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Senior Community Engagement
Needs Assessment
2016-2017 SENIOR COMMUNITY PROFILE
SUBMITTED BY
April 2017
Westminster Canterbury Richmond - Senior Community Profile 2016 - 2017
TABLE OF CONTENTS
Executive Summary I
Community and Household Demographics 1
Economy and Education 18
Health Care Access 22
Older Adult Health Indicators 26
Chronic Conditions 32
Mortality 36
Medicare Fee-for-Service Beneficiaries 39
Key Informant Conclusions 43
Older Adult Conclusions 49
Appendix A: Secondary Data Profile References 52
Appendix B: Secondary Data Terminology 53
Appendix C: Key Informant Participants 54
Appendix D: Demographics of Older Adult Survey Participants 57
Westminster Canterbury Richmond - Senior Community Profile 2016 - 2017
I
EXECUTIVE SUMMARY
Study Background
Westminster Canterbury Richmond is dedicated to improving the lives of older adults living in the
service area by serving them outside of their established walls. As part of their ongoing commitment to
older adults, Westminster Canterbury Richmond initiated a Senior Community Profile to evaluate the
health and social service needs of older adults. The Senior Community Profile, conducted from August
2016 to April 2017, assesses key indicators of health and well-being, including socioeconomic status,
morbidity and mortality, and the physical environment.
The Senior Community Profile offers a broad, but rich overview of the current status of older adults, and
is a compilation of secondary data, key informant testimony, and older adult feedback from the
community. Secondary data are comprised of data obtained from existing reputable resources,
including the U.S. Census Bureau and Centers for Disease Control and Prevention (CDC). For all
demographic and health indicator statistics, data from Richmond City, VA and Henrico County, VA were
incorporated. Sources for secondary data are included in a full reference in Appendix A. In addition,
definitions for statistical terms used in the report are included in Appendix B. Secondary data represent
a point in time study using the most recent data possible. When available, state and national
comparisons are provided as benchmarks.
Key informant testimony was gathered from 77 individuals living in and/or working in the Greater
Richmond Area. Their testimony will be found under “Community Perspective” within the report. The
following table is a detailed summary of the community sectors represented by key informants. It is
important to note that key informant testimony reflects the perceptions of some community leaders,
but may not necessarily represent all community leaders within the service area. Additionally, nearly
64% work in organizations that serve 500 or more older adults.
Count Percent
Senior/Aging Services 18 23.7%
Non-Profit/Social Services 11 14.5%
Faith-Based 10 13.2%
Government 8 10.5%
Health Care/Public Health Organization 7 9.2%
Other 6 7.9%
Business Sector 5 6.6%
Education 4 5.3%
Cultural Organization 2 2.6%
Finance/Law 2 2.6%
Mental/Behavioral Health Organization 1 1.3%
Housing 1 1.3%
Community Member 1 1.3%
Additional community sectors, referred to as “Other” in the table above, include Architect/Design,
Funder, and Philanthropic Leader.
Westminster Canterbury Richmond - Senior Community Profile 2016 - 2017
II
Lastly, older adult feedback was gathered from 338 individuals in the Greater Richmond Area. Their
feedback will also be found under “Community Perspective” in the report. Of those responses, 47%
were from Richmond City, 34% from Henrico County, 13% from Chesterfield County, 1% from
Goochland County, 2% from Hanover County, 1% from Powhatan County, and 2% from Other locations.
Westminster Canterbury Richmond expanded the scope of this component of the study to include
additional counties in an attempt to glean information from a broader range of residents in the Greater
Richmond Area.
While the older adult survey provides valuable insights, particularly when used in conjunction with the
other components of the research, the demographic information may not particularly mirror the actual
population due to non-random recruiting techniques. The demographic profile of the respondents who
completed the online survey is depicted in full in Appendix D.
In general, approximately three quarters of respondents were female (76.3%). The majority of
respondents were between the ages of 65 - 84 with 38.1% between the ages of 65 - 74 and 28.5%
between the ages of 75 - 84. Approximately 38% of respondents are married and another 21.5% are
widowed. In terms of health insurance, 65.9% of respondents have Medicare or Medicaid or any kind of
government assistance plan, 26.6% have insurance through their own or their spouse’s current
employer, and 23.3% have insurance purchased directly from an insurance company. Nearly 28% of
respondents reported having a disability. Approximately 63% of respondents were White, while about
33% were Black or African American. In terms of education level, about 46% of respondents have a 4-
year college degree or higher. Lastly, 33.7% of respondents reported their income between $20,000 and
$49,999 and another 29.4% reported their income between $50,000 and $99,999.
The completion of the Senior Community Profile enables Westminster Canterbury Richmond to take an
in-depth look at the issues facing older adults. The findings from the profile will be used to both inform
and engage the greater community in a collective initiative to improve the quality of life of older adults.
Westminster Canterbury Richmond’s Mission Statement:
As a faith-based charitable organization, we will provide services, specific to need, in a compassionate,
professional, holistic manner, through an inspiring environment and dynamic leadership for our residents,
employees and others we serve.
Key Findings
The following section provides key takeaways derived from data highlights found throughout the
Community Profile as noted by the Holleran consulting team. While many opportunities exist
throughout the report to improve the lives of older adults in the Greater Richmond Area, or more
specifically in Richmond City or Henrico County, four key themes have risen to the forefront. Another
point of reference in reviewing the key findings can be found in the 2016 - 2017 Older Adult Report
Card immediately following the Key Findings.
Westminster Canterbury Richmond - Senior Community Profile 2016 - 2017
III
1. Housing
Older adults have an enormous need for affordable housing options as they often struggle to maintain
a sustainable household income as they age. Thirty-percent of a household’s total income is considered
the cut-off for housing-cost burdens and avoiding financial hardship. Approximately 60% of adults who
rent in Richmond City and 58% in Henrico County spend more than 30% of their household income on
rent. Additionally, in Richmond City, nearly 38% of older adult homeowners are spending 30% or more
on their mortgage and housing expenses, which is higher than Henrico County, the state and the nation.
Richmond City has a higher percentage of older adults spending 30% or more of their income on both
rent or mortgage/housing expenses when compared to Henrico County. Furthermore, Richmond City
also has a much higher percentage of older adults living below 150% poverty level. Approximately 15%
of older adults in Richmond City have an income below 100% federal poverty level and another 13%
have an income 100% to 149% of the federal poverty level. This equates to nearly 6,500 older adults.
Nearly three quarters of key informants felt that there is high need for affordable housing for seniors in
the community. However, only 20% of key informants “agreed” or “strongly agreed” that there is a
variety of appropriate affordable housing options available in the area for older people. Additionally,
while 47% of older adult survey respondents feel there are affordable housing options in the
community for older adults, 31% feel there aren’t and nearly 22% weren’t sure. With nearly a quarter of
survey respondents unsure of the availability of affordable housing options in the area, this may indicate
a lack of information about available housing options in the community.
2. Transportation and Walkability
Transportation was frequently mentioned as an issue in the community by both key informants and
older adults themselves. Nearly three quarters of key informants felt that public transportation is not
available for older people to reach destinations such as hospitals, health centers, grocery stores,
shopping centers, banks, senior centers and parks. Additionally, only 14% of key informants agreed with
the statement, “In areas where public transportation is limited, community transport services, including
volunteer drivers and shuttle services, are available to older people.” Even less felt that there are sufficient
specialized transportation services for people with disabilities (12.2%). This may be a particular concern
in Richmond City where nearly 39% of the older adult population has a disability, which is higher than
the percentage in Henrico County, the state, and the nation. One key informant in particular explained
the transportation issue best. When asked what is needed to improve the community for older adults,
this key informant said, “A good public transportation system. Resources are not resources until they are
accessible. It’s like having a building with no light bulbs. Transportation is an instant multiplier of
opportunity.” Older adult survey respondents further emphasized the transportation issues in the
community. Approximately half of respondents did not feel public transportation was easy to use or
reliable or that public transportation stops are safe.
Walkability was another aspect of transportation that was a concern for both key informants and older
adult survey respondents. Only 17% of key informants were able to “strongly agree” or “agree” that safe
and well-maintained green spaces and pedestrian-friendly walkways are easily accessible for older
adults. For survey respondents, 40% felt there are well-lit safe streets and intersections as well as
countdown or beeping crosswalks at intersections. However, nearly an equivalent percentage did not
feel that they are accessible in the community. Consequently, when asked about the biggest challenge
Westminster Canterbury Richmond - Senior Community Profile 2016 - 2017
IV
faced when traveling, nearly half of respondents said they don’t feel safe walking where they need to
go. This can be a hindrance for older adults in both accessing services as well as engaging in physical
activity.
3. Aging in Place/Access to Services
Across the nation, more and more older adults and their families are searching for opportunities to
safely age in place. In 2016, the older adult population in Henrico County was 46,506 and accounted for
14.3% of the total population, and Richmond City had 27,424 older adults and accounted for 12.4%. By
2021, the older adult population is expected to grow to 55,955 and account for 16.4% in Henrico
County and to 34,226 in Richmond City, which will account for 14.6% of the total population. In
addition, of those older adults who live in non-family households, nearly 59% of older adults in
Richmond City are living alone and 49% in Henrico County. Both of these percentages are higher than
the state and the nation.
The desire to age in place is further emphasized by both key informants and older adult survey
respondents. According to key informants, the top transition decisions impacting individuals in the
community is providing caregiving services to aging parents. This was followed by retiring and
downsizing to a smaller home with less home/yard maintenance. While key informants felt services and
options to support life transitions are widely available in the community, the information about these
services is lacking. Only 30% of key informants felt older adults are able to easily find information on
services and options related to life transitions.
Additionally, over half of older adult survey respondents said that it was extremely or very important to
remain in their community as they age. Furthermore, while nearly half of respondents said it was
somewhat or very likely that they would move to a different home during their retirement years,
approximately a quarter still indicated that it was not likely that they would move and 18% weren’t sure.
According to survey respondents, the top two factors that would influence their decision to move were
looking for a home that will help them live independently and maintaining the outside of their home.
The ability to access health care and social services is another aspect of aging in place. Despite provider
to population ratios that are often better than the state and National Benchmark, it is well known that
the sheer number of providers does not always give the full picture of access. Key informants identified
navigating/accessing health care and social services as the top most pressing issue facing older adults in
the community. Inability to navigate the health care system was also identified by key informants as the
most significant barrier that keeps seniors from accessing health care when they need it. Inability to pay
out of pocket expenses was another top barrier along with lack of transportation. The cost of health
care services appears to be a particular issue in Richmond City as, according to 2013-2014 BRFSS data,
12.6% of adults aged 55 and older were unable to see a doctor due to cost.
4. Chronic Disease Management
Chronic disease management was identified by key informants as the second most pressing issue in the
community facing older adults. According to Medicare data, while older adult residents in Henrico
County are slightly more likely to be burdened by multiple chronic conditions (4 or more) when
compared to Richmond City, still more than a third of older adults in both areas have 4 or more chronic
Westminster Canterbury Richmond - Senior Community Profile 2016 - 2017
V
conditions. Managing multiple chronic illnesses can be challenging and costly, particularly when not
managed appropriately.
Health behaviors, such as tobacco use, diet, and exercise, and obesity are often correlated with certain
chronic health conditions. The percentage of older adults who are current smokers is higher in both
Henrico County (17.7%) and Richmond City (22.6%) when compared to the state and the nation.
Additionally, approximately 69% of older adults in both Henrico County and Richmond City are
considered overweight or obese. While this number is similar to the percentage in the state and the
nation, it is still concerning that over a third of older adults in the area are struggling with maintaining a
healthy weight.
While smoking and obesity are impacting older adults in both Henrico County and Richmond City, these
are manifesting themselves differently in the types of chronic conditions affecting older adults in each
area. In Richmond City, older adults are more likely to be burdened by colon/rectal cancer,
lung/bronchus cancer, prostate cancer, asthma, and chronic obstructive pulmonary disorder (COPD).
However, older adults in Henrico County are more likely to suffer from breast cancer, melanoma of the
skin, and heart disease. Henrico County also has a higher percentage of older adults who have been
diagnosed with a depressive disorder.
VI
2016-2017 Older Adult Health Report Card
Richmond City and Henrico County, Virginia
DOMAIN INDICATOR MEASURE RICHMOND
CITY
HENRICO
COUNTY VA U.S.
Socio-
Economic
Factors
Language Older adults who speak English less than very well 1.9% 4.5% 4.5% 8.5%
Income
Older adults living below 100% the poverty level 15.1% 6.2% 7.6% 9.4%
Older adults relying on food stamp/SNAP benefits 11.3% 4.6% 6.9% 8.5%
% of unemployed older adults (55-64 years) 6.0% 3.9% 4.5% 6.6%
Education Older adults with a bachelor’s degree or higher 28.6% 28.4% 27.0% 23.2%
Affordable Housing
Older adult renters spending more than 30% of their income on
housing 60.4% 58.1% 52.4% 54.7%
Older adult home owners spending more than 30% of their income
on housing 37.9% 24.5% 25.4% 27.8%
Social Support
Older adults living alone 59.0% 49.1% 42.3% 43.6%
Most prevalent transition need cited by key informants: Providing
caregiving services to aging parentsa 74.0% of key informants --
Health Care Access
% of older adults without health insurance coverage 0.4% 0.6% 1.0% 1.0%
Older adults unable to receive care due to cost 12.6% 8.4% 8.7% 9.0%
Older adults receiving a routine checkup within the past year 86.7% 84.1% 85.5% 82.5%
Physician to population ratio 990:1 1,020:1 1,330:1 1,040:1*
Mental health provider to population ratio 370:1 410:1 680:1 370:1*
Dentist to population ratio 790:1 1,450:1 1,570:1 1,340:1*
Most prevalent barrier to accessing care cited by key informants:
Inability to navigate the health care systemb 81.8% of key informants -- --
Most needed resource in the community cited by key informants:
Free/low cost dental carec 63.6% of key informants -- --
Built Environment
Key informants that agree the local community is an age-friendly
communityd 19.7% of key informants -- --
Food access and insecurity (Ranking from 1 (worst) to 10 (best)) 5.8 7.9 8.3 8.3*
Recreation/Exercise opportunities 88% 94% 81% 91%
= Areas of Strength = Areas of Moderate Need = Areas of Greatest Need
VII
2016-2017 Older Adult Health Report Card
Richmond City and Henrico County, Virginia (Cont’d.)
DOMAIN INDICATOR MEASURE RICHMOND
CITY
HENRICO
COUNTY VA U.S.
