At 81, George Stewart has been a longtime advocate for lesbian, gay, bisexual and transgender (LGBT) older people in New York City. He's a former Army clerk and U.S. Air Force court reporter, and last summer he was selected by the White House as one of six Champions of Change nationwide for LGBT Pride Month. Yet behind his active civic life and national profile lies another reality: George Stewart is low income, and as with millions of older people, he relies on federal assistance to supplement his income and on local services for community support. For many low-income LGBT older people, public assistance and support networks interlock as lifelines -- ameliorating poverty, reducing isolation and helping to manage the slew of challenges that come with getting older. Unfortunately, despite the prevalence of poverty among elders in this country, including LGBT elders, these realities are rarely brought to light.
Two reports issued this month do their part to begin filling the void. A new report from The Williams Institute at UCLA School of Law provides new research on poverty among LGB people, while new analysis from the Kaiser Family Foundation re-calculates poverty rates among elders when employing a more modern Census measure. Together, these studies substantiate what many in the LGBT aging field have known for years: the challenges associated with poverty intensify with age -- and more so when one is lesbian, gay, bisexual and/or transgender.
A new study from The Williams Institute, “New Patterns of Poverty in the Lesbian, Gay, and Bisexual Community,” shows higher and increasing poverty rates among lesbian, gay and bisexual people, with differing rates among lesbians, people living in rural areas, people with lower education levels, and African Americans, as four examples. (Transgender people aren't studied in this report for a lack of related population data, according to the report’s authors.) The report cites that one in five LGB people who live alone report living at or below the poverty level, and many rely on public assistance, including food stamps. Unfortunately, the report does little to examine poverty rates among elders, and the authors rely on the official federal poverty measure for their analysis, which as described below, severely underestimates poverty among older people.
On this topic, new analysis from the Kaiser Family Foundation shows that poverty rates among people age 65 and older increase in every state (and double in size in 12 states) when using a new supplemental poverty measure adopted by the Census Bureau in 2011. Widely regarded as outdated, the official Census poverty measure has been criticized for not factoring out-of-pocket health care expenses or regional differences in cost of living (as two primary critiques). Using this new Census measure, Kaiser found that the national poverty rate among people age 65 and older grew from 9 to 15 percent. And when the same measure counted a more widely defined low-income population -- elders with incomes up to 200 percent under the federal poverty line -- it found that nearly 48 percent of people age 65 and older live in or near poverty. Overall, studies have consistently found that the highest rates of poverty are among elders age 80 and older, which should signal how poverty intensifies with age.
If medical expenses and housing costs can derail nearly half of all elders into (or near) poverty, LGBT people should be especially concerned. Health disparities have been well-documented among LGBT people, and they disproportionately affect people of color, poor and low-income people, transgender people and elders. More recently, a federally-funded national health study of more than 2,500 LGBT older adults uncovered profound disparities in multiple areas across physical and mental health. Through my national advocacy work at SAGE (Services and Advocacy for GLBT Elders), I often hear my peers describe a common life trajectory for many low-income LGBT elders and older people of color: a person survives decades of hardship and discrimination -- in daily life, under the law and in the workforce -- only to enter his/her later years without the financial means to age in good health, much less retire. It seems that the same systems that impoverished us as LGBT people turn into the same systems that refuse to protect us when we’re older.
How exactly does poverty play out among LGBT older people? In its 2010 report on poverty and older adults, AARP reasons that due to aging, older people are more likely to experience poor health, disabilities and cognitive impairments, which increases the reliance on health care and long-term care. Although Medicare and Medicaid assist many low-income elders in covering a large portion of these costs, many elders still find themselves paying for medical expenses from their own pockets because they are underinsured, or because they are ineligible or not enrolled in the proper public assistance programs -- realities all too common for more marginalized older people. In addition, research and experience have shown that LGBT older people often delay health treatment out of fear of discrimination, which can exacerbate their health conditions and increase the cost of treatment. In turn, higher costs can lead to poverty and more distress -- and the pernicious cycle repeats and reinforces over time.
Moreover, many older people face unaffordable housing costs as either renters or owners, and a significant number have a limited ability to acquire acceptable and nutritious food; AARP notes that only 30 to 40 percent of eligible older people receive SNAP benefits despite being “food insecure.” And if required to rely on their assets, many poor older people would have little reassurance for long; the median total assets of the elderly poor in 2005, including home equity, was a little more $66,000. This means that many poor and low-income elders have little to no material assets; when their income runs out, their only safety net is what’s funded by government.
These two reports sound the importance of broadening our understanding on poverty and its effects on marginalized populations. They also speak to the need for multiple policy interventions, including: widely adopting new poverty measures that more completely accounts for income and resources among elders; strengthening research and data collection on LGBT elders to better study the compounding effects of poverty, discrimination and aging; strengthening and reforming public assistance programs such as Social Security, SSI, SNAP and others to continue supporting low-income elders; enrolling LGBT older people into new health insurance plans at the state level, while educating them about the array of benefits available under the Affordable Care Act; prohibiting discrimination on the basis of sexual orientation and gender identity in the workplace, housing and public accommodations, at all government levels; and funding aging programs that engage LGBT older adults, so that they have the supports they need to age financially secure in their communities. When a destabilizing life event hits, and one’s finances are drained, these types of government-funded programs become the only lifelines for many elders without the assets or kinship systems to survive.
For many, the recession has made salient the economic vulnerability of low-income families, including elders. Now let's name how poverty and discrimination interrelate to complicate aging for millions of LGBT elders. And then let’s challenge our government to respond.