USC Hamovitch P.I., Volume 5, Issue 2 Summer 2015

Hamovitch PI

Summer 2015

A research publication of the Hamovitch Center for Science in the Human Services at the USC School of Social Work

Scholars explore aging across borders

Researchers from the United States and Mexico are seeking new approaches to ensuring the health and well-being of older adults.

New study examines religion and faith among older adults in the baby boomer generation

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The trend is clear: The United States and Mexico are getting old.

An estimated 72.1 million older adults will be living in the United States by 2030, more than twice as many as in 2000. The proportion of older adults is expected to triple in Mexico by 2050, driven by falling birth rates and smaller family sizes.

As the two countries begin to grapple

Postdoctoral scholar to explore U.S. domestic policy as research associate at Urban Institute

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with issues such as changing social support structures, chronic diseases, and other challenges to the health and well-being of older populations, a unique partnership led by scholars at the USC Edward R. Roybal Institute on Aging and Mexico’s Instituto Nacional de Geriatría is embracing an international approach to the problems of aging.

Aging | continued on page 10

Researchers test new solutions to depression and chronic illness in vulnerable communities

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Vol. 5, Issue 2 Summer 2015 From the Director The world’s rapidly expanding aging population is one of the more decisive global phenomena of our time. The high birth rates witnessed during the first half of the 20th century are the main driving force behind the exceptionally swift increase in the number of older individuals. The United Nations estimates that by 2050, the number of older adults will surpass 2 billion. In 1950, that figure was a mere 202 million. Our part of the world is no exception.

The USC Roybal Institute on Aging operates in the midst of this aging phenomenon, which is the backdrop to a complex set of interrelated social, economic, and political concerns.

Prevention of ills caused by aging, treatment of such ills, and service delivery in diverse settings remain in focus of Roybal researchers. This special issue on the Roybal Institute on Aging highlights some of the efforts of the institute’s scholars to generate relevant knowledge, influence policy, foster university–community partnerships, and design best practices for service providers nationally and globally. I hope you enjoy this issue.

Have an enjoyable summer!

Haluk Soydan, PhD Director of the Hamovitch Center

Dean Marilyn Flynn Director Haluk Soydan Editor Eric Lindberg

Hamovitch PI is a research newsletter published quarterly by the Hamovitch Center for Science in the Human Services at the USC School of Social Work. Send questions, comments, and reprint requests to elindber@usc.edu

Front page: Researchers María Aranda and William Vega are building scholarly connections with colleagues in Mexico to explore issues of health and well-being among aging populations.

Photo/Eric Lindberg

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Associate professor shatters myths about older populations Dodger Stadium just north of downtown Los Angeles, she had a close relationship with her maternal grandmother, who lived with her for the first five years of Aranda’s life.

“My parents also reinforced the value of respecting elders and seeking them out and hearing their stories,” Aranda said. “I developed at a very young age the patience that is needed to lend an empathetic ear to the life stories of older people.”

As the first-born child of two monolingual Spanish speakers, Aranda also found Every time she tried to find evidence- herself thrust into the role of mediator based solutions to the problems facing her early in life. She would help translate corolder patients with mental health chal- respondence from government agencies lenges, she was told there just wasn’t any such as the Department of Motor Vehicles research on that topic, particularly per- and ensured that her parents would attend taining to people from racial and ethnically teacher–parent conferences.

“I was basically living in two worlds—the diverse communities. world my parents lived in as monolingual “I got tired of listening to that, so I made speakers and very much allied with their a conscious choice to pursue my educaPuerto Rican roots, but also living in this tion so I could contribute to that body of world, in mainstream America,” she said. knowledge,” said Aranda. “I wrote a lot at “It was a challenge, but I learned analytical the beginning regarding the dos and don’ts skills and how to navigate two worlds that of working with certain older ethnic and would sometimes collide.” racial minority populaAs a result of develtions. There had been very oping strong interpersonal little rigorous research.”

“More people understand Several decades later, abilities at a young age, she the value of serving that field has blossomed excelled in school, ultipeople from vulnerable and Aranda is considmately earning a bachelor’s communities. They ered a leading scholar on degree in social work from are very resilient. issues surrounding mental California State University, health and services for It’s the system that Los Angeles, and a master older, low-income adults of social work degree from is recalcitrant and from communities of color.

