a ...reign of neoliberal ideology, politics, and policies. The resulting deregulation, tax
cuts, privatization, and use of deficits to shrink the social sector, they say, helped pave the way for the erosion of the middle class and the expectation of retirement security for future generations. They expect that neoliberalism will soon be back in full force. To combat the neoliberal
agenda, they propose of broader strategy for economic growth across all age groups.
Social Security Politics: Ideology and Reform Svihula, Judie; Estes, Carroll L.
The journals of gerontology. Series B, Psychological sciences and social sciences,
03/2007, Letnik:
62, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Objectives. The purpose of this study was to examine the distribution of dominant values, actors, and ideological advocacy coalitions influencing the Social Security debate across two presidential ...administrations. Methods. Through content and cluster analyses, we analyzed federal legislative hearing testimonies on Social Security reform spanning 11 years. Results. Witnesses consistently expressed six dominant values: (a) advancing the market, (b) self-interest, (c) generational equity, (d) belief in market activity, (e) recommendations for market solutions, and (f) favoring the replacement of Social Security with private accounts. We identified three advocacy coalitions: conservative, progressive, and nonaligned. Conservatives dominated the hearings and were more consistent in their expression of market values when compared to progressives, who expressed social contract values less frequently. Congressional Democrats were inconsistent in upholding Social Security's social contract values. The distribution of testimonies paralleled historical, political, and economic events. Discussion. Our research indicates that one can interpret social policies as well as policy options as sets of values, and these as ideological models. We anticipate that the coherence on one political ideological view (market) and the relative lack of consistency in another (social contract) will be highly consequential for the future of Social Security, U.S. politics, and the public.
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