Working to improve the lives of Hispanic older adults, their families and caregivers Report on the National Community Engagement Survey Washington, D.C. October, 2016
Acknowledgements The National Hispanic Council on Aging (NHCOA) is grateful to those that have contributed to the National Community Engagement Survey report. The report and data collection was produced with the support of a number of organizations and individuals all of whom are committed to the wellbeing of Hispanic older adults, their families and caregivers. Their assistance was invaluable in designing the survey, collecting data, analyzing results, and preparing the report. First, NHCOA would like to thank a number of community-based organizations and their dedicated staff members for their participation in implementing the surveys. These organizations include Abriendo Puertas in Miami, Florida; Mexican American Opportunity Foundation in Los Angeles, California; West Dallas Senior Centers, Dallas, Texas; and Senior Community Outreach Services, Inc. in McAllen, Texas. We appreciate the time and energy they put into making the data collection process a success. In addition, we want to express our gratitude to all the older adults, family members and caregivers who participated in the survey. We also would like to recognize the NHCOA staff members who contributed their time and effort to the development of the report. Maria Fernanda Mata was instrumental in collecting and analyzing the data, Janet Cohello played a strong role in implementing the community survey and tabulating the information, and Martha Weise Peredo wrote and edited the report. The implementation of the study and production of the report was directed by Vice President Maria Eugenia Hernandez-Lane. Finally, we would like to express our deep gratitude to our sponsors, who, with their generous contributions, allowed us implement this community engagement survey along California. These sponsors are AARP, Abbott, AbbVie, Aetna Foundation, AstraZeneca, DHHS Office of Minority Health, Herbalife, Humana, Lilly, Pfizer, PhRMA, United Health, Univision, Verizon, and Walmart. 2 N H C O A N a t i o n a l C o m m u n i t y E n g a g e m e n t S u r v e y
Table of Contents Acknowledgements... 2 Table of Contents... 3 Executive Summary... 5 Community Engagement Survey Report... 6 I. Introduction... 6 II. Methodology... 7 III. Summary of Findings... 7 A. Demographic Profile... 7 B. Civic Engagement... 8 C. Analysis and Results... 8 1. Sociodemographic Information... 8 a. Self-Identification... 8 Graph 1: Self-Identification... 9 b. Place of Residence... 10 Graph 2: Place of Residence... 10 c. Gender and Age... 11 Graph 3: Age... 11 d. Marital Status... 12 Graph 4: Marital Status... 12 e. Country of Origin... 13 Graph 5: Country of Origin... 13 f. Educational Attainment and English Proficiency... 14 Graph 6: Educational Attainment... 14 g. Employment Status and Personal Annual Income... 15 Graph 7: Personal Annual Income... 15 2. Community Engagement... 16 a. Main Concerns of Hispanic Elders... 17 Graph 8: Main Concerns of Hispanic Elders... 17 b. Participation in Advocacy Events... 18 3 N H C O A N a t i o n a l C o m m u n i t y E n g a g e m e n t S u r v e y
Graph 10: Participation in Advocacy Events... 18 c. Importance of Community Engagement... 19 Graph 10: Importance of Community Engagement... 19 d. Benefits of Community Engagement... 20 Graph 11: Benefits of Community Engagement... 20 e. Personal Satisfaction with Levels of Community Engagement... 21 Graph 12: Benefits of Community Engagement... 21 f. Topics About Which Latinos Would Be Willing to Participate and Advocate... 22 Graph 13: Topics About Which Latinos Would Be Willing to Participate and Advocate... 22 g. Actions that Participants Would Take to Advocate for Needs in the Latino Community... 23 Graph 14: Actions That Participants Would Take to Advocate for Needs in Their Communities... 23 IV. Tables and Annexes... 24 Table 1: Self-Identification of Participants... 24 Table 2: City of Residence... 24 Table 3: Gender... 24 Table 4: Country of Origin... 25 Table 5: Marital Status... 26 Table 6: Educational Attainment... 26 Table 7: English Proficiency... 26 Table 8: Employment Status... 27 Table 9: Personal Annual Income... 27 Table 10: Top Three Needs or Concerns... 27 Table 11: Importance of Community Engagement... 28 Table 12: Benefits of Community Engagement... 28 Table 13: Level of Satisfaction of Personal Community Engagement... 28 Table 14: Top Three Areas of Advocating Interest... 29 Sources Cited... 30 4 N H C O A N a t i o n a l C o m m u n i t y E n g a g e m e n t S u r v e y
