Miss. Code. tit. 18, pt. 2, ch. 1, 18-2-1-IX, att. 18-2-1-IX-H
Most Mississippians are living longer and healthier lives in greater comfort than their ancestors would have thought possible. Improved living conditions, better nutrition, sanitation, vaccinations, cures for many infectious and contagious diseases, and advances in medical technology have contributed to an increased longevity.
Most gains in the longevity of Mississippians are a result of modern medicine and healthier lifestyles. People living longer presents a challenge for planners and policy makers to develop strategies and solutions to address the growing demands and needs of those who are living much longer than ever anticipated.
A new demographic balance is emerging. Mississippi has approximately 457,144 individuals age sixty years and older (2000 Census). Elderly citizens now constitute 19% of the State's total population. Mississippi was once among those states with the lowest proportion of aged; now Mississippi is experiencing the "graying" of its population.
Between 1990 and 2000, the older population increased 6.9% as compared to the total population which will increase 18% by the year 2010. The most rapid increase is expected between the years 2006 and 2026 when the "Baby Boom" generation reaches sixty.
Rural
Because Mississippi is predominately a rural state, the DAAS has adopted the official Census definition of rural which describes rural areas as "open country and communities of 2,500 or less." (Advocates in Mississippi prefer the definition of rural as "counties with a population of 50,000 or less inhabitants which are not contiguous to urban, metropolitan, or other densely populated areas.") The 2000 Census identified 1,361,945 individuals (old and young) living in rural areas; this represents 53% of the total population in the state. The rural population is subdivided into the rural -farm population, which comprises all rural residents living on farms, and the rural - non-farm population, which comprises the remaining rural population. The 2000 Census and the 1996 Statewide Older Adult Needs Assessment indicated that the majority of older Mississippians live in rural areas.
The 1996 Needs Assessment showed that older rural people, by almost all economic, health, and social indicators, are poorer, less healthy, live in poorer housing, have fewer options in personal transportation, and have significantly limited access to health professionals as well as community-based programs and services. It has often been argued that being old and living in rural Mississippi is a form of "double jeopardy." Elderly Mississippians living in rural areas confront many barriers in gaining access to programs designed to help them. The barriers include inadequate transportation and information systems.
Identifying methods to best serve the rural elderly remains a priority for the DAAS. Several methods used to satisfy service needs of older residents in rural areas are: the intrastate funding formula which includes a rural factor; the state nutrition pilot program in home-delivered frozen meals; Medicaid Waiver home-delivered meals; collaborative partnerships with transportation; rural health fair programs, and a statewide toll-free information system.
Minorities
The DAAS is committed to the belief that serving the needs of Mississippi's minority elderly is a central mission and challenge facing the Aging Network. Minority is a term used by the Aging Network in the State to represent African American, American Indian/Alaskan Native, Asian/Pacific Island, Hispanic, and others. The 2000 Census Data identified 117,862 African American elderly persons in the State, 1,517 Asian/Pacific Islanders, and 2,697 Hispanics.
Minority elders are more likely to be economically and socially needy. Over 49% have incomes below the poverty level as determined in the 1996 Needs Assessment. The low-income minority population is projected at 57,166. Minority elders are less likely to have equal access to health care providers and facilities.
The minority population in the State presents the Aging Network planners, policy makers, and providers with general factors such as cultural differences, language barriers, and myths of the minority elderly, to be considered in the delivery of aging services to the minority population. Outreach and service access are prioritized for the individual meeting criteria that define them as low-income minority via the Client Screening Form ranking system by the AAA at the time of intake into the system. Preference for providing services to minority elders with economic or social needs is given particular attention.
Native Americans
The 2000 Census identified 940 Native Americans age sixty and older in Mississippi. The DAAS identified the Area Agencies on Aging where the highest concentration of Native Americans reside, and provided the information to East Central AAA. The Mississippi Band of Choctaw Indians coordinates with the AAA in training efforts for the aging network staff.
Economic and Social Status
Older Mississippians, as a group, have a lower economic status than other adults in today's society. Minority elders have substantially lower incomes than their Caucasian counterparts. Many older Mississippians are living day-to-day trying to make ends meet with a limited income.
The 1996 Needs Assessment revealed that approximately 29% of all Mississippians sixty plus live below the national poverty guidelines. The incidence of poverty increases with age among all elderly but at an even higher rate among minority elderly (49%). Minority females and individuals living alone constitute the poorest segment of the older population.
The 1996 Needs Assessment findings indicate that:
- One in five elderly live in poverty;
- Elderly women and minorities are impacted more by poverty;
- Elderly poor have substantial health, housing, and nutrition costs;
- Elderly poor experience more acute health conditions and have high rates of chronic health conditions;
- Elderly poor spend nearly 20% of their income on out-of-pocket medical costs;
- Social security and other benefits do not ensure incomes above the poverty level for elderly poor Mississippians; and
- Elderly poor are at-risk for inadequate nutritional intake.
The 2000 Census indicated that 111,987 older Mississippians have incomes below the poverty level, with the highest number in the age 75 years and older category.
