Center for Improving Care Delivery for the Aging (CICADA)

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Delivering high-quality, accessible, and affordable health care to older Americans is fundamental to their health, wellbeing, function, and independence. Yet, with a growing chronic disease burden, rapid growth of health care costs, and fragmentation of care delivery, aging Americans are increasingly finding that high- quality care is not available, accessible, or affordable. The health care system in the United States (US) is not organized to address the fundamental health needs of older Americans. Moreover, the persistence of health disparities in the US, particularly for minority elders, suggests that health system dysfunction affects this population disproportionately. There is a critical need to reorganize and reorient health care delivery to coordinate care; maintain and improve quality of life as populations age; address inequities and health disparities; and implement new models of payment rewarding the value of care rather than the volume of care. Health services research (HSR) studies the organization, financing, and delivery of health care, providing an evidence base that is central to addressing issues of care quality, access, affordability, and equity. HSR is critical to identifying and implementing solutions to improve the current shortcomings of health care delivery and, thus, the health and wellbeing of aging Americans. As a discipline, HSR has been a cornerstone of identifying and addressing disparities in health and health care delivery. Minority investigators are underrepresented in HSR, with Blacks and Hispanics accounting for only 6.9% and 3.7%, respectively, of the HSR workforce. Yet underrepresented HSR researchers bring essential diverse perspectives and, often, personal experiences to bear in understanding the social, economic, political, and environmental determinants of racial and ethnic disparities in health and health care. Furthermore, according to the federal Office of Minority Health, underrepresentation in research leads to underfunding of health research as well as a lack of culturally appropriate theories, models, and methodologies. Thus, developing a representative cadre of researchers who can undertake studies that address the challenges facing our aging population and, in particular, disparities in aging, is an absolute priority. To address this need, we propose the Center for Improving Care Delivery for the Aging (CICADA), a Resource Center for Minority Aging Research (RCMAR) at the University of Pennsylvania (Penn). CICADA aims to train emerging scientists from underrepresented backgrounds in the interdisciplinary science of HSR as it applies to the most pressing issues for aging Americans, particularly minority elders. Redressing researchers from backgrounds underrepresentation in HSR is critical to finding innovative public health solutions, creating a robust learning environment, and developing the trust needed to implement innovative solutions in minority populations.