Aging America: Uncovering Disparities in Geriatric Healthcare

MEDICAL SCIENCE MEETS SOCIAL SCIENCE 

Destri Eichman has known that she wanted to be a doctor for many years. However, when she opted to attend a liberal arts institution, Westminster College in Fulton, Missouri, for her undergraduate degree, she began to consider the nuances and disparities in the healthcare system from an interdisciplinary perspective. While in her honor’s college class, Global Problems and Solutions, Destri began examining the problems in healthcare with a social science lens. 

“I was actually working as a patient care technician in a geriatric psychiatric ward of a hospital at the time of my class,” Destri says. While she hadn’t come to college planning to work with elderly patients, when the opportunity arose, she jumped at the chance to interact with patients in a clinical setting. “I was taking care of older patients with Alzheimer’s, dementia, schizophrenia and other mental disabilities, and being on the side of seeing what aging America is experiencing in that specific setting helped me select a problem to study.” 

Rather than take a purely scientific or numerical approach, Destri decided to color her research with anecdotal and personal insights from the physicians she was working alongside at the hospital.

“My first question was not how would I approach this as a scientific problem, but more so, how could I investigate?” Destri says. “I wanted to figure out the real story of what aging Americans are experiencing today.” 

“In my field we like numbers and statistics, and of course with this project that was an important part of it,” she explains, “but for me it was actually getting to talk to the patients I was caring for, being able to speak to my grandparents, and understanding that there is a real problem here.”

Yet the more Destri sought to research the gaps in geriatric healthcare, the clearer it became that enough research on the topic does not exist. Destri admits that she was unaware of just how large the disparity is in care for the elderly. As she met more and more patients and heard her colleagues’ concerns, her research argument formed with the broad aim of raising awareness and helping her audience to understand that breadth and depth of this problem.

“We don’t like to think of ourselves as aging, and we don’t like to put our resources towards people who are getting older,” Destri says. “But here is this humongous problem, and currently in our country, we are not doing enough to solve it.” 

A THREE-FOLD PROBLEM 

Destri began her project by conducting a literature review of the limited scholarly works on this topic. What provided perhaps even greater value to Destri’s project and understanding of the issue though, was her conversations with physicians at the hospital where she worked. While Destri chose to protect the confidentiality and vulnerability of her patients, her colleagues were able to provide experienced-based insights for her research that unveiled many disparities in healthcare for the aging.

Destri boiled down many of the issues facing the aging population and their access to health care in three parts: financial strain, chronic illness, and social isolation. 

“Many people are living longer nowadays, but they haven’t financially prepared for that,” she says. She adds that while many older Americans qualify for Medicare or Medicaid, they are often unaware that these services still require a private insurer and out-of-pocket premium payments.  

“When people do live longer than they expected, they are often faced with increased chronic conditions, for example heart disease or cancer,” she continues. Destri discovered that the chronic conditions facing many elderly Americans are exacerbated by their lack of access to specialist doctors to care for their health concerns. The healthcare system tends to privilege competitive fields like cardiac surgery, oncology and orthopedic surgery, so many doctors opt to pursue careers in those fields. This has left a shortage of approximately 10,000 physicians in geriatric medicine. 

“The brunt of geriatric care falls on the primary care physicians, who already have a large plethora of needs they have to meet,” Destri says. 

The final disparity Destri located in care for elderly populations, is the social toll aging can take on a person.

“We’re a youth driven culture, and that tends to ostracize the elderly,” she explains. “Putting someone away in a care home or a hospital only to see them for visits isn’t the level of proactive care we’d see for other populations.” 

ASKING WHY INSTEAD OF WHAT 

What started out as a project in her sophomore year eventually grew and evolved throughout the course of Destri’s college career. Having worked on the project until her final year in undergraduate, Destri noted how much her perspective changed throughout the course of her research. 

“Going into this project, I was experiencing these issues in a hospital setting and was specifically searching out research exposing what was going wrong,” she says. “I was getting fired up about how awful the problems in geriatric healthcare are, so my research was hashing out all the things we need to do better.” 

But as the project itself aged, Destri noticed the questions she started asking changed too. She recognized that researchers in the sciences are often rightly concerned with a question of understanding what is occurring and finding a data-driven solution. Adding the social science and humanities perspective to her research gave Destri a new appreciation for the nuances that go into asking the “why” behind societal issues. 

“It would have been really easy for me just to present all the problems,” she says, “but being able to change my perspective and force myself to look more deeply into the ‘why’ behind these problems was really valuable to my research.” 

As she started seeking answers to the question, “Why are these problems occuring?” Destri began examining everything from societal influencers that privilege youth to political platforms and policies that allow these problems to continue. By adding these questions to her project, Destri’s hope is that the research extends far beyond the bounds of her one project. 

“I want this project to be a call to action…not just another piece of research that gets put away on a shelf,” she says. “Going forward, I want this work to educate the healthcare community about this population that is being underserved. For individuals, I hope it helps us to recognize our own ageist behaviors.” 

Destri also hopes this research encourages audience members to do their own research on the topic and, in turn, use their voice to advocate for vulnerable populations. 

“A lot of this research is sort of hidden. You have to look for it. If you’re interested in the topic, do your research. Use your platform to advocate,” she says. “Advocate through social media. Speak to people affected by the issue. Do something, in whatever field you’re in.” 

JUST THE BEGINNING

Destri is certain that this project laid the foundation for her mentality as a future physician. The project spanned from her Destri’s sophomore year until graduation, and she was happy to find she didn’t experience burnout or disinterest on the topic. 

“As a biochemistry major, a lot of my education was based in a lab,” Destri says. “Having to take off my ‘lab hat’ and put on my ‘social sciences hat,’ and integrating those different things was a challenge.” Yet reflecting on the project, Destri is happy she has already started honing the softer skills she will use in her future medical practice to serve her patients. 

As Destri prepares to take the MCAT and apply to medical schools, she admits she isn’t entirely sure what field of medicine she wants to pursue. 

“There are disparities within every field,” she says. As a biochemistry and Spanish double major, Destri does know that she wants to serve minority and disadvantaged populations with her medical degree. “I don’t think this is a project where you bookend it and call it done. I think I could continue to expand on it throughout my career.”

Alpha Chi values the way Desti is making her scholarship effective for good.