Executive Summary Hispanic older adults, their families and caregivers are a remarkably resilient population. Over the course of the past year, the National Hispanic Council on Aging (NHCOA), through a national survey, found Hispanic older adults to be enthusiastic about working to overcome sometimes daunting challenges. Hispanic older adults face pressing problems in the areas of economic security, healthy aging, housing and access to services. Earlier this year, NHCOA implemented a community engagement survey among 931 Hispanic older adults and their family members and caregivers in California, Florida, Texas and Washington, DC. Sixty-four percent of survey participants were older adults. The survey found that, despite the challenges they face, Hispanic older adults are eager to engage in their communities and seek solutions to their most pressing issues. It found that most Hispanics are satisfied that they are engaged in their communities, but they are engaged in informal ways like helping their neighbors, instead of through advocacy. This could be because Hispanics tend to see community engagement as helping others rather than taking on a formal role in the system to achieve community solutions. For example, a Hispanic person may help neighbors by giving them rides to appointments, rather than advocating for community shuttle service. The enthusiasm among survey participants, however, to be civically engaged can translate to real change with the assistance of organizations that specialize in working with this hard-to-reach community, such as NHCOA, and community leaders. Through this effort Hispanic older adults will learn to navigate the system and engage in needed advocacy and community engagement in their communities. The survey also found that the main concerns among Hispanic older adults and the areas in which they would like to be engaged civically are: 1) health care access, 2) affordable housing and 3) hunger and nutrition. 5 N H C O A N a t i o n a l C o m m u n i t y E n g a g e m e n t S u r v e y
Community Engagement Survey Report I. Introduction Between June 7, 2016, and September 17, 2016, NHCOA implemented a community engagement survey with seniors, families and caregivers in California, Florida, Texas and Washington, DC. The goal of the survey was to understand the perceptions of Hispanic older adults, their families and caregivers in reference to the following three areas: 1) key issues impacting them and their communities; 2) civic engagement on these issues; and 3) the role of local communities in the development and implementation of public policies, programs and services that fit the needs of the diverse older adult population locally and nationwide. The survey found that Hispanic older adults understand the key issues that affect them and are eager to engage in the development of programs and policies to address these issues. One important finding of the survey is confirmation that Hispanics view the concept of civic engagement differently than does the wider US society. Hispanics often view civic engagement in terms of helping others in their community. They engage in their community by helping their neighbors on a personal basis, such as caring for their children or a sick relative, or providing food for someone in need. They volunteer their time and effort on behalf of their communities, but generally in an informal manner. Often, they do not relate being civically engaged to participating in the political process, such as contacting their representatives about important topics, attending city hall meetings, or engaging in advocacy or formal voluntarism. The findings of this survey should inspire a call to action for Latino communities nationwide to become civically engaged in the process of policy-making, and advocate for programs and services that address their needs. The survey findings are also intended to serve as a basis for national and local advocacy for programs and services that are culturally and linguistically appropriate for Latino seniors, their families, and caregivers. Hispanic older adults continue to face critical challenges in the areas of economic security, healthy aging, housing and access to programs. This is in part because programs are not designed to address these challenges, and in part because Hispanic older adults and their families are generally not reached by mainstream education efforts. As a result, Hispanic older adults and their families often do not know about available programs or how to access them. Given the rapid growth of the US aging population in general and of the population of Hispanic older adults in particular, it is critical that all sectors of US society are committed to ensuring that all of the nation s seniors can age in security and in the best possible health. 6 N H C O A N a t i o n a l C o m m u n i t y E n g a g e m e n t S u r v e y
II. Methodology The study implemented a survey between June 7 and September 17, 2016, among a sample of 931 Hispanic adults, family members and caregivers living in California, Florida, Texas and Washington, DC. Surveys were administered in both Spanish and English in partnership with NHCOA local community-based organization and community leaders. The study was designed to target low-income Hispanic communities for inclusion in the sample. Survey participation was voluntary and anonymous. III. Summary of Findings Following is a summary of the findings of the survey, including participant demographics and level of civic engagement. A. Demographic Profile 1. Sixty-four percent of survey participants were older adults. 