Despite low poverty rates for elderly Mississippians as a group, a substantial number of older persons continue to have incomes just above the poverty level. The majority of older Mississippians between ages 65-74 have incomes above the poverty level. There are 73,849 females between the ages 65-74 who have incomes above the poverty level and 31,470 males 75 and older who have incomes above the poverty level. The African American elderly in both age groups (65-74 and the 75+) are more prone to have incomes below the poverty level than any other minority group.
The 1996 Needs Assessment indicated that over 30% of the sixty plus population surveyed did not talk to or spend time on a daily basis with someone who does not live with them. Over 10% were socially active only once a week or less. This raises concern for the social needs of a large segment of Mississippi's elder population. The population of limited English-speaking minority elders is at even higher social risk. AAAs use the maximum cultural and language barrier sensitivity when addressing elders.
Economic and socially needy individuals are prioritized in rank on the Client Screening Form at the time of intake into the AAA service system. Outreach and service access are prioritized for the individual meeting criteria that define them as economically and socially needy and preference for providing services to minority elders with economic or social needs are given particular attention.
At-Risk Individuals
Older people at risk of losing their independence includes the very old, those who are abused, neglected, or exploited; those who do not have a caregiver to assist them in times of need; those who are physically or mentally impaired or disabled; and those who are poor, economically deprived, and uneducated. These factors are not indicative of all older persons; however, many of them do apply to a large number of older people in Mississippi.
The 1996 Needs Assessment indicated the limitations of the state's elderly who are at risk and vulnerable. Of the 3,300 or more persons surveyed:
- One in five reported their health as poor;
- 30 percent reported that health problems interfere with their activities of daily living;
- 10 percent could not prepare their own meals;
- 19 percent could not do household cleaning; and
- 16 percent could not shop for themselves.
Older people who are poor are particularly vulnerable to losing their independence because they lack the means to purchase goods and services that could help them remain self-sufficient. In Mississippi this includes older women who live alone; those who live in rural areas, where goods and services are often unavailable or hard to reach; and minorities who are plagued with barriers preventing access to services.
The Old-Old
The 2000 Census estimated 153,289 older Mississippians age 75 years and older. This group of individuals is referred to as the old-old and is expected to grow twice as fast as the rest of the population. The old-old population tends to require more social, medical, and supportive services and be more dependent on long-term care. The 75+ population is most likely to suffer from chronic health conditions which will leave them unable to perform activities of daily living without a support system.
Older Women
Statistics indicate that elderly women live longer than their male counterparts and are an increasing proportion of the State's elderly. There are 253,840 women sixty years and older in Mississippi and minority females constitute the poorest segment of the older population.
Physical and Mental Disabilities
Individuals with disabilities, especially persons age sixty and older, have difficulty accessing community service agencies in order to obtain services. The DAAS and AAAs work to ensure that persons with disabilities are assisted by coordinating services with other agencies. Where need indicates, local AAAs assist in the construction of access ramps, provide eye sight screenings and low cost eyewear, and conduct projects on a regular basis. The Office of the Governor, Division of Medicaid, Home and Community-Based Services Waiver project assists in the delivery of services to this population.
According to the Department of Mental Health State Plan, approximately 12.5% of the adult population with serious mental illness are elderly (age sixty years and older) and are served through the public community mental health system. DAAS and the AAAs work with the Department of Mental Health in its continued efforts to assist elders in need using the community-based stratagem.
Living Arrangements
The DAAS 1996 Needs Assessment indicates that an overwhelming majority of elderly persons surveyed wished to maintain a sufficient level of independence while remaining in their own homes, neighborhoods, and communities. Most (89%) of the age sixty and over population surveyed lived in single family homes (including mobile homes), over 55% live with a spouse; 26% were widowed, almost 27% live alone, and 20% live with children.
Inadequate housing is a problem for many older Mississippians with low and moderate incomes. Significant numbers of homes owned by older persons need major repairs and home repair was cited as a priority concern for elders in the 1996 Needs Assessment. Some homes occupied by older persons still lack complete plumbing, particularly in rural areas or small towns. Fixed incomes, high medical expenses, and physical limitations make it difficult for older citizens to keep up with major home maintenance.
Most older citizens prefer to remain in the home they have lived in for years. The majority of elderly Mississippians, especially minorities, prefer to remain in their communities and be cared for by family, friends and relatives. Disturbingly, the 1996 Needs Assessment indicated that over 23% of those surveyed stated that "no one" or "they don't know who" would care for them if they became sick or disabled for an extended period of time. This percentage increased by age group and for widowed females. These individuals are at high risk for institutionalization.
As the demographics of seniors indicate, Mississippi, as well as the rest of the United States, is in the midst of an Aging boom that is restructuring the population. The demographics of Mississippi's older population suggest that older Mississippians struggle to maintain themselves in their own homes. For many, aging in place with dignity and remaining independent is a condition they may never realize. For all, the loss of independence is a constant fear.
Miss. Code. tit. 18, pt. 2, ch. 1, 18-2-1-IX, att. 18-2-1-IX-H