Low-income Seniors Research Articles

Recommendations for acceptance of digital public services by low-income seniors in smart cities by human-centered design

Background: In Brazil, the federal government has developed a digital platform for public health services, with state and municipal governments connecting their solutions to unify citizen registration. Objective: To understand the phenomena involved, in order to provide recommendations for the acceptance of digital technologies by low-income elderly people in the context of smart cities. Method: The theory of the consolidated meta-analytic approach (TCMA) was used for a systematic bibliographic review (SBR) and case studies presented in a Design Postgraduate class, carried out in collaboration between two Brazilian Federal Universities. Results: Creation of recommendations in three categories within the framework of human-centered design. Conclusions: This study identifies opportunities for the development of products, services and public policies for the digital inclusion of low-income older people in the context of smart cities.

Feasibility of aging in place clinics in low income senior housing

The purpose of this study was to describe the feasibility of implementing interdisciplinary senior housing clinics. Feasibility was based on evidence of resident participation, services provided, improvement in clinical outcomes and sustaining clinics over time. Data were collected prospectively in four senior housing communities which included approximately 375 residents 60 years of age and older. Over the 12-month implementation period, 228 residents were seen, 61 % of all residents. We gave 131 immunizations, checked 576 blood pressures, completed 92 foot care treatments, 69 hearing evaluations and cerumen removal, completed 16 advance directives, 119 Annual Wellness Visits, and 13 assessments for acute medical problems. Overall, 87 individuals (38 %) had a decrease in their blood pressures, 121 (54 %) maintained their pressures and 19 (8 %) had increases in blood pressures. We reached over half of the residents living in these communities and estimated we could financially maintain the clinics with reimbursement based on billing.

A comparison of self-reported chronic disease, health awareness and behaviours in social housing residents: cross-sectional study of communities in Ontario and Quebec

ObjectiveSocial housing programs are integral to making housing more affordable to Canadian seniors living in poverty. Although the programs are similar across Canada, there may be inter-provincial differences among the health of residents that could guide the development of interventions. This study explores the health of low-income seniors living in social housing in Quebec and compares it with previously reported data from Ontario.Results80 responses were obtained in Quebec to compare with the previously reported Ontario data (n = 599) for a total of 679 responses. More Ontario residents had access to a family doctor (p < 0.001). Quebec residents experienced less problems with self-care (p = 0.017) and less mobility issues (p = 0.052). The visual analog scale for overall health state was similar in both provinces (mean = 67.36 in Ontario and 69.23 in Quebec). Residents in Quebec smoked more cigarettes per day (p = 0.009). More residents in Ontario participated in moderate physical activity (p = 0.09), however, they also spent more time per day on the computer (p = 0.006).

Neighbourhood Care Teams: Integrating Health Care and Social Services for Seniors in Toronto Community Housing

Toronto Seniors Housing Corporation (TSHC), owned by the City of Toronto, provides housing for 15,000 low-income seniors in 83 seniors-designated buildings across Toronto. The North Toronto Ontario Health Team (including primary care, hospital, community and home-care) partnered with one of the TSHC buildings in North Toronto to develop and implement a Neighbourhood Care Team (NCT) model to support TSHC’s Integrated Service Model to address tenants' health and social needs, co-designed with the tenants. The goal of the NCT is to provide an integrated model of care that is accountable to meeting the needs of people living within a specific neighbourhood so that people experience one system that provides simple access to service, and care that is coordinated with streamlined communication of health care providers.&#x0D; The NCT objectives include:&#x0D; &#x0D; Increasing primary care provider connections&#x0D; Increasing mental health &amp; addictions care access and support options&#x0D; Increase Digital Health access and literacy to support primary care and specialist access, reduce social isolation and increase wellness&#x0D; Reduce avoidable ED and hospital use.&#x0D; &#x0D; The service design is guided by a co-design process with the tenants as follows:&#x0D; &#x0D; Door to door survey to engage tenants in identifying their barriers and the services and supports most meaningful to them&#x0D; Eliciting and voting on key education and support initiatives at an influenza vaccination clinic&#x0D; Communication back to tenants regarding the results of the survey and how the strategies/activities planned for the building have been prioritized based on their feedback.&#x0D; Multi-organization Education Fair focusing on the top issues addressed during the vaccination clinic survey which was well attended&#x0D; Regular educational sessions in response to tenant interest, combined with a self-screening component to help link the information to a concrete service/intervention to promote better health.&#x0D; Providing translation support to enable access and engagement by tenants from a variety of cultural backgrounds.&#x0D; Ongoing commitment to continue and co-design services and elicit tenants’ feedback.&#x0D; &#x0D; The team has worked to design structures to strengthen coordination and collaboration among the various delivery partners:&#x0D; &#x0D; Multi-organizational bi-weekly huddles to discuss residents identified with unmet needs (with consent or anonymized without consent) and identify options for improving their access to health care/social services and respond to their needs in a timely manner&#x0D; Designed pathways for ensuring attachment to primary care, access to primary care and specialist support, access to home care services and assistance with social determinants of health&#x0D; Established mechanisms to obtain informed consent and enable information sharing between delivery partners.&#x0D; &#x0D; Multi-modality tenant engagement to tailor services and supports to a TSHC building has led to increased involvement by tenants and a growing interest by tenants in strategies to improve their health and social inclusion. Cross-sector collaboration is an efficient and effective way to establish needs-based integration of health and social care services in this setting. Strong leadership as well as co-developed processes, frequent building meetings and cross-sector huddles were effective ways of sharing innovative ways of meeting needs with limited resources.&#x0D; &#x0D; &#x0D; &#x0D;

