quickly reveals their collective plight.4 The black aged live approximately five years less than whites, and about one-third live on incomes below the official poverty level compared to 12 percent of the white elderly. Elderly black women living alone are seriously deprived economically with over 60 percent living in poverty. The quality of housing has not improved, with probably over one-third living in substandard housing.

Despite some improvements in health care, the health status of the black aged continues to be poor. The higher death rate at younger ages reflects disparity in the receipt of quality health services by the black population. The reality is that there is not nearly enough money for aged blacks to pay for adequate care. Their poverty status works against their ability to obtain good health care. Medicare is not adequate to meet their needs since it covers about 40 percent of medical care costs.

The Needs of the Black Aged

There is a need for clarity and priority setting in relation to the needs of the black aged and how they should be met. The National Caucus on Black Aging and other groups concerned about the conditions of black people are continuing to advocate for a holistic approach in meeting their needs.

The emphasis on need meeting should deal with primary goals that will improve the quality

Unfortunately, social policy that is designed to serve the aged continues to be fragmented and at times contradictory.

of life. For example, there is a tremendous need for improving the "life satisfaction" of the black aged. Utilizing life satisfaction as a conceptual tool, we should address their emotional, psychological, and physical needs and concerns including a sense of well being and happiness, the feeling of being wanted and of being a significant person, and the need for adequate food, housing, transportation, and other types of services.

We should also be concerned about the black aged's ability to meet effectively the developmental changes that they face. These developmental needs encompass the continuing search for adequacy and the need for competency. It includes for many black aged, especially because of low income, the need to develop and pursue

"second careers" after retirement and to maintain an income level that has been inadequate for years. Further, the psychological stress of aging, and physical changes, the loss of contemporaries through death, and the change in life style necessitated by shrinking income point to developmental needs of continual adjustment to reality.

Much has been written of late about the resiliency and strength of black people. These factors, well documented in the work of Billingsley and Robert Hill," sustained black aged individuals and families in the face of tremendous obstacles. The conceptual utility of life satisfaction and of meeting the developmental needs of black people can be translated into meaningful social policy if there is the will to do so. However, there are tremendous gaps between needed and existing policy.

Black Perceptions of Needed Policy Change

The 1971 White House Conference on Aging developed an extensive set of recommendations in relation to black aged and social policy. The recommendations of the Black Special Concerns sessions reflected the consensus of a broad cross section of black leadership and individuals intimately involved in the aging field.

Recognizing the economic insufficiency of the black elderly, one of the major recommendations that emerged was to have a minimum guaranteed income of $6,000 for a single person and $9,000 for an aged couple.' This recommendation has much currency in that while the financial status of the elderly has improved since 1971, the fact remains that the income of the average household headed by elderly black women is only half that of elderly white women and that of elderly black men and women is only two-thirds that of their white counterparts.

Another crucial recommendation that emerged from the special sessions dealt with the minimum age eligibility requirements. Delegates requested that the minimum age for social security be reduced by seven (7) years for black men due to their lower life expectancy. Recommendations were also made to increase the housing supply, add nutritional programs, and strengthen medical care and services for the elderly. These recommendations have not been, for the most part, successfully implemented. Nutritional programs have been strengthened and there has been much discussion on strengthening income and health services through welfare reform and National Health Insurance but to date these objectives have not been met.

The discussions that have emerged around welfare reform as proposed by President Carter

illustrate in many ways the problems faced by programs geared for social goals and outcomes in the public policy arena. The President's welfare reform package has not really moved forward. The reasons given by Congress and other involved parties often point to cost considerations and similar concerns. The income level of needy American families, young and old, partly depends on the outcome of the welfare reform debate.

Political Realities and Strategies

The inability to enact a progressive social policy in relation to the aged is tied very much to the same dynamics that work against welfare reform. The aged are not conceptualized in the policy arena as any different from other low income groups. The black aged, especially, have to deal with the problem of race, in many instances, plus the handicapping reality of being poor. Decisions are greatly affected in the policy market place by the politics of power and number.

It is unfortunate that undergirding the politics of power are a set of attitudes and values that form the first line of resistance against meaningful social policy change for the poor, black, and aged. We have not really moved far in separating the deserving from the undeserving poor. Fault psychology continues to permeate the fabric of our social programs which "blames the victim" for his own plight. This, perhaps, should be the target of our social strategies. Rather than working only from the "top down" with welfare reform and health reform packages, it is necessary to engage in a grassroots strategy.

Groups and lobbies concerned with the aged must move to effectively solicit help and create understanding at the local and neighborhood levels.

Further, new coalitions must be formed between the black aged and politically effective institutions like the labor movement which deal effectively in the politics of power. Interests are similar, for unions are concerned about what happens to their workers after retirement. A higher level of political consciousness must be developed for the elderly vote because politicians tend to respond to those constituencies that vote together (bloc voting) and make their needs and interests known. It should be kept clearly in mind that social policy and programs for the aged are usually translated into legislative terms, discussed and compromised in the public political market place in Congress, state legislatures, and city councils all over the country. It is in this arena that bloc voting, power politics, coalition politics, and similar strategies are effective.

