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Diversity, Equity, Inclusion…and Access

Equity vs. Equality: Understanding the Difference

In the senior living industry, community design and activity planning are frequently structured around concerns about what will most universally appeal to a certain age set or generation.

However, as discussed in a previous blog post, recent research shows that the most lucrative approach going forward is likely to be focused on lifestyle groups rather than age-based categories.

In the process of focusing on age, says Ashton Applewhite, more influential factors can be missed: “Age plays much less of a role in shaping our paths through life than we think it does — far less than social factors like socioeconomic status, geography, ethnicity and gender…. Applying a generational lens obscures the multitude of inequities that exist within age cohorts and also cut across them.”

A report by the Milken Institute predicts that the impact of COVID-19 will evoke an “even deeper commitment” to support for healthy aging and equitable health outcomes for older adults. “Diversity, equity, and inclusion must be made a top priority.”

A worthy goal, to be sure, but one that requires a common vocabulary across the industry. The word equity, in particular, is frequently misunderstood. It tends to be conflated with the related yet distinct word equality, and is often filtered through the vague, austere context of “equal opportunity.” Without a concrete definition, the word’s etymological relationship to justice is easily overlooked.

CEDAW, the Convention on the Elimination of All Forms of Discrimination Against Women, clarifies its use of equality by specifying the criteria for substantive equality, or equality of results. Achieving this, CEDAW emphasizes, requires acknowledging and accommodating differences, rather than assuming that equality of results can be achieved simply by treating everyone the same.

The Milken Institute similarly elaborates on the particulars of equity in a November 2020 article:

While the terms equity and equality may sound similar, the implementation of one versus the other can lead to dramatically different outcomes for marginalized people.

Equality means each individual or group of people is given the same resources or opportunities. Equity recognizes that each person has different circumstances and allocates the exact resources and opportunities needed to reach an equal outcome.

Racial Diversity and Cultural Inclusion

According to a 2020 publication by the Brookings Institution, racial diversity across the U.S. population is increasing faster than expected. Brookings reports that U.S. Census data shows that nearly 40% of the country’s population identifies with “a race or ethnic group other than white.” The most recently released data from the U.S. Census provides more growth specifics.

Pew Research Center additionally found that one of every five Americans lives in a multigenerational household, and that Asian-American, Latino-American, and African Americans are the most likely groups to be part of such a residence. Significantly for the senior housing industry, Latino-Americans and Asian-Americans are the two fastest-growing population groups. The study also found that women were approximately 2% more likely than men to live with multiple generations.

These figures support the investment potential of intergenerational living communities like The Canyons, located in Portland, Oregon. Multifamily dwelling models also provide an opportunity to address myriad factors for equity and inclusion. Multifamily units respect cultural norms and distribute housing costs across a larger extended family group. They also create greater age diversity in the overall living community.

Ageism and its Overlap with Ableism

That said, regardless of whether or not inclusive community housing is also multi-family or intergenerational, differences in ability must be acknowledged and accommodated. Given the tendency for many institutions and organizations to lump ageism and ableism together, it’s important to avoid assumptions in either direction.

In her article on Medium, museum specialist Jennifer L. Riddell points out how outreach programs fostering age diversity among those served by an institution can effectively obscure inequities in its own employment practices. She clarifies the specifics of the DEAI approach in the workplace, an acronym in which the word access is included along with the usual trio of diversity, equity, and inclusion.

“As a baseline and perhaps starting place,” Riddell points out, “DEAI policies usually itemize the list of the seven legally protected employment statuses– race, gender, disability, religion, ethnicity, genetic/medical information, and age (over 40).”

That last category includes a lot of us, including present company. However, I’m well aware that my experience will never be equivalent to that of someone of the same age who happens to appear older than me. Perception of age is typically the deciding factor.

A 2021 Forbes article lays bare the reasons that ageism and ableism should be “front and center” in discussions about diversity, equity, and inclusion. Author Sheila Callaham points out that age is frequently omitted from the equation, and that if employee cultures are oblivious to the insidiousness of ageism, then one can hardly expect them to recognize “the intersection of age across other dimensions of diversity, including ableism.”

