President’s corner: If candidates won’t focus on aging issues, journalists better

By Trudy Lieberman
AHCJ president and director of the health and medicine reporting program at the Graduate School of Journalism at City University of New York
From the Fall 2007 issue of HealthBeat

At the AHCJ Urban Health Journalism Workshop held in New York in October, Paul Kleyman, editor of Aging Today, presented a fascinating panel focusing on stories about the aging population living in cities. Dr. Mary Jane Koren, who heads The Commonwealth Fund's program for frail elders; Victor Rodwin, a New York University professor who directs the World Cities Project for the International Longevity Center; and Allen Glicksman, research director for the Philadelphia Corporation for Aging, wove a compelling narrative about the stories that we as journalists should be telling about the health and well-being of our senior citizens.

As I listened to the speakers, the question I kept asking myself was: Where do the presidential candidates stand on long-term care? Of the thousands or maybe millions of words that have been written so far about the candidates and their health care proposals, few have been about aging, the quality and financing of long-term care or, for that matter, the future of Medicare – all crucial issues facing this country. You almost might say the candidates are ignoring those topics, which is a shame given the realities of aging in America. "Put this on somebody's agenda. This is important," Koren told me later.

At the workshop she presented data that should make any candidate take notice. One PowerPoint slide showed that in 2000, Medicare beneficiaries with health problems and no other insurance had out-of-pocket medical expenses that consumed 44 percent of their income. By 2025, that proportion will reach 63 percent. Koren also noted that more than one-third of Medicaid spending goes to long-term care and that the number of people with chronic illness who will need care is exploding. It's not hard to see what might happen if politicians don't soon tackle long-term care. All the panelists drove home the point that the United States does not have systems in place to help America's growing number of elders.

Earlier this year, the Long-Term Care Financing Project at Georgetown University's Health Policy Institute released a study of policy options for financing long-term care looking at four strategies that offer different mixes of public and private arrangements. But for me the study's real take-away was the revelation that one-fifth of the people who currently need long-term care say they are not getting it and are likely to suffer serious consequences as a result. Again I thought of the candidates. What positions do they have on these strategies? Are they aware that so many people who have a great need for care are not receiving it?

Another warning comes from the World Health Organization which points out that an aging population and urbanization are two major global trends that will shape the 21st century. Its just-released "Global Age-Friendly Cities: A Guide" presents a checklist for cities to examine how age friendly they are in eight areas such as outdoor spaces and buildings, transportation, social participation, and community and health services.

The guide is not meant to rank cities with one another but offers a way for cities to take stock of what they need to do to improve their services for their aging citizens. Journalists, too, can take stock of their cities and bird dog what cities are doing to make themselves age friendly. The checklist invites reporters to explore all kinds of stories. For example: Does community emergency planning deal with the needs of vulnerable older people?

If our editors and news directors believe that stories about aging and old people don't attract young readers, viewers and listeners, they should think again. The young audiences they covet may have to foot the bill for their parents' health care and nursing home expenses and figure out how to get them to doctors' appointments when the city doesn't provide adequate transportation services for people who can no longer drive.

Trudy Lieberman is director of the health and medicine reporting program at the Graduate School of Journalism at City University of New York. She also is president of the AHCJ board of directors.