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Poll: Sandwich Generation Worried About Own Long-Term Care

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In this photo taken Monday, July 6, 2015, Kamila Al-Najjar, center, visits with her mother, Joan Groen, right, at her assisted living facility as her daughter, Inanna Al-Najjar, 14, left, looks on in Santa Rosa, Calif.  Caught between kids and aging parents, a new poll shows the sandwich generation worries more than most Americans their age about how they'll afford their own care as they grow older.  (AP Photo/Eric Risberg)

In this photo taken Monday, July 6, 2015, Kamila Al-Najjar, center, visits with her mother, Joan Groen, right, at her assisted living facility as her daughter, Inanna Al-Najjar, 14, left, looks on in Santa Rosa, Calif. Caught between kids and aging parents, a new poll shows the sandwich generation worries more than most Americans their age about how they’ll afford their own care as they grow older. (AP Photo/Eric Risberg)

LAURAN NEERGAARD, AP Medical Writer

WASHINGTON (AP) — Caught between kids and aging parents, the sandwich generation worries more than most Americans their age about how they’ll afford their own care as they grow older, a new poll shows. But most aren’t doing much to get ready.

Nearly 1 in 10 people age 40 and over are “sandwiched” — they’re supporting a child while providing regular care for an older loved one, according to the poll by The Associated Press-NORC Center for Public Affairs Research.

Another 8 percent may join the ranks of double-caregivers in the next five years, citing declining health of an older relative or close friend.

Dueling responsibilities can make some days feel like a tug-of-war.

“If my mom needs something badly, I get pulled away from my kids a lot,” said Kamila Al-Najjar of Santa Rosa, California, a lawyer with two children and self-described health advocate for her mother. She visits her mother’s assisted living facility at least twice a week and checks in daily by phone, to oversee a list of illnesses.

“You’re dealing with someone who is aging, toward the end of their life; then you have to deal with a teenager. I hear from my mom and daughter that I’m a nag. There’s no winning in it,” she said.

Adding to the challenge, 40- and 50-somethings tend to be at the height of their careers — and need to hang onto their jobs despite difficulties of caregiving, said Susan Reinhard, who directs AARP’s Public Policy Institute. Employer flexibility is a top issue as the population ages, she said.

“It’s not just their own financial security, it’s the financial security for their children and for the future,” Reinhard said.

After age 65, government figures show nearly 7 in 10 Americans at some point will need long-term care — from a relative, home aide, assisted living or nursing home.

Yet the AP-NORC Center poll found overall, most Americans 40 and older — 54 percent — have done little or no planning to get ready for this often pricey reality. Only a third reports setting aside money for those needs. That’s even though Medicare doesn’t pay for the most common types of long-term care, and a nursing home can cost more than $90,000 a year.

Drill down to the 9 percent of this age group who make up the sandwich generation, and their experience leaves them far more concerned about their own senior years.

About half worry about being able to pay for their future care needs or having to move into a nursing home, compared with just over a third of other adults, the poll found. Also, 44 percent of sandwichers fear leaving debts to family, compared with 28 percent of others polled.

But the poll found the sandwich generation no more likely than other middle-aged adults to be planning and saving, possibly because of time or resources.

Al-Najjar is glad her mother “saved all her life … so she didn’t have to stress out about stuff like that.” Caring for her has changed how she spends and plans for the future.

“It’s like a wake-up call,” she said. There are “a lot of seniors in the United States that don’t have that money.”

The squeeze isn’t ending as children grow up. Among currently sandwiched parents, 29 percent have adult children living at home, the poll found; others are providing adult children with financial assistance, meaning some are sandwiched even after their children leave the nest.

Another challenge: Finding services to help seniors live out their days at home. AARP recently opened an online “livability index” to rank communities on such factors as accessible housing and transit options.

And the National Association for Area Agencies on Aging runs an Eldercare Locator — at www.eldercare.gov and 1-800-677-1116 — to help people find local resources. Last year, the locator averaged more than 22,000 requests for assistance a month. A recent report found the top needs: transportation, mostly to get to doctor appointments; in-home services, such as meals and personal care; and finding affordable housing or making age-friendly home modifications.

