Ethnic Shifts Raise Issues in Elder Care

Abstract

BABY BOOMERS MAY SEEM LIKE A thundering herd about to trample the US health care system with a raft of age-related chronic illnesses. But these soon-to-be seniors will challenge health professionals in ways that go beyond their sheer numbers. Theleadingedgeofboomerswhoreach age65yearsin2011willusherinthemost diversepopulationofseniors inthecountry’shistory.By2030, theUSCensusBureauprojectsthattheproportionofwhites aged65yearsorolderwilldeclineby11% whiletheolderblackpopulationincreases by25%.ThepercentagesofHispanicand Asianelderlyareexpectedtonearlydouble (http://www.census.gov/prod/2006pubs /p23-209.pdf). These seismic demographic shifts will require a greater understanding of the different ways in which chronic illnesses and their complications affect diverse elderly populations, said experts at the recent Gerontological Society of America’s annual scientific meeting. Carmen Green, MD, of the University of Michigan, Ann Arbor, said chronic pain severe enough to interfere with daily activities is a “silent epidemic” that affects one-third to half of older US adults. But Green’s work has zeroed in on an area not previously studied: whether the prevalence and severity of chronic cancer-related pain differ between older black and white cancer survivors. She presented preliminary findings fromasampleof400blackandwhitepatients aged 53 to 77 years who survived multiple myeloma or breast, colorectal, lung,orprostatecancer.Overall,17%had painat the timeof thestudyand32%had pain at some point since their diagnosis. The prevalence of pain did not differ between blacks and whites, but blacks reported more severe pain than whites. On a scale of 0 (no pain) to 10 (worst pain imaginable), blacks rated their most severe pain at 6.5 compared with 3.5 for whites. Blacks scored their least severe pain at 2.5 compared with 0.9 for whites. At the time the survey was taken, blacks reported their current pain severity was 4.0 compared with 1.5 for whites. The data did not account for differences in treatment among cancer survivors.