Leveraging Multisector Plans for Aging to Promote Health Equity

As our population skews older, ensuring equitable access to healthcare and social services becomes increasingly important. Multisector Plans for Aging (MPAs) have emerged as a pivotal framework for addressing the diverse needs of older adults and promoting health equity. This comprehensive strategy encompasses initiatives aimed at enhancing well-being and quality of life for older Americans, while tackling systemic disparities.

MPAs have been trending with state-level planners to meet the needs of a growing older adult population, as well as addressing the needs of people living with disabilities and caregivers. The goal of developing a state MPA is to create a long-term plan that coordinates a system of care and support for older adults, people with disabilities and their caregivers. Plans also should address social determinants of healthy aging like access to affordable housing and transportation.

Cross-sector involvement in developing plans and implementing them is an essential component of MPAs, which typically span a more than 10-year term. MPAs matter because they create an umbrella plan that aligns state and local efforts and enhance collaboration to ensure access to care and services that help people age well.

Nearly half the states in the country either have developed an MPA or are in the process of doing so:

  • 5 states (California, Colorado, Massachusetts, Texas and Vermont) have an MPA in place;
  • 6 states (Maryland, Missouri, New York, North Carolina, Pennsylvania and Utah) have legislation or an executive order to develop an MPA;
  • 13 states (Connecticut, Illinois, Indiana, Iowa, Minnesota, Nevada, New Hampshire, North Dakota, Oklahoma, Oregon, South Carolina, Tennessee and Washington) are developing an MPA.

A Center for Health Care Strategies Learning Collaborative, funded by the SCAN Foundation, West Health and the May & Stanley Smith Charitable Trust, has been a catalyst for MPA progress in many states. The collaborative has developed resources that are useful to other states looking to begin developing their own MPAs.

Health equity means ensuring that all individuals have equal opportunities to attain their full health potential, independent of social, economic, or demographic circumstances. It also means addressing systematic disparities in health outcomes, access to healthcare services, and resources distribution. The concept of health equity recognizes that not everyone starts from the same baseline of health and that race, ethnicity, income, education, geography and other social determinants of health can significantly impact one's well-being. Achieving health equity means implementing policies and interventions aimed at reducing these disparities and promoting fair and just access to healthcare and other resources necessary for good health.

MPAs can be used to promote health equity in four key ways:

  1. Identifying and addressing disparities:

    * Focusing on recognizing and addressing disparities among older adults, particularly those from marginalized communities, is fundamental to MPAs. By collecting and analyzing data on health outcomes, access to care and social determinants of health, policymakers can pinpoint areas of inequity and tailor interventions to meet the specific needs of underserved populations.

    * Through targeted initiatives, such as expanding Medicaid coverage, increasing funding for community health centers, and investing in culturally competent healthcare services, MPAs can bridge the gap in access to quality care for vulnerable older adults, including racial and ethnic minorities, low-income individuals and those in rural areas.
  2. Promoting age-friendly communities:

    * Age-friendly communities lie at the heart of MPAs. Such environments address social determinants of health by supporting older adults in leading healthy, active and independent lives. These communities prioritize accessibility, inclusivity and social connectedness, making it easier for older residents to access healthcare, transportation, housing and recreational opportunities.

    * “Creative aging” is a promising strategy to improve older adults’ quality of life, for example via participation in community music endeavors as at the MacPhail Center for Music in Minneapolis. Organizations like Lifetime Arts and the New Horizons International Music Association are useful resources for communities looking to include creative aging approaches in their MPA work.

    By implementing age-friendly policies and infrastructure improvements, such as pedestrian-friendly streets, affordable housing options and accessible public transportation, MPAs can help mitigate the barriers faced by disadvantaged older adults, fostering health equity.
  3. Strengthening caregiving support:

    * Family caregivers play a vital role in supporting older adults, often providing essential help with activities of daily living, medication management and emotional support. However, caregivers may experience significant challenges, including financial strain, caregiver burnout and limited access to resources.

    * MPAs recognize the importance of supporting caregivers and offer a range of initiatives to alleviate their burden. This includes respite care services, caregiver training programs and financial assistance programs. By bolstering caregiver support, these plans not only enhance the well-being of older adults but also promote equity by ensuring that caregivers, regardless of socioeconomic status, have the support they need to provide quality care.
  4. Fostering collaboration and innovation:

    * Achieving health equity requires a collaborative approach that engages stakeholders across sectors, including government agencies, healthcare providers, community organizations and advocacy groups. MPAs serve as a catalyst for fostering collaboration and driving innovation in aging-related services and support.

    * By convening diverse stakeholders and promoting cross-sector partnerships, MPAs can leverage the collective expertise and resources needed to address complex health equity challenges and develop innovative solutions responsive to the unique needs and preferences of older adults from all backgrounds.

As we navigate the demographic shift toward a larger older population, prioritizing health equity becomes paramount in ensuring that all older adults can age with dignity and grace. MPAs offer a comprehensive roadmap for advancing equity by addressing disparities, promoting age-friendly communities, supporting caregivers, and fostering collaboration and innovation. By implementing and refining these strategies, we can build a society where older adults of every race, ethnicity, income level and geographic location have equal access to the resources and support they need to thrive.

How to get involved? Preparing for the rapid aging of a state’s population requires a proactive and comprehensive approach to planning and implementation that includes active co-creation with advocates from a variety of fields. The success of MPAs in large part depends upon the extent to which organizations work together. There are numerous ways to engage in a state’s MPA process.

For states with a plan, advocates can promote the work accomplished to date to ensure momentum. Also, many states have committees that may benefit from additional subject matter experts.

States in the early stages of an MPA can benefit from advocacy as they gain legislative support. People can inform elected officials of the challenges this demographic shift will present and the need for a comprehensive plan. Additionally, using surveys or focus groups for feedback is vital as states gather information about their status quo and prioritize needs.

Due to the integrated and proactive nature of MPAs, engaging non-traditional partners is key. Whether it is an arts organization or a K-12 educational system, there are roles to be played because MPAs are for everyone in a state, not just older adults. Active participation in planning and executing MPAs is critical to their success. Please get involved!

All authors are part of ASA's Health and Well-Being Advisory Council. Claire Dowers-Nichols is the executive director of Healthy Living, Inc., a nonprofit operator of comprehensive wellness centers for adults ages 50 and older in Oklahoma City and Norman, OK. She has spent 20 years developing programs to better serve older adults. Prior to this, she co-founded the Oklahoma Healthy Aging Initiative and launched a rural geriatric telehealth program at the University of Oklahoma Department of Geriatric Medicine. Jyotsna Pandey, MD, PhD, is a board-certified pathologist and professor at Central Michigan College of Medicine, focused on promoting community health improvement projects to promote healthy aging, particularly on falls prevention via educating and empowering elders. Benjamin W. Veghte, MPA, PhD, directs the WA Cares Fund, the nation’s first universal long-term care insurance program in Washington State. He is also an MIT CoLab Mel King Community Fellow and member of the Care Guild, a group of 125 innovators redesigning care for the 21st century. Previously, he was vice president for Policy at the National Academy of Social Insurance. Talyah Sands Leavitt, MPH, is the director of directs Health Improvement and Healthy Aging at the Association of State and Territorial Health Officials.

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