USC in 1982. reinforces barriers to As an associate professor As a clinical social quality care.” and associate director of worker, Aranda’s work clinical and behavioral again spanned two worlds: intervention research at the María Aranda medical social work with USC Edward R. Roybal a focus on home-based Institute on Aging, she has care and a mental health led multiple federally funded studies focused practice in the public sector with local comon issues such as the interplay between munity-based agencies and the Los Angeles depression and chronic health problems County Department of Mental Health. among older Latinos, how to build a theraShe was quickly drawn to working peutic relationship based on cultural values, with older adults, exploring how they are and how caring for older adults in marginal- affected by severe mental health disorders ized populations can affect family members. such as schizophrenia, Alzheimer’s disThe seeds of her successful clinical and ease, and depression. When research career were planted at a young she returned to USC in age. Growing up a stone’s throw away from the mid-1990s to earn a

As a licensed clinical social worker in Los Angeles in the 1980s, María Aranda grew weary of hearing a common refrain.

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Photo/Vincent Lim

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doctorate in social work, interest in research on older populations, chronic health conditions, and mental health had started to grow.

But Aranda was well aware that many biases and stigma about older individuals remained.

“Services for older adults are the last to get funded and the first to get defunded,” she said. “It’s a forgotten population and ageism is alive and well in our society.”

In particular, she noted a widespread belief that racial and ethnic communities take care of their aging family members and are inherently opposed to outside help.

“Many believe there is a high respect and reverence for older adults and that we take care of our own,” Aranda said. “Although some of that is true, there are still some overarching problems, such as access to services and pockets of poverty that still have been intractable to change. There is still a lot of work to be done.”

She also dismissed the notion that communities of color are not accepting of therapies developed and delivered by mainstream researchers and practitioners. A recent study she led on a depression care program for older Latinos with chronic medical conditions found that participants not only embraced a form of psychosocial care known as problem-solving therapy, but they also attended nearly every treatment session and reported high levels of satisfaction.

That pilot study, known as Programa Mano Amiga, focused on developing strong practitioner–patient relationships and embracing the cultural values and linguistic preferences of older Latino participants.

Aranda said clinicians need to show warmth and personalismo, or a sense of prioritizing and recognizing the importance of each patient–provider relationship.

“You give them the therapy in their language of preference, you recognize and incorporate their cultural values, you break down barriers to access to care, and voila,” she said. “It’s an obvious phenomenon, but one that people need to change their initial perceptions about.”

Results of the pilot study, which ended in 2012, fed into two new projects funded by the Patient-Centered Outcomes Research Institute—one to study the ability of community health workers to assist low-income individuals with depression and chronic health problems (see page 8), and another known as Programa Esperanza that will explore whether culturally tailored therapy can reduce depression among older Spanishspeaking Latinos with multiple medical issues who receive care from AltaMed Health Services, a large health provider in Los Angeles and Orange counties..

If the approaches prove to be successful, cost effective, and acceptable to both patients and clinicians, Aranda | continued on page 7

María Aranda speaks during a kickoff event for a new study exploring culturally tailored depression care for older Spanish-speaking Latinos. A close childhood relationship with her grandmother prompted Aranda, associate professor and associate director of clinical and behavioral intervention research at the Roybal Institute, to pursue a clinical and research career focused on older populations.

Research examines baby boomers’ faith or lack thereof coinvestigators on the three-year $1.5 million project to better understand religious beliefs, particularly how people in their golden years identify with and practice a religion and how faith affects overall health and wellbeing as people approach death.

Awareness of mortality can often fuel a search for To answer that question, the John Templeton meaning and an interest in religion in old age.

Foundation has funded a new research study by Vern “We’re not interviewing people who have been told Bengtson, a senior scientist at the USC Edward that they’ll die soon, but I expect that many people will R. Roybal Institute on Aging at the USC School talk about experiences with severe illnesses or experiof Social Work and AARP/University Chair of ences caring for close family members with severe illGerontology Emeritus at the USC Leonard Davis nesses,” Bengtson said. “And others will say that material School of Gerontology. things have become less relevant than spiritual things “We’re asking people to reflect on how their religious the longer they have lived.” and spiritual lives may have changed as they have grown For almost 45 years, Bengtson has followed thousands older,” Bengtson said. “Our hypothesis is that the post- of individuals and hundreds of families as part of the retirement years are an occasion for people to more seri- Longitudinal Study of Generations, which he initiated ously reflect about the meaning of life and their religious in 1970 as a young assistant professor at USC with funds and spiritual commitments.” from the National Institutes of Health.