Who is most affected by carbon tax? Evidence from Chinese residents in the context of aging

Previous research on the distributional effects of carbon tax has primarily focused on different income groups, with less examination of different age groups. Nevertheless, significant differences in the effect of carbon tax are expected for different age groups, particularly for the vulnerable elderly. Based on detailed data regarding the consumption patterns, this study first investigates direct and indirect emissions for different age groups of residents. And then we analyze the distributional effects of carbon tax on residents of different ages and income groups using an input–output price model. The results show that the indirect carbon payment burden rate on the elderly (i.e., the proportion of carbon tax expenditure in total expenditure) is 1.2 times that of the general population. The combined impact of income and age on comprehensive indirect carbon payment rates is estimated to be 1.4 times that of the general people, showing that the carbon tax exacerbates the energy poverty of low-income seniors to a greater extent. In addition, supportive measures can effectively reduce the carbon tax cost burden of the elderly and low-income residents. Even if the carbon tax is levied more vigorously, it can still enhance the ability of vulnerable groups to overcome negative energy shocks.

ANNUAL WELLNESS VISITS (AWV) FOR RESIDENTS IN LOW-INCOME SENIOR HOUSING

Abstract Despite the known benefits, less than one-fifth of all eligible Medicare patients receive an Annual Wellness Visit (AWV). Consequently, we brought the AWV to the older residents in low-income senior housing. Across all four communities the residents are invited to receive an AWV during their birthday month via an individual invitation. Invitations are sent to the facility manager who places them in the residents’ mailboxes. As per Medicare requirements, the Annual Wellness Visit includes such things as medical and family history, review of providers and/or suppliers, height, weight, blood pressure monitoring, medication review, evaluations of health behaviors, cognition, immunizations, mood, safety, and health screenings. At the end of the review the resident is provided with a set of health goals for the year and a small token birthday gift from the team. Approximately half of those who were invited each month came to the clinic for their Annual Wellness Visit. None of the residents to date who have had a Welcome to Medicare Visit were aware of the opportunity. Goals have focused on better adherence to health behaviors, particularly medication adherence, diet and physical activity, and updating immunizations. Most reported adherence to appropriate age-related screenings, and monitoring of cardiovascular disease and screening for and assessment of diabetes and hypercholesteremia. Lastly, we have been able to encourage the completion of the Maryland Orders for Life Sustaining Treatment among many of the participants who were previously unaware of this form and/or not willing to address it.

