Advocacy Organizations

Organizations historically have helped to shape public policy in health and aging by raising awareness of issues; by educating stakeholders, decision makers, and the public; and by taking action to advance, block or otherwise shape change.

Some of the United States' most significant public programs and policies are the outcomes of widespread advocacy. The politics leading to the enactment of Medicare was driven in large part by more than a decade of advocacy by labor and aging organizations and was shaped significantly by the positions of trade organizations representing insurers and providers. The contemporary national debate over the future of the Social Security program engages thousands of national, state, and local aging organizations, mostly giving expression to near-universal opposition to privatizing or radically altering program protections for current and future generations. At the state level, the enactment of New York State's Elderly Pharmaceutical Insurance Coverage (EPIC) program was largely the outcome of pressure from grassroots senior membership organizations.

Over the years, thousands of national, state, and local advocacy organizations have formed as the result of real or perceived needs for organized support around issues. These organizations function at multiple levels within local service delivery organizations and systems as well as at local, state, and national policy levels.

At the local level, for example, nursing home ombudsman programs advocate on behalf of the rights of vulnerable elders. Area agencies on aging seek to identify and address service needs, and public health agencies work to protect the public's health interests. Often, issues emerge in the context of local experiences that become defined as systemic problems requiring policy change.

State and national organizations use multiple advocacy tools and approaches. These include producing research and policy information to help define and resolve issues, educating the public on the dimensions of issues, working directly with decision makers and stake-holders to build cases around issues, and overseeing the implementation of policy change. The structure and missions of such advocacy organizations vary widely from individual membership organizations (e.g., American Association of Retired Persons [AARP], Committee to Preserve Social Security and Medicare, Alliance for Retired Americans), to social justice organizations (e.g., National Hispanic Council on Aging, Older Women's League, Gray Panthers, Families USA), to organizational membership organizations (e.g., National Association of Area Agencies on Aging, American Association of Homes and Services for the Aged, National Council on Aging), to professional/research associations (e.g., American Public Health Association, Gerontological Society of America, National Academy of Social Insurance), to political action committees within advocacy organizations. National organizations often have state-based offices and chapters, allowing them to advocate at the grassroots level as well as at the national level. Most states also have independent advocacy groups that play significant roles in state and local policy (e.g., Coalition of Wisconsin Aging Groups, Oklahoma Alliance on Aging).

As in the past, organized advocacy will both shape and be shaped by socioeconomic trends and emerging policy issues. The growing need for income and health security currently, and presumably for the foreseeable future, under current health care policies interacts with the rising cost of health care and tax and military policies that are growing the federal debt, providing fertile ground for aging-related advocacy during the decades to come. Population aging, especially anticipated increases in the 85-years-and-older population, will propel long-term care and support of caregivers onto the agenda of advocacy organizations. The improved health of many people among today's elderly populations provides a new opportunity to use the social capital of the aging—yet another emerging area waiting for advocacy organizations to champion change. In short, aging advocacy organizations will have much reason to be centrally involved in identifying [Page 13]and giving direction to future health and aging agendas, policies, and programs.

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