Bengtson and longtime former USC colleague Findings from the study, which surMerril Silverstein, now the Marjorie Cantor Endowed veyed several generations of California Professor in Aging at Syracuse University, are families, resulted in more than 200

By Vincent Lim

Do people become more religious as they age?

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published research articles and several books in gerontology, theories of aging, and family sociology. Funding from the Templeton Foundation also supported research for Bengtson’s latest book, Families and Faith: How Religion is Passed Down across Generations.

The Templeton Foundation is dedicated to supporting discoveries related to questions about human purpose and ultimate reality. Both of Bengtson’s projects align with the foundation’s interest in the human condition and the elements of a meaningful life.

“Most research on religion and the family covers only a short period of time in a family’s life,” said Kimon Sargeant, vice president of human sciences at the Templeton Foundation. “Bengtson and Silverstein’s work, drawing on the Longitudinal Study of Generations survey data, will offer new understanding of how religion is—and is not—conveyed across generations of families, as well as critically examine whether religious involvement can be good for one’s health.”

A ninth wave of data for the Longitudinal Study of Generations will be collected as part of this most recent project to examine how religiosity is related to health, mortality, and family relationships in the postretirement years. Silverstein will lead the longitudinal survey (quantitative) portion of the project and Bengtson will oversee the qualitative interviews.

Of the older individuals who will be interviewed for Bengtson’s portion, approximately one third will have been interviewed in previous study waves. The other two thirds will be identified by leaders of religious or nonreligious organizations as having a significant degree of involvement in their organizations.

“We are broadening our reach,” Bengtson said. “We want to speak with priests, pastors, ministers, and rabbis.

But we want also to talk with leaders of nonreligious groups, such as secular humanist societies.”

This is the first time his research team will interview secular humanists. The researchers will be investigating three types of trajectories of change in religiosity: those who have increased their religious participation in later life, those whose religious participation has remained the same since mid-life, and those who have lost or rejected their religious commitment in old age.

“The most intriguing group might be those who have given up on religion in their later years,” Bengtson said.

“These are the real outliers. We don’t hear much about them. But neither do we hear much about those who increase their religious involvement in later life. We want to find out about both.”

The research team believes the project has the potential to alter the understanding of spirituality in the baby boomer generation.

“Fifty-eight million boomers represent a great recruitment pool for churches wanting members,” Bengtson said. “But churches don’t seem to be aware of this potential.”

Bengtson and Silverstein plan to organize a conference in Los Angeles that will bring together spiritual leaders,

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Photo/Eric Lindberg

Photo/Pixabay

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Vern Bengtson, a senior scientist at the USC Roybal Institute on Aging, is leading a study exploring why older adults embrace, maintain, or disregard religion as they age.

academic researchers, and health care professionals such as social workers to discuss how to best address the spiritual needs of individuals in retirement and old age.

“We want to interview a sample of religious leaders to get their perspective on aging and spirituality,” Bengtson said. “We want to see what they think about religious change in later life from their experiences with the thousands of followers that they have known in their careers.”

One of the aims of the project is to reconsider what religion offers older adults and what older adults offer to religion.

Bengtson said he hopes the findings from the study can help religious and nonreligious groups and organizations better support the spiritual needs of older adults.

“We want to find out what spiritual organizations are doing to meet the age-relevant needs of seniors,” said Bengtson, a past president of the Gerontological Society of America. “We want to see how they’re ministering to those with a special interest in reengaging in spiritual life in their later years.” t

Postdoc secures prominent research position

By Vincent Lim

After spending the last two years as a postdoctoral scholar at the school’s Edward R. Roybal Institute on Aging, Stipica Mudrazija will join the Urban Institute in Washington, D.C. as a research associate.

He credits his time at USC with helping him further develop ideas about what kind of research he wanted to pursue in the future and helping him land a position at one of the nation’s most influential think tanks.

“I’m fairly certain that I wouldn’t have had the opportunity to join the Urban Institute had I not had the opportunity at the Roybal Institute,” Mudrazija said.

He hopes to bring a unique international perspective to the think tank, which focuses on U.S. domestic policy issues.