CLIMATE CHANGE, AIR POLLUTION, AND MENTAL HEALTH AMONG OLDER KOREAN AMERICAN RESIDENTS IN LOW-INCOME SENIOR HOUSING

Abstract Given the impact of climate change and air pollution on human health, the present study examined how older individuals’ perceived disruption by extreme weather and air pollution would be linked with mental health. We focused on older Korean Americans living in low-income senior housing and selected anxiety as an indicator of mental health. Data came from surveys with Korean American residents in five low-income senior housing facilities located in the Greater Los Angeles area (n=343, Mean age = 78.4). Anxiety, measured with the GAD-7, averaged 3.38 (SD = 3.77). Perceived levels of disruption caused by extreme weather and air pollution averaged 1.71 (SD = .69) and 1.75 (SD = .72), respectively, out of a range from 1 (not at all) and 4 (very much). Individuals who reported greater disruptions by extreme weather and air pollution had a higher level of anxiety. Given the high correlation between the two types of disruption (r = .56, p &amp;lt; .001), we tested separate regression models of anxiety. Each variable of the perceived disruption by extreme weather (β = .18, p &amp;lt; .001) and air pollution (β = .18, p &amp;lt; .001) was found to have a significant impact on anxiety. Although limited by the use of a small sample of convenience restricted to one ethnic group in one geographic location, our findings suggest the potential mental health impact of climate change and air pollution and call attention to intervention strategies.

STRATEGIES FOR ENGAGING LOW-INCOME SENIOR HOUSING RESIDENTS IN INTERDISCIPLINARY WELLNESS CLINICS

Abstract Engaging residents in low-income senior housing communities in health and wellness services can be challenging. Despite the significant healthcare needs of residents in senior housing communities, numerous barriers to engaging residents exist including the mistrust of academic or healthcare institutions, stigma about health conditions and treatment, and lack of awareness about services available. To successfully implement Interdisciplinary Wellness Clinics, a participatory approach was used through engagement of stakeholders in the housing communities. The Interdisciplinary Wellness Clinic team worked closely with the Senior Program Manager and the community and regional property managers to establish a plan for implementation. The needs of the communities, day and timing of the clinics that would fit with their schedules, and a plan for ways to invite and engage the residents was developed. Flyers were made by the interdisciplinary team for visits at each community and sign-up sheets for the services provided on any given month. The flyers were posted on bulletin boards within the communities or in a central location for residents to access them by the community property managers. Intermittently, associated with holidays for example, we also held raffles for gifts for anyone who attended the clinic. Regular meetings were held with the property managers at each of the senior housing communities to solicit their input and brainstorm strategies for continued engagement of residents and identify new approaches to increase engagement in wellness clinic services.

Services, Quality of Life And Satisfaction of Senior Citizens in Bacolod City

The main purpose of this study was to come up with a general description and relationship among the extent of services, quality of life and satisfaction of senior citizens in Bacolod city. The areas of services include; health social access to public transport, utility discount and mandatory Philhealth coverage. Areas in the quality of life includes; health status, financial security, organizational affiliation, household relations and access to senior citizens’ benefits. Areas on satisfaction includes; appreciation of good health, social support, emotional security, contentment and leisure and activity. The study employed the descriptive, comparative and relational analytical schemes in coming up with a general description, comparison and relationship among the selected variables. The mean, t-test and Pearson Product Moment of Correlation formula was used. Findings of the duty revealed that senior citizens were adequately provided with all these services particularly on health, social public transport, utility discount and mandatory Philhealth services. They are experiencing quality living with regards ti their relationship in their household and access to Philhealth benefits. However, findings showed that they are not adequately contented with regards to health condition and financial security. They were having high level of satisfaction on the aspect of social support, emotional security, and leisure activities. Moreover, study showed that there was significant relationship between services and quality of life of senior citizens. Likewise, a significant relationship between the services and satisfaction of senior citizens and a significant relationship between the satisfaction and quality of life of senior citizens has existed. The study concluded that on services, although the extent was not at its highest degree of contentment to the services but senior citizens were contented of all the services provided to them. On quality of life, senior citizens were not fully contented and happy about the quality of life they were experiencing to note that a moderate extent on contentment was perceived by the senior citizens. On satisfaction, senior citizens degree of satisfaction was high considering that majority of life satisfaction was perceived by them to be high particularly in social, emotional, leisure and contentment. It was concluded further that senior citizens were not fully satisfied or contented about their health condition. The study highly recommends that medical programs/project shall provide greater emphasis on the following; married, low income, rural areas, male, without college degree senior citizens. Social services programs/project shall provide greater emphasis on the following; married, low income, rural areas, without college degree. Access to public transport programs/project shall provide greater emphasis on the following; married, low income. Utility discount programs/project shall provide greater emphasis on the following; married, without college degree, low income and leisure activity with greater emphasis on married, without college degree and low income senior citizens

Development of a Needs Assessment for Low-income Seniors in Cleveland Ohio: A student-driven Interprofessional Approach.