“People don’t generally make these calls until they’re in crisis,” said association CEO Sandy Markwood. “If mom and dad need this as they get older, you should prepare for that, too.”

Carroll Burnett of Whitesboro, Texas, cared for his 88-year-old father, who’d suffered a stroke, for a year before he died in March.

“I felt good that I could take care of him,” said Burnett, a retired tool and die maker who had help from his wife and one of his three grown children. But he’s saving up: “I don’t want any of my kids to go through what I did.”

The AP-NORC Center survey was conducted by telephone April 7 to May 15 among a random national sample of 1,735 adults age 40 or older, with funding from the SCAN Foundation. Results for the full survey have a margin of sampling error of plus or minus 3.2 percentage points.

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Associated Press writer Stacey A. Anderson and AP news survey specialist Emily Swanson contributed to this report.

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Online: http://www.longtermcarepoll.org

Copyright 2015 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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Activism

COMMENTARY: The Biases We Don’t See — Preventing AI-Driven Inequality in Health Care

For decades, medicine promoted false assumptions about Black bodies. Black patients were told they had lower lung capacity, and medical devices adjusted their results accordingly. That practice was not broadly reversed until 2021. Up until 2022, a common medical formula used to measure how well a person’s kidneys were working automatically gave Black patients a higher score simply because they were Black. On paper, this made their kidneys appear healthier than they truly were. As a result, kidney disease was sometimes detected later in Black patients, delaying critical treatment and referrals.

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Sen. Akilah Weber Pierson, M.D (D-San Diego). File photo. Sen. Akilah Weber Pierson, M.D (D-San Diego). File photo.
Sen. Akilah Weber Pierson, M.D (D-San Diego). File photo.

By Sen. Akilah Weber Pierson, M.D., Special to California Black Media Partners 

Technology is sold to us as neutral, objective, and free of human flaws. We are told that computers remove emotion, bias, and error from decision-making. But for many Black families, lived experience tells a different story. When technology is trained on biased systems, it reflects those same biases and silently carries them forward.

We have seen this happen across multiple industries. Facial recognition software has misidentified Black faces at far higher rates than White faces, leading to wrongful police encounters and arrests. Automated hiring systems have filtered out applicants with traditionally Black names because past hiring data reflected discriminatory patterns. Financial algorithms have denied loans or offered worse terms to Black borrowers based on zip codes and historical inequities, rather than individual creditworthiness. These systems did not become biased on their own. They were trained on biased data.

Healthcare is not immune.

For decades, medicine promoted false assumptions about Black bodies. Black patients were told they had lower lung capacity, and medical devices adjusted their results accordingly. That practice was not broadly reversed until 2021. Up until 2022, a common medical formula used to measure how well a person’s kidneys were working automatically gave Black patients a higher score simply because they were Black. On paper, this made their kidneys appear healthier than they truly were. As a result, kidney disease was sometimes detected later in Black patients, delaying critical treatment and referrals.

These biases were not limited to software or medical devices. Dangerous myths persisted that Black people feel less pain, contributing to undertreatment and delayed care. These beliefs were embedded in modern training and practice, not distant history. Those assumptions shaped the data that now feeds medical technology. When biased clinical practices form the basis of algorithms, the risk is not hypothetical. The bias can be learned, automated, and scaled.

For us in the Black community, this creates understandable fear and mistrust. Many families already carry generational memories of medical discrimination, from higher maternal mortality to lower life expectancy to being dismissed or unheard in clinical settings. Adding AI biases could make our community even more apprehensive about the healthcare system.

As a physician, I know how much trust patients place in the healthcare system during their most vulnerable moments. As a Black woman, I understand how bias can shape experiences in ways that are often invisible to those who do not live them. As a mother of two Black children, I think constantly about the systems that will shape their health and well-being. As a legislator, I believe it is our responsibility to confront emerging risks before they become widespread harm.

That is why I am the author of Senate Bill (SB) 503. This bill aims to regulate the use of artificial intelligence in healthcare by requiring developers and users of AI systems to identify, mitigate, and monitor biased impacts in their outputs to reduce racial and other disparities in clinical decision-making and patient care.

Currently under consideration in the State Assembly, SB 503 was not written to slow innovation. In fact, I encourage it. But it is our duty must ensure that every tool we in the healthcare field helps patients rather than harms them.