“What I hope to bring is the idea that lessons from other countries can be informative for the policy debate and different reform options in the United States,” Mudrazija said.

Growing up in the early 1990s during the tumultuous years following the breakup of Yugoslavia, Mudrazija was a witness to the social, political, and economic transition that shaped what the independent nation of Croatia is today.

“For many researchers, it all goes back to your experiences growing up,” he said.

“I grew up during the Croatian War of Independence in a newly formed country that was just beginning to build its institutions while simultaneously facing all of the challenges common to former socialist countries of Central and Eastern Europe.”

Croatia was moving from a centrally planned to a free-market economy at the same time it was rebuilding itself following the war and coping with a rapidly aging population. As in many other transitional countries, these changes were fraught with great difficulty.

“When it comes to the role of government,

Photo/Vincent Lim

A promising scholar from the USC School of Social Work is taking his talents to the nation’s capital.

its services and policy making in general, After two years as a postdoctoral many of us tend to take things for granted, scholar at the USC Roybal Institute on and it’s only when things start going wrong Aging, Stipica Mudrazija will bring his that we fully realize the importance of international perspective to issues related effective policy making,” Mudrazija said. to U.S. domestic policy as a research His interest in policy would ultimately associate at the Urban Institute. lead him away from his European homeland and to the United States.

Mudrazija first came to the United States He contrasted this with his experience in to study public policy at Georgetown the United States.

University in Washington, D.C., where he “The beauty of the American system— initially focused on the comparative study while it can be frustratingly inefficient— of pension system reforms. is that issues get discussed and at great length,” Mudrazija said.

His research continued to evolve at “It’s an incredible advantage the Lyndon B. Johnson School of Public Affairs at the University of Texas at Austin, to be here and have the where he pursued a doctorate under opportunity to learn from the mentorship of Latino aging expert some of the leading experts Jacqueline Angel. in the field.”

Mudrazija noticed that most of the discussions and analyses of different policy Stipica Mudrazija options to reform the system of public support for the growing older population—including public pensions and health Reflecting on his experiences as a care—focused on the fiscal impact on the Croatian citizen and a junior analyst in government and the direct effects on benthe research department of the Croatian eficiaries of these programs while largely National Bank, Mudrazija noted that open disregarding the role of the family.

“People live in families, and to the extent policy discussions were mostly superficial that family members care for and support and, importantly, failed to materialize each other, there’s likely until the public pension system was in going to be some sort of serious financial distress and in need of adjustment in their support dramatic changes.

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Aranda | from page 3 Aranda said she would like to see them brought to scale in systems of care across the United States.

In addition to her research at the Roybal Institute, Aranda is a national problem-solving therapy trainer and is currently serving on two Institute of Medicine committees, one focused on family caregiving for older adults and the second on the decision-making capacity of Social Security beneficiaries.

She said she is gratified to see social work being brought into the fold of those discussions.

“More people understand that social workers have a pivotal role in bringing people together, in using relationships to effect change, and the value of serving people from vulnerable communities,” she said.

Aranda made it a point to emphasize that individuals in those communities should not be viewed as weak and unable to handle adversity.

“They are very resilient. It’s the system that is recalcitrant and reinforces barriers to quality care,” she said. “I remember my work early on when I used to do home visits as a young social worker and see people who had very little but who had developed alternative resources to be able to survive and thrive.

I don’t want to lose sight of that.”

Although she acknowledged that funding and general support for research to address barriers to care for older adults have been historically inadequate in her eyes, Aranda said she was encouraged by the creation of the Roybal Institute five years ago at the USC behavior in response to changing public support,” Mudrazija said. “For example, adult children may have to spend more time and money helping their frail older parents if public support becomes inadequate.”

Intergenerational relations and the transfer of financial and nonfinancial support were the focus of his dissertation, and he continued this line of research at USC. “It’s great being in Los Angeles because it’s one of the great centers for aging research and expertise in the nation,” Mudrazija said.

“It’s an incredible advantage to be here and have the opportunity to learn from some of the leading experts in the field.”

USC is home to the Edward R. Roybal Institute on Aging, whose mission is to advance research whose goal is to enhance optimal aging for persons in minority and low-income communities. It is also home to the Leonard Davis School of Gerontology, which is the oldest and largest school of gerontology in the world.

