Diversifying Population Calls for Rethinking of Senior Care, Delivery Strategies

As the aging population becomes more ethnically diverse, caregivers will need to adapt current strategies equipped to patients’ social and cultural backgrounds.

Understanding the “cultural contexts” of patients can lead to improved treatment and diagnoses, says Peggye Dilworth-Anderson, professor, health policy & management, interim co-director of the Institute on Aging at the University of North Carolina in an interview with Kaiser Health News

The U.S. population will be considerably more racially and ethnically diverse by 2060, according to projections from the U.S. Census Bureau. 


“The next half century marks key points in continuing trends—the U.S. will become a plurality nation, where the non-Hispanic white population remains the larges single group, but no group is in the majority,” said U.S. Census Bureau Acting Director Thomas L. Mesenbourg.

Between 2012 and 2060, the age 65 and older population is expected to more than double, from 43.1 million to 92 million, the Census Bureau reports. Additionally, the older population would represent one in five U.S. residents by the end of the period. Currently, the older population accounts for one in seven Americans. 

One of the first steps in defining the connection between cultural competency and health disparities Dilworth-Anderson mentions is making sure there is equity in health care to look at the world from the patient, family, and caregiver points of view. 


Since many cultures have different views of assessing loved ones’ care needs, a level of trust must first be built to foster that care, says Dilworth-Anderson.

Location is only part of the equation in receiving proper, effective care, she notes. The other part depends on whether providers understand patients’ backgrounds and take them into account, and whether they are good at reading between the lines of what’s being said with consideration to patients’ beliefs. 

In Latino and African American cultures, multiple family members are part of the decision-making process and want to be included in all conversations regarding loved ones’ care treatments, Dilworth-Anderson said to KHN. This can be tricky, since HIPPA privacy regulations protect patients’ medical records and other personal health information.

There may also be a delay in receiving a diagnosis or treatment in dementia from these families, as Dilworth-Anderson says these conditions can be considered a “normal part” of getting older in these cultures.

Another possible problem is that not all minority caregivers take advantage of all the support services available to them, she says. Given the idea that memory loss or agitation is culturally accepted, these families most likely would not take advantage of outside help.

“We need to look at how people are the same and how they are different,” says Dilworth-Anderson. “For example, the Hmong, Vietnamese, and African American cultures all hold the elderly in high esteem. However, each group has certain ways of caring for them, according to their customs. We need to know this and respond appropriately.”

Written by Jason Oliva