All-Inclusive Care: Infrastructures of Aging Activism, 1965-1987
Date of Award
Spring 2023
Document Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Department
History of Science and Medicine
First Advisor
Rogers, Naomi
Abstract
This dissertation explores the visions of health that aging activists first conceptualized in the 1970s, and the methods and strategies they used to implement their ideas over the next two decades. Focusing mainly on the San Francisco Bay Area, I draw upon administrative records, grant proposals, foundation reports, program evaluations, Congressional hearings, newsletters, and organizing manuals from the activist organizations Gray Panthers and Older Women’s League, as well as the elder care organization On Lok. While savvy engagements with public bureaucracies and funding agencies secured the organizations’ futures, this effort to adapt regulations from within distinguished them from many of their contemporaries. In addition, these activists centered their own aging bodies as part of their activist politics, and openly reckoned with the physical and mental changes that accompanied their old age. They demanded the right to be healthy as their bodies changed, not merely the right to access health care that would attempt to reverse or obscure those changes. Beginning in the 1950s, the first chapter dissects the published materials of a nascent aging justice movement. These materials offer insights into the principles that animated the movement and movement leaders’ efforts to engage new participants. I argue that the white, administrative, middle-class backgrounds of many early Gray Panthers, as well as their strong belief in an effective social safety-net, influenced their early strategies of outreach and organization. Through a study of the Over 60 Health Clinic, a free clinic founded by the East Bay network of the Gray Panthers in the mid-1970s, the second chapter examines why health reform became such a critical focus for aging activists. Inspired by a growing health activist movement, the Gray Panthers created a clinic that centered the specific medical needs of older patients and encouraged their active participation. Ultimately, these same values led clinic leaders to devote significant resources to coalition-building with other Bay Area community clinics. The third chapter maps the development of On Lok, which opened in 1972 as one of the first adult day health centers in the United States. On Lok was developed as a community-based “alternative to the nursing home,” and it was built upon the radical belief that frail and vulnerable older patients could safely age in their homes and communities. On Lok grew out of the specific circumstances and activist environment of San Francisco’s Chinatown, but their savvy bureaucratic navigation increased On Lok’s visibility among policymakers. Eventually, On Lok was championed across the country as a model of successful long-term care. The fourth and final chapter traces the above experiments and campaigns past the decade of their founding and into the tumult of the 1980s. Despite deep cuts in governmental social service funding and a rising conservative movement, incremental efforts to expand the scope and continuity of care for older people continued. Relying on the coalitions they had built over the 1970s, as well as close working relationships with state agencies, these health programs adapted to significantly constrained circumstances. Even as they were limited financially, aging activists continued to expand the scope of their vision for health. Focusing on the important role of family caregivers, they insisted that adequate elder care must be relational, supporting both the recipients and providers of care. Lastly, an epilogue examines the convergence of these primary care and long-term care experiments with the establishment of the Coalition for Elders’ Independence, an organization founded just as many of the leaders of the aging activist movement began to pass away in the late 1980s. I map the shifting goals of these programs and reflect upon their efforts to create systems of “all-inclusive care” for the elderly. By centering interdependence and community participation as meaningful health outcomes, these activists created reforms that brought care and action together.
Recommended Citation
Sandler, Maya Cory, "All-Inclusive Care: Infrastructures of Aging Activism, 1965-1987" (2023). Yale Graduate School of Arts and Sciences Dissertations. 1057.
https://elischolar.library.yale.edu/gsas_dissertations/1057