2. The largest self-identified nationality among participants was Mexican, at 40%. The second-largest nationality was that of participants who were born in the US, of Hispanic descent. Participant-identified nationality corresponded to national US Hispanic countryof-origin statistics. 3. The majority of survey participants had only an elementary education (31%), and 63% did not speak English fluently. This finding illustrates the need for linguistically and culturally appropriate outreach, education and inclusion efforts for this population. 4. More than 50% of participants were living on an annual income of less than $10,000, which generally does not cover basic expenses in the target geographic program. An additional 23% of participants had an annual income of between $10,000 and $14,000. 5. Sixty-nine percent of participants identified the most critical and pressing issues they face as access to healthcare and low-income housing, while 45% identified their most pressing issue as access to food. 7 N H C O A N a t i o n a l C o m m u n i t y E n g a g e m e n t S u r v e y
B. Civic Engagement 1. Most participants felt that civic engagement was highly important, at 81%. 2. Participants who were civically engaged were often engaged in collective endeavors, such as attending neighborhood meetings (47%), as compared with making phone calls (19%) or writing letters (18%) to policy makers. 3. Forty-five percent of participants were very satisfied with their community involvement and only 15% were dissatisfied. 4. Forty-three percent of participants were willing to be more active in their communities, and 19% were willing to organize advocacy campaigns. Specifically, 68% were interested in strengthening local community relations, 65% were willing to learn about services to share the information with their neighbors and 56% were willing to strengthen their community. 5. Participants were also eager to be involved in addressing issues which corresponded to the areas which they had identified as their most pressing needs: 68% identified access to health care, 64% identified affordable housing and 44% identified programs to address hunger and nutrition C. Analysis and Results 1. Sociodemographic Information The survey targeted key demographic information on participating Hispanic older adults, families and caregivers, including place of residence, gender, age, marital status, country of origin, educational attainment and personal income. Sociodemographic information gathered through the survey provided a profile of the survey sample and was largely parallel to national Hispanic community demographic data. a. Self-Identification Sixty-four percent of participants self-identified as older adults, followed by 16% who identified as promotores/leaders, 11% caregivers, and 10% organization staff. 8 N H C O A N a t i o n a l C o m m u n i t y E n g a g e m e n t S u r v e y
Graph 1: Self-Identification 9 N H C O A N a t i o n a l C o m m u n i t y E n g a g e m e n t S u r v e y
b. Place of Residence Among the 931 Hispanics participating in the survey, 29% lived in McAllen, Texas; 27% in Los Angeles, California; 22% in Miami, Florida; 13% in Washington, DC; and 9% in Dallas, Texas. These cities were targeted because they have the largest Hispanic communities in the US. Graph 2: Place of Residence 10 N H C O A N a t i o n a l C o m m u n i t y E n g a g e m e n t S u r v e y
c. Gender and Age Survey participants were 75% female and 25% male. This disparity may be related to the cultural tendency of Hispanic women to be more involved in their local community and engage in activities that may result in resources and information for their families. On average, survey participants were 61 years old, with the youngest being 18 and the oldest 92. Over 53% of participants were 65 years old or older, as the survey team actively targeted older adults. Graph 3: Age 18% 53% Less than 44 Between 45-64 More than 65 29% 11 N H C O A N a t i o n a l C o m m u n i t y E n g a g e m e n t S u r v e y
d. Marital Status Thirty-five percent of survey participants were married, 28% were divorced or separated (18% and 10% respectively), 8% were widowed, and 18% were single/never married. Fiftythree percent were either married or widowed. Graph 4: Marital Status 12 N H C O A N a t i o n a l C o m m u n i t y E n g a g e m e n t S u r v e y
e. Country of Origin When participants were asked about their countries of origin or descent, the survey found that 40% identified themselves as Mexicans, followed by Cubans (10%), Salvadorans (5%), Puerto Ricans (4%) and Hondurans (3%). Eighteen percent of those surveyed identified themselves as Americans, and were of Hispanic descent. This finding mirrors the national Hispanic statistics on national origin and illustrates the diversity of this ethnic group. Graph 5: Country of Origin Others 30% United States 18% El Salvador 5% Cuba 10% Mexico 40% 13 N H C O A N a t i o n a l C o m m u n i t y E n g a g e m e n t S u r v e y