This issue is neither new nor resolved, even within the senior living industry. In 2014, LeadingAge magazine published the findings of a Leadership Academy group project, conducted by “a very diverse group of individuals from across the spectrum of aging services providers.” Among the group’s conclusions was this:

We realized that there is a cruel irony at play. If there is one place in society where an elder should be accepted and honored, no matter how frail and no matter what challenges he or she is living with, shouldn’t it be a retirement community?

We started asking ourselves some painful questions: Are we really honoring older adults when we focus on and celebrate only those who are well? Where else in society would it be acceptable to segregate and marginalize people who are deemed “undesirable” by their peers? Why is this happening? And most importantly, what can we do about it?

This article published by The Gerontologist provides an in-depth examination of the social nuances determining comity or enmity between different generational groups at an active adult retirement community (AARC). It gives a detailed account of how age-related divisions softened and changed over time, while social segregation related to physical ability and illness did not.

The inclusion of the word access in DEAI discussions is important to all of the seven protected demographics, but is most often used in terms of disability. Accessible, ability-inclusive communities ensure maximum engagement for those who are non-disabled as well as those with varying accommodation needs. Despite the frequent ageist response to frail elders, sometimes referred to as “fear of the future self,” one never knows when disability may be a personal concern. Ability-inclusive design makes space for those whose disabilities would otherwise restrict access, while also providing a proactive safety net for presently active elders who may experience a sudden change in health status. For elders who must adapt their activity level for health reasons, it is important that ability-inclusive design also include community access in the social sense. Given the impact of segregation and social exclusion on longevity—as well as both physical and mental health—social inclusion is a basic need that must be met.

The Unique Needs of LGBTIA+ Elders

Another aspect of diversity, equity, access, and inclusion (DEAI) is sexual and gender identity. Each of these can be a source of marginalization in itself, but LGBTIA+ oppression also frequently intersects with inequities relating to race, class, and ability.

According to the Not Another Second project, 41% of LGBT+ older adults report having a disability—a 6% higher rate than reported by their heterosexual, cisgender peers. Although hardly the only group representing intersectional disparities in access and life quality, survey data collected from the LGBT+ elder population represents many clear examples. Naturally, these effects are further compounded for LGBT+ elders of Color.

Facts provided by Not Another Second illuminate the following experiences among LGBT+ elders: 34% are worried that they must hide their true identity to access acceptable housing, 48% have experienced discrimination when seeking a senior living community, and roughly half of the overall LGBT+ population live in states where they are not legally protected from housing discrimination. Discrimination rates and related health disparities for trans and gender non-conforming elders are well-documented, as is the risk of physically violent hate crimes. Fortunately, trans community resources such as this report offer recommendations for policy and practice in supporting transgender and gender-expansive elders.

The unique, often intersectional disparities experienced by LGBT+ elders present a vital call to action across the community. Educating staff, then residents, can be a powerful way of building inclusive community. Monmouth university offers both training options and a “Cross-Gen Pride” podcast series. The online resource for Not Another Second also features an LGBT+ historical timeline, as well as additional resources and information about the book and film, in which LGBT+ seniors tell their stories.

DEAI Education Means Doing the Homework

Again, being mindful of difference and the ways equity-based support looks different across both separate and intersecting marginalized groups is crucial. Understanding difference means familiarity with some specific details of each lived experience, and while that may sound like work, it can also promote better understanding of oneself and one’s primary affinity group.

A good rule of thumb for understanding and redressing issues of inequity and exclusion is to seek information from primary sources. This certainly includes research and survey data, but should always include firsthand perspectives as well.

About the Author

Wenona Kimbro is the Associate Editor of SeniorTrade Media. She is passionate about life quality for seniors, and writes on this topic from a broad intersectional perspective. Wenona has an MFA in creative writing from Pacific University, preceded by a BA in applied linguistics from Portland State University. Wenona’s writing regularly draws on her professional background in caregiving, memory care support, dis/ability support, mental health care coordination, and advocacy for individuals with intellectual disability. She has matrilineal blood ties to the Cherokee, Choctaw, and Chickasaw tribes, and is interested in learning from tribal models for aging well. She also brings an LGBTQ+ lens to her work, informed by both educational and personal experience.


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