“He has been very productive at the Roybal Institute for the past two years, and we are excited to see that he will continue

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Photo/Courtesy of María Aranda

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School of Social Work and an increased focus on translational and applied research across the university.

“Los Angeles is the quintessential research laboratory and hub of innovation,” she said. “And USC is an enormous engine that really respects and values the community, innovation, and making a difference, not only for the community now but for decades to come.” t

Family ties, especially to her grandparents, influenced María Aranda (seated, top left) as she pursued a clinical and research career focused on older Latino populations.

his research and have the opportunity to familiar with over time, such as private inform aging policy in the nation,” said pensions and budget issues related to fedWilliam Vega, the Cleofas and Victor eral entitlement programs.

Ramirez Professor of Practice, Policy, Founded in 1968, the Urban Institute Research and Advocacy for the Latino has a long track record of well-respected Population, USC provost professor, and research that has informed policy debates, executive director of the USC Roybal Mudrazija said.

Institute on Aging.

“Major policy think tanks are strongly Mudrazija’s research on intergenerational research-oriented organizations, but they public and family support in the United also keep a close eye on the policy agenda States and international context continued inside the Capital Beltway and around the to evolve and expand during his time at nation,” he said. “Ultimately, they are trying USC. Some of this research resulted in to make their research available at the time published articles in the European Journal when it is most likely to help shape the of Ageing and the Journals of Gerontology. policy-making process.”

These opportunities would not have been Still, he knows that political change in possible without the help of his mentors. the United States can move at a glacial “I’ve been blessed with excellent mentors pace, which is not necessarily an undesirin Dr. Jacqueline Angel at The University able characteristic of the system. of Texas at Austin and Dr. William Vega at “This is not a process where you have to or USC,” Mudrazija said. “At the end of the even want to reinvent the wheel every time day, you have to be lucky to have people you approach reforms,” Mudrazija said. “If who can provide guidance and keep your we look to history for lessons, the impact best interests in mind.” of incremental changes is generally more His focus at the Urban Institute will be lasting in the long run than the impact of on issues that he has become intimately sudden and dramatic changes.” t

Study enlists community health workers in battle against chronic illness, depression

Photo/Eric Lindberg

Mixing major depression and chronic illnesses can prove dangerous and even deadly.

Photo/Courtesy of María Aranda

Community health workers Elsa Linares, Silvia Rico (top photo, left to right), and Rosalinda Loza-Rangel (bottom photo, left) are helping patients with depression and chronic health issues.

Struggling with health issues such as diabetes and heart disease can lead to depressive disorder, which in turn may have a negative effect on the ability of individuals to manage their health care, creating a downward spiral that results in increased mortality.

This issue is particularly critical in low-income communities of color, where residents face high rates of chronic health problems.

A research initiative led by Kathleen Ell, the Ernest P. Larson Professor of Health, Ethnicity, and Poverty at the USC School of Social Work, is exploring how new strategies such as the use of community health workers can help low-income and racially and ethnically diverse populations gain the upper hand on their health and mental health issues.

“They talk about their depression, how hard it is from their perspective to reduce that sadness,” Ell said. “They talk about problems with the care system itself—difficulty getting appointments, having to take a day off work. They talk about problems communicating with nurses or doctors. They are telling us where things are good and where they aren’t good.”

The issue of co-occurring depression and chronic illness is especially concerning in safety-net clinics overseen by the Los Angeles County Department of Health Services. Providers face heavy workloads and thus have little time to dedicate to building a therapeutic relationship with their patients.

Further complicating matters, many patients have limited health literacy and may feel uncomfortable discussion their illness and health care preferences with physicians, leading to poor adherence to treatment and worsening health.

“They are impoverished, mainly Spanish-speaking people with multiple serious medical conditions and depression,” said María Aranda, an associate professor with the USC School of Social Work. “It’s not uncommon that some of them are living day-to-day, living with other people in crowded conditions.”

To help bridge the gap between health care workers and these culturally diverse populations, researchers are testing a new model of care called

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A Helping Hand, in which a community health worker engages with patients to enhance their health literacy, improve their communication with doctors, and help them connect with other health resources in the community. The study is supported by a $1.3 million award from the Patient-Centered Outcomes Research Institute.