f. Educational Attainment and English Proficiency Nearly half of the survey participants had only an elementary school education or had not completed high school (31% and 17%, respectively). Eighteen percent of participants held a Bachelor s degree or higher, roughly mirroring national education statistics. About 63% of survey participants spoke a little or no English (45% and 18%, respectively). These low levels of formal education and English proficiency point to difficulties in accessing services or programs and understanding important information not presented in a culturally or linguistically appropriate manner. Graph 6: Educational Attainment 14 N H C O A N a t i o n a l C o m m u n i t y E n g a g e m e n t S u r v e y
g. Employment Status and Personal Annual Income About half of all survey participants were retired, corresponding to their ages, as 53% of them were older adults (65 years old and older). Only 35% were younger Latinos who were working. Among those, only 15% had an annual income of over $25,000. Over 50% of survey participants reported having an annual income of less than $10,000, followed by 23% making between $10,000 and $14,000 annually. These data support national data which show high levels of income insecurity among Hispanic older adults and that Hispanics are likely to work in low-salary jobs. Graph 7: Personal Annual Income 15 N H C O A N a t i o n a l C o m m u n i t y E n g a g e m e n t S u r v e y
2. Community Engagement The following survey results explore the role that Hispanics play in the development and implementation of policies, programs and surveys. It does so by evaluating the importance that Hispanics give to community engagement and civic participation. Variables explored in the community engagement section of the survey included: 1) the major concerns of Hispanic older adults; 2) participation in advocacy events; 3) the importance of community engagement; 4) the benefits of community engagement; 5) personal satisfaction with their levels of community engagement; and 6) topics about which participants would be willing to participate and advocate. 16 N H C O A N a t i o n a l C o m m u n i t y E n g a g e m e n t S u r v e y
a. Main Concerns of Hispanic Elders Survey participants were asked to identify the top three needs or concerns affecting Hispanic older adults. About 69% of participants identified health care access and affordable housing. Another 45% identified meals and nutrition, followed by 26% who identified recreational activities and chronic disease prevention. The fourth most common answer among participants was the need for employment and job training. Graph 8: Main Concerns of Hispanic Elders 17 N H C O A N a t i o n a l C o m m u n i t y E n g a g e m e n t S u r v e y
b. Participation in Advocacy Events Survey participants attended the following advocacy events most commonly over the past year: neighborhood meetings (47%), advocacy group meetings (35%), and public hearings (32%). Participants were less likely to submit written communication to mass audiences or local organizations, such as letters to the editor (8%) or letters to neighbors (13%). This finding could be related to lack of information among Hispanic communities about how to contact local representatives, limited English proficiency, and/or low levels of formal education. Moreover, many Latinos come from countries where public participation and advocacy could spark reprisals or are otherwise penalized. These findings demonstrate the need for designing and implementing advocacy trainings and education campaigns that are culturally and linguistically appropriate for this population. Graph 10: Participation in Advocacy Events 18 N H C O A N a t i o n a l C o m m u n i t y E n g a g e m e n t S u r v e y
c. Importance of Community Engagement When participants were asked about the importance of being actively involved in the community, 81% said it was very important and 16% said it was somewhat important. Participants recognized the importance of being engaged and raising their voices on local issues that directly affect them. Yet, survey results cited above show that many of them did not participate in advocacy or otherwise in the legislative process. This could be because many of them do not know how to navigate the system, are afraid of contacting authorities because of home country experiences with autocratic governments, or are not comfortable writing letters to their representatives or for mass consumption because of lack of English proficiency or low levels of formal education. This recognition of the need for community engagement paired with the lack of engagement in the political or legislative process may point to the need for trained community leaders. Graph 10: Importance of Community Engagement 19 N H C O A N a t i o n a l C o m m u n i t y E n g a g e m e n t S u r v e y
d. Benefits of Community Engagement Participants identified the following among the top three benefits that community engagement may bring to seniors lives: 1) building local partnerships (68%), 2) learning about services available (65%), and 3) strengthening the community (56%). This data shows that Hispanic participants are aware of the importance and benefits of community. Graph 11: Benefits of Community Engagement 20 N H C O A N a t i o n a l C o m m u n i t y E n g a g e m e n t S u r v e y