Health
Behaviors
Physical and Mental
Health
Older adults reporting fair or poor health 20.2% 21.4% 24.2% 25.4%
Older adults limited in activity due to poor physical or mental health 27.3% 26.5% 27.0% 29.8%
Older adults with a disability 38.9% 32.7% 34.2% 36.3%
Overweight or obese older adults 69.0% 68.6% 69.0% 68.8%
Tobacco Use Older adults who currently smoke 22.6% 17.7% 14.1% 12.9%
Preventative
Screenings
Older adults who received a flu vaccine in the past year 56.2% 58.6% 56.5% 53.2%
Older adult women who had a breast exam/mammogram/Pap test in
the past 2 years
84.3%; 88.9%;
69.4%
81.4%; 71.7%;
64.0%
81.2%;
80.9%;
58.1%
78.3%;
78.8%;
51.7%
Older adult men who had a PSA test in the past 2 years 79.7% 82.7% 82.0% 79.3%
Older adults who had a sigmoid/colonoscopy in the past 2 years 44.4% 36.2% 38.7% 38.0%
Health
Outcomes
Chronic Conditions
Older adults with arthritis 41.0% 44.6% 48.1% 47.0%
Total cancer incidence rate per 100,000 older adults 2,046.7 1,901.0 1,900.0 2,002.1
Older adults with diabetes 22.9% 19.5% 19.3% 20.2%
Older adults with coronary heart disease 9.7% 12.3% 9.2% 9.7%
Older adults diagnosed with asthma who still have a diagnosis 83.1% 64.4% 76.3% 73.0%
Older adults with COPD 13.7% 7.5% 11.5% 11.2%
Premature Death Years of potential life lost (death before age 75) per 100,000 people 9,700 5,700 6,100 5,200*
Death Rates Total cancer mortality rates per 100,000 older adults 1,099.1 986.8 979.4 963.3
Alzheimer’s death rate per 100,000 adults age 65 years and over 169.7 221.3 163.2 199.6
= Areas of Strength = Areas of Moderate Need = Areas of Greatest Need
* Represents the 90th percentile across the nation
a Only 30% of key informants felt information on available services to support a life transition (e.g., retiring older adults) is easily accessible. b Additional barriers included the inability to pay out-of-pocket expenses (co-pays, prescriptions, etc.) and lack of transportation. c Additional missing resources or services included Geriatricians/Gerontologists and free/low cost vision care. d Services or resources cited as missing included, affordable housing, affordable services to age in place, transportation, safe and well-maintained
green spaces and walkways, and an effective communication system.
Westminster Canterbury Richmond – Senior Community Profile 2016 - 2017
Page 1
COMMUNITY AND HOUSEHOLD DEMOGRAPHICS
In this section:
Overall Population Housing Tenure and Value
Population Estimates Household Status
Veteran and Disability Status Community Perspective
Overall Population
Henrico County and Richmond City are both located in the western part of Virginia. Henrico County
comprises one of the 95 counties in the state. With an estimated population of 325,197, Henrico County
is the fifth most populated county in the state as of 2016. Since 2010, the population in Henrico County
increased by nearly six percent. By 2021, it is estimated the county will experience an additional growth
of almost 5%, making it home to 341,218 residents.
Henrico County curves around Richmond City surrounding it to the west, north, and east. An
independent city in Virginia, Richmond City is home for an estimated 220,653 residents making it the
fourth most populated city in the state of Virginia out of 593 cities. In 2016, the population increased by
8% from 2010, and it is estimated the city will experience an additional growth of 6% by 2021 and will
be home to 233,821 residents.
Map of Henrico County Map of Richmond City
Westminster Canterbury Richmond – Senior Community Profile 2016 - 2017
Page 2
Table 1. Total Population Estimates (2016; 2021)
Henrico County Richmond City
2016 Estimate 325,197 220,653
Growth 2010 – 2016 6.0% 8.1%
2021 Projection 341,218 233,821
Growth 2016 - 2021 4.9% 6.0%
Older Adult Population Estimates
The population in Richmond City is notably younger when compared to Henrico County, Virginia,
and the nation. According to the 2010-2014 census, the median age of residents in Richmond City was
32.6; whereas residents in Henrico County had a median age of 37.8, 37.6 in Virginia, and 37.4 across
the nation.
In 2016, the older adult population (aged 65 years and over) in Henrico County was 46,506 and
accounted for 14.3% of the total population and Richmond City had 27,424 older adults and accounted
for 12.4%. By 2021, the older adult population in Henrico County is projected to grow to 55,955
and account for 16.4% of the total population, an increase of nearly 9,500 people. By the same
token, the older adult population in Richmond City is projected to grow to 34,226 and account for
14.6% of the total population, which is equivalent to about 6,800 people.
Racial Composition among Older Adult Population
The older adult population aged 65 years and over in Henrico County is predominantly White
(74.1%). The racial composition in Richmond City is nearly equal between the proportion of the
population that is White (47.6%) and the proportion of the population that is Black/African
American (50.0%). In Henrico County, the Black/African American and Asian populations will grow
slightly by 2021. In Richmond City, the racial composition will change slightly by 2021 with decreases in
the White and Black/African American populations and small increases in other racial groups.
Table 2. Older Adult Population by Race/Ethnicity, Population 65 Years and Over (2016; 2021)
Henrico County Richmond City
2016 Estimate
N=46,506
2021 Projection
N=55,955
2016 Estimate
N=27,424
2021 Projection
N=34,226
White 74.1% 71.5% 47.6% 47.2%
Black or African American 20.9% 22.2% 50.0% 49.7%
American Indian and Alaska Native 0.3% 0.3% 0.4% 0.4%
Asian 3.5% 4.5% 0.8% 0.8%
Native Hawaiian and Other Pacific
Islander 0.0% 0.0% 0.0% 0.0%
Some Other Race 0.3% 0.4% 0.4% 0.7%
Two or More Races 0.8% 1.1% 0.9% 1.2%
Hispanic or Latino 1.5% 1.9% 1.3% 1.6%
*Hispanic/Latino residents can be of any race, for example, White Hispanic or Black/African American Hispanic
Westminster Canterbury Richmond – Senior Community Profile 2016 - 2017
Page 3
Over 90% of older adults aged 65 and over in Henrico County and Richmond City speak English as their
primary language. This figure is similar to that of the state but is greater than the nation.
Table 3. Language Other than English Spoken at Home, Population 65 Years and Over (2010 - 2014)
United States Virginia
Henrico
County
Richmond
City
Spoken language other than English 14.5% 8.5% 7.9% 3.9%
Speak English less than “very well” 8.5% 4.5% 4.5% 1.9%
Figure 1. Percentage of older adults speaking English less than “very well”
Veteran and Disability Status
Nearly 22% of older adults in Henrico County and 19% in Richmond City are veterans. The percentage in
Richmond City is lower than Henrico County, Virginia (23.3%) and the nation (21.6%). The percentage
of disabled older adults in Richmond City (38.9%) is higher than the percentage in Henrico
County (32.7%), the state (34.2%) and the nation (36.3%). The disabilities that affect older adults
the most in Henrico County are ambulatory disabilities, independent living disabilities, and
hearing disabilities. This is similar in Richmond City in regard to ambulatory disabilities and
independent living disabilities, but cognitive disabilities also affect older adults in this area.
Table 4. Veteran Population, Population 65 Years and Over (2010 - 2014)
United States Virginia Henrico County Richmond City
21.6% 23.3% 21.5% 19.2%
8.5%
4.5%
4.5%
1.9%
0.0% 2.0% 4.0% 6.0% 8.0% 10.0%
U.S.
Virginia
Henrico County
Richmond City
Westminster Canterbury Richmond – Senior Community Profile 2016 - 2017
Page 4
Table 5. Disabled Population, Population 65 Years and Over (2010 - 2014)
United States Virginia
Henrico
County
Richmond
City
Population with a Disability 36.3% 34.2% 32.7% 38.9%
Hearing Disability 15.0% 13.6% 12.4% 10.1%
Vision Disability 6.7% 6.1% 5.5% 7.5%
Cognitive Disability 9.3% 8.9% 8.0% 10.7%
Ambulatory Disability 23.3% 21.9% 20.7% 27.3%
Self-Care Disability 8.6% 8.3% 9.2% 9.7%
Independent Living Disability 15.7% 15.0% 17.0% 20.3%
Housing Tenure and Value
The majority of older adults in both Henrico County and Richmond City own their residence (75% and
63% respectively). However, the percentage of those older adults that own their residence in Henrico
County is much higher than Richmond City. Owner costs without a mortgage are substantially higher in
Richmond City when compared to Henrico County, the state and the nation. In addition, the percentage
of older adult homeowners spending more than 30% of their income on their mortgage/owner
costs is much higher in Richmond City (37.9%) when compared to Henrico County (24.5%),
Virginia (25.4%) and the nation (27.8%). Thirty-percent of a household’s total income is considered
the cut off for housing-cost burden and avoiding financial hardship.
The median rent in Henrico County is $958, which is notably higher when compared to Richmond City
($777), the state ($848) and the nation ($757). However, a greater percentage of older adult renters in
Richmond City spend 30% or more of their income on rent when compared to older adults in
Henrico County, the state and the nation. Specifically, this figure comprises 60% of older adults in
Richmond City as opposed to 58% in Henrico County, 52% in Virginia, and 55% across the nation.
Table 6. Housing Tenure, Population 65 Years and Over (2010 - 2014)
United States Virginia Henrico
County
Richmond
City
Older Adults Who Own Their Residence 78.5% 81.7% 75.4% 63.2%
Older Adults Who Rent Their Residence 21.5% 18.3% 24.6% 36.8%
Table 7. Housing Value and Costs, Population 65 Years and Over (2010 - 2014)
United
States Virginia
Henrico
County
Richmond
City
Median Home Value $164,900 $217,700 $200,500 $176,400
Median Monthly Owner Costs With a Mortgage $1,295 $1,414 $1,247 $1,281
Median Monthly Owner Costs Without a Mortgage $449 $429 $438 $575
Median Rent $757 $848 $958 $777
Older adults spending more than 30% of income on
mortgage/owner costs 27.8% 25.4% 24.5% 37.9%
Older adults spending more than 30% of income on rent 54.7% 52.4% 58.1% 60.4%
Westminster Canterbury Richmond – Senior Community Profile 2016 - 2017
Page 5
Figure 2. Housing costs greater than or equal to 30% of income, 2010 - 2014
Household Status
Households are identified as either family households or non-family households. In Richmond City, 62%
of older adults live in non-family households. This percentage is much higher when compared to older
adults in Henrico County (51%), Virginia (44%), and the nation’s figure of 46%. Furthermore, 59% of
Richmond City older adults living in non-family households live alone. The percentage equates to
nearly 6,000 older adults. In Henrico County, about 49% of older adults live in single-person
households, which is equivalent to nearly 6,500 older adults. Richmond City’s figure is notably
higher when compared to the percentage of older adults who live alone in Henrico County, the state,
and across the nation. However, the percentage in Henrico County is still worse than the state and the
nation as well. Living alone generally entails a higher risk for social isolation and this figure may warrant
attention.
Table 8. Households by Type, Population 65 Years and Over (2010 - 2014)
United States Virginia Henrico
County
Richmond
City
Family Households 53.9% 55.6% 49.4% 38.5%
Non-family Households 46.1% 44.4% 50.6% 61.5%
Householder Living Alone 43.6% 42.3% 49.1% 59.0%
54.7%
27.8%
52.4%
25.4%
58.1%
24.5%
60.4%
37.9%
0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0%
Older adults spending ≥
30% of income on rent
Older adults spending ≥
30% of income on
mortgage/owner costs
Richmond City Henrico County Virginia U.S.
Westminster Canterbury Richmond – Senior Community Profile 2016 - 2017
Page 6
43.6%
42.3%
49.1%
59.0%
0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0%
U.S.
Virginia
Henrico County
Richmond City
Figure 3. Percentage of older adults living alone, 2010 - 2014
In regard to marital status, only 33% of older adults in Richmond City are currently married, which is
much less than older adults in Henrico County (49.9%), the state (56.2%), and across the nation (54.6%).
However, nearly 34% of older adults in Richmond City and 30% in Henrico County are widowed. These
figures are comparable to the state and the nation. Notably, Richmond City has a higher percentage of
older adults who were never married compared to older adults in Henrico County, Virginia, and the
nation.
Table 9. Marital Status, Population 65 Years and Over (2010 - 2014)
United States Virginia Henrico
County
Richmond
City
Now Married, except separated 54.6% 56.2% 49.9% 33.3%
Widowed 27.1% 27.0% 30.2% 33.5%
Divorced 12.2% 11.2% 14.0% 20.0%
Separated 1.2% 1.2% 0.9% 2.8%
Never Married 4.9% 4.2% 5.0% 10.4%
Approximately 5% of older adults in Henrico County and 4% in Richmond City live with 1 or more
grandchildren under 18 years. However, only 1% of these older adults are responsible for grandchildren.
Table 10. Population 65 Years and Over Responsible for Grandchildren Under 18 Years (2010 - 2014)
United States Virginia Henrico
County
Richmond
City
Living with Grandchild(ren)
5.0% 5.3% 5.1% 3.6%
Responsible for Grandchild(ren) 1.2% 1.3% 1.3% 1.4%
Westminster Canterbury Richmond – Senior Community Profile 2016 - 2017
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Community Perspective
Key Informant Perspective
Key informants were asked to comment on individuals facing life transitions, such as retirement or
moving to a personal care home, and the services available to assist with transitions. The following table
represents the types of transition decisions that individuals in the community face, according to key
informants. The most common transition decisions in the community are providing caregiving
services to aging parents, retiring, and downsizing to smaller home with less home/yard
maintenance.
Table 11. Life Transition Decisions According to Key Informants
Count Percent
Providing caregiving services to aging
parents
57 74.0%
Retiring
47 61.0%
Downsizing to smaller home with less
home/yard maintenance
45 58.4%
Changes in employment status
42 54.5%
Seeking Home & Community-Based Services
to support aging in place
39 50.6%
Moving to Independent Living Community or
Continuing Care Retirement Community
(CCRC)
37 48.1%
Changes in available income
36 46.8%
Receiving Hospice or Palliative Care
33 42.9%
Elderly parents moving into their adult child's
home
31 40.3%
Moving to a Personal Care Home, Assisted
Living Facility, or Nursing Home
29 37.7%
Grief Counseling
20 26.0%
Attending an Adult Daycare
15 19.5%
No/Not Applicable
4 5.2%
Other
3 3.9%
Only 23 key informants or 30.3% felt older adults are able to easily find information on available
services and options related to life transitions. While the majority of key informants seemed to feel
that services and options related to life transitions are available in the community, they seemed to feel
the awareness and knowledge of available services is seriously lacking. Many felt that information about
these services is not easy to find and that older adults may lack the motivation to reach out and seek
the information. Compounding this issue is that there is not enough support and outreach in the
Westminster Canterbury Richmond – Senior Community Profile 2016 - 2017
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community to assist older adults in finding this information either. Along these lines, one key informant
stated, “It seems like given the number of people who are faced with these transitions that there would
be more guidance available. Or more tools for helping to make decisions. I don't think that there is
acknowledgement among the business community that there is an opportunity to provide services
throughout a continuum of needs as people age. It's not really linear, but I believe that the perception is
that it's an ever downward spiral. More general education about aging, retirement, choices to be made,
etc., would be really helpful.”