Older persons with low socioeconomic status in the United States have different and unique health needs compared to younger persons. As part of a student-led, interprofessional partnership, we performed a needs assessment of community dwelling older persons with low socioeconomic status in an urban location within Ohio, USA. Three entities participated in the needs assessment: a student-run health clinic, a Federally Qualified Health Center, and an apartment complex of the study population. Health professional students from medical, dental, nursing, social work, nutrition, and physician assistant programs led the needs assessment process. The process consisted of multiple phases, which included preliminary literature review, survey development, data collection, and analysis. The final survey was multidisciplinary, with six content areas covered in 37 items. One hundred nineteen survey responses were received, and multiple areas of need were identified including food insecurity, dental care access, and mental health. 93% of participants had at least one unmet health need and 39% of respondents met our classification for high need. The needs of the local study population had key differences from previously published data in more generalized populations of older community-dwelling individuals in the United States, notably lower utilization of dental care (43% vs. 66%), increased prevalence of possible food insecurity (30% vs. 17%), and increased use of age-appropriate preventive cancer screening services. Multiple areas of need were successfully identified through a student-led interprofessional needs assessment. Future student teams can address the identified needs, again through interprofessional collaborations. This process may have unique benefits to help build robust community-academic partnerships, while fostering interprofessional collaborative opportunities among healthcare students.

고령친화형 서비스 융합의 시니어 주거단지 개발 방안 연구

This study is to find ways to respond to Korea’s low-growth and aging issues with suggesting a future residential complex model through advanced domestic and international cases. The 50+ community shows a new vision for building a preemptive housing system, spreading private-led service supply, and further creating an “Aging In Place” environment.&#x0D; Active seniors in their 50s and 60s are the generations not only with relatively large assets, but also with poor economic and residential conditions due to divorce, business failure, and unemployment. It is also necessary to develop community-based social support service system to support housing, stable income and leisure activities, and create premium housing services to fulfill their unmet needs and trendy lifestyles especially for active seniors with high income.&#x0D; In the United States, the senior housing business is expanding centering on large private construction companies’ franchises. In addition, various service infrastructures, such as 50+ community, independent living, assisted living, nursing home, and dementia care home, are built together in a huge complex according to the consumer’s requirements. In Europe, senior citizens live in flat, apartments, condos, share homes, or houses and use community-based social welfare service and programs. The famous European retirement communities are usually surrounded by the beautiful natural environment with luxurious resort facilities.&#x0D; The 50 plus community is a preemptive model that can contribute to the creation of the “Aging In Place” environment in Korea. It is also necessary to develop a new ageing-friendly residential complex model for encouraging investments of the private sectors. A private-led 50+ community model is to be differentiated from the public-centered model which mainly focus on supporting daily living services for super-aged, low-income, and disabled seniors. The preemptive new model may be triggering a new senior housing business and solve the social problems in this super-aged society.

Patient Perspectives on a Tailored Self-Management Education and Support Intervention for Low-Income Seniors With Chronic Health Conditions

BackgroundThe Assessing Outcomes of Enhanced Chronic Disease Care Through Patient Education and a Value-based Formulary Study (ACCESS) was a 2 x 2 factorial randomized trial that tested the impact of a tailored self-management education support (SMES) program, which demonstrated a 22% reduction in adverse clinical events. We sought to qualitatively explore participants’ perspectives on the SMES intervention, and the ways in which it may have improved self-management skills. MethodsWe used a qualitative descriptive approach and conducted individual semistructured interviews. We conducted inductive and deductive thematic analysis using NVivo 12 (QSR International, Burlington, MA). ResultsWe interviewed 20 participants who had recently completed the 3-year SMES intervention. The following 3 main themes emerged from the data: (i) empowerment; (ii) intervention acceptability; and (iii) suggestions for improvement. Regarding empowerment, we identified subthemes of health literacy, self-efficacy, self-management, and active role in health. Several participants reported that empowerment promoted health behaviour change or improved confidence in self-management. Regarding acceptability, we identified subthemes of ease of use and presentation style. Most participants expressed positive feelings toward the intervention and felt that it was easy to understand. Finally, we identified subthemes of learning style, content, and engagement strategies, within the theme of suggestions for improvement. Some participants said that the messages were too general and did not fully address the complex health concerns they had. ConclusionsOur results highlighted key strategies to promote patient engagement and self-management behaviours and demonstrated how they may have been used to improve clinical endpoints. Additionally, we demonstrated the novel use of marketing principles in SMES interventions.

