Prioritizing New York’s older adults

Since 2010, older adults in New York City have surpassed the number of school-aged children, growing nearly 17 times faster than the entire population. Despite older adults over 50 contributing nearly $72 billion to the state’s budget – just 1% is dedicated to their needs. 

With older populaces soon to become the norm nationwide, the state's department of aging recently released a Master Plan outlining urgent challenges faced by older adults and those with disabilities, along with suggested proposals such as direct care workforce recruitment and community-based services. 

At City and State’s inaugural New York Aging summit held at Hebrew Union College, advocates urged for a cultural shift against ageism – from weighing in on widespread economic and food insecurity experienced by older adults and the caregiving crisis. 

“You will never hear anyone in New York City aging ever pit young people against old adults. That is ageism. These are two anchors of society, and each needs to be supported with the systems and services they need,” said keynote speaker Lorraine Cortés-Vázquez, commissioner of the New York City Department for the Aging.

As longer lifespans become increasingly common, city and statewide advocates urge for greater investments in older adults’ economic security, whether it be in the form of pension, personal savings or Social Security – the future of which is now at stake thanks to President Donald Trump’s budget reconciliation efforts. Food insecurity continues to increase among older adults, as 500,000 are enrolled on SNAP benefits, 49,000 are in section 8 housing, with 86,000 living in public housing. Nearly 73% of these adults are heads of households, with some relying entirely on Social Security income to get by.

While workforce opportunities still exist for most older adults, for those above 75 years old with health issues, supportive community care systems have proven to yield a better quality of life while remaining cost-effective. 

“It is less expensive from a public policy perspective to keep a person in their community with those wraparound services: home care, meals, older adult centers, transportation,” said Commissioner Cortés-Vázquez. “It costs us anywhere between $50,000-$58,000 to provide those supports so that someone could stay in their community. It costs us $185,000 per person per year to keep somebody in the nursing home. Do the math.”

With just 2.6% of New York's older population in nursing homes and institutional care, advocates contend that investments should be made to those who can readily benefit from a community care model. According to Neeraja Nagarajan, associate partner at McKinsey & Company, for every dollar invested in aging initiatives, the state earns $3 back, through Medicaid cost reduction or in GDP uplift, by freeing up burdens for older adults and caregivers.

On the side of caregiving, an estimated 1.3 million caregivers live in New York City, with most being women. Many are overburdened physically and financially – spending nearly 25% of their income on caregiving.

“Caregiving is a crisis,” said Cortés-Vázquez. “This is an invisible workforce that would take us  $17.5 billion to replace. Impossible. It’s impossible to replace that kind of invisible task force. It is with a spirit of gratitude that we as a society should have for those 1.3 million caregivers in New York City.” 

While the new Master Plan for Aging outlines caregiving career pipelines, much of the social safety net protecting older adults is under threat – from anticipated cuts in funding to the Older Americans Act, Adult Protective Services, Medicaid, Medicare and SNAP benefits. In hopes of mitigating gaps in services, the state has allocated $50 million to address program shortages and workforce issues at local aging agencies. 

“To think that less than 1% of the budget goes towards the elderly. It tells the story of itself as to how we see the elderly,” said Daveth Forbes-Thomas, CEO of NYC Health + Hospitals/McKinney. 

“It’s going to take more than just the election to change the way that we actually look at the elderly to know that they contributed, and they're still contributing,” said Forbes-Thomas. “But yet we don't value them enough to make a significant piece of the budget for them.”