Other Select Comments Related to Life Transitions
“Each of these services requires significant research, usually online. This can be difficult for
seniors and busy adult children, who may not be living in the same region.”
“I think the silent generation is just that--suffering in silence and social isolation and being
preyed on by family and fraud scams. This population needs greater outreach. I also have
concern for vulnerable elderly is less than adequate care settings--both homes and
institutional settings.”
“In light of the fact that for many older or disabled individuals, the preferred option would
be to remain independent in their own homes with 'wrap-around' services. There is often a
daunting challenge to be faced in trying to find, arrange, and finance available options
among an assortment of provider sources. Coordination of service providers can require
energy and capacity beyond what many of those needing services can consistently muster.
For the majority continuing care settings - while offering in many ways the simpler and
more secure/sustainable solution - are not affordable. More and more of today's seniors are
wary of entering what they fear may tend to be a paternalistic environment; others find no
appeal in living within an age-segregated environment.”
“It seems there are many resources, but they are not well known. Also, some people seem
to need help yet are reluctant to seek or accept it.”
“It would be great to have a comprehensive listing for all of the items listed about in the
Richmond metropolitan area.”
“Most of the information is available online. However, there are a large number of seniors,
in particular, that are intimidated or unaware of the online search capabilities available to
them.”
“There needs to be a single, TRUSTED source of information for seniors. It needs to be
unbiased and safe.”
“This "system" is almost impossible for people to navigate. And most folks wait until a
catastrophic event before educating themselves about available services.”
Creating environments that are truly age-friendly requires action in many sectors including housing,
transportation, health and social services. Most older adults want to age in place. Doing so is possible if
homes are appropriately designed or modified and if a community includes affordable housing options
for varying life stages. On the other hand, frequent, reliable and specialized transportation options need
to be in place to support older adults to manage their day-to-day lives and enhance their quality of life
as they age. With this in mind, key informants were asked to rate the age-friendliness of the community.
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Housing and Transportation
Key informants first rated statements related to age-friendly housing and transportation. Housing and
transportation statements addressed the availability of affordable housing options, affordable support
services to age in place, public transportation, community transport services, and specialized
transportation services for people with disabilities. Approximately 60% or more of key informants either
“disagreed” or “strongly disagreed” that these services are available in the community. The availability of
affordable housing and public transportation seemed to be of particular concern in the area.
Specifically, 69.5% of key informants stated there are not a variety of appropriate, affordable
housing options available in the area for older people. Additionally, 72.8% felt public
transportation is not available for older people to reach key destinations such as hospitals, health
centers, grocery stores, shopping centers, banks, senior centers, and parks.
Statement Strongly
Disagree Disagree
Neither
Agree nor
Disagree
Agree Strongly
Agree Mean
There are a variety of appropriate,
affordable housing options available in
the area for older people.
16.7% 52.8% 11.1% 18.1% 1.4% 2.3
Affordable support services are available
to enable older people to remain at
home, to “age in place.”
13.9% 51.4% 18.1% 15.3% 1.4% 2.4
Public transportation is available for
older people to reach key destinations
such as hospitals, health centers, grocery
stores, shopping centers, banks, senior
centers, and parks.
42.9% 29.9% 13.0% 14.3% 0.0% 2.0
In areas where public transportation is
limited, community transport services,
including volunteer drivers and shuttle
services, are available to older people.
23.9% 38.0% 23.9% 14.1% 0.0% 2.3
Sufficient specialized transportation
services are available for people with
disabilities.
28.4% 35.1% 24.3% 12.2% 0.0% 2.2
Social and Civic Participation
Key informants then rated statements related to age-friendly social and civic participation opportunities.
Social and civic participation statements addressed the availability of suitable community activities, well-
maintained green spaces and pedestrian-friendly walkways, volunteer opportunities, employment
opportunities, and opportunities for inter-generational activities. Volunteering was the only opportunity
that was positively rated by over half of key informants (55.4%) as being readily available within the
community to older adults. Approximately 51% of key informants either “disagreed” or “strongly
disagreed” that there are a wide variety of community activities available to appeal to a diverse
population of older people. Additionally, over 40% also “disagreed” or “strongly disagreed” that
Westminster Canterbury Richmond – Senior Community Profile 2016 - 2017
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there are flexible employment opportunities for older people and that older people are provided
opportunities to share their knowledge and experiences with other generations. However, notably,
key informants may not be as well informed on the availability of these opportunities as over 30%
selected “neither agree nor disagree.” Accessibility of safe and well-maintained green spaces and
pedestrian-friendly walkways to seniors particularly garnered the lowest rating as nearly 68% of
key informants indicated they “disagreed” or “strongly disagreed” with the statement.
Statement Strongly
Disagree Disagree
Neither
Agree nor
Disagree
Agree Strongly
Agree Mean
A wide variety of community activities is
available to appeal to a diverse population
of older people.
4.2% 46.5% 19.7% 21.1% 8.5% 2.8
Safe and well-maintained green spaces and
pedestrian-friendly walkways are easily
accessible to older people.
20.8% 46.8% 15.6% 15.6% 1.3% 2.3
There are flexible volunteer opportunities
for older people available in the community. 4.1% 14.9% 25.7% 48.6% 6.8% 3.4
There are flexible employment opportunities
for older people available in the community. 19.2% 26.0% 38.4% 15.1% 1.4% 2.5
Older people are provided opportunities to
share their knowledge, history and expertise
with other generations.
13.7% 27.4% 31.5% 27.4% 0.0% 2.7
Community and Health Services
Key informants then rated statements related to the availability of age-friendly community and health
services. Community and health services statements addressed the availability of support services to
promote and maintain health, home care services, community emergency planning, and an effective
communication system. Over 50% of key informants “agreed” or “strongly agreed” that both health and
community support services, as well as home care services, are available in the community. However,
57% said that there is not an effective communication system that reaches residents of all ages in
the community. Another nearly 44% of key informants also “disagreed” or “strongly disagreed” that
community emergency planning takes into account the vulnerabilities and capacities of older people.
Lastly, key informants rated the overall age-friendliness of the community. Only approximately 20% of
key informants “agreed” or “strongly agreed” that the local community is an age-friendly
community overall.
Westminster Canterbury Richmond – Senior Community Profile 2016 - 2017
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Statement Strongly
Disagree Disagree
Neither
Agree nor
Disagree
Agree Strongly
Agree Mean
A range of health and community support
services is offered for promoting and
maintaining health.
6.7% 20.0% 22.7% 48.0% 2.7% 3.2
Home care services are offered that
include health services, personal care, and
housekeeping.
5.5% 12.3% 26.0% 49.3% 6.8% 3.4
Community emergency planning takes
into account the vulnerabilities and
capacities of older people. 6.1% 37.9% 30.3% 25.8% 0.0% 2.8
The community has an effective
communication system that reaches
residents of all ages.
13.7% 43.8% 23.3% 19.2% 0.0% 2.5
Overall, I believe the local community is an
Age-Friendly community. 9.2% 36.8% 34.2% 19.7% 0.0% 2.6
Key informants provided several comments related to what is needed in the community to make it a
better place for older adults. The key themes among the comments were affordable housing and
affordable health/support services, better public transportation system and transportation options,
increased opportunities for socialization and intergenerational activities, and improve walkability.
Additionally, key informants thought increased education is needed of both seniors on available
services as well as the public on the benefit of older adults in the community. Select verbatim comments
are provided below.
Select Comments Related to Improving the Community for Older Adults
“A good public transportation system. Resources are not resources until they are accessible.
It's like having a building with no light bulbs. Transportation is an instant multiplier of
opportunity.
“Affordable housing is the number one issue that leads to many other problems, including
poverty and homelessness. The projects in Richmond have created pockets of poverty and
increased crime and they are not the answer for those with low income. Many older citizens
are living in blighted conditions in our community that are not visible to the general public.
We need to continue the movement that AARP and VCU Gerontology and the AAA
agencies are doing to encourage people to age in place safely and with proper supports in
place.”
“I would like for everyone in our community to realize what a large and diverse cohort of
older persons we have. And, what a resource they are for us! Their wants and needs are as
individual as they are. There is always a lot of attention and passion devoted to supporting
children -- let's recognize that there are older adults here who have contributed to our
neighborhoods, and worked and raised families, who deserve safe, resourceful,
communities they can thrive in.”
“More focus on consumer education of services and who pays for them.”
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“The issue of transportation continues to be the number one concern of the seniors we have
spoken to. There are a variety of opportunities and organizations that provide
transportation services, but there is a cost for these services - in spite of organizations such
as Senior Connections providing free vouchers for some of these services. The County can
do better with education on this subject, as well as consideration of providing some EMS
services to seniors differently - particularly in the case of seniors calling "911" to receive
their medications.”
“Better options to live outside of age-restricted developments in a broader community with
decent transportation and improved walkability”
“Intergenerational programs and activities to reduce social isolation.”
Senior Living, Life Planning and Senior Needs
Lastly, key informants answered questions pertaining to senior living options, life planning services, and
specific senior needs. First, key informants were asked several questions about senior living options in
the Greater Richmond area regarding need, availability, amount of information, and consumer
understanding. Looking across all topics, key informants seemed most concerned about affordable
housing for seniors and adult day care. Nearly three quarters of key informants felt there is a high level
of need for affordable senior housing in the Richmond area. Unfortunately, an equivalent percentage of
key informants’ also felt affordable senior housing isn’t readily available in the area. Furthermore,
approximately 41% feel there is no information about affordable senior housing and nearly 60% feel
their older adult consumers have a low level of understanding of it. In terms of adult day care, over half
of key informants feel there is only a moderate need for adult day care and that it is moderately
available in the community. However, nearly a quarter of key informants said there is no information
about it and about 50% say their older adult consumers have a limited understanding of it.
Key informants also rated how critical they felt certain life planning services are for the seniors they
serve. These services include medical directives/end of life decisions, transitions through stages of
aging, financial/retirement planning, legal planning, and memorial service and arrangement planning.
With the exception of memorial service and arrangement planning, the majority of key informants felt
that all of the aforementioned life planning services are very critical for seniors. Medical directives and
end of life decisions was the most critical with 89% of key informants feeling this service is very critical.
Although only approximately a third of key informants thought memorial service and arrangement
planning is very critical for seniors, nearly half thought it was at least somewhat critical.
Finally, keeping in mind the whole person, including mind, body, and spirit, key informants were asked
whether they felt certain needs of seniors are being met in the community. These needs included access
to regularly attend worship services, access to spiritual counseling, regular interaction with a supportive
community, spiritual support during crisis or transition, and opportunities to volunteer. As a whole,
approximately 60% of key informants believed all previously mentioned needs were at least somewhat
being met in the community. However, nearly 28% of key informants felt seniors do not have regular
interaction with a supportive community.
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Older Adult Perspective
In addition to feedback provided by key informants, older adults in the community also completed a
survey in order to provide their perspective. Survey respondents were asked similar, but more pointed,
questions about their community, housing, transportation, community engagement/civic participation,
and the availability of information.
Community and Housing
In terms of community and housing, survey respondents were asked about the importance and
likelihood of remaining in their community and their home as well as the factors that would influence
their decision to move. Over half of respondents (56.8%) felt it was extremely or very important to
remain in their community as they age. When asked about their likelihood to move to a different home
outside of their community, nearly half (49%) of respondents said it was somewhat or very likely that
they would move. However, still approximately a quarter of respondents indicated that it was not likely
that they would move during their retirement years and another 18% said they weren’t sure. According
to survey respondents, the top factors that would influence their decision to move were looking
for a home that will help you live independently, maintaining the outside of your home,
providing peace of mind for themselves and their children, and wanting to live near amenities.
Table 12. Factors Influencing Decision to Move According to Survey Respondents
Count Percent
Looking for a home that will help you live
independently as you age
188 56.8%
Maintaining the outside of your home
(lawn/snow removal, etc.) will be very tiring as
you age
147 44.4%
Provide peace of mind for me and my children
142 42.9%
Wanting to live near the amenities (shopping,
medical facilities, restaurants, parks, etc.) that I
need and want
137 41.4%
Opportunity to socialize with my peers
125 37.8%
Looking for a different home size that meets your
needs
118 35.6%
Maintaining your current home will be too
expensive
101 30.5%
Wanting to move to an area that has better
health care facilities
93 28.1%
Wanting to be closer to family
92 27.8%
Looking for an area that has a lower cost of living
91 27.5%
Needing more access to public transportation
67 20.2%
Wanting to live in a different climate
60 18.1%
Other
11 3.3%
Westminster Canterbury Richmond – Senior Community Profile 2016 - 2017
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Additionally, survey respondents were asked if they have access to certain home repair and seasonal
services, affordable housing options, and accessible features such as no-step entry and wider doorways.
For the most part, respondents felt they have access to services, housing, and accessible features.
However, nearly 51% do not feel they have access to a low-cost or free home repair service in the
community. Additionally, while 47% of respondents felt there are affordable housing options in
the community, nearly 22% weren’t sure. This may indicate a lack of information about housing in
the community.
Table 13. Access to Housing-Related Services According to Survey Respondents
Yes No Not sure
Affordable home repair contractors who are
trustworthy and do quality work 57.6% 27.6% 14.8%
A low-cost or free home repair service 30.3% 50.8% 19.0%
Seasonal services (lawn work or snow
removal) which are affordable 57.2% 27.8% 15.0%
Affordable housing options (such as active
adult communities, assisted living and
communities with meal plans or shared
outdoor spaces)
47.2% 30.9% 21.9%
Features such as no-step entry, wider
doorways, first floor bedroom and bath, grab
bars in bathrooms
51.2% 36.6% 12.2%
Transportation
Respondents also provided their perspective on transportation in the community including access,
challenges, and their personal needs. Survey respondents were asked about their ability to access
several transportation related services and features in the community. Public transportation was of
most concern to respondents as approximately half did not feel it was easy to use or reliable or
that public transportation stops are safe. However, pedestrian safety in the community was split
among respondents. Over 40% of respondents felt there are well-lit, safe streets and intersections as
well as countdown or beeping crosswalks at intersections. However, nearly an equivalent percentage did
not feel these are accessible in the community. Consequently, when asked about the biggest
challenge faced when traveling, nearly half of respondents (49.4%) said that they don’t feel safe
walking where they need to go. This is a serious concern because when respondents were asked what
they do to stay physically active, nearly 80% said walking.
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Table 14. Access to Transportation-Related Services According to Survey Respondents
Yes No Not Sure
Special transportation for older adults or
individuals with disabilities 47.7% 25.1% 27.2%
Easy-to-read traffic signs 67.2% 24.4% 8.4%
Affordable and easy to use public parking
lots, spaces and areas to park 52.0% 36.4% 11.6%
Well-lit, safe streets and intersections for
pedestrians, bicyclists and drivers 47.6% 43.6% 8.8%
Pedestrian crossing with countdown or
beeping crosswalks 41.7% 45.7% 12.7%
Public transportation that is easy to use and
reliable 37.7% 50.3% 12.0%
Safe public transportation stops or areas 33.8% 50.0% 16.3%
Community Engagement and Civic Participation
Next, respondents discussed community engagement and civic participation. Survey respondents were
asked how often they engage in social interactions, types of social interaction, and what makes them
feel connected to their community. The majority of respondents engage in social/community events
multiple times per week or a few times a month (63.6%). Additionally, respondents appear to
have regular social interactions with their friends, family, or neighbors, as over a third of
respondents (36.8%) said they interact at least once a day or more. Another 39% of respondents
interact several times a week. The top three frequent means of social interaction chosen by
respondents were in-person visits (68.8%), telephone (68.0%), and church or other organizational events
(57%).
