A Critical Policy Analysis of Medicare Parts B and D: a Focus on Latin/x and African American Older Adult Mental Health

Abstract

Mental health is critical to age well. Mental health concerns (e.g., depression, anxiety) are pervasive in older adulthood, and older adults of minority status experience compounding consequences such as discrimination and stigma, which may place these populations at a greater risk for mental illness. Current legislation provides mental healthcare for older adults; however, the impact of this healthcare coverage on improving the mental health among minority older adults is less known. Thus, the purpose of this article is to explore the impact of Medicare Parts B and D with a focus on Latin/x and African American older adults in the USA. Guided by the Social Determinants of Mental Health and Segal’s (2018) critical analysis framework, this analysis framework expands specifically on five components of Segal’s critical framework to include (a) the social issue/social problem and affected populations; (b) the power imbalance or struggle driven by political, social, and economic factors; (c) actual policies, public laws, or administrative rules; (d) the implementation of social welfare programs; and (e) the actual impact. Results of this analysis indicate that minority status seniors may experience ongoing challenges with mental health due to long-standing barriers to unmet needs, treatment access, and restrictions and issues in shortages of mental health service providers, primarily licensed clinical social workers. The authors conclude with implications for policy modifications, such as universal healthcare. Finally, implications for social work practice are discussed, as part of the Grand Challenges for Social Work to close the health gap.