Development of a prediction model for the depression level of the elderly in low-income households: using decision trees, logistic regression, neural networks, and random forest

Korea is showing the fastest trend in the world in population aging; there is a high interest in the elderly population nationwide. Among the common chronic diseases, the elderly tends to have a high incidence of depression. That said, it has been vital to focus on preventing depression in the elderly in advance. Hence, this study aims to select the factors related to depression in low-income seniors identified in previous studies and to develop a prediction model. In this study, 2975 elderly people from low-income families were extracted using the 13th-year data of the Korea Welfare Panel Study (2018). Decision trees, logistic regression, neural networks, and random forest were applied to develop a predictive model among the numerous data mining techniques. In addition, the wrapper’s stepwise backward elimination, which finds the optimal model by removing the least relevant factors, was applied. The evaluation of the model was confirmed via accuracy. It was verified that the final prediction model, in the case of a decision tree, showed the highest predictive power with an accuracy of 97.3%. Second, psychological factors, leisure life satisfaction, social support, subjective health awareness, and family support ranked higher than demographic factors influencing depression. Based on the results, an approach focused on psychological support is much needed to manage depression in low-income seniors. As predicting depression in the elderly varies on numerous influencing factors, using a decision tree may be beneficial to establish a firm prediction model to identify vital factors causing depression in the elderly population.

The US Council of Economic Advisers on Changing Female Labor Force Participation

Population and Development ReviewEarly View DOCUMENTS The US Council of Economic Advisers on Changing Female Labor Force Participation First published: 13 June 2023 https://doi.org/10.1111/padr.12562Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL References Abraham, K., and M. Kearney. 2020. “Examining the Decline in the U.S. Employment-to-Population Ratio: A Review of the Evidence.” Journal of Economic Literature 58(3): 585– 643. https://doi.org/10.1257/jel.20191480 Baker, M., J. Gruber, and K. Milligan. 2008. “Universal Child Care, Maternal Labor Supply, and Family Well-Being.” Journal of Political Economy 116(4): 709– 745. https://doi.org/10.1086/591908 Black, S., D. Schanzenbach, and A. Breitwieser. 2017. “ The Recent Decline in Women's Labor Force Participation.” Hamilton Project. https://www.brookings.edu/wp-content/uploads/2017/10/es_10192017_decline_womens_labor_force_participation_blackschanzenbach.pdf. Blau, F., and L. Kahn. 2013. “Female Labor Supply: Why Is the United States Falling Behind?” American Economic Review 103(3): 251– 256. https://doi.org/10.1257/aer.103.3.251 BLS (U.S. Bureau of Labor Statistics). 2019. “ Number and Percent of Eldercare Providers Who Were Parents of Household Children Under Age 18 by Sex and Selected Characteristics, Averages for the Combined Years 2017–2018.” https://www.bls.gov/news.release/elcare.t09.htm. BLS (U.S. Bureau of Labor Statistics). 2022. “ Employee Benefits in the United States.” https://www.bls.gov/ncs/ebs/benefits/2022/home.him. Council of Economic Advisers. 2015. Economic Report of the President. https://www.whitehouse.gov/wp-content/uploads/2021/07/2015-ERP.pdf. Gelbach, J. 2002. “Public Schooling for Young Children and Maternal Labor Supply.” American Economic Review 92(1): 307– 322. https://doi.org/10.1257/0002828.02760015748 Goldin, C. 2006. “The Quiet Revolution That Transformed Women's Employment, Education, and Family.” AEA Papers and Proceedings, 1– 21, https://scholar.harvard.edu/files/goldin/files/the_quiet_revolution_that_transformed_womens_employment_education_and_family.pdf. Haeck, C., P. Lefebvre, and P. Merrigan. 2015. “Canadian Evidence on Ten Years of Universal Preschool Policies: The Good and the Bad.” Labour Economics, 36: 137– 157. https://doi.org/10.1016/j.labeco.2015.05.002 Maiello, M. 2017. “ Diagnosing William Baumol's Cost Disease.” Chicago Booth Review. https://www.chicagobooth.edu/review/diagnosing-william-baumolscost-disease. Morrissey, T. 2017. “Child Care and Parent Labor Force Participation: A Review of the Research Literature.” Review of Economics of the Household 15(1): 1– 24. https://doi.org/10.1007/s11150-016-9331-3. National Partnership for Women and Families. 2022. “ State Paid Family and Medical Leave Insurance Laws.” https://www.nationalpartnership.org/our-work/resources/economic-justice/paid-leave/state-paid-family-leave-laws.pdf. OECD (Organization for Economic Cooperation and Development). 2019. “ Public Spending on Childcare and Early Education.” OECD Family Database. https://www.oecd.org/els/soc/PF3_1_Public_spending_on_childcare_and_early_education.pdf. OECD (Organization for Economic Cooperation and Development). 2022. “ LFS by Sex and Age: Indicators.” https://stats.oecd.org/index.aspx?r=967539#. Shen, K. 2021. “ Who Benefits from Public Financing of Home Care for Low-Income Seniors?” Working paper, Harvard University. https://scholar.harvard.edu/files/kshen/files/caregivers.pdf. Siminski, P., and R. Yetsenga. 2022. “Specialization, Comparative Advantage, and the Sexual Division of Labor.” Journal of Labor Economics 40(4): https://doi.org/10.1086/718430. Ziliak, J. 2014. “ Supporting Low-Income Workers through Refundable Child-Care Credits.” Brookings Institution. https://www.brookings.edu/research/supporting-low-income-workers-through-refundable-child-care-credits/. Early ViewOnline Version of Record before inclusion in an issue ReferencesRelatedInformation