Even though respondents seem to have regular social interactions and participate frequently in
community events, they were still asked what would make them feel more connected to the community.
Not surprisingly, 38% of respondents state that they already feel connected to their community.
Regardless, over 41% of respondents felt activities specifically geared towards older adults
(41.9%) and activities and events that are affordable for older adults (48.2%) would help them
feel more connected.
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Table 15. Connection to the Community According to Survey Respondents
Count Percent
Activities and events that are affordable for
older adults
161 48.2%
Activities specifically geared to older adults
140 41.9%
Conveniently located venues for entertainment
132 39.5%
Opportunities that involve both younger and
older people to socialize together
128 38.3%
I already feel connected to my community
127 38.0%
Continuing education classes
117 35.0%
A variety of cultural activities for diverse
populations
112 33.5%
Social clubs such as for books, gardening, crafts
or hobbies
91 27.2%
Visits or call from community members
60 18.0%
Respondents were also asked their current or future participation in social/community activities,
volunteering, and connection to a worshipping community. Over 60% of respondents said that they
currently participate in family gatherings (66.1%), church activities (62.4%), and going to restaurants
(62.2%). These were the top three activities that respondents currently participate. Notably, while only
36% of respondents currently participate in lifetime learning opportunities, nearly 54% stated
that they would like to participate in these types of opportunities. This was the top activity in which
respondents would like to participate. When asked about volunteering, 61% of respondents
currently volunteer. Only 6% of respondents have no interest in volunteering. Additionally, over
three-quarters of respondents are connected to a worshipping community (76.9%). Nearly 83% rely
on their congregation for spiritual guidance. Over half also rely on their congregation for social
interaction (54.0%) as well as peace of mind (55.5%).
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Table 16. Participation in Social/Community Events According to Survey Respondents
I currently
participate
I would like to
participate
I have no
interest
Community events (resource fairs,
holiday parties, etc.) 40.0% 41.6% 18.4%
Physical recreation activities, like walking
groups 44.0% 38.1% 17.9%
Church activities 62.4% 22.5% 15.1%
Movies 54.7% 36.6% 8.7%
Family gatherings 66.1% 22.1% 11.7%
Shopping for fun 45.3% 28.6% 26.1%
Live theatre 45.0% 34.6% 20.4%
Concerts/musical performances 50.5% 38.1% 11.4%
Sporting events 34.8% 25.1% 40.1%
Lifetime learning opportunities 36.1% 53.6% 10.4%
Restaurants 62.2% 32.4% 5.4%
Other 61.5% 33.3% 5.1%
Information Source
Lastly, survey respondents provided input on the availability of information in the community.
Respondents were asked several questions related to their primary source of information as well as
access to the internet. According to respondents, the top three sources of information for services,
such as health care, housing, home care, transportation, or social activities, were family or friends
(65.3%), doctor or health care professional (61.7%), and the internet (59.9%).
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Table 17. Primary Source of Information According to Survey Respondents
Count Percent
Family or friends
218 65.3%
Your doctor or other health care professional
206 61.7%
Internet
200 59.9%
Local senior centers
121 36.2%
Faith-based organizations
110 32.9%
Local Area Agency on Aging (AAA)
109 32.6%
AARP
104 31.1%
Local government offices such as the
Department of Health
82 24.6%
Local non-profit organizations
68 20.4%
Phone book
60 18.0%
Local library
47 14.1%
Other
8 2.4%
The majority of respondents have access to the internet (87.2%). Additionally, 82% of respondents
use their computer mostly at home, while 50% use it on their smart phone/tablet. Over 10% chose
“Other” as a response, and the majority of these respondents specified using the internet at work.
Approximately sixty-two percent of respondents use the internet at least once a day or more.
ECONOMY AND EDUCATION
In this section:
Income and Earnings Employment
Poverty Status Education
Income and Earnings
The following table depicts the percentage of older adult households earning an income and/or
collecting from secondary sources, like Social Security or retirement savings. Henrico County older
adults are slightly more likely to earn an income when compared to older adults in Richmond City
and the nation but comparable to the state. However, the mean earnings are lower among older
adults in Henrico County ($46,239) when compared to their counterparts in Richmond City
($56,134), Virginia ($57,104), and the nation ($50,291). The percentage of older adult households in
both Henrico County and Richmond City with a secondary source of income is generally consistent with
the state and the nation. However, over 11% of older adults in Richmond City rely on Food
Stamp/SNAP Benefits, and this figure is higher when compared to Henrico County, the state and
the nation.
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Table 18. Household Earnings, Population 65 Years and Over (2010 - 2014)
United
States Virginia
Henrico
County
Richmond
City
Households with Earnings 35.3% 38.4% 38.3% 34.5%
Mean Earnings $50,291 $57,104 $46,239 $56,134
Households with Social Security Income 90.8% 90.1% 91.5% 88.6%
Mean Income $19,195 $19,293 $20,004 $16,552
Households with Supplemental Security Income 6.4% 5.1% 3.8% 7.6%
Mean Income $9,019 $8,726 $10,120 $8,669
Households with Cash Public Assistance Income 1.8% 1.5% 0.9% 1.6%
Mean Income $3,451 $3,054 $3,455 $3,693
Households with Retirement Income 48.3% 54.6% 52.9% 47.0%
Mean Income $24,069 $30,009 $25,034 $25,473
Households with Food Stamp/SNAP Benefits 8.5% 6.9% 4.6% 11.3%
Figure 4. Population 65 years and over mean household earnings, 2010 - 2014
The median household income for older adults is estimated to increase by more than $2,800 in both
Henrico County and Richmond City between 2016 and 2021. Additionally, older adults aged 55 to 64
years in Henrico County will see the highest increase in their median earnings in 2021 by approximately
$4,600. In Richmond City, the highest increase in median earnings occurs with older adults aged 65 to
74 with earnings increasing by approximately $2,700.
$50,291
$57,104
$46,239
$56,134
$0 $10,000 $20,000 $30,000 $40,000 $50,000 $60,000
U.S.
Virginia
Henrico County
Richmond City
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Table 19. Older Adult Median Household Income Estimates and Projections (2016; 2021)
Henrico County Richmond City
2016 Estimate 2021 Projection 2016 Estimate 2021 Projection
Householder Age 55 – 64 $70,376 $75,038 $43,657 $45,928
Householder Age 65 – 74 $55,070 $57,838 $47,942 $50,733
Householder Age 75 – 84 $37,075 $38,974 $29,103 $30,563
Householder Age 85 and Over $29,332 $30,435 $20,600 $21,004
Median Household Income $62,674 $65,630 $41,763 $44,624
Poverty Status
In general, older adults across Richmond City are more likely to live in poverty when compared to older
adults across Henrico County, Virginia, and the nation, as determined by the federal poverty level. The
federal poverty level represents the dollar amount below which a household has insufficient income to
meet minimal basic needs. The federal poverty level may also be reported as a percentage. Households
that are below 100% of the poverty level have an income less than the amount deemed necessary to
sustain basic needs. Households at 100% to 149% of the poverty level have an income 1.0 to 1.49 times
the necessary amount. In Richmond City, approximately 15% of older adults have an income below
100% of the federal poverty level and another 13% have an income 1.0 to 1.49 times the federal
poverty level. The combined percentage equates to nearly 6,500 older adults.
Table 20. Poverty Status in the Past 12 Months, Population 65 Years and Over (2010 - 2014)
United
States Virginia
Henrico
County
Richmond
City
Population Below 100% of the Poverty Level 9.4% 7.6% 6.2% 15.1%
Population At 100% to 149% of the Poverty Level 10.9% 9.4% 8.5% 13.2%
Population At or Above 150% of the Poverty Level 79.7% 82.9% 85.2% 71.7%
Figure 5. Older adult population receiving food stamp/SNAP benefits by poverty status, 2010 - 2014
9.4%
7.6% 6.2%
15.1%
8.5%
6.9%
4.6%
11.3%
0.0%
2.0%
4.0%
6.0%
8.0%
10.0%
12.0%
14.0%
16.0%
U.S. Virginia Henrico County Richmond City
Population living below 100% poverty level
Households receiving food stamps/SNAP benefits
Westminster Canterbury Richmond – Senior Community Profile 2016 - 2017
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Employment
The following table depicts the employment status of older adults in Henrico County and Richmond
City. Among older adults who are actively seeking employment, Richmond City has a higher
unemployment rate for older adults aged 55 to 64 years (6%) and aged 65 to 74 years (5%) when
compared to Henrico County and the state but similar or better than the nation.
Table 21. Employment Status, Population 55 Years and Over (2010 – 2014)
United States Virginia Henrico
County
Richmond
City
Age 55 to 64 Years in Labor Force 64.3% 67.1% 70.6% 61.8%
Unemployed Civilian Labor Force 6.6% 4.5% 3.9% 6.0%
Age 65 to 74 Years in Labor Force 25.3% 27.6% 30.7% 28.9%
Unemployed Civilian Labor Force 6.2% 3.6% 4.1% 5.4%
Age 75 Years and Over In Labor Force 6.0% 6.5% 5.6% 6.5%
Unemployed Civilian Labor Force 5.7% 4.0% 4.3% 2.6%
Education
The percentage of Henrico County older adults with a high school diploma is notably higher when
compared to older adults across Richmond City, Virginia, and the nation. However, the
percentage of older adults with a bachelor’s degree or higher is similar in Henrico County and
Richmond City. Both percentages are higher than the state and the nation. Specifically, about 83%
of older adults residing in Henrico County and 75% in Richmond City have at least a high school degree,
whereas around 28% of older adults in both areas have a bachelor’s degree or higher.
Table 22. Educational Attainment, Population 65 Years and Over (2010 – 2014)
United States Virginia Henrico
County
Richmond
City
High school graduate or higher 79.9% 78.6% 82.8% 74.8%
Bachelor’s degree or higher 23.2% 27.0% 28.4% 28.6%
Westminster Canterbury Richmond – Senior Community Profile 2016 - 2017
Page 22
Figure 6. Educational attainment, Population 65 years and over, 2010 - 2014
HEALTH CARE ACCESS
In this section:
Health Insurance Coverage Community Perspective
Health Care Provider Access
Health Insurance Coverage
Henrico County older adults are slightly more likely to be uninsured (0.6%) when compared to
Richmond City older adults (0.4%), but less likely to be uninsured when compared to the state and
the nation (both 1%). The percentage of uninsured disabled older adults in both Henrico County and
Richmond City are generally low, and the figures are both less than the state and the nation.
Table 23. Uninsured Population Aged 65 Years and Over (2010 - 2014)
United States Virginia Henrico County Richmond City
1.0% 1.0% 0.6% 0.4%
Table 24. Health Insurance Coverage by Disability Status, Population 65 Years and Over (2010 - 2014)
United States Virginia Henrico
County
Richmond
City
Population 65 Years and Over With a Disability 36.3% 34.2% 32.7% 38.9%
With Health Insurance 99.3% 99.2% 99.6% 99.7%
Without Health Insurance 0.7% 0.8% 0.4% 0.3%
79.9%
23.2%
78.6%
27.0%
82.8%
28.4%
74.8%
28.6%
0.0% 20.0% 40.0% 60.0% 80.0%
Percent high school
graduate or higher
Percent bachelor's
degree or higher
Richmond City Henrico County Virginia U.S.
Westminster Canterbury Richmond – Senior Community Profile 2016 - 2017
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Health Care Provider Access
Health care provider density or the provider to population ratio is a measure of overall health care
access. In Richmond City, the ratio of primary care providers to residents and dentists to residents
is substantially better than Henrico County, the state and the National Benchmark. The ratio of
mental health providers to residents is also better in Richmond City when compared to Henrico County
and the state and closely mirrors the National Benchmark. In general, provider to population ratio is
better or within reach in both Henrico County and Richmond City when compared to the National
Benchmark. The National Benchmark represents the 90th percentile, i.e., only 10% of locations are better.
Table 25. Health Care Provider Density (2016)
National Benchmark
(90th
Percentile) Virginia
Henrico
County
Richmond
City
Physician to Population Ratio 1,040:1 1,330:1 1,020:1 990:1
Dentist to Population Ratio 1,340:1 1,570:1 1,450:1 790:1
Mental Health Providers to
Population Ratio 370:1 680:1 410:1 370:1
The following tables depict the ability of older adults to afford health care when needed and receive
routine checkups. Approximately 13% of older adults in Richmond City consider cost a barrier to
seeing a doctor, which is higher than Henrico County, Virginia, and the nation. Additionally, older
adults in Richmond City are more likely to have received a routine checkup in the past year when
compared to older adults across Henrico County, the state, and the nation.
Table 26. Population 55 Years and Over Unable to See a Doctor Due to Cost (2013 - 2014)
United States Virginia Henrico County Richmond City
9.0% 8.7% 8.4% 12.6%
Table 27. Population 55 Years and Over Receiving a Routine Checkup in the Past Year (2013 - 2014)
United States Virginia Henrico
County
Richmond
City
Within the past year (anytime less than 12
months ago) 82.5% 85.5% 84.1% 86.7%
Community Perspective
Key Informant Perspective
Key informants were asked to identify the most significant barriers that keep seniors/elderly in the
community from accessing health care when they need it. The inability to navigate the health care
system was identified as the top barrier to seniors/elderly accessing health care. Additional barriers
to older adults accessing health care included inability to pay out of pocket expenses such as co-pays
and prescriptions as well as lack of transportation. The “other” responses included fear of going into the
hospital and never coming home, hesitancy to ask for help or have people in their home, and
recognizing that they need care.
Westminster Canterbury Richmond – Senior Community Profile 2016 - 2017
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Table 28. Most Significant Barriers Accessing Health Care According to Key Informants
Count Percent
Inability to Navigate Health Care System
63 81.8%
Inability to Pay Out of Pocket Expenses (Co-
pays, Prescriptions, etc.)
58 75.3%
Lack of Transportation
57 74.0%
Availability of Providers/Appointments
35 45.5%
Lack of Providers accepting
Medicare/Medicaid
32 41.6%
Lack of Trust
26 33.8%
Time Limitations (Long Wait Times, Limited
Office Hours, Time off Work)
23 29.9%
Lack of Health Insurance Coverage
23 29.9%
Language/Cultural Barriers
22 28.6%
Basic Needs Not Met (Food/Shelter)
21 27.3%
Other
4 5.2%
None/No Barriers
2 2.6%
Key informants were then asked to identify health-related resources or services that are missing or
lacking in the community to support seniors/elderly. The top resources or services identified as
missing or lacking in the community are free/low cost dental care, geriatricians/gerontologists,
free/low cost vision care, and memory care specialists. The “other” responses included caregiver
supports and education, coordination of care/review of meds when multiple specialists are involved,
and good habit building.
