¶ … Elderly in Monrovia, CA The population of people aged 65 years or greater is steadily escalating, as baby boomers come of age. It is estimated that this age bracket accounts for 10% of the total world population, and is statistically increasing. As this sector of the population steadily increases, there are of course, accompanying health care issues: osteoarthritis, cardiac and kidney issues, Alzheimer's or dementia, and an ever-growing problem with depression. For this essay, we will concentrate on several health issues that plague seniors nationally, but will specifically focus on the aging population over 65 in Monrovia, California.

Monrovia is a smallish city located at the foothills of the San Gabriel Mountains in the San Gabriel Valley, Los Angeles County. Monrovia was settled in the late 1800s as a central hub for the growing orange grove industry, but has now become more of a bedroom community that supports the urban sprawl of the valley area. Monrovia's population has held steady since the 2000 census, growing only .6%. The city's median age is 38, and families represent 67% of the population. There are more people of Hispanic origin (37%) in Monrovia, with other at 25%, white at 20%, Asian at 9%, and Black at 8%. Income for Monrovia, though, is a bit higher than the U.S. national average, and higher than Los Angeles County: Monrovia $63,383, U.S. Average $60,374, and Los Angeles County $58, 647. 46% of the population are married couples, 33% non-families, and almost 9% are families or singles who are 65 years of age or older (MuniNet, City of Monrovia Guide, U.S. Census Bureau).

Because of Monrovia's proximity to Los Angeles, it does have a propensity for a higher than average air pollution risk, and its location on near the San Andreas fault gives it an earthquake likelihood over 7 times the national average. Average yearly rainfall is 24," the national average 39" -- and temperatures range from the mid-upper 30s in January to the low 80s in July, making the city a bit more evenly temperate than many in the Los Angeles basin. Cost of living is 63% higher than the national average, with the bulk of that increase coming in general consumer expenditures. Crime in general is 4% below the national average, but 52% higher for vehicle theft and 46% higher for robbery (PropertyMaps, 2007).

Monrovia is a somewhat typical smaller Southern California city that still has the flavor of a smaller town with organic and farmer's markets, local arts and festivals, and a more localized education system. As noted in the crime statistics, however, it has not escaped the rise in vehicular crime, but is far safer than most of Los Angeles County for violent crime. Monrovia is served by a community hospital and several health care clinics, albeit relatively small with 50 active beds. The hospital does support Medicare and Medicaid, and has 30 full time Registered Nurses on staff, updated accreditation, but is considered a short-term care facility by licensing boards (HospitalData.Com, 2007).

There is only one Senior Center in Monrovia, with several other organizations close by in El Monte and Baldwin Park. There are, however, 4-6 organizations that, through volunteer or federal funding, do provide outreach programs for the elderly, with Catholic Social Services providing the bulk of non-governmental care (Monrovia's population is almost 70% Catholic) (Monrovia Community Organizations, 2007). As of 2006, there were 85 seniors in nursing homes, 76 people in group homes, and 73 people in noninstitutional group quarters (CityData.com, 2006).

Key findings for the area (Los Angeles County which also correlates to Monrovia) show the following based on populations over 65, ranked male and female, and ranged for the 4 major groups studied in the research:

Figure 1 -- Overall Mortality in Los Angeles County

Cause of Death

Overall & Average Age of Death

Male

Female

White

Hispanic

Black

Asian

Heart Disease

1-33%

Age: 74

1

1

1

1

1

1

Cancer

2-23%

Age: 70

2

2

2

2

2

2

Stroke

3-7%

Age: 78

3

3

3

3

3

3

Respiratory Disease

4-5%

Age: 77

4

4

4

5

5

Pneumonia and Influenza

5-4%

Age: 72

6

5

5

4

Alzheimer's

10-1.5%

Age: 85

8

Note: If blank, does not fit into the top 10 causes of death for that population, Source: "Mortality in Los Angeles County," Centers for Public Health, 2001.