Enhancing social connections through an acting and improvisation course for older Americans in low-income housing

ABSTRACT Background Older adults living in subsidized housing may be at increased risk of social isolation. Applied theater, a participatory art program, can facilitate social connections among older adults. Methods A professionally-facilitated 12-week acting and improvisation course was held in two federally subsidized buildings in an urban setting. The mixed-method design included thematic analysis of interviews, participant observation, field notes, and statistical analysis of change over time in social isolation, community belonging, and social exclusion. Results Participants were motivated to meet other building residents, and the course included aspects that encouraged social bonding. Conclusions Although recruitment of socially-isolated older adults presented challenges, this study presents lessons on what motivates residents of low-income senior housing to enroll in an acting program and how to design a theater course in this setting that promotes group bonding.

“Aging in Displacement: Urban Revitalization and Puerto Rican Elderhood in Chicago”

Displacement has marked the individual and collective lives of Puerto Ricans in Chicago, especially those who migrated in the 1950s and 1960s. For these older persons, the arrival of the gentry and the yuppies of yesterday, the hipsters of today, and the disappearance of familiar faces in their current neighborhoods are not new phenomena, but rather parts of a profoundly familiar process. They came of age in displacement. Today some Puerto Rican older adults have achieved housing security and are able to age in place because they live in low-income senior housing. Yet a sense of displacement still looms large in their daily lives with the upscaling of and new-build gentrification in their current neighborhood. This work sheds light on the meaning of place for older adult Puerto Ricans who have experienced what psychiatrist and urban studies scholar Mindy T. Fullilove calls a history of “serial displacement.” Through life history narratives and ethnographic snapshots, this paper highlights the neglected reality of “aging in displacement,” or the experience of growing up and growing older in a context of repeated socio-spatial dislocation and how individual and collective life histories of community upheaval texture the spatial and social meanings of place.

