Health of Older Adults in New York City Public Housing: Part 1, Findings From the New York City Housing Authority Senior Survey

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Older adults are an important and growing part of the social fabric of New York City (NYC). As people age, they face health concerns that can affect their ability to live comfortable, independent lives. Recent national surveys have found that more than 60% of older Americans have multiple chronic conditions and 20% have a physical disability.1,2 The quality of life older adults experience can be greatly improved by living in supportive physical and social environments and having routine access to high-quality health care services. More than 61,500 New Yorkers aged 65 and older live in New York City Housing Authority (NYCHA) public housing developments. 3 Age group projections suggest that the growth of this group will outpace that of NYC's older adult population,4 as NYCHA residents are more likely to stay in their residences instead of moving into assisted living facilities or out of the City. The large and growing number of older NYCHA residents also presents tremendous opportunities to target health, social, and financial services towards older adults in NYC. Despite the critical financial relief provided by subsidized housing, poverty remains a critical challenge for many. Almost half of older NYCHA residents live with incomes below the federal poverty level. In general, lowincome adults have higher rates of chronic illnesses, have worse access to health care services, and receive poorer quality of care than higher-income adults.5-7 In 2007, NYCHA convened a multidisciplinary task force to develop a strategy and recommend actions to address the needs of its large and expanding older population. The same year, the Age-friendly New York City initiative was launched by the NYC Mayor's Office and City Council with the New York Academy of Medicine.8 Following these efforts, NYCHA collaborated with the New York City Departments of Health and Mental Hygiene (DOHMH) and for the Aging (DFTA), as well as with the City University of New York (CUNY) School of Public Health, to conduct a survey among NYCHA residents aged 65 and older to examine health status and barriers to care in the context of nearuniversal Medicare coverage. This report summarizes our survey findings, makes recommendations to improve physical and mental health outcomes among older public housing residents in NYC, and aims to promote a more informed dialogue among residents, community-based organizations, and City agencies on how best to improve quality of life for older New Yorkers living in NYCHA housing. About the Data More than 1,000 randomly selected adults aged 65 and older living in NYCHA housing were interviewed by telephone in June 2009 for the NYCHA Senior Survey. Participants' demographic information was obtained from the NYCHA Tenant Data System. Analyses presented in this report were statistically weighted to be representative of all older NYCHA adults, and all comparisons discussed in the text are statistically significant. Additional data sources were used to draw comparisons between the demographics and health of older NYCHA adults and those of older adults in NYC and the US. Qualitative feedback was gathered from meetings with resident leaders across the five boroughs and a variety of NYCHA officials and development-based staff. OVERVIEW OF THE NEW YORK CITY HOUSING AUTHORITY (NYCHA) NYCHA is the largest public housing authority in North America, comprising more than 178,000 apartments in 334 developments with 2,602 residential buildings throughout the five boroughs of NYC. Nearly 404,000 individuals officially reside in NYCHA's public housing developments. The first senior development exclusively for residents aged 62 and older, Gaylord White Houses in Manhattan, was completed in 1964. Since then, the number of senior developments has grown to 42, and 14 mixed family developments include designated buildings for older adults. In total, 10,000 apartments in NYCHA's public housing portfolio are reserved for older adults. …