Regenstrief Institute Research Scientist Kathleen Unroe, M.D., MHA, is a co-author of a position paper from the American Geriatrics Society delving into the intersection of structural racism and ageism in healthcare. The paper presents a framework to describe these concepts whose negative effects on health outcomes can be amplified when they intersect.
The goal of the position paper is to help identify healthcare inequality concerns of individuals experiencing both ageism and racism and to promote solutions to these barriers to quality care. Dr. Unroe, who is also an Indiana University School of Medicine faculty member, notes that the paper issues a challenge to build more equitable systems of care including attracting more minorities to clinical professions and training all healthcare professionals to attend to the needs of those who may be experiencing disparities in care.
“I believe the intersection of racism and ageism is underexplored and underappreciated. The cumulative effects over a lifetime of experiencing systemic racism contribute to disparities in health outcomes. There is a body of literature that supports that reality. Ageism is also pervasive in our society. This paper brings together these concepts.”Dr. Unroe, Indiana University School of Medicine faculty
Clinicians who care for older adults and researchers who study how to improve the health and quality of life of the aging population have long focused on the impact of ageism and how that affects and influences health. Addressing racism in healthcare has also activated many clinicians and researchers.
“This paper seeks to bring both of those concepts together to highlight the particular needs of individuals at risk of experiencing both ageism and racism. It challenges us to build more equitable systems of care. The goal of this work is to bring together these concepts and to examine the particular challenges posed by ageism and racism.”
A graphic in the position paper lists the implications of the intersection of racism and ageism for racially and ethnically minoritized older people:
Delayed/foregone care
Exclusion from medical research
Adverse health outcomes, including death and disability
Morbidity and mortality from COVID-19
Dr. Unroe, a geriatrician and advocate for older adults, notes that meeting challenges at the intersection of ageism and racism includes increasing representation in the healthcare workforce of people from racially minoritized groups, supporting healthcare trainees from diverse backgrounds to achieve success and including race and age diverse voices in healthcare policy discussions.
Her research, clinical and policy interests are focused on improving the quality of care -- especially access to palliative and end-of-life care -- for nursing home residents of all races and ages. She led OPTIMISTIC, a novel eight-year, $30.3 million CMS-funded demonstration project aimed at improving the quality of care and reducing unnecessary hospitalizations of those who live in nursing homes. She is the founder and chief medical officer of Probari, a business designed to disseminate the successful OPTIMISTIC clinical care model. Regenstrief Institute is an investor. A long-time member of the American Geriatrics Society, Dr. Unroe has served as chair of the organization’s public policy committee.
In a news release, the American Geriatrics Society said “Exploring the Intersection of Structural Racism and Ageism in Healthcare,” published in the Journal of the American Geriatrics Society, is “grounded in the Society’s belief that a just healthcare system recognizes that membership in groups — whether classified by age, race, gender, socioeconomic status or other descriptors — should not affect the quality of the healthcare that is delivered or who is trained to deliver that care.” (NJ/Newswise)
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