The Relationship of Food Insecurity to Nutritional Risk in Independent Living Older Adults

Understanding the factors that augment optimal health during aging is critical as the US older adult population is increasing. Most research about food insecurity, nutritional risk, and perceived health among older adults are in urban areas or congregate living facilities. Thus, the purpose of this project was to study the relationships among these factors, plus activities of daily living, in community-dwelling older adults in a medium-sized city. Using a qualitative-quantitative study design, a cross-sectional survey was completed by 167 low-income senior apartment residents. Food insecurity in this group was higher than the national and state rate, yet nutrition assistance programs were underutilized and participants under 75 years were more food insecure than their older counterparts. Food insecure residents were at greater nutritional risk, had poorer self-reported health status, were more likely to be depressed, and had a less independent function, including limitations on the ability to shop for and prepare food. The study area is desirable to retirees due to lower cost of living; however, access to services, such as grocery stores, public transportation, and health care providers is limited. This research indicates the need for increased outreach, nutrition assistance, and support services to ensure healthy aging in these regions.

The role of patient navigation in supporting low-income older adults in their housing needs during hospital to home transitions: A qualitative descriptive study from Ontario, Canada

Introduction Housing is an important determinant of health. Little research has explored hospital and community agency staff perspectives on how to support the housing needs of low-income older adults. Therefore, this paper examines the challenges associated with supporting low-income seniors as they transition from hospital to home and explores what role, if any, patient navigation models of care could have in addressing housing needs. Methods A thematic secondary analysis that triangulated data from two qualitative studies was used. In total, interviews and/or focus groups with 109 hospital and community care workers were re-analyzed, applying a new interpretive lens to the data to reveal new insights. Data were collected in Ontario, Canada. Results Participants described how low-income older adults have increasing complex care needs that influence their housing, but housing supports are limited and difficult to navigate. Participants believed further support was needed and suggested that a housing-specific patient navigation model of care may be beneficial, but difficult to implement due to the limitations of existing services. Discussion Our findings provide a unique perspective on the challenges hospital and community staff face in caring for older adults with housing needs. Patient navigation with a focus on housing may support these older adults. Further work needs to be undertaken to better understand how to best implement sustainable housing patient navigation models of care.

Monitoring summertime indoor overheating and pollutant risks and natural ventilation patterns of seniors in public housing

Indoor heat and air pollution pose concurrent threats to human health and wellbeing, and their effects are more pronounced for vulnerable individuals. This study investigates exposures to summertime indoor overheating and airborne particulate matter (PM2.5) experienced by low-income seniors and explores the potential of natural ventilation on maintaining good indoor thermal conditions and air quality (IAQ). Environmental and behavioural monitoring and a series of interviews were conducted during summer 2017 in 24 senior apartments on three public housing sites in NJ, USA (1930s’ low-rise, 1960s’ high-rise and LEED-certified 2010s’ mid-rise). All sites had high exposures to overheating and PM2.5 concentrations during heat waves and on regular summer days, but with substantial between-site and between-apartment variability. Overheating was higher in the 30s’ low-rise site, while pollutant levels were higher in the 60s’ high-rise. Mixed linear models indicated a thermal and air quality trade-off with window opening (WO), especially in some ‘smoking’ units from the older sites, but also improved both thermal and PM2.5 concentration conditions in 20% of the apartments. Findings suggest that with warmer future summers, greater focus is needed on the interdependencies among (1) thermal and IAQ outcomes and (2) technological and behavioural dimensions of efforts to improve comfort for vulnerable occupants.

TECHNOLOGY DESIGN AND IMPLEMENTATION TO PROMOTE EQUITY, INCLUSION, AND DIVERSITY

Abstract The design of technology and technology-based solutions for the challenges many older adults face must consider principles of equity, inclusion, and diversity, or there is a risk of exacerbating digital divides in our society. This session focuses on the design, evaluation, and implementation of technologies to support older adults considering the diversity of the older adult population with respect to factors such as race and ethnicity, income level, health conditions, and cognitive status. M. Harris will discuss the facilitators and barriers identified by Black older adults related to the use of wearable devices for health monitoring. J. Chung will present on the development of a smart speaker application to support wellness among low-income senior housing residents. C. Berridge and E. Sanders will discuss designing technology solutions related to diversity with respect to cognitive status, with Berridge discussing preferences of older adults with mild Alzheimer’s disease for a technology-delivered planning tool, and Sanders presenting technology-based solutions to support the prospective memory of older adults with diverse cognitive impairments. Finally, Schiaffino will present a study examining the acceptability of community-based telehealth programs among vulnerable older adults as a function off health, language, and ethnicity. General themes of inclusive design to ensure that all older adults can benefit from existing and emerging technology-based solutions will be highlighted.