Introduction
The Western United States comprises 13 states that lie on the western part of the United States of America. They include Utah, Arizona, Oregon, New Mexico, Nevada, Colorado, Alaska, Washington, California, Hawaii, Wyoming, Idaho, and Montana. This region is commonly referred to as The West or the American west. Since the US expanded towards The West soon after it was founded, the meaning of the name “The West” has undergone an evolution since then. The region is not merely a geographical designation rather it has a special connotation in terms of anthropology. Whereas there is some internal diversity, the area is generally considered to have a by and large common culture shared history and one perception of the world, and intimately related English dialects. There are however some idiosyncratic differences interspersed in the geographical area.
Demographics
The US Census Bureau describes The Western US as the area covered by the 13 states covered. It further gives the estimated population of the region to be about 34 million. The proportion of the older people in the western US varies greatly in every state where some states experience greater growth while others experience lesser increases. These are the statistics of 2009. Older population refers to people aged 65 years plus
- California was one of the 11 that had over 56.5% people aged 65 and above with 4.1 million people.
- Two States Montana and Hawaii had over 14% or more people aged 65 and above. Montana had 14.6% and Hawaii had 14.5% of the total population is the older generation.
- In Nevada, Arizona, Utah, Alaska, Idaho, and Colorado state, the older population increased by 25%. In New Mexico, there was a high level of poverty among the older population.
- Utah had an estimated increase of 251,159 in population. The other states had the following statistics, Arizona 866,734, Oregon 516,862, New Mexico 261,342, Nevada 306,843, Colorado 533,580, Alaska 52,849, Washington 806,202, California 4,148,055, Hawaii 188,180, Wyoming 66,867, Idaho 187,418 and Montana 141,903.
The Impact of Population Change on Health
The geographic distribution of the elderly population and the recent changes observed have a critical impact on government policies, especially healthcare. The implication includes both directly and indirectly, besides it also affects the state and local policy, and these, in turn, influence the federal policy decisions (Nelson, 2002, p. 2662). The federal government usually depends on the population statistics collected by the US Census Bureau so that it can be able to disburse about $200 billion cash to the three levels of government. The older generation is a very important group of the general population that the government has to take care of especially when addressing healthcare Nelson, 2002, p. 2662).
The reason why older people are a group to watch when addressing healthcare policies is that they are the most vulnerable people. This is because their bodies have deteriorated functionality including reduced mobility, limited access to important resources, and changed physiology and all these limit their adaptability (Nelson, 2002, p. 2662). This makes them more vulnerable to changing health. The vulnerability of the older population due to adaptability challenges can have a grave impact on health and societal strategies to help cope with the implications. The older population in the western US is disproportionately compromised because the climate has a great impact on the health of older people, yet these older people’s adaptability is compromised (Nelson, 2002, p. 2662). The climatic conditions like temperatures extremes in Utah and California often cause health problems. The West has witnessed worse conditions like vector-borne diseases and other challenges. The older generation in this region is threatened by cooling and heating, stress on water and food, poor mobilization, and decreased immunity. As a result, many health programs are targeting older people (Nelson, 2002, p. 2662). Medicaid and Medicare are the main health agencies offering healthcare to these populations.
The aging population of The West is a great influence on healthcare research as well. There has been increased research in individual states and on a regional basis aimed at helping in the development of health policies. The cost of healthcare continues to grow and the aging population also increases steadily and it’s estimated that with fundamental changes, the west will spend about 27% of their income on the provision of healthcare. Out of that, about one-third will be for taking care of the older population (ages 65 and above). In the next two decades, about 50% of the entire healthcare encounters are likely to be involving the aging population.
The Healthcare Needs of The West
Addressing the health needs of the aging population of the west is not very different from the needs of the general population though some medical conditions are more common among the elderly. The needs of the older population include safe and decent housing, access to basic goods and services, quality healthcare, and transport. The healthcare services needed by this population include preventive services for common diseases and affordable care for the elderly who may not be having the regular income (Strine, et al, 2008b, p. 151). The majority of older people live in populated states like California which is in the West. The other western states are averagely populated but still host a considerable number of the older population.
The older generation also needs social and civic engagement so that they can be able to remain connected to the community and not feel isolated. Older people can get lonely and end up getting stressed especially after retirement when they stay at home and are not involved in the activities of the community (Strine, et al, 2008b, p. 151). The older population also requires support for them to be independent like doing their domestic chores and reminders to take their medication and so on. When they are not able to use these they require support like homecare and transport.
The aging population of the west also needs special care for the increasing rates of chronic and degenerative diseases which are very costly to manage (Strine et al, 2008a, p. 42). The CDC estimated that about 80% of the older population in the west suffered at least one chronic medical condition while 50% suffered at least two conditions. With the population growing faster in California, Utah, Nevada, and Alaska, the cost of health care in the west is likely to skyrocket. With the increasing number of elderly people, Expenses like home healthcare and/or paying for nursing home services are the greatest threat to the public resources of this region (Strine, et al, 2008b, p. 155). The federal government will be forced to increase disbursement to each state for Medicaid and Medicare.