The research team is in the midst of enrolling approximately 350 individuals with major depression and diabetes, heart failure, or coronary heart disease from two community health centers. Patients will be randomly enrolled in usual care or the A Helping Hand program to determine whether the program improves their ability to manage their depression and health problems, attend clinic appointments, and develop stronger relationships with their health care providers.

Key outcomes include whether support from community health workers, known as promotoras, will reduce depression and the frequency of patient hospitalizations and emergency room visits, increase self-management of chronic diseases, and enhance satisfaction with care. Ell said the promotora concept resonated with several patients who are members of the study’s stakeholder advisory group.

“They prefer the idea of having a promotora or community health worker who can talk to them at their language and literacy level,” she said.

Promotoras are often bilingual community members who have a natural ability to interact with their peers and a heartfelt attitude toward improving the quality of life in their neighborhoods.

The project team collaborated with Visión y Compromiso, the leading promotora organization in California, to hire three promotoras to offer practical assistance to patients regarding problem-solving skills and education about depression, diabetes, and other chronic illnesses. They received specialized training in how to deliver psychosocial care and help patients navigate the health care system.

“They are community resource experts, so they also provide ongoing linkages to financial, legal, and housing services, among others,” said Aranda, whose responsibilities as study coinvestigator included training the promotoras. “Usually they will have the pulse on what is happening in the community. They spend a little more time with the patient, so they are able to get much more information across a number of domains, including health, mental health, and social services.”

Promotoras are increasingly being employed in the health care sector as the United States shifts toward a patient-centered care model in which a team of health care workers, often including a physician, nurse, social worker, and community health worker, provides wraparound services to each client.

Although progress is slow, Ell said she remains optimistic that the U.S. health care system is moving

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Photo/John Livzey

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in the right direction, albeit slowly, with its new focus on multidisciplinary care.

“My concern is the political process—it’s frustrating to listen to the political discussions about health care and the Affordable Care Act,” she said.

“We have to try some new things. We have to change how we provide care.”

If the study indicates that offering support from promotoras is a cost-effective strategy to improve health care in vulnerable communities, the researchers are hopeful that the model will be adopted throughout Los Angeles County and in other regions with large populations of low-income and culturally diverse individuals. t

Kathleen Ell, the Ernest P. Larson Professor of Health, Ethnicity, and Poverty, is leading a study exploring how promotoras, or community health workers, can help patients with serious health problems and depression manage their physical and mental health.

Photo/Courtesy of Roybal Institute

Researchers from the USC Roybal Institute on Aging joined scholars in Mexico City last summer for a conference on support for aging populations.

Aging | from page 1 “We’re in the early stages of trying to develop an overall structure and philosophy that’s going to underlie how we support global research on aging in Latin America. We are entrepreneurs at this point,” said William Vega, executive director of the Roybal Institute, provost professor, and the Cleofas and Victor Ramirez Professor of Practice, Policy, Research and Advocacy for the Latino Population.

Although there are clear differences between the two countries, Vega said Mexico and the United States are both in the process of developing and deploying support systems related to aging.

Mexico is quickly approaching a population replacement birth rate, whereas recent estimates suggest the United States is hovering below replacement level. Mexico is just starting to envision a nationwide system for aging services. The United States has structures in place that will need to be adjusted to adapt to its growing population of older adults.

“What we have in common is this fluid migration of people across the border,” said María Aranda, associate professor and associate director of clinical and behavioral intervention research at the Roybal Institute. “Those people are getting older, whether here in the United States or in Mexico, so we have a joint interest in understanding how people age successfully in both countries.”

To begin exploring that joint interest, the Roybal Institute and researchers in Mexico formed the Global Research Network on Aging and Health. In addition to holding conferences and workshops in both countries, the network is developing binational research projects and promoting evidence-based research.

For instance, the partnership is beginning to take advantage of a large-scale data collection effort conducted in Mexico during the past decade that is similar to the Health and Retirement Study in the United States, a biannual survey conducted nationwide with approximately 20,000 Americans older than 50.

That information can be used to compare the aging experience in both countries, such as how individuals of Mexican origin living in the United States manage challenges in late life versus individuals who stay in Mexico or travel frequently between the two countries.

Are support programs for older adults created in the United States applicable in Mexican contexts?

“If so, what sociocultural adaptations and systematic and organizational changes would have to be made for there to be a significant adoption of these evidence-based practices in health and mental health settings?” Aranda said. “Are there interventions and services occurring in Mexico that we could learn from? I always see our learning as bidirectional.”

