Advancing Equitable Aging: A Q&A with Ramsey Alwin, CEO of the NCOA

By 2030, one in five people will be of retirement age. As the older adult population continues to grow and change the health care landscape, it’s critical to consider the health disparities affecting their unique care needs and experiences.??

Ramsey Alwin , President and CEO of the National Council on Aging , is bringing these considerations to the CVS Health National Health Equity Advisory Board, which helps identify best practices for the company’s health equity strategy, programs and policies.???

I recently sat down with Ramsey to talk about the biggest health disparities facing older adults and what is needed to advance equity for this growing population. #HealthyAgingMonth???

Q1: Can you explain what the National Council on Aging does and the work you’re doing to advance health equity???

Ramsey: We are proud of our 70+ year history of working to improve the lives of millions of older adults, especially those who are struggling. At the National Council on Aging, we help older adults every day secure jobs, enroll in programs that help with food and medicine, manage chronic conditions like diabetes and hypertension, prevent falls, and gain access to life-saving vaccines. We take all we learn from our work directly with older adults and the community-based organizations that serve them and apply it to our advocacy to strengthen the programs we all rely upon to age well — Medicare, Medicaid, Social Security, and programs funded by the Older Americans Act that provide community support.???

?Q2: What barriers do older adults face when accessing quality care, especially those belonging to historically marginalized communities???

?Ramsey: A recent NCOA study found that most older Americans face barriers affording health and long-term care. Specifically, it found that 80% of adults 60 years and older do not have the financial resources to pay for more than two years in a nursing home. Many older adults depend on Social Security for most of their retirement income and, with an average payment of about $1,700/month this year, that is a modest benefit that does not cover the entire cost of living.???

We deeply believe that health is wealth. You’ll always find one impacting the other. If you’re healthy, you can work, provide for yourself or your family, and have a great quality of life. But often, not having enough financial resources means you cannot get well or stay healthy. It’s a vicious circle. Our research has shown that, among those 60+, women and Black or Hispanic/Latino(a) people are most affected financially by chronic conditions when we look at both out-of-pocket costs and lost wages.??

?We want to shine a light on these inequities and advocate for policies that diminish or eradicate them. For instance, we found that diabetes costs people 60+ about $20,000 per year. We applaud the $35 cap on insulin for people on Medicare in the Inflation Reduction Act, which should help deflate some of that huge cost. And there is so much more we need to do to ensure affordable, accessible, culturally responsive health care is available to all older Americans.???

?We know that historically marginalized communities most often experience hardships — both health and economic — and struggle to receive culturally responsive services and support.?We also recognize that belonging to more than one historically marginalized group, whether based on race/ethnicity, gender or sexual orientation, can further exacerbate health disparities, increasing the likelihood of chronic conditions and economic insecurity.???

?Sometimes, there are barriers to receiving the care itself. Our team conducted an analysis of data from a Federal Reserve study which showed us that LGBTQ+ individuals were significantly more likely than non-LGBTQ+ respondents to have experienced discrimination while receiving or scheduling medical care. Not surprisingly, such discrimination can and does lead to poorer health outcomes.?This further exacerbates health outcomes for people who identify as part of multiple historically marginalized communities.???

?Q3. You’re a member of the CVS Health National Health Equity Advisory Board. As a key advisor for our health equity strategy, how do you envision us continuing to partner together to advance health equity for older adults????

?Ramsey: We think aging well should be a right, not something that depends on luck or privilege. And, because aging well does depend a lot on one’s background, geography, race and ethnicity, we believe it is a social justice issue.??

That’s why NCOA developed an Equity Promise two years ago, to describe our focus on diverse older adults who have experienced the most disadvantages historically. We focus on a community-driven and diversity-first approach. We want to ensure that our outreach meets the needs of communities that have not historically enjoyed the gift of longevity — neither the quantity nor quality of years. Since CVS Health is present in so many communities, we can work together to reach those who need us most. It’s time to start a national dialogue that your ability to age well should not be based on your gender, color, sexuality, income or zip code. We look forward to working with CVS Health in these efforts.??

?Q4: NCOA hosted its Age + Action Conference in June, what were some of the key themes/takeaways from the event???

?Ramsey: Those who work in the aging space are deeply committed to making life better for older adults . The key to doing that is strengthening the collaboration between health care companies like CVS Health, government agencies like Health and Human Services and the Administration for Community Living, and community-based organizations that are closest to the seniors we serve.???

?These collaborations help implement and enact programming such as administering the COVID-19 and flu vaccine to all older adult populations, combating hunger, addressing loneliness, and highlighting the challenges of caregiving. We need to work together to deliver the optimal results for this population. Our fight for equitable aging is one day a time, one step at a time, but most importantly, done together. We were delighted to be a convener again of everyone who works in and cares about this field.??

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CVS Health is working with organizations like the NCOA to ensure that our health equity strategy reaches all communities and addresses the unique barriers and circumstances facing older adults. In order to meet the needs of our health care customers and patients of the future, all industry leaders must work to ensure that equitable aging is a facet of every care experience and initiative.??