Another problem is mental health which has often been overlooked in many states in the region but it is a very crucial issue (Stephen, 2003, p. 489). Community service to the elderly is being overwhelmed because mental problems are on the increase. Mental health is very important to the overall health and social involvement and therefore reducing vulnerability to problems (Parks & Roberts, 2006, p. 339). Issues like loneliness, social isolation, depression, and dealing with losses can critically affect general healthiness. However, there are a number of random cases where community service for the elderly is has been improved considerably like in California, Idaho, Washington, Nevada, and Utah. The rest of the western states are also setting policies in place to improve their health services.
Key Healthcare Challenges
The nursing home model of caring for the elderly offer two main benefits. First, it offers nursing and therapeutic care for people recovering from medical conditions or injuries. The objective is to ensure that the older patients are well attended to and returned to the community in good health (Stephen, 2003, p. 489). A second objective is to care for patients suffering serious chronic health problems or cognitive impairment and they may not be expected to get better but need rehabilitation and management of symptoms just to cope with the situations (Strine et al, 2008a, p. 42). The number of older people living in nursing homes has reduced in California, Washington, Arizona, and Idaho. People have had a negative attitude about these nursing homes implying that the patient who visit these places never get to recover hence discriminating people by age.
Another challenge has been the availability of visiting doctors. Over the past decade, doctors have been coming back to medical practice and engaging in the house to house calls. This is because the Medicare policies changed and a doctor can be reimbursed when they visit homebound patients. Some families cannot afford to pay for nursing home expenses and hence they just take care of their aging relatives from home. However, these older persons still need professional services (Parks & Roberts, 2006, p. 339). This means that a medical practitioner has to visit them to give these services. The patient could be disabled or the means to transport them to health facilities are lacking especially when it involves a lot of requirements. Sometimes it’s difficult to provide safety for the patient, therefore, jeopardizing them at home (Strine et al, 2008a, p. 44). Experienced geriatric doctors can make visits to attend to these patients and will be reimbursed by the insurance accordingly.
The number of visiting doctors in Colorado, Oregon, and Nevada has improved considerably hence geriatric services are not a big problem. Besides, the county’s involvement in the care of the older population as well as the support from the government has seen the healthcare of this region improve. There is a lot of volunteer services on the part of the community had these services bolster care for the elderly.
The nursing home in California, like the Meyers Memorial Home in Fall River Mills, has been working with the community and the government to acquire more funds to improve its services. The nursing home facilities in California received extra funding last year to increase the number of caregivers to boost their services and wages. In Nevada, the Highland Manor Of Fallon in Churchill County has improved its staff and the number of volunteers who work under the direction of professional medical practitioners. They offer long-term inpatient care to older people and the disabled (Stephen, 2003, p. 489).
Wellness Program
Old people are disproportionately vulnerable to chronic disease and other injuries like arthritis, heart diseases, or falls causing disability. In the western US, the chronic wellness program is the collaboration between states, the national council on aging, and human and health service agencies (Kane & Kane, 2001, p. 142). These bodies have set up a community-based model of preventing and providing care. These wellness programs have improved self-efficacy, reduced utilization of health services, and allowed players or participants to adopt healthy lifestyles and self-management behavior. The program uses evidence-based services that have been proven to work better. The benefits drawn from the use of evidence-based practice are lower medical expenses, decreased number of medical and injury cases (Kane & Kane, 2001, p. 142), enhanced productivity and efficiency, boosted morale and retention of workers, and finally less absenteeism and stress level among workers.
Reference List
Kane, R.L & Kane, R.A., (2001). What Older People Want From Long-Term Care, And How They Can Get It. Health Aff, 20(6), 114-127.
Nelson, D. E. (2002). State Trends in Health Risk Factors and Receipt of Clinical Preventive Services Among US Adults During the 1990s. JAMA, 287 (20): 2659-2667.
Parks, B.C., & Roberts, J.T. (2006). Globalization, Vulnerability To Climate Change, And Perceived Injustice. Society And Natural Resources, 19 (4), 337-355.
Stephen, B. (2003). Improving the United States’ System of Care for Older Adults With Mental Illness: Findings and Recommendations for The President’s New Freedom Commission on Mental Health. American Journal of Geriatric Psychiatry, 11(5), 486-497.
Strine, T.W. et al. (2008). The Associations Between Life Satisfaction and Health-related Quality of Life, Chronic Illness, and Health Behaviors among U.S. Community-Dwelling Adults. Journal Of Community Health, 33(1), 40-50.
Strine, T.W., Chapman, D.P., Balluz, L., & Mokdad, A.H. (2008). Health-Related Quality Of Life And Health Behaviors By Social And Emotional Support: Their Relevance To Psychiatry And Medicine. Social Psychiatry And Psychiatric Epidemiology, 43(2), 151-159.