Aranda recently coauthored a book chapter on falls and fall-related injuries among older adults in Mexico

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with Luis Miguel Gutiérrez Robledo, adapted before it can be used to support director general of the Instituto Nacional farmworkers just a few hours north in de Geriatría, and Mariana López-Ortega, California’s Central Valley. a researcher with the Instituto Nacional Conducting research in Mexico also de Geriatría and former postdoctoral tends to be cheaper, Vega noted, describing scholar at the Roybal Institute. a recent large-scale trial involving USC The research, published in Challenges of School of Social Work researchers that Latino Aging in the Americas, which was tested whether supplementary income coedited by Vega, showed that more than in the form of a monthly stipend from one third of adults older than 60 experi- the government would improve or harm ence a fall each year. health. The researchers, curious whether “They have almost the same rate of falls, recipients of the stipend might spend it about one out of three, as Mexican-origin on tobacco or alcohol, tested the approach older adults living in the United States,” in one town in the state of Yucatán and Aranda said. used another town as a control.

The authors called for early detection They found the intervention actually of older adults at risk of being injured in improved health and did not increase a fall and increased funding for services the use of substances such as cigarettes to decrease falls, injuries, or alcohol. and death. Their rec“It was cheap and effecommendations include “What we have in tive,” Vega said. “You can promoting a global carry out experiments in common is this fluid research agenda on falls places in Mexico that migration of people and fall-related injuyou couldn’t do in the across the border. ries, launching a public United States because Those people are education and awareit’s too expensive. It’s ness campaign focused getting older, whether very difficult to pull on preventable risk facthose things off here. here in the United tors, and developing best Just getting the alignStates or in Mexico, so practices for fall prevenment of all the bureauwe have a joint interest cracies to do something tion and treatment. in understanding how As Mexico begins conlike that is difficult.”

Naturally there are sidering how to imple- people age successfully political considerations ment these types of in both countries.” in both countries that services for older adults, influence the emerging María Aranda particularly in lowerresearch partnership. income and rural areas of For instance, the United the country in comparison to urban centers, which tend to have States is facing challenges related to its more health and social care programs, entrenched infrastructure and programs, Vega said scholars at the Roybal Institute such as Social Security and Medicare.

Mexico has not been considered an can offer valuable guidance in terms of undeveloped country for years and the science behind research and practice. boasts a strong democratic political “They have very little going on in terms system.

Nonetheless, the national of developing evidence-based intervenbudget and funding priorities are tions,” he said. “That’s something they significantly affected every six years, really need because they are in the process of developing their national delivery each time a new president is elected. system for services in aging. They are Fortunately, Vega said, the Instituto talking about building 10,000 aging cen- Nacional de Geriatría has benefited from stable leadership. ters around the country.”

“They have major university capabiliHowever, lessons learned in Mexico can prove just as valuable for researchers ties and are really developing first-class in the United States, he said, particu- research,” he said of Mexico and other larly in terms of deploying interven- Latin American democracies, such as tions in a wide range of contexts. For Chile and Colombia. “They now have example, a program delivered in urban capacity that is self-sustaining. That Los Angeles likely would need to be Roybal | continued on page 12

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Roybal director receives endowed professorship

Photo/Andrew Taylor

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A leading scholar at the USC School of Social Work has been honored with an endowed professorship.

William Vega was installed as the Cleofas and Victor Ramirez Professor of Practice, Policy, Research and Advocacy for the Latino Population. In addition to serving as provost professor and executive director of the USC Edward R. Roybal Institute on Aging, Vega holds appointments in social work, preventive medicine, psychiatry, family medicine, psychology, and gerontology.

He is an elected member of the prestigious Institute of Medicine and specializes in studying health, mental health, and substance abuse in the United States and Latin America. Throughout his career, Vega has been interested in investigating how the health status of individuals changes over time after immigrating to the United States.

“The issues faced by Latinos in the United States are not restricted to one ethnic group nor are they restricted to one nation,” Vega said. “I’m committed to a wide lens of critical thinking that addresses fundamental causes and fundamental solutions. I’m committed to setting a standard of scholarship for future occupants of this chair.”