Because of the limited dollars set aside for social programs, aging interests must compete within the social welfare allocation market place for funds. Recent history has again illustrated that legislative and policy outcomes are closely tied to cost considerations. When, in fact, the national goal is to curb inflation, then "national policy on aging" type social programs (welfare reform, health reform) receive low priority.

This policy and political dynamic sets up a struggle for existing social program and welfare dollars between equally needy interests. For example, aging interests must then compete with children interests in the market place. Funding for senior citizen centers must compete with

A higher level of political consciousness must be developed for the elderly vote because politicians tend to respond to those constituencies that vote together.

funds for children's day care centers. Too often the resolution of such conflicts is for limited funds to be divided between the competing interests. This results in several inadequately funded programs that serve and therefore impact upon a limited number of people.

In order to compete more successfully in the social welfare market place for dollars via the public arena, the advocacy structure for the elderly and the black aged in particular must be strengthened and gain more visibility and viability. The aging interest must develop its own image and presence within the public policy arena where social policy and programs are determined.

The aged are primarily perceived as being a part of other primary reference groups, i.e., urban dwellers, blacks, the poor, middle American whites, and the like. The ability to affect social policy for the aged will depend greatly on the ability of the aging interest coalition to fully emerge as an entity with a political identity and with political clout. Some strides have been made in this direction but much remains to be accomplished.

Toward a National Policy on Aging

America has not taken seriously enough its responsibility to the poor, needy, and those not in a position to purchase all the goods and services needed to maintain an adequate quality of life. Public policy has continued to "punish" the "have nots" for having not! This is evident when

one examines the levels of need that are met through social security and through public welfare type programs. Some progress has been made, for example, in passing the inflationary clause for raising social security payments according to the cost of living. Welfare reform, if successful, will promise, hopefully, an adequate economic floor (guaranteed income level) below which no American family will fall. Please keep in clear focus that we annually spend less than 5 percent of our Gross National Product on social and educational programs. That is sad commentary in a society that is the world's most advanced civilization.

The present Social Security Act of 1935 and the Older Americans Act of 19658 as amended are the major pieces of social legislation for the aged. Within the Acts are provisions for health care (Medicare), income, social services, nutrition programs, older worker employment programs, training and research. These programs are helpful and provide health, income, and maintenance services for millions of our aged citizens. The question is raised, however, at what level of adequacy, and what is the effect on the quality of life of the aged population. The black aged continue to live primarily in poverty and in ill health.

What is needed is a National Policy on Aging that avoids fragmentation and that is comprehensive. Further, the levels of need of aged blacks especially call for a more adequate level of income and services, particularly health care and housing. The policy also should be designed to be

Too often the resolution of conflicts is for limited funds to be divided between the competing interests.

equitable. The entire question of entitlements needs to be addressed. Too often blacks do not even live to receive social security benefits due to a shortened life expectancy. The recommendation made around an earlier eligibility for blacks by the Black Concerns Session of the 1971 White House Conference, the National Caucus on Black Aging, and recently by the Congressional Black Caucus, should be incorporated by the policy makers.

There are needs such as housing that are critical and must be addressed through legislation in a more realistic manner. Additionally, more research needs to be conducted that will

provide direction for the types of housing that will be most useful. This housing must be sensitive to the cultural patterns of blacks since the black aged still frequently live with relatives in an extended family arrangement. The question then arises about the feasibility of a high rise apartment limited to people over age 65. Will this me the needs of the black aged? These and sim.lar issues need to be critically addressed.

The knowledge and technical competence are available for designing a holistic, comprehensive national policy on aging that will be sensitive and effective for blacks and for all Americans. But, it

needs to be marshalled, organized, challenged, and listened to by policy makers in the public policy arena. With enough effort all of the needed provisions and articles could be prepared that would consolidate the existing programs, close gaps in services, and provide new ones. The political reality of carrying out such an undertaking is such that strong leadership from the President and Congress will be necessary for any type of success. Additionally, leadership needs to be marshalled in the private sector and the private aging interest agencies need to lend all their resources and efforts to make the goal of a comprehensive national policy a reality.

In my view, a significant part of the "bottom line" in relation to aged blacks is income. The presence of an adequate income level for aged blacks would help to alleviate many problems suffered by this population. More adequate food could be purchased, services would be more accessible through money for transportation, more adequate housing could be maintained or secured and so on. Hopefully, an adequate income floor will be a major consideration as we move toward more rational policy design and service delivery.

Closing

This article has set forth the author's perception of what needs to be done. There is a sense of urgency that should be recognized within the body politic of public policy as it determines social policy outcomes. The quality of life of aged blacks is, perhaps, declining, instead of improving.

Inflation, housing declines, urban decay, inadequate health services, are all clinical signs that provide clues to the quality of life questions.