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Table 29. Missing Health-Related Resources/Services According to Key Informants
Count Percent
Free/Low Cost Dental Care
49 63.6%
Geriatricians/Gerontologists
48 62.3%
Free/Low Cost Vision Care
45 58.4%
Memory Care Specialists
40 51.9%
Health Education/Information/Outreach
39 50.6%
Mental Health/Behavioral Health/Substance
Abuse Services
38 49.4%
Free/Low Cost Medical Care
37 48.1%
Prescription Assistance
33 42.9%
Health Screenings
21 27.3%
Primary Care Providers
14 18.2%
Immunization/Vaccination Programs
13 16.9%
Other
6 7.8%
Medical Specialists (Cardiologist,
Dermatologist, Neurologist)
5 6.5%
None
4 5.2%
Older Adult Perspective
Like the key informants, survey respondents were also asked about the barriers they encounter
accessing health care as well as the health care services that are available and accessible in the
community. Nearly 47% of respondents stated that they do not encounter any barriers when trying to
access health care. However, for those respondents that do experience barriers, the top barriers selected
are similar to the responses given by key informants. Difficulty understanding/navigating the health care
system and inability to afford medical bills or medication/prescriptions topped the list with
approximately 31% and 23% of respondents selecting these barriers respectively. Additionally, 21% of
respondents said they had difficulty getting a ride to appointments.
Westminster Canterbury Richmond – Senior Community Profile 2016 - 2017
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Table 30. Most Significant Barriers Accessing Health Care According to Survey Respondents
Count Percent
None/No Barriers
154 46.8%
Difficulty understanding/navigating the
health care system
101 30.7%
You can’t afford your medical bills or
medications/prescriptions
75 22.8%
Cannot get a ride to appointments
68 20.7%
You can’t afford your insurance co-pays
56 17.0%
You can't get an appointment
56 17.0%
Not enough time
47 14.3%
Lack of health insurance coverage
43 13.1%
You can't find a primary care physician
30 9.1%
Language/Cultural issues
21 6.4%
Other
11 3.3%
Key informants felt free low/cost dental and vision care as well as geriatricians/gerontologists were the
top health care services lacking in the community. However, when survey respondents were asked what
health care services are available in the community, home health and home care services received the
lowest percentage of responses. Only about a third of respondents said they had access to affordable,
well-trained, certified home health care providers (33.4%) and home care services including health,
personal care and housekeeping (35.9%). Additionally, only 41% feel they have access to affordable
medical equipment.
OLDER ADULT HEALTH INDICATORS
In this section:
General Health Status: Physical & Mental Substance Abuse
Body Mass Index
Nutrition
Vaccinations
Smoking
General Health Status
General self-rated health status provides a strong predictive measure for overall health outcomes.
Richmond City older adults are less likely to report fair or poor health when compared to older
adults in Henrico County, Virginia, and the nation. Compared to older adults across the nation,
older adults in both Henrico County and Richmond City are less likely to report poor or fair
health. Twenty percent of Richmond City older adults report fair or poor health compared to 21% of
older adults in Henrico County.
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Table 31. Population 55 Years and Over Reporting Fair or Poor Overall Health (2013 - 2014)
United States Virginia Henrico County Richmond City
25.4% 24.2% 21.4% 20.2%
Figure 7. Population 55 years and over reporting fair or poor health, 2013 - 2014
Adults in poor physical or mental health are defined as having reported 14 or more days for which their
mental or physical health was “not good” within the past 30 days. Contrary to the self-rated general
health status finding noted in the previous section, 19% of Henrico County older adults report
experiencing 14 or more days of poor physical health and 9% experienced 14 or more days of
poor mental health in the previous month. The physical health rates are higher when compared to
the rates for Richmond City, the state, and the nation. The mental health rates are also higher than the
rates for Richmond City and the state, but are equitable to the nation.
Table 32. Population 55 Years and Over with Poor Physical and Mental Health
Days in the Past Month (2013 - 2014)
Poor Physical Health Days United States Virginia Henrico County Richmond City
1 – 13 days 21.4% 20.0% 22.2% 21.5%
14 – 30 days 16.9% 16.4% 19.1% 16.6%
Poor Mental Health Days
1 – 13 days 16.1% 13.5% 19.0% 15.3%
14 – 30 days 9.5% 8.4% 9.2% 8.1%
The likelihood of being diagnosed with a depressive disorder increases as one experiences more
physical or mental health days. Twenty-two percent of older adults in Henrico County have been
7.8%
17.6%
7.9%
16.3%
6.2%
15.2%
4.3%
15.9%
0.0% 5.0% 10.0% 15.0% 20.0%
Poor Health
Fair Health
Richmond City Henrico County Virginia U.S.
Westminster Canterbury Richmond – Senior Community Profile 2016 - 2017
Page 28
diagnosed with a depressive disorder. This figure is much higher when compared to the rates of
Richmond City, the state and the nation.
Table 33. Mental Health Status of Population 55 Years and Over (2013 - 2014)
United States Virginia Henrico County Richmond City
Population Diagnosed with a
Depressive Disorder 18.0% 16.4% 22.0% 15.2%
The combination of poor physical and mental health can often inhibit daily activity. Twenty-seven
percent of Richmond City older adults report having activity limitations due to poor physical or
mental health. This percentage is similar to the figures in Henrico County and Virginia, but lower when
compared to the nation.
Figure 8. Limitations in activity due to poor physical or mental health, 2013 - 2014
Food Environment
The ability to maintain a healthy weight through diet and physical activity is influenced by both
behavioral and environmental indicators. Environmental indicators include, but are not limited to, access
to healthy foods and access to exercise opportunities.
The food environment index measures overall food access based on 2 indicators, limited access to
healthy foods and food insecurity. The index is based on a score of 0 (worst) to 10 (best). The first factor,
limited access to healthy foods, measures the proportion of the population that is low income and does
not live close to a grocery store. The second factor, food insecurity, measures the percentage of the
population that did not have access to a reliable source of food during the past year. The food
environment index in Richmond City (5.8) is much worse when compared to the index in Henrico
County (7.9), Virginia (8.3), and the National Benchmark of 8.3.
21.0% 21.3% 23.5%
18.4%
29.8% 27.0% 26.5% 27.3%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
U.S. Virginia Henrico County Richmond City
14 or More Poor Physical or Mental Health Days
Activity Limitations Due to Poor Physical or Mental Health
Westminster Canterbury Richmond – Senior Community Profile 2016 - 2017
Page 29
Table 34. Food Environment Index (2016)
National Benchmark
(90th
Percentile) Virginia Henrico County Richmond City
8.3 8.3 7.9 5.8
Grocery Store Access
Access to grocery stores can have a profound influence on the overall health of a community. The
United States Department of Agriculture (USDA) defines grocery stores as supermarkets and smaller
grocery stores primarily engaged in retailing a general line of food, such as canned and frozen foods,
fresh fruits and vegetables, fresh and prepared meats, fish, and poultry. Grocery store access provides a
measure of healthy food access and environmental influences on dietary behaviors. Grocery store
access rates per 100,000 are much higher in Richmond City when compared to the rates in
Henrico County, Virginia, and across the nation.
Figure 9. Grocery store access per 100,000, 2014
A community’s health and overall quality of life is also affected by access to exercise opportunities. The
measure is based on the proportion of residents who live reasonably close to a physical activity location.
Physical activity locations may include parks (local, state, and national) or facilities identified by the
NAICS code 713940 (gyms, community centers, YMCAs, pools, etc.). The percentage of residents who
have access to exercise opportunities is higher in Henrico County (94%) when compared,
Richmond City (88%), the state (81%) and the National Benchmark of 91%. The high percentage of
residents with access to exercise opportunities did not necessarily translate into a substantial
percentage of older adults who exercise. Specifically, 71% of older adults in Henrico County
reported exercising in the past month compared to 74% in Richmond City. However, both of these
percentages are still higher than the state and nation.
21.1
18.7
20.5
29.4
5.0 10.0 15.0 20.0 25.0 30.0
U.S.
Virginia
Henrico County
Richmond City
Westminster Canterbury Richmond – Senior Community Profile 2016 - 2017
Page 30
Table 35. Access to Exercise Opportunities (2016)
National Benchmark
(90th
Percentile) Virginia Henrico County Richmond City
91% 81% 94% 88%
Table 36. Population 55 and Over that Exercised in the Past Month (2013 - 2014)
United States Virginia Henrico County Richmond City
69.6% 69.0% 70.8% 74.0%
Body Mass Index
Body Mass Index (BMI) is a factor of diet and physical activity and is correlated with chronic health
conditions. It is calculated based on the height and weight of an individual. The following table depicts
the percentage of older adults who are overweight or obese. The percentage of older adults who are
overweight or obese is 69% across Richmond City, Henrico County, the state, and the nation.
Table 37. Overweight or Obese, Population 55 Years and Over (2013 - 2014)
United States Virginia Henrico County Richmond City
68.8% 69.0% 68.6% 69.0%
Figure 10. Overweight or obese older adult population, 2013 - 2014
Smoking
Smoking is detrimental to nearly every organ in the body and is often correlated with poorer health
outcomes and chronic health conditions such as lung cancer, stroke and heart disease. Richmond City
and Henrico County older adults are much more likely to currently smoke when compared to
68.8%
69.0%
68.6%
69.0%
0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0%
U.S.
Virginia
Henrico County
Richmond City
Westminster Canterbury Richmond – Senior Community Profile 2016 - 2017
Page 31
older adults in the state and the nation. Nearly 23% of older adults in Richmond City currently smoke
compared to 18% in Henrico County, 14% in Virginia and 13% across the nation.
Table 38. Smoking Status, Population 55 Years and Over (2013 - 2014)
United States Virginia Henrico County Richmond City
Current Smoker (Every day or
Some days) 12.9% 14.1% 17.7% 22.6%
Former Smoker 37.8% 36.3% 32.6% 29.6%
Substance Abuse
Binge drinking is defined as males having 5 or more alcoholic drinks and females having 4 or more
drinks on 1 occasion. Heavy drinking is defined as males having more than 2 alcoholic drinks and
females having more than 1 drink per day. About 6% of older adults across the state, Henrico County
and Richmond City participate in binge drinking, which is less than the nation’s figure of 7.4%. In
Richmond City, 5% of older adults are heavy or chronic drinkers. This figure is higher when
compared to Henrico County and Virginia, but comparable to the nation.
Table 39. Binge or Heavy Alcohol Consumption, Population 55 Years and Over (2013 - 2014)
United States Virginia Henrico County Richmond City
Binge Drinkers 7.4% 6.1% 6.3% 6.6%
Heavy or Chronic Drinkers 4.8% 4.3% 3.1% 5.2%
Vaccinations
The flu vaccine is recommended as an annual prevention measure, particularly for older adults. Henrico
County older adults are slightly more likely to receive a flu vaccine when compared to their
counterparts in Richmond City (56.2%), the state (56.5%) and the nation (53%).
Table 40. Population 55 Years and Over Receiving a Seasonal Flu Vaccine in the Past Year (2013 - 2014)
United States Virginia Henrico County Richmond City
53.2% 56.5% 58.6% 56.2%
The pneumonia vaccine is typically recommended for older adults as a means to prevent more serious
illness. Older adults in Henrico County, Richmond City, and Virginia more likely to receive a
Pneumonia vaccine in their lifetime (between 52% and 53%) when compared to older adults
across the nation.
Table 41. Population 55 Years and Over that Has Ever Had a Pneumonia Vaccine (2013 - 2014)
United States Virginia Henrico County Richmond City
50.7% 52.4% 52.9% 53.5%
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CHRONIC CONDITIONS
In this section:
Arthritis
Cancer
Diabetes
Heart Disease
Respiratory Disease
Asthma
Arthritis
Arthritis is defined as inflammation of the joints. In Henrico County, 45% of older adults have been
diagnosed with arthritis. The percentage of arthritis patients is higher than Richmond City but less
than the state and nation.
Table 42. Population 55 Years and Over Diagnosed with Arthritis (2013 - 2014)
United States Virginia Henrico County Richmond City
47.0% 48.1% 44.6% 41.0%
Cancer
The overall cancer incidence rate in Richmond City is higher when compared to Henrico County,
Virginia, and the nation. However, Richmond City and Henrico County are burdened by different cancer
types. Richmond City has a substantially higher cancer incidence rate for colon and rectal, lung
and bronchus, and prostate cancer; whereas in Henrico County, the incidence rates for breast
cancer and melanoma of the skin are higher when compared to Richmond City, the state and the
nation. Both Richmond City and Henrico County have lower pancreas cancer incidence rates than the
state and the nation.
Table 43. Older Adults Ages 65+ Cancer Incidence Rates per Age-Adjusted 100,000 by Site (2009 - 2013)
United States Virginia
Henrico
County
Richmond
City
Breast, Female 419.7 421.9 431.9 410.3
Colon and Rectum 199.3 181.5 200.7 221.8
Lung and Bronchus 356.6 354.3 327.5 432.1
Melanoma of the Skin 77.6 75.8 100.0 60.5
Pancreas 76.5 75.5 64.6 67.0
Prostate 621.8 567.7 609.4 711.9
Total Cancer Incidence 2002.1 1900.0 1901.0 2046.7
Westminster Canterbury Richmond – Senior Community Profile 2016 - 2017
Page 33
Figure 11. Total cancer incidence rate among older adults ages 65 and over, 2009 - 2013
Cancer screenings are important for the early detection and treatment of cancer. For women, clinical
breast exams, mammograms, and Pap smears are recommended. In general, older adult women in
Richmond City are slightly less likely to have ever received breast cancer screening exams and
mammograms when compared to older adult women in Henrico County, the state, and the nation.
However, Richmond City older adult women are more likely to have received a breast exam as
well as a mammogram within the past two years. In particular, 84% of Richmond City older adult
women had a breast exam in the past 2 years and 89% of older adult women had a mammogram in the
past 2 years.
Table 44. Breast Cancer Screening among Population 55 Years and Over (2013 - 2014)
Breast Exam United States Virginia* Henrico County* Richmond City*
Ever 91.0% 89.9% 88.8% 86.5%
In the Past 2 Years 78.3% 81.2% 81.4% 84.3%
Mammogram
Ever 96.0% 95.4% 97.7% 94.6%
In the Past 2 Years 78.8% 80.9% 71.7% 88.9%
*Data only available for 2014
Again, older adult women in Richmond City are less likely to have ever received a Pap Test when
compared to Henrico County, the state, and the nation. However, they are more likely to have
received a Pap Test within the past 2 years. Nearly 91% of older adult women in Richmond City have
ever received a Pap Test and approximately 69% have received one within the past 2 years.