Vega lauded Helen Ramirez, whose donation created the endowed professorship, for her work as director of the Los Angeles County Department of Adoptions in the 1970s and 1980s.

“The work that her family did and the work that she did in her lifetime are very much the kinds of things that have inspired me throughout my career and keep me going in my research,” he said. t

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“Now we are developing a true network, not just the two polarities between Mexico and USC, but further integration into larger networks of research.”

William Vega in line with a broader emphasis by USC on increased academic and research collaboration with colleagues in Central and South America.

“Now we are developing a true network, not just the two polarities between Mexico and USC, but further integration into larger networks of research,” Vega said.

Michalle Mor Barak, the Dean’s Professor of Social Work and Business, has been selected to serve on a committee tasked with reviewing the quality of major schools of social work in top universities in Israel. A native of Israel, Mor Barak specializes in issues of diversity and inclusivity in the workplace.

Associate Professor María Aranda has been selected to serve on two new Institute of Medicine committees, the Committee to Evaluate the Social Security Administration’s Capability Determination Process for Adult Beneficiaries and the Study on Family Caregiving for Older Adults. She has also served on the institute’s Mental Health Workforce for Geriatric Populations committee.

The Saks Institute for Mental Health Law, Policy, and Ethics at the USC Gould School of Law has awarded $50,000 over two years to doctoral student Liat Kriegel to support her proposed dissertation study related to the criminalization of mental illness.

The competitive award was also open to postdoctoral candidates and assistant professors. Kriegel’s faculty mentors are Assistant Professor Benjamin Henwood and John Brekke, the Frances G. Larson Professor of Social Work Research.

“We’re looking at a much larger platform for exchange of scholarly ideas.”

Developing more cohesiveness at the university level in terms of how USC approaches global research will be needed, he added. Support can be segmented and inconsistent at times, but Vega said he is confident that the entrepreneurial approach will lead to better integration and visibility of programs such as the Global Research Network on Aging and Health.

“It is an exciting time and now is the moment for it to happen,” he said. “Right now there is a superarc of growth at USC in program capacity and we don’t want to leave this behind.

“In the end, the goal is to improve the quality of life for aging people. It’s not to put USC or Mexico in the spotlight, it’s to get something done.” t

Assistant Professor Emily Putnam-Hornstein has been honored with the 2015 Peter W. Forsythe Award for Leadership in the Field of Child Welfare from the National Association of Public Child Welfare Administrators. The award recognizes her scholarly leadership of the Children’s Data Network at the USC School of Social Work, a data and research collaborative focused on the linkage and analysis of administrative records related to the health, safety, and well-being of children. The annual honor is awarded to an individual who has made a notable and significant contribution to research, policy, or promising practices in public child welfare.

Avelardo Valdez was appointed by then-U.S. Attorney General Eric Holder to serve a four-year term on the Science Advisory Board of the Office of Justice Programs in the U.S. Department of Justice. A professor at the USC School of Social Work, Valdez and his fellow board members will offer their views on the state of research in the justice system and affiliated fields, including guidance on how to encourage the use of science and research by practitioners.

Photo/Brian Goodman

Photo/Courtesy of Michalle Mor Barak

Roybal | from page 11 doesn’t mean there won’t be fluctuations, but the capacity is there.”

In the coming years, Vega is hopeful the research network will continue to expand.

Since its formation five years ago, the network has branched out to other major research centers specializing in aging issues and demography.

A conference in 2014 held in Mexico City gathered leading scholars from the United States, Mexico, and China to discuss potential joint research programs focused on social support for older adults.

Another multinational conference is slated for fall 2015 to continue an increasingly global dialogue about issues related to successful aging.

Vega hopes to open the network to other Latin American countries as well,

Carl Castro, assistant professor and research director of the USC Center for Innovation and Research on Veterans & Military The Phi Alpha Honor Society has selected Charles Kaplan, Families, has been invited to join the advisory board of the King’s research professor and associate dean of research, as its Faculty Centre for Military Health Research at King’s College, based in Member of the Year based on the excellence of his collaboration London. He is the only member of the board from the United and implementation of the society’s fall and spring research sym- States and was selected based on the depth of his knowledge of posia. Kaplan has been recognized for his tireless and enthusiastic military health research and his unique international perspective. support of the students, faculty members, and research enterprise Castro also chairs a NATO research group on military mental of the USC School of Social Work. health training.