In the Mohawk Valley, there were 83 primary care doctors per 100,000 patients in 2018. Compare that to 148 primary care doctors per 100,000 patients on Long Island, and you start to get a sense of the healthcare concerns facing older, rural New Yorkers. Those problems were laid out in a research report and policy paper released by AARP New York on Tuesday.
Compound the issue of fewer doctors with less access to high-speed internet — rural residents over the age of 65 are 1.6 times more likely to lack high-speed internet when compared to their nonrural counterparts, according to the AARP report — and the picture becomes even clearer: Despite being sicker and more disabled than younger, urban residents, older New Yorkers in rural areas face huge challenges in digital and in-person access to care, a problem experts say will only worsen as the Baby Boom generation continues to age.
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Elected officials, AARP leaders and independent researchers discussed the healthcare challenges facing rural New Yorkers over the age of 50 — which is a population of more than 1 million people, according to the report — during a virtual event Tuesday. In addition to highlighting the problems facing older rural New Yorkers, officials also discussed possible solutions.
Major problems identified by the report include that rural residents are more likely than urban residents to die prematurely from the five leading causes of death: heart disease, cancer, unintentional injury, chronic lower respiratory disease and stroke; that there are half as many critical access hospitals for every rural New Yorker as there are for every New York City resident; and that only 52% of rural Medicare beneficiaries said their provider offered telehealth vs. 67% in urban areas.
AARP New York’s proposed solutions include a state tax credit for family caregivers, who spend on average over $7,200 on caregiving annually; increased funding for in-home healthcare workers and home and community-based services; subsidies for low-income older rural New Yorkers to help them afford technological devices; and a strategy to equalize home high-speed internet utilization across all ages and geographies by 2025 — New York ranks 46th in the nation in “digital equity,” according to the report.
More than 150 people attended Tuesday’s video call.
Insufficient internet access in rural communities was an especially timely topic following the recent passage of the $1.75 trillion federal infrastructure bill, which includes a $65 billion investment that could bring access to high-speed internet to rural communities like those in the Mohawk Valley, according to a press release by Sen. Chuck Schumer.
During the AARP event, New York State Comptroller Thomas DiNapoli said improved internet access is crucial, in part because it can expand telehealth services.
“The state has taken steps to make broadband available to most New Yorkers. But there is still a digital divide in rural parts of New York, and for lower income New Yorkers who don’t have access, or are unable to afford a home subscription,” DiNapoli said in a pre-recorded statement.
For instance, 99% of residents in Manhattan and Albany have internet access, compared to just 24% in Hamilton County and 73% in Yates County, according to AARP New York’s research. The event’s plenary speaker, Nicol Turner Lee, a senior fellow in Governance Studies at the Brookings Institution who has researched internet access disparities extensively for an upcoming book, said the internet-access divide comes down to money and location–not necessarily a desire to use technology. Turner Lee, along with AARP New York, called for programs that, in addition to increasing broadband connectivity, put devices in seniors’ hands and help them learn how to use those devices.
“They’re disconnected from what I believe are the pathways towards improved quality of life: Proximity to health care institutions, proximity to caregivers, holistic caregivers, proximity to family members and friends,” she said. “This is about ensuring that seniors are not only connected to see the beautiful faces of their grandchildren but they are also connected for the purposes of living a life well-lived.”
State Sen. Rachel May, who chairs the Committee on Aging as well as the Legislative Commission on Rural Resources, discussed how the shortage of home health care workers contributes to the health challenges facing the state’s rural seniors.
“We heard the anguish of families of people in need of home care who just couldn’t find the workers,” she said.
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The lack of home health care workers in rural areas is, in part, due to transportation issues and low Medicare reimbursement rates, May said. But mostly, the problem is low wages.
“We heard over and over about the fact that the minimum wages upstate for fast-food workers (are) higher than the minimum wage for home care workers, and that is very discouraging,” May said.
To help address this problem, May pointed to a bill she was working on that would ensure a base wage for home health care workers to be at least 150% of the local minimum wage. She said this investment would pay off in the long run because it would take workers off public assistance programs and keep older people in their homes, where they pay property taxes and spend money in their neighborhoods.
“And when you allow family members to stay in the workforce instead of having to step out and leave their jobs to care for a loved one, that also has positive repercussions on our tax base,” May said.
Greg Olsen, acting director of the New York State Office for the Aging, also discussed funding opportunities that could help the healthcare needs of rural seniors. He said his office was pushing for a $2.7 billion increase to the Older Americans Act, which would result in $75 million for New York state, as well as about $78 million that could come to the state’s Office for the Aging via the Build Back Better bill.
This kind of funding can help pay for innovative solutions, from providing seniors access to art classes and pets to combat feelings of depression and isolation to training for caregivers, Olsen said.
Beth Finkel, the state director of AARP New York, said the research report and Tuesday’s event were only a start.
“I want to emphasize that this is the beginning,” she said. “This is our first shot across the bow.”
Andrew Waite can be reached at [email protected] and 518-417-9338. Follow him on Twitter @UpstateWaite.
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