2,002.1
1,900.0
1,901.0
2,046.7
1,000 1,200 1,400 1,600 1,800 2,000
U.S.
Virginia
Henrico County
Richmond City
Westminster Canterbury Richmond – Senior Community Profile 2016 - 2017
Page 34
Table 45. Cervical Cancer Screening among Population 55 Years and Over (2013 - 2014)
Pap Test United States Virginia* Henrico County* Richmond City*
Ever 95.4% 95.5% 97.1% 90.8%
In the Past 2 Years 51.7% 58.1% 64.0% 69.4%
*Data only available for 2014
Prostate-Specific Antigen (PSA) tests are recommended for men to detect prostate cancer. Older adult
men in Richmond City are much more likely than older adult men in Henrico County, across
Virginia and the nation to ever receive PSA tests. Eighty-six percent of men in Richmond City had a
PSA test in their lifetime compared to 75% in Henrico County and across Virginia and 73% across the
nation.
Table 46. Prostate Cancer Screening among Population 55 Years and Over (2013 - 2014)
PSA Test United States Virginia* Henrico County* Richmond City*
Ever 72.7% 74.5% 74.7% 86.3%
In the Past 2 Years 79.3% 82.0% 82.7% 79.7%
*Data only available for 2014
Sigmoidoscopies/Colonoscopies are used to detect the presence of colorectal cancer. In general,
Richmond City older adults are slightly more likely than older adults in Henrico County, Virginia
and across the nation to receive a sigmoidoscopy or colonoscopy screening in their lifetime.
Table 47. Colorectal Cancer Screening among Population 55 Years and Over (2013 - 2014)
Sigmoidoscopy/
Colonoscopy United States Virginia* Henrico County* Richmond City*
Ever 74.8% 76.2% 75.5% 79.4%
In the Past 2 Years 38.0% 38.7% 36.2% 44.4%
*Data only available for 2014
Diabetes
Diabetes is caused either by the body’s inability to produce insulin or effectively use the insulin that is
produced. Richmond City older adults are slightly more likely to be diagnosed with diabetes (23%)
when compared to older adults in Henrico County (20%), across Virginia (19%) and the nation
(20%).
Table 48. Older Adults Diagnosed with Diabetes, Excluding Gestational Diabetes (2013 - 2014)
United States Virginia Henrico County Richmond City
20.2% 19.3% 19.5% 22.9%
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Heart Disease
In general, Henrico County older adults are more likely to have heart disease when compared to
older adults in Richmond City, the state, and the nation. In particular, 11% of Henrico County older
adults have been diagnosed with heart attack, 12% with angina or coronary heart disease, and 7% with
stroke.
Table 49. Population 55 Years and Over Diagnosed with Heart Disease (2013 - 2014)
United States Virginia Henrico County Richmond City
Heart Attack 9.5% 9.0% 10.6% 6.5%
Angina or Coronary Heart Disease 9.7% 9.2% 12.3% 9.7%
Stroke 6.1% 5.8% 7.3% 4.8%
Figure 12. Heart Disease among older adults ages 55 years and over, 2013 - 2014
Respiratory Disease
Air pollution is often associated with higher rates of respiratory diseases like asthma and COPD. Fine
particulate matter is a form of air pollution and is a measure of the overall outdoor air quality. It is
measured as an average daily amount in micrograms per cubic meter. The National Benchmark for daily
fine particulate matter is 9.5. The particulate matter is much higher across Richmond City (12.4), Henrico
County (12.4) and the state (12.7) when compared to the National Benchmark. Another measure of air
quality is the frequency of high ozone days. According to the American Lung Association, Henrico
County received a “D” grade for a weighted average of 3.2 ozone days per year. Data was not
collected in Richmond City. The grading system is based on a weighted grading system of A to F.
Weighted averages are calculated based on the number of poor air quality days and the severity of
pollution present.
6.1%
9.7%
9.5%
5.8%
9.2%
9.0%
7.3%
12.3%
10.6%
4.8%
9.7%
6.5%
0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0% 14.0%
Stroke
Coronary Heart
Disease
Heart Attack
Richmond City Henrico County Virginia U.S.
Westminster Canterbury Richmond – Senior Community Profile 2016 - 2017
Page 36
Table 50. Daily Fine Particulate Matter (2016)
National Benchmark
(90th
Percentile) Virginia Henrico County Richmond City
9.5 12.7 12.4 12.4
Asthma
Asthma is reported as the percentage of individuals who have ever had asthma (lifetime diagnosis) and
the percentage of individuals who currently have asthma. Richmond City older adults are more likely
to ever be diagnosed with asthma as well as still have the condition if diagnosed when compared
to Henrico County, Virginia, and the nation. Specifically, 20% of Richmond City older adults have
been diagnosed with asthma compared to 11% in Henrico County, 12% across the state and 13%
nationwide. About 14% of older adults in Richmond City have also been diagnosed with COPD,
which is higher when compared to COPD diagnosis rates for older adults in Henrico County, the
state, and the nation.
Table 51. Population 55 Years and Over Diagnosed with Asthma (2013 - 2014)
United States Virginia Henrico County Richmond City
Ever diagnosed with Asthma 12.5% 11.9% 11.2% 20.1%
Still have Asthma 73.0% 76.3% 64.4% 83.1%
Table 52. Population 55 Years and Over Diagnosed with COPD (2013 - 2014)
United States Virginia Henrico County Richmond City
11.2% 11.5% 7.5% 13.7%
MORTALITY
In this section:
Overall Mortality and Premature Death Cancer Mortality
Leading Causes of Mortality
Overall Mortality and Premature Death
The following table depicts the overall mortality rate for older adults. Richmond City has a much
higher death rate for older adults in the “55 – 64” age category as well as a slightly higher death
rate in the “65 years and over” age category when compared to Henrico County, Virginia, and the
nation. The data corresponds to the higher number of premature deaths that is reported in Richmond
City when compared to Henrico County, the state, and the National Benchmark (Table 54).
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Table 53. Multiple Cause of Death Rate per 100,000 (2014)
United States Virginia Henrico County Richmond City
Deaths Death
Rate Deaths
Death
Rate Deaths
Death
Rate Deaths
Death
Rate
Population Age 55 – 64* 348,808 870.3 8,597 826.3 299 740.4 346 1,316.4
Population Age 65 and
Over 1,922,271 4,198.0 46,424 4,266.0 2,034 4,385.6 1,153 4,525.8
*Crude rate provided since rate only includes one age category.
Figure 13. Mortality rate among population 55 years and over, 2014
Table 54. Premature Mortality: Years of Potential Life Lost Before Age 75 per 100,000 (2016)
National Benchmark
(90th
Percentile) Virginia Henrico County Richmond City
5,200 6,100 5,700 9,700
Leading Causes of Mortality
The following table depicts age-adjusted mortality rates for the 8 leading causes of death in the nation.
Richmond City has a higher mortality rate for heart disease and stroke when compared to Henrico
County, the state, and the nation. However, older adults in Henrico County are far more likely to
die from Alzheimer’s disease and influenza and pneumonia compared to their counterparts in
Richmond City, Virginia, and the nation. Other mortality rates are comparable to the state and
nation.
4,198.0
870.3
4,266.0
826.3
4,385.6
740.4
4,525.8
1,316.4
400.0 1,400.0 2,400.0 3,400.0 4,400.0
65 years and over
55 - 64 years
Richmond City Henrico County Virginia U.S.
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Table 55. Population 65 and Over Mortality Rate per 100,000 by Leading Cause of Death (2014)
United States Virginia Henrico
County
Richmond
City
Heart Disease 1,062.1 993.6 961.6 1109.8
Cancer 915.0 921.8 987 949.7
Chronic Lower Respiratory Disease
(CLRD) 276.6 245 272.7 264
Stroke 247.3 257.4 262.9 318.6
Alzheimer’s Disease 199.6 163.2 221.3 169.7
Accidents 105.0 111.7 93.7 Unreliable
Diabetes 119.3 104.2 94.4 104.4
Influenza and Pneumonia 97.1 113.1 154.8 73
Cancer Mortality
The 5 deadliest types of cancer nationally, in ranking order, are lung and bronchial cancer, colon and
rectal cancer, breast cancer, pancreatic cancer, and prostate cancer. The following table depicts
mortality rates for each of these types for older adults ages 65 and over in Henrico County and
Richmond City. The overall cancer mortality rate in Richmond City and Henrico County are higher
than both the state and nation. With the exception of breast cancer, Richmond City has a higher
mortality rate than Henrico County, the state, and the nation for all reported cancer types.
However, Henrico County does have a slightly higher breast cancer mortality rate than Richmond City.
Table 56. Older Adults ages 65 and Over Cancer Mortality per 100,000 by Site (2009 - 2013)
United States Virginia
Henrico
County
Richmond
City
Breast, Female 97.4 99.9 126.4 106.4
Colon and Rectum 85.8 82.4 84.3 113.5
Lung and Bronchus 275.5 283.4 284.7 325.2
Pancreatic 64.5 64.4 59.3 71.0
Prostate 151.7 164.6 145.0 199.7
All Cancer Sites Mortality Rate 963.3 979.4 986.8 1,099.10
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Figure 14. Cancer mortality rate among population 65 years and over, 2014
MEDICARE FEE-FOR-SERVICE BENEFICIARIES
In this section:
Common Chronic Conditions Emergency Department Visits and Per
Presence of Multiple Chronic Conditions
Hospital Readmissions
Capita Costs
Preventable Hospitalizations
Common Chronic Conditions
The following table depicts the percentage of Medicare beneficiaries aged 65 years and over affected by
chronic conditions. The percentage of Medicare beneficiaries in Henrico County with a given
chronic condition is generally higher when compared to Richmond City, Virginia, and the nation.
However, Alzheimer’s disease/dementia and asthma appear to be more prevalent among older adults in
Richmond City when compared to their peers in Henrico County, the state, and across the nation.
963.3
979.4
986.8
1,099.1
500 600 700 800 900 1,000 1,100
U.S.
Virginia
Henrico County
Richmond City
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Table 57. Chronic Conditions among Medicare Beneficiaries 65 Years and Over (2014)
United States Virginia Henrico
County
Richmond
City
Alzheimer’s Disease/Dementia 11.5% 10.4% 11.8% 11.9%
Arthritis 30.7% 29.2% 31.5% 29.1%
Asthma 4.5% 4.6% 4.7% 5.0%
Atrial Fibrillation 9.3% 8.9% 9.7% 7.8%
COPD 11.0% 9.5% 9.3% 8.4%
Cancer 8.9% 8.9% 10.4% 9.2%
Chronic Kidney Disease 17.3% 16.2% 16.0% 17.2%
Depression 13.6% 12.6% 14.0% 13.2%
Diabetes 27.1% 26.7% 25.0% 26.7%
Heart Failure 14.6% 12.0% 12.2% 12.6%
Hyperlipidemia 47.9% 50.5% 50.3% 43.9%
Hypertension 58.4% 59.5% 60.2% 58.7%
Ischemic Heart Disease 29.3% 24.8% 27.2% 24.5%
Osteoporosis 6.7% 5.9% 7.3% 5.6%
Schizophrenia/Other Psychotic
Disorders 2.6% 2.0% 1.9% 2.4%
Stroke 4.0% 3.7% 4.6% 4.0%
Note: Bold font indicates the percentage is higher when compared to the county, state, and nation.
Presence of Multiple Chronic Conditions
In general, Henrico County Medicare beneficiaries aged 65 years and over are more likely to have
4 or more chronic conditions when compared to older adults in Richmond City and the state but
are similar to the nation. However, Henrico County has a lower percentage for 0 to 1 multiple chronic
conditions when compared to Richmond City, Virginia, and the nation.
Table 58. Chronic Conditions per 100,000 Medicare Beneficiaries 65 Years and Over (2014)
United States Virginia Henrico
County
Richmond
City
0 – 1 Chronic Condition 32.1% 31.9% 30.1% 34.2%
2 – 3 Chronic Conditions 30.6% 33.3% 33.5% 31.2%
4 – 5 Chronic Conditions 21.9% 21.8% 22.5% 21.4%
6 or More Chronic Conditions 15.4% 13.0% 13.9% 13.3%
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Figure 15. Chronic conditions among Medicare beneficiary population, 2014
Hospital Readmissions
The percentage of hospital readmissions for Richmond City Medicare beneficiaries ranges from 7% for
residents with 2 to 3 chronic conditions to 24% for residents with 6 or more chronic conditions.
Hospital readmission percentages are generally higher in Richmond City when compared to
Henrico County, the state and the nation, with the exception of the percentage for beneficiaries
with 2-3 chronic conditions, which is similar across all four locations.
Table 59. Hospital Readmissions for Chronic Conditions 65 Years and Over (2014)
United States Virginia Henrico
County
Richmond
City
0 – 1 Chronic Condition 5.8% 6.3% * *
2 – 3 Chronic Conditions 7.2% 7.5% 7.5% 7.2%
4 – 5 Chronic Conditions 10.4% 10.8% 9.5% 11.8%
6 or More Chronic Conditions 21.7% 22.3% 21.7% 23.6%
* Data suppressed because there are fewer than 11 Medicare beneficiaries in the cell.
Emergency Department Visits and Per Capita Cost
With the exception of Medicare beneficiaries with 0 to 1 chronic condition, the rate of Emergency
Department visits for Medicare beneficiaries in Richmond City is notably higher when compared
to Henrico County, the state and the nation. In Richmond City, Emergency Department rates per
1,000 beneficiaries range from 112.2 for residents with 0 or 1 chronic condition to 2,044.3 for residents
with 6 or more chronic conditions. However, the per capita cost for chronic conditions in Richmond City
is lower or comparable to the cost in Henrico County, Virginia, and the nation with the exception of
beneficiaries with 6 or more chronic conditions in which the cost is slightly higher. The highest per
15.4%
21.9%
30.6%
13.0%
21.8%
33.3%
13.9%
22.5%
33.5%
13.3%
21.4%
31.2%
0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0%
6 or more conditions
4 - 5 conditions
2 - 3 conditions
Richmond City Henrico County Virginia U.S.
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capita cost in Henrico County is among beneficiaries with 6 or more chronic conditions and
equates to approximately $32,103.
