Promoting the health and well-being of older adults should be a priority

Promoting the health and well-being of older adults should be a priority
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Twenty four hours. That’s how long my friend’s mom was trapped on her couch, virtually paralyzed without help after being discharged from the hospital after suffering a bad fall. For millions of Americans, holidays are about the lavish meal, with some sports and maybe freakishly upbeat Hallmark holiday movies. For my friend and so many others caring for elderly relatives, it’s about the caregiving.

Her physical and psychological pain could have been avoided if her built environment were more age-friendly and our health system was more attune to the importance of housing in supporting healthy aging. Of course, part of the problem is so much of our housing stock is an adequate. About 90 percent of people wish to age in community and not in a health care institution.

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However, less than 4 percent of housing stock is suitable for individuals with moderate mobility difficulties. Simple universal design features that help prevent falls, like slip-resistant tiles, showers instead of bathtubs and properly placed grab bars, are too often absent in the built environment of older adults. They lack housing options most appropriate for them.

I got to appreciate the opportunity to better integrate housing and health firsthand as part of the Advisory Council for the Bipartisan Policy Center’s Senior Health and Housing Task Force led by Henry Cisneros and Mel Martinez, former secretaries of the U.S. Department of Housing and Urban Development. This effort produced the Healthy Aging Begins at Home report, the most widely distributed report in the history of the center. Downloading reports is one thing, taking action to improve the health of our older citizens is quite another.

Falls are all too common. About a third of older adults fall each year, resulting in about 2.5 million emergency-department visits, 700,000 hospitalizations and approximately $34 billion in health care costs. Falls are the leading cause of injury-related deaths in older adults and most falls occur in the home setting.

But, it’s more than this. Even during this extended economic expansion, housing affordability is becoming of increasing concern to millions of Americans. In Housing Older America’s Older Adults 2018, written by the Joint Center for Housing Studies of Harvard University released earlier this month, nearly a third of people 65 and older — nearly 10 million people — are cost burdened, spending at least 30 percent of their incomes on housing.

The economic challenge is expected to be greater in the future, even for those who that are middle income. Today, about 24 million middle-income — defined as a net worth between $69K and $345K – people 65 and older and this group is expected to grow 55 percent over the next 15 years.

To help curb increasing costs of our health-care system, we must find mechanisms to help keep people healthy. Housing is one of the social determinants of health and influences others. As Sen. Ben SasseBenjamin (Ben) Eric SasseCNN to partner with The Des Moines Register on polling ahead of 2020 Iowa caucuses Sasse calls on DOJ to investigate its handling of wealthy sex offender's plea deal Beto O'Rourke seen as a top contender in 2020: poll MORE (R-Neb.) and other national leaders point out, we are facing a social isolation and loneliness epidemic. Housing that helps build community, particularly intergenerational community and social capital can be a remedy. Housing models for older adults that cost-effective, bring people together and inspire greater purpose, minimize falls, efficiently deliver health services and leverage technology, including tele-health, should be our future.

Unfortunately, we are not currently moving toward a better future, despite expert recommendations. Federal funding for supportive housing for older adults under HUD”s Section 202 elderly housing program is scarce. No new construction has been funded since 2012, with current money covering only renewals on existing grants. Moreover, allocations for these costs were cut 5 percent, by $33 million, in 2016-17. 

As a real estate developer and consultant in the aging field, I have seen firsthand the positive impact of age-appropriate housing on promoting the health and well-being of older adults. As a friend, I have seen the downside when housing and health systems fails us. Collectively we can do more and with 78 million baby boomers aging into our health-care system, our fiscal responsibilities demands we must.

Ryan Frederick is the founder of SmartLiving 360 and developer of age-friendly housing. He is a 2018 Encore Public Voices Fellow.