Figure 2 -- Overall Mortality Ranking of National Causes of Death in Senior Populations and Comparisons With Los Angeles County -- Top Six Causes (2002)

Cause of Death

National/%

LA Cty/%

National

Interestingly enough, though, one might expect the percentage of respiratory diseases to be higher in Los Angeles County than the national average due to air pollution, this is not the case.
Like the national averages, heart disease and cancer remain the two leading causes of death for senior citizens -- 33% for heart disease and 20% for cancer. Strokes follow a lower third, with respiratory and immune diseases lagging. However, depending on the ethnic makeup of the population, Alzheimer's disease increased since the 1970s, both nationally and for Los Angeles County, so that it is now within the leading mortality indicators for persons 65 or older; even though the average age of death from Alzheimer's is in the mid 80s. However, although infectious diseases are no longer ranked as one of the top causes of death within seniors, older adults are far more vulnerable to common infections, and drug-resistant bacteria show that in seniors over 80, pneumonia is one of the most serious diseases (Trends in Health Data, CDC, 2009).

Statistical data does not show any particular factor for those seniors living in Los Angeles County to be more or less affected or susceptible to disease than any other part of the nation. Within areas of other ethnic majority (e.g. Eastern Cities with higher African-American populations), other diseases present themselves in higher ratios -- kidney disease for instance; but overall national averages remain consistent for the Monrovia area. The difference in percentages for Alzheimer's patients in California vs. The national average are, according to recent statewide studies, due to the difference in the aging of the population nationally vs. California (Ross, 2009).

Programs in the Monrovia/Los Angeles County area dealing with either the top causes of mortality or the causes that are increasing the most include:

Alzheimer's -- A specific Alzheimer's Council has been funded that shows as of 2011, Alzheimer's will have an even more dramatic effect upon California as the baby boomer generation ages. Advances in medicine are allowing seniors to live longer, and the disease is expected to double in severity in California by 2030. Recommendations are expensive, but shown to be necessary to keep the cost of care reasonable: Build an integrated and comprehensive long-term care service network for dementia and Alzheimer's; develop robust family caregiver policies that utilize public and private funding, and support the increase of geriatrically trained workers (Ibid, 9).

Cancer -- Even with the health care cuts that have hit California, researchers at the University of Southern California and the Norris Comprehensive Cancer Center are on the national cusp of providing breakthrough treatments for a number of cancers. These treatments are cutting edge, and are expected to be available with FDA approval within the next five years (University of California Health Sciences, 2009).

Heart Disease -- As both age and obesity increases in the Los Angeles County area, heart disease continues to rise. Often on a fixed budget, seniors are particularly vulnerable to a poor diet; typically high in carbohydrates or fast-food items, low in fresh fruit and vegetables. Coupled with a decrease in activity, heart disease is often the result. Legislation has been signed into law requiring chain restaurants to disclose calorie and fat content, increasing spending on educating seniors about exercise and nutrition is in effect, but needs more public health focus (Lin, 2009).

Respiratory Disease -- California has made major strides in decreasing respiratory problems due to air pollution -- a vast improvement from the 1960s when it had several days per year with "mask alerts." Strict regulations on automobiles, industry, and trash burning account for a number of improvements. However, it now appears that non-smog related respiratory diseases are hitting the elderly. Medical professionals agree, though, that this is less an environmental factor than a reduction of the body's own immune system to fight of influenza complications, pneumonia, etc. (See: Breathe California).

According to B. Sapp-Pradia, Los Angeles County liaison for Senior Citizens, various programs are in place in both Monrovia city and Los Angeles County specifically designed for seniors, often administered by the Area Agency on Aging. This service organization contracts with over fifty other community agencies to deliver services that promote the well-being and independence of seniors (Sapp-Pradia, 2009).

Home delivered meals and nutrition programs

Home-based care and illness management

Alzheimer's Day Care

Health and Wellbeing classes and information

Integrated Care Management

Elder Care

The community is well poised to assist seniors in Monrovia with these and other services such as legal advice, health insurance, activities, and even ombudsman programs. Program help sheets, documents, and forms for enrollment are easily accessed at the Los Angeles County web page (www.lacounty.gov), or simply by calling the Senior…