Table 60. Emergency Department Visits for Chronic Conditions per 1,000 Beneficiaries 65 Years and Over
(2014)
United States Virginia Henrico
County
Richmond
City
0 – 1 Chronic Condition 117.5 116.9 115.2 112.1
2 – 3 Chronic Conditions 318.7 318.6 306.2 359.0
4 – 5 Chronic Conditions 647.3 691.3 654.2 748.4
6 or More Chronic Conditions 1,767.5 1,938.1 1,796.6 2,044.3
Table 61. Per Capita Cost for Chronic Conditions 65 Years and Over (2014)
United States Virginia Henrico
County
Richmond
City
0 – 1 Chronic Condition $1,698.9 $1,639.9 $1,881.3 $1,561.4
2 – 3 Chronic Conditions $5,206.8 $4,723.2 $4,986.0 $4,992.0
4 – 5 Chronic Conditions $10,880.5 $10,184.1 $11,025.2 $11,052.1
6 or More Chronic Conditions $31,238.2 $28,981.7 $29,793.0 $32,102.7
Figure 16. Per capita costs for 65 years and older beneficiaries, 2014
$31,238.2
$10,880.5
$5,206.8
$1,698.9
$28,981.7
$10,184.1
$4,723.2
$1,639.9
$29,793.0
$11,025.2
$4,986.0
$1,881.3
$32,102.7
$11,052.1
$4,992.0
$1,561.4
$0.0 $5,000.0 $10,000.0 $15,000.0 $20,000.0 $25,000.0 $30,000.0 $35,000.0
6 or more conditions
4 - 5 conditions
2 - 3 conditions
0 - 1 condition
Richmond City Henrico County Virginia U.S.
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KEY INFORMATION CONCLUSIONS
In this section:
Most Pressing Issues Missing or Lacking Resources/Services
Anxiety about Aging and Ageism Open-Ended Feedback
Most Pressing Issues
Key informants were asked to identify the 5 most pressing issues facing seniors/elderly in the
community. The most pressing issues identified were navigating/accessing health care and social
services, chronic disease management, Alzheimer’s disease/dementia/memory loss, social
isolation, and poverty/financial insecurity.
Table 62. Most Pressing Issues According to Key Informants
Count Percent
Navigating/Accessing Health Care & Social
Services
52 67.5%
Chronic Disease Management (Heart Disease,
Stroke, Diabetes, Cancer, Arthritis)
46 59.7%
Alzheimer’s Disease/Dementia/Memory Loss
44 57.1%
Social Isolation
42 54.5%
Poverty/Financial Insecurity
36 46.8%
Transportation
34 44.2%
Affordable Housing/Homelessness
26 33.8%
Injuries/Falls
26 33.8%
Mental/Behavioral Health Issues
21 27.3%
Financial Scams/Fraud
18 23.4%
Elder Abuse/Neglect
10 13.0%
Hunger/Food Insecurity
9 11.7%
Other
5 6.5%
Overweight/Obesity
2 2.6%
One key informant emphasized the complexity of the health care system, “The health care system and
services to support elders are increasing(ly) complex and difficult to navigate for those not working
within the system. The complexity of services, eligibility, and insurances are overwhelming for both
elders and those that care for them.”
Another key informant explained the effect of transportation on social isolation, “Only 5% of the
metropolitan city is covered by full-service public transportation. If you don’t have a car or can’t drive,
Westminster Canterbury Richmond – Senior Community Profile 2016 - 2017
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either anytime or at night, you are isolated. City and county can provide specialized transportation only
a little. No shopping. No wandering. Just isolation. No other major city in the world has this situation. It
is an artifact of deliberate racial segregation, now fully in place and no longer labeled as such. But now
and over the next decades, its victims will increase exponentially.” In addition, “Other” responses
included ageism, assistance with daily living activities, lack of knowledge of resources/activities, re-
hospitalization, and reliable/affordable long-term care.
Key informants were also asked to provide additional information regarding issues facing seniors in
their community and their reasons for ranking the aforementioned issues the way they did. The
following textbox summarizes select verbatim comments.
Select Comments Regarding the Most Pressing Issues Facing Seniors/Elderly
“A growing number of seniors have difficulty managing their finances to include appropriate
housing, insurance needs, and medical coverage- including prescription drug coverage.
Unfortunately, many seniors have to choose what area they spend their money; healthcare
associated costs continue to rise. Access to social services is likely limited for many, as some
seniors may not qualify for Medicaid or live in a setting where social services are offered.
Also, signing up for many medical services (insurance plans, Part D coverage) is online-
something that not all seniors are comfortable with at this time.”
“Chronic disease can lead to unemployment, social isolation, limited income, lack of food,
housing and financial concerns. Transportation to and from medical appointments and
errands is critical for those who do not have a vehicle or cannot drive due to health or other
reasons. Navigating the health care and social service system is a complaint that I hear often
in my work and is so complex for older adults, whether you are educated or not. It seems that
the five issues I chose all feed into each other and are most prevalent.”
“Seniors are afraid of memory loss/dementia in any form and want to know much more
about how they can sharpen their own brains and avoid deterioration. They also need and
want help in dealing with the intricacies of Dementia/Alzheimer’s when it confronts them in
themselves or in their family.”
“Transportation is a problem for seniors who cannot drive or whose comfortable driving
territory is shrinking. We have limited regional transportation and inadequate transportation
resources. This is a problem at all economic levels.”
“Chronic Disease Management is an issue when it impacts a senior or family member, and it
can often prevent engagement and social networking. We try to work with the issue of
chronic disease management in a supportive social environment and also introduce the
senior to other opportunities and activities as a part of management and rehabilitation.”
“Social Isolation is a real "fear" of some of our seniors, but mostly of those of us who know
what social isolation can do. It is not first in their minds, but it increases the risk of declining
health, increased dependency and decreased living skills.”
“Most of my members have pensions but are struggling with health issues and with not
wanting to leave their homes to move into assisted living facilities. They are isolated in their
homes but they don't want to move.”
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“Lack of knowledge and lack of someone offering solutions/resources keep many seniors at
home. They don't know where to start and after a while, they give up trying. Many don't use
the internet, our most flexible resource about what is possible. Many may not want to do an
activity that they know about but don't know what else might be available. Others don't
have a clue and finally stop thinking about it.”
“The Age Wave will present issues that we have never seen before. If quality is inconsistent,
adding more needy people could tip over the care system. Too many people are unprepared
and those that are still have to master a complex maze of providers where there's a wide gap
between quality and inadequate service. Living beyond your means is a major threat for
those who are living longer.”
“The impact of Alzheimer's Disease and other dementias on not only the person suffering
with the disease but the caregiver and family unit can be devastating - costly in both
individual personal suffering as well as economic and social costs overall. This issue
intersects with the lack of affordable housing as the assisted living end of that continuum in
that so many persons needing a supportive living environment but not yet requiring nursing
facility level care have few affordable options of dependable quality. Similarly, the lack of
easily accessible and affordable transportation options intersects with the problem of social
isolation as individuals get 'marooned in areas underserved by good aging/disability-friendly
public transportation. With rapid changes and increasing complexity in the health and
social service delivery network- with confusing options and obstacles - many older adults
struggle with finding clear dependable pathways to ensure continuity, quality, and
accessibility in care and support services to maintain maximum independence and quality of
life.”
Missing or Lacking Resources/Services
Key informants were asked to identify any resources or services that are missing or lacking in the
community to support seniors/elderly. The top three resources or services identified as missing or
lacking in the community are transportation, respite care, and caregiver support services. This
finding is consistent with other research findings in the field that older adults want to grow old in their
present residence, provided that the home and social environment supports the unique changes that
come along with aging. “Other” responses included affordability of services and housing, aging in place
options, navigating health care between numerous specialists, mental health services, more home
visiting and check-in services for the homebound. Many key informants acknowledge that there are a
number of these services available in the community. However, they questioned the affordability,
quality, and awareness of these services. One key informant explained, “There is a specific lack of
resources for people in the middle market - those who don’t qualify for subsidies and don’t have the
funds for private pay.”
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Table 63. Missing or Lacking Resources/Services According to Key Informants
Count Percent
Transportation
44 57.9%
Respite Care (Short-Term, Temporary Care
to Provide Relief to Caregivers)
39 51.3%
Caregiver Support Services
38 50.0%
Home Care Services (Assistance with
Bathing, Dressing, Eating)
31 40.8%
Intergenerational Programs (Interactive
Activities for Seniors & Children)
30 39.5%
Financial Management/Counseling Services
26 34.2%
Home Modification/Repair Services
25 32.9%
Home Health Care Services (Assistance with
Medical Needs)
22 28.9%
Adult Day Programs/Adult Daycare Centers
21 27.6%
Fitness and Wellness Programs
20 26.3%
Elder Fraud Prevention
20 26.3%
Social/Recreational Programs
19 25.0%
Legal Services
19 25.0%
Meal Preparation/Meal Delivery Services
18 23.7%
Lifelong Learning Opportunities
17 22.4%
Yard Maintenance Services
17 22.4%
Housekeeping Services (Cleaning, Laundry)
13 17.1%
Security
11 14.5%
Hospice/Palliative Care/Grief Counseling
10 13.2%
Other
9 11.8%
None
1 1.3%
Key informants were also asked to provide additional information regarding missing or lacking
resources/services for seniors in their community. Select verbatim comments from key informants are
provided in the box on the following page.
Select Comments Regarding Missing or Lacking Resources/Services
“All of these services and resources are available, maybe more will be needed, but they are
available. They aren't always affordable even for middle income seniors (or at least they
don't think they are affordable). They may be there, but THEY DON'T KNOW HOW TO FIND
THEM OR WHAT TO LOOK FOR. Transportation and respite care are both in short supply.
Yes we need more, but MORE won't help, if no one knows what is available.”
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“I believe the most important need is home care services provided by personal care assistants
or CNAs. These individuals lack proper training, adequate salary, health care insurance and
child care benefits. As a result, the health care field is lacking qualified individuals to provide
care for older adults who choose to remain living in their homes. Although this continues to
arise as a problem in Virginia, not enough is being done to improve the opportunities for
these assistants and the people they serve. As baby boomers age, this will be an ongoing
concern, as baby boomers will not want to live in a nursing facility to get care for activities of
daily living. They will want to live in their own homes.”
“In the above list, I would like to emphasize transportation. There also needs to be more
programming related to positive views on aging. Negative views on aging relates to physical
health outcomes as well as psychological. Stigma around aging and older people contributes
to isolation.”
“The older the person gets, the more centralized all these services need to be. I think the
retirement communities do a good job of providing the needed services, but these
communities are expensive. A more affordable (equivalent to their Medicare monthly
payment) and accessible option would serve the community and the aging well.”
“While I am not sure there is a 'shortage' of home health care or home care services, there
may be more specifically a lack of affordable home health care or home care services. There
is tremendous variation in terms of availability of certain services, depending on whether one
is examining urban, rural, or suburban areas. For example, while it does not appear that
there is an overall shortage of home health care, some rural areas experience home health
care shortage in terms of a lack of choice of providers.”
Anxiety about Aging and Ageism
Lastly, key informants also answered questions regarding their own anxiety about aging as well as the
prevalence of ageism, discrimination or prejudice on the basis of a person’s age, in the community.
Approximately 62% of key informants expressed mild to moderate anxiety about their own personal
anxiety. In terms of ageism, about 95% felt that ageism was somewhat or very prevalent in the
community. Only 5% believe that ageism is not present at all in the community. The prevalence of
ageism in a community can present many challenges for older adults. It can affect their choice,
independence, dignity, and negatively impact their overall quality of life.
Open-Ended Feedback
To conclude the survey, key informants were asked to provide open-ended feedback on what is being
done well in the community in terms of quality of life. The majority of key informants agreed quality
programs, services, and providers are available in the area. However, they are concerned with whether
older adults can access and/or afford these services. Transportation is still a big concern. Key informants
felt there is an adequate amount of volunteer opportunities available in the community as well. Both
Age Wave and Senior Connections were recognized as organizations trying to make an impact on the
quality of life of older adults. Below are select comments that were provided by key informants.
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In your opinion, what is being done well in the community in terms of quality of life?
(Community Assets/Strengths/Successes)
“A lot of volunteer opportunities.”
“As is probably the case in most communities, those that can afford to live well, do live
well. Lower income individuals often do not have needed services and supports. Faith-based
communities often do a better job of serving all individuals, regardless of income level.”
“Collaboration, prevention programs, intergenerational, person-centered approaches.”
“Excellent aging network between VCU Gerontology, Senior Navigator, Alzheimer's
Association, and other key organizations.”
“Henrico County has an advocate for the aging person who offers services to the elder
population. Henrico County also offers an EngAGE program.”
“I think that Senior Connections is doing a good job with trying their programs and there
are many other community agencies that are doing good things. I think there is an issue
with coordinating programs & with awareness of what is available.”
“Numerous support services and service providers are well informed of what they do/do not
do and how to refer to other appropriate services.”
“Overall, the city and surrounding counties in the Richmond area are age-friendly and offer
a wide variety of services and opportunities for their older residents. However, the city and
counties have pockets of poverty where folks do not have the same privileges as those who
are financially stable. In rural areas of Virginia, there is a significant lack of community
senior services, and social and medical services.”
“People at Westminster Canterbury and many other places from Senior Connections to the
Age Wave Coalition are addressing the good things. We have the beginnings of a good
bud/paratransit system but it is not complete. We have good services but many people do
not realize they need help until they cannot make the decision to reach out for them.
Affordable services is an issue.”
“Region wide Age Wave Plan, which collects assets and informs community.”
“Senior Connections is engaged in care planning for the community, but planning is in its
infancy and the governing bodies of localities are not engaged as they should be.”
“Special provisions to make the arts accessible and affordable to older adults. Some
opportunities for intergenerational sharing/support.”
“There are many people and organizations who are identifying specific needs in our
community. There is some overlap, but intentions are generally good and hopefully these
inquiries will result in direct, person-centered care for individuals.”
“Things appear better in the city, but skews toward the more affluent elderly. I may be less
aware of many programs, but I am very connected and active with social media and web
searches, which would not be the case with the elderly. I did a web search and it is better
than I thought. Transportation remains a critical issue.”
“Through work of the Age Wave Coalition, livable communities are being addressed.”
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Is there any additional information that you would like to provide regarding the needs of older
people or other populations in your community?
“Affordability with quality option.”
“I would like to emphasize the need for increased social connectedness. Also the need for
transportation options.”
“I would encourage Westminster Canterbury to work within their tether to the church and
its principles. As such, there should be some mechanisms to assist some individuals with
less resources. There should be flexibility in its services to meet the needs of the people.”
“The Age Wave planning group has done a good job of developing a plan and are working
hard to implement it. It would be great if there was more attention focused on the fact that
there is a plan and to further engagement in the business community and integrate efforts
between service providers, academia, and most notably governmental agencies.”
“The need to experience where they live as they would at home - Free to live and worship
according to their convictions, have privacy, direct how they are approached and receive
honor and deference from care providers and staff, which is not condescending or
patronizing, treating older adults as children.”
“There is a subset of older adults that seem to fall through the cracks and for whom there is
no niche: limited to moderate income, capacity for self-care in all ADLs including meals,
limited ability to drive and no public transportation.”
“Those who can afford to reside at WCR have the opportunity to reach out to other older
adults in their community who cannot afford to reside in a CCRC. I would encourage them
to continue to be a part of their community and offer their skills and services to those less
fortunate.”
“To say it again and another way: The absence of transportation is the great hidden factor
in metro Richmond's resources. Studies of available resources may make Richmond appear
well resourced -- in fact it is in many ways -- but because there is no normal accessibility
to these resources the studies are invalid.”
