Policy and Aging: A Social Work/Social Justice Perspective
By Nancy R. Hooyman

Policy issues that affect older adults and their families are in the news almost daily – the complexity and confusion surrounding Medicare Part D, cuts to Medicaid at both federal and state levels, and proposals to privatize Social Security or to set up individual health savings accounts. Often these policy discussions are framed as a crisis - as if the growth of older adults were the problem, threatening to “break the budget” and adding to the skyrocketing federal deficit.

An alternative approach, consistent with social work’s social justice perspective, is to analyze how policies – or lack of socially-just policies – create economic and health disparities across the life course which intensify problems faced by older people and their families. In other words, gaps in existing policies that negatively affect families across the life course, not just in old age, are the challenge to be addressed by social workers, not the demographic changes per se.

This was the approach presented by Judith Gonyea and Andrew Scharlach at the CSWE Gero-Ed Center sponsored Gero-Ed Institute held at the 2006 CSWE APM. Larger structural issues, such as the changing nature of work and retirement, increasing racial, gender and economic inequities, and health disparities were highlighted as the context for policy development and implementation.

Most social work programs do not have the resources or the student interest to offer a specialized course on aging and social policy. Consistent with the Gero-Ed infusion approach, this Institute focused on addressing issues of age and ageism within foundation policy courses. This ensures that all social work graduates have foundation competencies about policies (Policy Knowledge/Skills/Values) that impact older adults and their families within a social justice framework. Some examples of foundation policy courses that have infused and made explicit aging content are available in the syllabi section of the Gero-Ed Center’s Teaching Resources.

Some faculty who teach foundation policy courses to BSW or first year MSW students may respond, “Of course my course deals with aging because I teach about Social Security.” However, a Gero-Ed Center review of many policy course syllabi found that discussions of Social Security may not be explicitly related to older adults’ economic vulnerability, especially inequities based on race, gender or sexual orientation – or Medicaid or SSI may be discussed only in terms of low income children – or the Family and Medical Leave Act presented only in terms of leave to care for children. By explicitly infusing aging into discussions of social policy, the intersections with race, gender, sexual orientation, functional ability and class also become visible. (See also Dr. Scharlach’s presentation “The Changing Nature of Health and Disablity”)

Admittedly, a foundation policy course does not provide students with opportunities to learn in-depth about policies that affect older adults. But foundation policy courses can provide students with additional resources:

Resources

Gero-Ed Institute Resources: Economic and Health Disparities Across the Life Course: Implications for Aging, Policies and Programs

Suggested Readings on Health and Long-Term Care Policy

Suggested Web Sites on Aging, Health and Long-Term Care

Public Policy and Diversity (Video) by Fernando Torres-Gil and presented by the Social Work Aging Resource Center, San José State University, College of Social Work

Students for Social Security (SSS) and Concerned Scientists in Aging (CSA) have a joint newsletter “Our Shared Future”