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A Growing Challenge
The older adult population (age 55 and up) climbs in droves each year, yet a constant refrain voiced by older adults is the overwhelming preference of aging in place in their communities. The advantages to aging in place include community engagement, improved mental and physical well-being, and cost-savings to older adults and family members. However, while the vast majority of older adults want to age in place and stay connected in their communities, significant barriers remain.
Only one percent of housing units in 2011 had standard universal design elements such as no-step entrances, grab bars, and bedrooms and bathrooms on the entry-level floor. Thus, it’s unsurprising that one out of three older adults sustains a fall each year in their own homes, resulting in 2.5 million nonfatal falls treated in an emergency room. Sadly, more than 25,000 older adults died from accidental falls in 2013.
Community development and public health practitioners and advocates can play a critical role in ensuring that there are health, safety, and accessibility features for older adults regardless of their income. They can work together to ensure that affordable housing is accessible and safe, and that older adults have access to wellness and health services. The National Community Reinvestment Coalition (NCRC) recently published a working paper on aging in community through the Federal Reserve Bank of San Francisco titled: Staying at Home: The Role of Financial Services in Promoting Aging in Community. This paper identifies a number of opportunities that community-based development organizations and financial institutions can offer in ensuring that older adult homes and units are safe, healthy, and accessible.
Community development and public health practitioners and advocates can play a critical role in ensuring that there are health, safety, and accessibility features for older adults regardless of their income.
A Growing Opportunity
The NCRC views aging in community as an integrative strategy that incorporates housing and home modifications, safety features, and health care; engages older adults; and provides accessibility to basic services from protecting older adults against financial exploitation to providing transportation to meet basic needs. Community development organizations from community development corporations to regional housing development organizations and Community Development Financial Institutions (CDFIs) can play a major role in housing development, home modifications, and providing affordable financing to older adults.
Civic Works, a non-profit community service provider based in Baltimore, Maryland, has provided home modifications to over 1,350 low-income older adult homeowners to improve their safety and health. They have teamed up with Johns Hopkins University School of Nursing’s CAPABLE Initiative, which features nurses and occupational therapists who help older adults create Adult Daily Living (ADL) plans for exercise and social engagement in the community. Empowering and Strengthening Ohio’s People (ESOP), a housing and financial counseling organization, located in Cleveland, Ohio, established a Small Dollar Loan Fund with a community development credit union and savings and loan to help older adults prevent foreclosure due to back taxes or other financing challenges. ESOP requires that all borrowers receive financial coaching and counseling during the loan process. ESOP has also conducted 152 financial workshops in Northeast Ohio that have reached 789 older adults in the past 12 months, since financial education and awareness is a critical element of Aging in Community.
East Bay Asian Local Development Corporation (EBALDC), a community development corporation (CDC) headquartered in Oakland, California, created an “Age-Friendly” corridor in the San Pablo neighborhood of West Oakland, which houses a number of low-income older adults. EBALDC partnered with Life Long Medical Care, a Federally Qualified Health Center, to provide hypertension screening, education, and referrals for local residents, many of whom were older adults. Candace Baldwin of Capital Impact Partners also mentions Life Long Medical Care in her blog on Age-Friendly Health Centers. EBALDC also did a “heart health” pilot project from October 2015 through January 2016 that included a blood pressure clinic at the California Hotel, where 120 older adults reside.
Scaling Aging in Community Through Financial Institutions
Community development organizations and community health practitioners will need increased access to financial and technical resources from financial institutions and health care systems to meet the growing demand for Aging in Community. Financial institutions should partner with CDFIs to structure investments that support housing upgrades and health enhancements. Another key recommendation is combining Community Reinvestment Act (CRA)-eligible investments in Aging in Community with potential investments from health care institutions through the Affordable Care Action Community Health Needs Assessment requirement. For more on ways banks and financial institutions can partner and create local opportunities benefiting older adults, see the full paper.
Aging in Community is one of the few triple social utilities: older adults benefit, community and society benefit from the continued engagement of older adults, and in most case there are significant cost savings to the health care system by having older adults Age in Community. With stronger financial institution partnerships more and more older adults will benefit.