OLDER ADULT CONCLUSIONS Caregiving Services Age-Friendliness of Community
Open-Ended Feedback
Caregiving Services
Approximately 61% of survey respondents have personally had experience providing caregiving services
to a loved one. Those respondents that provided caregiving services to a loved one offered further
insight into the resources that were most important to supporting their care. Ninety-one comments
were provided. Of those 91 comments, the two most frequently mentioned resources were doctor or
other health care professional and family. Nearly 33% of the comments mentioned doctor while about
34% discussed family. Additional resources that were frequently mentioned included in home care or
home health (25%), church (16%), friends (16%), and hospice (15%). Still others occasionally mentioned
retirement communities, specifically assisted living, support groups, and the internet/information about
services.
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Age Discrimination and Age-Friendliness
Survey respondents were asked about both age discrimination as well as the age-friendliness of the
community. The majority of survey respondents have not experienced any discrimination due to their
age (69.4%). Yet still, nearly 31% of respondents say that they have experienced some form of age
discrimination. Despite this, nearly half of survey respondents (49.1%) feel the community is either
extremely or very age-friendly. Additionally, another 39% feel the community is at least somewhat age-
friendly. Only 12% feel it is not very or not at all age-friendly.
Open-Ended Feedback
Lastly, survey respondents were invited to provide open-ended feedback on their age-friendliness rating
and/or additional information to better understand their needs. Not surprisingly, given survey
respondents positive ratings for age-friendliness, many of the comments were positive. A number of
respondents feel they live in neighborhoods that are diverse in regard to age, regularly interact socially
with their neighbors, and that those they encounter are, for the most part, very helpful. Many feel they
have easy access to activities and that there is plenty to do in the area.
However, given this, there are a few concerns that came to light. While many respondents felt activities
and entertainment are plentiful in the area, it was acknowledged that this may be difficult for those
older to access if they don’t have good financial resources, have mobility issues, or don’t have
transportation. This may be why some did say they feel socially isolated. Furthermore, a few did feel that
there aren’t always activities available that are specifically targeted at older adults.
Transportation and employment were the most frequently mentioned concerns within the open-ended
feedback. Respondents feel there is a lack of transportation in the area particularly for those who may
live in more rural areas. This can be a challenge in trying to access the entertainment venues and
activities in the area. Employment was another concern mentioned by some respondents. Those who
expressed concern for employment did not feel jobs were readily available in the community. However,
some also did feel that they experience discrimination due to their age at work but not necessarily in
other aspects of their lives. Below are select comments that were provided by survey respondents.
Select Comments Regarding Age-Friendliness or Additional Needs
“Accessibility to public transportation and non ADA compliance.”
“As we take walks we see neighbors and our neighborhood has numerous social events.”
“Diverse neighborhood Middle aged as well as older adults helping one another.”
“Downtown isn't safe or easy to navigate regardless of age, but is of more concern as I get
older.”
“Employment field difficult.”
“Great young neighbors who are available and willing to help with things like shoveling
snow and changing light bulbs high up.”
“I am a professional who wishes to continue my career and grow--in the workplace; I find a
bias against women who are older. The community is otherwise age-friendly.”
“I am isolated in the country and only go into the city when it requires a doctor's
appointment or business.”
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“I don't feel like I'm treated differently at my church, at the gym or in the community due
to my age.”
“I don't know of a lot of events/activities going on throughout the community that are
specifically targeted towards aging and older adults.”
“I live in a more rural area so it is not possible to walk to any stores/services.”
“I participate in my local country club which has several age friendly opportunities. My
church also offers the same opportunities. Plus my neighborhood has a good mix of age
groups.”
“I'm not familiar with many of the resources available throughout the community for older
adults.”
“In restaurants & other convenience-type shopping places, I am very often referred to as
"Honey", "Dear", etc. which is not respectful to the elderly.”
“Lack of transportation. Also rural environment makes it difficult to make seniors aware of
resources that are local.”
“Living independently requires mental and physical agility. At some point those begin to
fail, and changes will need to be made. We would prefer to be independent, of course, but
need to be realistic.”
“Most of my current needs are available to me within a 10-15 mile radius. I still drive so
can get to most anything I care to be at. It would be a different matter if I could not drive
myself.”
“No multicultural activities or help in the community for older adults who speak English as
a second language.”
“Some resources, but limited. Resources can be difficult to identify & access can be limited
to low income. Middle income or limited income w/o impoverishment have few resources
to assist.”
“The community I live in has many people of many age group and we have several
community groups that bring us together.”
“There many civic, churches and independent people that are willing to help. Senior
discounts at restaurants and adult day care also available. My biggest problem is
transportation. There is very little transportation here.”
“This is a small community where many of us have "aged" together and know each other.
There are several communities that are designated 55 or older in the community. The
county Parks and Recreation has programs geared toward older citizens. Senior
Connections opened a friendship Café here within the last 2 years. Many churches in the
area have Senior Groups and/or activities.”
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Appendix A. Secondary Data Profile References
American Lung Association. (2016). State of the air. Retrieved from
http://www.lung.org/our-initiatives/healthy-air/sota/city-rankings/states/virginia/
CDC Wonder (2014). Leading causes of death by state and county. Retrieved from
http://wonder.cdc.gov/
Centers for Disease Control and Prevention. (n.d.). Behavioral risk factor surveillance system.
http://www.cdc.gov/brfss/
Centers for Medicare & Medicaid Services. (2014). County reports. Retrieved from
http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-
Reports/Chronic-Conditions/MCC_Main.html
Community Commons. Community Health Needs Assessment. Retrieved from
http://www.communitycommons.org/
County Health Rankings & Roadmaps. (2016). Virginia. Retrieved from
http://www.countyhealthrankings.org/app/virginia/2016/overview
National Cancer Institute (2009-2013). Cancer incidence and mortality. Retrieved from
http://www.statecancerprofiles.cancer.gov/index.html
The Nielsen Company. (2016). Senior life 2016. Retrieved from
https://answers.nielsen.com/
U.S. Census Bureau. (n.d.). American fact finder. Retrieved from
http://factfinder2.census.gov/faces/nav/jsf/pages/index.xhtml
U.S. Department of Health and Human Services. (2014). Healthy people 2020. Retrieved from
http://www.healthypeople.gov/2020/default.aspx
Virginia Department of Health. (n.d.). Behavioral risk factor surveillance system. Retrieved from
http://www.vdh.virginia.gov/brfss/
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Appendix B. Secondary Data Terminology
Age-Specific Rate – Age-specific rates are calculated in the same manner as crude rates, but the
number of cases or deaths and the population are based on a specific age group.
Crude Rate - Generally defined as the total number of cases or deaths divided by the total population
at risk. Crude rate is generally presented as per populations of 1,000, 10,000 or 100,000. It is based on
raw data and does not account for characteristics such as age, race, and gender.
Family - Defined as more than one person living together, either as relations or as a married couple.
Frequency - Often denoted by the symbol “N,” frequency is the number of occurrences of an event.
Household - Defined as one or more people sharing a residence. Examples include college students
sharing an apartment or a single male living alone.
Incidence Rate - Indicates the number of new disease cases in a specified amount of time. Time is
determined by the number of years candidates for the disease are observed before they are diagnosed.
Poverty Guidelines - A version of the federal poverty measure. They are issued each year by the
Department of Health and Human Services. The guidelines are a simplification of the poverty thresholds
for use for administrative purposes (determining financial eligibility for federal programs).
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Appendix C. Key Informant Participants
Name Agency
Heidi Abbott, Esq. Hunton & Williams LLP
Gigi Amateau United Way
Melissa Andrews Leading Age Virginia
Beth Barber Commonwealth Council on Aging
Joann Bawiec Bon Secours Memorial College of Nursing
Mr. and Mrs. Gregg Beck Thalhimer Commercial Realty
Will Blackwell Westminster Canterbury Richmond
Devin Bowers Virginia Department for Aging and
Rehabilitative Services
Susan Brown Davis The Community Foundation Serving Richmond
and Central VA
Amy Burkett Department of Medical Assistance Services
(DMAS)
Rev. Ben Campbell Richmond Hill
Chief Humberto I. Carsounel, Jr. Henrico County Police Division
Anne Chan Sheltering Arms Rehab Center
Eileen Ciccotelli Virginia Business Coalition on Health
Carolyn Comerford Senior Center of Greater Richmond
Constance Coogle, Ph.D. Virginia Center on Aging
Bob Cox Westminster Canterbury Richmond
Jeff Cribbs Richmond Memorial Health Foundation
David DeBiasi, RN AARP
Rev. Dr. Alex Evans Second Presbyterian Church
Vicki Fowler Westminster Canterbury Richmond
Russel Gardner Westminster Canterbury Richmond
Tracey Gendron VCU Department of Gerontology
Rob Goodall NET 30
Suzanne Hall St. James's Episcopal Church
Mary Hawley Westminster Canterbury Richmond
Jay Holdren VCU Department of Internal Medicine
Lee Householder project_HOMES
Rev. Bobby Humle-Lippert Grace Covenant Presbyterian Church
Debra Jacobsen Westminster Canterbury Richmond
Christine Jensen Riverside Center for Excellence in Aging and
Lifelong Health (CEALH)
Adrienne Johnson SeniorNavigator
Rev. Gary Jones St. Stephens Episcopal Church
Brint Keyes Overbrook Presbyterian
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Name Agency
Marie Kolendo Greater Richmond Chapter of the Alzheimer's
Association
Emily Krause Westminster Canterbury Richmond
Joani Latimer Virginia Department for Aging and
Rehabilitative Services
The Rev. Larry E. Lenow Trinity United Methodist Church
Sloan Lindsey Westminster Canterbury Richmond
Teri Lovelace Virginia Community Capital
Beth Ludden Genworth Financial Inc.
Amy Marschean, J.D. Virginia Department for Aging and
Rehabilitative Services
Lynn McClintock Westminster Canterbury Richmond
Karen Moeller VCU Department of Gerontology
Andrew Moore Glave & Holmes Architecture
Angie Phelon Senior Connections
Sharon Poznanczyk Westminster Canterbury Richmond
Katherine Ramsey, Esq. Virginia Estate and Trust Law
Susan Revere R.A.M.P.S: Ramp Access Made Possible by
Students
Rev. Phoebe Roaf St. Phillips Episcopal Church
Ramona Schaeffer Centers for Disease Control and Prevention
Tom Silverstri Richmond Times-Dispatch
John Swierczewski Covenant Home Care
The Rev. Dr. Alexander Tartaglia Virginia Commonwealth University
Beth Travis Westminster Canterbury Richmond
John Vithoulkas Henrico County
Marilyn West M.H. West & Co., Inc.
Jay White A Grace Place Adult Care Center
Debbie Whitmore Westminster Canterbury Richmond
Colleen Wilhelm Family Lifeline
Jonathan Zur The Virginia Center for Inclusive Communities
Unidentified Participant N/A
Unidentified Participant N/A
Unidentified Participant N/A
Unidentified Participant N/A
Unidentified Participant N/A
Unidentified Participant N/A
Unidentified Participant N/A
Unidentified Participant N/A
Unidentified Participant N/A
Unidentified Participant N/A
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Name Agency
Unidentified Participant N/A
Unidentified Participant N/A
Unidentified Participant N/A
Unidentified Participant N/A
Unidentified Participant N/A
Unidentified Participant N/A
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Appendix D. Demographics of Older Adult Survey Participants
Demographics
Location
Richmond City 47.0%
Henrico County 34.0%
Chesterfield County 13.6%
Goochland County 0.6%
Hanover County 2.1%
Powhatan County 0.6%
Other 2.1%
Gender
Male (N=79) 23.7%
Female (N=254) 76.3%
Age
55 – 64 (N=71) 21.3%
65 – 74 (N=127) 38.1%
75 – 84 (N=95) 28.5%
85 or older (N=40) 12.0%
Marital Status
Single (never married) (N=34) 10.3%
Married (N=124) 37.5%
Not married, living with partner (N=20) 6.0%
Separated (N=24) 7.3%
Divorced (N=58) 17.5%
Widowed (N=71) 21.5%
Health Insurance*
Insurance through a current employer of yours or your spouse
(N=88) 26.6%
Insurance purchased directly from an insurance company (not
through an employer) (N=77) 23.3%
Medicare or Medicaid or any kind of government assistance plan
(N=218) 65.9%
Veterans Administration or other military health care (N=33) 10.0%
Any other insurance coverage (N=89) 26.9%
Disability
Yes (N=91) 27.7%
No (N=237) 72.3%
* Respondents could select more than one option, therefore the percentages may sum to more than 100.0%.
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Demographics, (Cont’d)
Race/Ethnicity*
White (N=205) 62.5%
Black or African American (N=109) 33.2%
American Indian or Alaska Native (N=5) 1.5%
Native Hawaiian or other Pacific Islander (N=2) 0.6%
Asian (N=6) 1.8%
Hispanic or Latino (N=17) 5.2%
Other (N=4) 1.2%
Education Level
Never attended school (N=2) 0.6%
Grades 1 – 8 (elementary school) (N=0) 0.0%
Grades 9 – 11 (some high school, but no diploma) (N=15) 4.5%
Grade 12 (High school diploma or GED) (N=53) 16.1%
Some college, technical or vocation school (N=51) 15.5%
Associate’s degree (N=51) 15.5%
4-year college degree (N=89) 27.0%
Graduate or professional-level degree (N=63) 19.1%
Other (N=6) 1.8%
Income
Less than $10,000 (N=25) 7.8%
$10,000 to $19,999 (N=25) 7.8%
$20,000 to $29,999 (N=50) 15.6%
$30,000 to $49,999 (N=58) 18.1%
$50,000 to $74,999 (N=57) 17.8%
$75,000 to $99,999 (N=37) 11.6%
$100,000 to $149,999 (N=29) 9.1%
$150,000 or more (N=39) 12.2%
* Respondents could select more than one option, therefore the percentages may sum to more than 100.0%.
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Demographics (Cont’d)
Zip Code Representation
Zip Code % Zip Code %
23220 10.7% 23236 0.9%
23227 9.8% 23838 0.9%
23219 8.3% 23173 0.6%
23231 5.0% 23232 0.6%
23222 4.5% 23282 0.6%
23229 4.2% 23284 0.6%
23233 3.9% 23297 0.6%
23218 3.3% 23288 0.6%
23226 3.3% 23059 0.6%
23221 3.0% 23063 0.6%
23075 3.0% 23111 0.6%
23225 2.7% 23241 0.3%
23060 2.7% 23260 0.3%
23223 2.4% 23286 0.3%
23230 2.4% 23295 0.3%
23113 2.4% 23238 0.3%
23235 2.1% 23242 0.3%
23237 2.1% 23255 0.3%
23832 2.1% 23069 0.3%
23294 1.8% 23103 0.3%
23224 1.5% 23114 0.3%
23150 1.5% 23139 0.3%
23112 1.5% 23803 0.3%
23234 1.5% 23831 0.3%
23116 1.2% 23875 0.3%
23228 0.9% 23894 0.3%
23141 0.9% 24529 0.3%