e. Personal Satisfaction with Levels of Community Engagement Over 85% of survey participants were either satisfied or somewhat satisfied with their levels of community engagement. This finding is in contrast to the finding that most participants do not attend public hearings or neighborhood meetings and they do not contact elected officials. It is possible that the high rate of personal satisfaction of participants levels of community engagement is related to the cultural understanding among Hispanics of community involvement as directly helping others, such as by giving an older adult a ride or helping him with groceries, rather than attending a formal meeting to advocate for shuttles that could transport older adults to commercial locations. This perception represents an opportunity for local authorities and state agencies to reach out to local leaders and young Latinos, as well as local and national organizations like NHCOA that are experts in working with hard-to-reach Hispanics, to begin to create the connection between informal engagement and formal methods of advocacy to advocate for services that are culturally and linguistically appropriate for Hispanic older adults. Graph 12: Benefits of Community Engagement 21 N H C O A N a t i o n a l C o m m u n i t y E n g a g e m e n t S u r v e y
f. Topics About Which Latinos Would Be Willing to Participate and Advocate The majority of survey participants identified the following top three subject areas in which they would be interested in advocating: 1) health care access (68%); 2) affordable housing (64%), and 3) meals and nutrition (44%). These answers coincided with the survey data cited above on the three main concerns of survey participants. They also coincided with national statistics that show that: 1) Hispanic older adults are more likely to have no health insurance than non-hispanics (about 7.6% versus 1.7%), making access to healthcare more difficult; 2) Latino families are more likely to rent their houses than non-hispanics (55% vs. 34%) i, implying a greater burden among Hispanic families in finding affordable or subsidized rental housing; and 3) eighteen percent of US Hispanic older adults are poor, compared with 8% of the non-hispanic white older adult population. ii Graph 13: Topics About Which Latinos Would Be Willing to Participate and Advocate 22 N H C O A N a t i o n a l C o m m u n i t y E n g a g e m e n t S u r v e y
g. Actions that Participants Would Take to Advocate for Needs in the Latino Community About 43% of survey participants said that they were willing to be more involved in community issues. In addition, participants were committed to developing local advocacy campaigns (19%), getting involved in aging issues (19%), and educating themselves to better help and serve others (19%). These data indicate that Hispanics are eager and willing to serve others and to advocate for needs in their communities. Their relative inaction to date, as cited above, may be due to their lack of knowledge about how to navigate the system and advocate for change. This conclusion leads to a recognition that linguistically and culturally appropriate trainings and information centers that teach Hispanics to navigate local and national systems are the ways to begin to make Hispanic voices heard. Hispanic organizations and local leaders are crucial, in that they are the logical entities to provide these trainings and implement information centers. Graph 14: Actions That Participants Would Take to Advocate for Needs in Their Communities Be more active and get involved in community issues 43% Develop advocacy campaigns in my community 19% Get involved on aging issues 19% Educate myself to help others 19% 23 N H C O A N a t i o n a l C o m m u n i t y E n g a g e m e n t S u r v e y
IV. Tables and Annexes Table 1: Self-Identification of Participants Table 2: City of Residence Table 3: Gender 24 N H C O A N a t i o n a l C o m m u n i t y E n g a g e m e n t S u r v e y
Table 4: Country of Origin 25 N H C O A N a t i o n a l C o m m u n i t y E n g a g e m e n t S u r v e y
Table 5: Marital Status Table 6: Educational Attainment Table 7: English Proficiency 26 N H C O A N a t i o n a l C o m m u n i t y E n g a g e m e n t S u r v e y
Table 8: Employment Status Table 9: Personal Annual Income Table 10: Top Three Needs or Concerns 27 N H C O A N a t i o n a l C o m m u n i t y E n g a g e m e n t S u r v e y
Table 11: Importance of Community Engagement Table 12: Benefits of Community Engagement Table 13: Level of Satisfaction of Personal Community Engagement 28 N H C O A N a t i o n a l C o m m u n i t y E n g a g e m e n t S u r v e y
Table 14: Top Three Areas of Advocating Interest 29 N H C O A N a t i o n a l C o m m u n i t y E n g a g e m e n t S u r v e y
Sources Cited i U.S. Census Bureau, American Fact Finder. (2014). Selected population profile in the United States: 2014 American Community Survey 1-Year Estimates. [PDF file]. ii U.S. Bureau of the Census, Current Population Survey, & Annual Social and Economic Supplements. (2014). Table 3. Poverty Status of People, by Age, Race, and Hispanic Origin: 1959 to 2014. Excel. 30 N H C O A N a t i o n a l C o m m u n i t y E n g a g e m e n t S u r v e y