Millions of Americans aged 65 years and older are not receiving potentially lifesaving preventive services, according to a report issued by the Centers for Disease Control and Prevention and the U.S. Department of Health and Human Services on March 14.
Approximately 85% of flu-related deaths and 63% of flu-related hospitalizations occur in adults aged 65 years and older. Data have shown that the pneumococcal vaccine is a cost-effective way to improve survival and reduce hospital stay in older adults with community-acquired pneumonia, according to the authors of the report, "Enhancing Use of Clinical Preventive Services Among Older Adults: Closing the Gap."
However, in 2009, more than 31% of older adults had not received an influenza vaccination in the past year, while more than 33% reported that they had never received a pneumococcal vaccination.
The report included eight indicators to measure the use of clinical preventive health services by U.S. adults aged 65 years and older: influenza vaccination; pneumococcal vaccination; counseling for smoking cessation; and screening for breast cancer, colorectal cancer, diabetes, lipid disorders, and osteoporosis.
Breast cancer screening and cholesterol screening were the most widely used services. Only 17% of women aged 65 and older reported not receiving breast cancer screening in the past 2 years, while only 5% of adults aged 65 and older said they had not had blood cholesterol screening in the past 5 years.
The report also highlighted ethnic disparities in many of the preventive services for older adults. Approximately 49% of Asian/Pacific Islanders and 47% of Hispanics in the United States reported that they had not undergone colorectal cancer screening, compared with 37% of blacks, 35% of American Indians/Alaska Natives, and 34% of whites. In addition, approximately 51% of Hispanics, 47% of blacks and Asian/Pacific Islanders, and 36% of American Indians/Alaska Natives reported never receiving a pneumococcal vaccine, compared with 30% of whites.
The report recommended interventions for improving preventive care for older adults, including promoting annual wellness visits, reducing barriers to preventive care services, and tailoring preventive health messages to the needs of each individual.
The report also recommended several additional preventive services for older adults: screening and counseling for alcohol misuse; zoster vaccination; aspirin use; blood pressure screening; cervical cancer screening; depression screening and counseling; and obesity screening and counseling.
The full report is available online.