The health of our families depends on it.

About the Author 

Sen. Akilah Weber Pierson (D–San Diego) is a physician and public health advocate representing California’s 39th Senate District.

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Activism

As California Hits Aging Milestone, State Releases Its Fifth Master Plan for Aging

“California’s Master Plan for Aging started a powerful movement that is shaping the future of aging in our state for generations to come,” Gov. Gavin Newsom said in a statement, calling the initiative a “future-forward” model delivering real results for older adults, people with disabilities, and their families.

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iStock.
iStock.

By Bo Tefu, California Black Media  

On Jan. 27, California released its Fifth Master Plan for Aging Annual Report,titled “Focusing on What Matters Most,” outlining the state’s progress and priorities as its population rapidly grows older.

The report, issued by the California Health and Human Services Agency (CalHHS), provides updates on the Master Plan for Aging’s “Five Bold Goals”: housing, health, inclusion and equity, caregiving, and affordability.

The report comes as Californians aged 60 and older now outnumber those under 18 for the first time, a demographic shift expected to accelerate over the next decade.

“California’s Master Plan for Aging started a powerful movement that is shaping the future of aging in our state for generations to come,” Gov. Gavin Newsom said in a statement, calling the initiative a “future-forward” model delivering real results for older adults, people with disabilities, and their families.

Launched in 2021, the Master Plan for Aging takes a “whole-of- government” and “whole-of-society” approach, coordinating state agencies, local governments, community organizations, and private partners. The annual report highlights significant milestones, including more than 100 California communities joining AARP’s Age-Friendly Network and $4 million in state funding awarded to local organizations to develop aging and disability action plans in 30 communities statewide.

The report also underscores California’s leadership at the national level, noting that dozens of states have followed its example and that federal legislation inspired by the plan was reintroduced in the U.S. Senate in December 2025.

CalHHS Secretary Kim Johnson emphasized the plan’s focus on equity and resilience amid ongoing challenges.

“The Master Plan for Aging continues to provide a vision, a focus, and a platform for collaboration,” Johnson said. “Equity is at the center of all that we do.”

Looking ahead, the report notes that by 2030, one in four Californians will be age 60 or older, positioning the Master Plan for Aging as a central framework for meeting the state’s long-term social, economic, and health needs.

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Community

Candidates Vying for Governor’s Seat Debate at Ruth Williams–Bayview Opera House in San Francisco

The gubernatorial debate participants included Antonio Villaraigosa, former Los Angeles mayor; Matt Mahan, San Jose mayor; Betty Yee, former California state controller; Xavier Becerra, former U.S. Secretary of Health and Human Services, and attorney general of California; Steve Hilton, political commentator and political adviser; Tom Steyer, entrepreneur, and Tony Thurmond, California’s superintendent of public instruction.

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The gubernatorial debate was hosted by KTVU’s Greg Lee, KTTV’s Marla Tellez and KTVU’s Andre Senior. The candidates are (l.-r.): Xavier Becerra, Steve Hilton, Matt Mahan, Tom Steyer, Tony Thurmond, Antonio Villaraigosa, and Betty Yee.
The gubernatorial debate was hosted by KTVU’s Greg Lee, KTTV’s Marla Tellez and KTVU’s Andre Senior. The candidates are (l.-r.): Xavier Becerra, Steve Hilton, Matt Mahan, Tom Steyer, Tony Thurmond, Antonio Villaraigosa, and Betty Yee.

By Carla Thomas 

 

On Tuesday, Feb. 3, seven candidates took the stage at the historic Ruth Williams–Bayview Opera House in San Francisco for the gubernatorial debate, hosted by the Black Action Alliance (BAA) in partnership with KTVU and sister station KTTV Fox 11 in Los Angeles.

 

For many voters, it marked a first opportunity to hear directly from several candidates seeking to lead the nation’s most populous state.

 

The gubernatorial debate participants included Antonio Villaraigosa, former Los Angeles mayor; Matt Mahan, San Jose mayor; Betty Yee, former California state controller; Xavier Becerra, former U.S. Secretary of Health and Human Services, and attorney general of California; Steve Hilton, political commentator and political adviser; Tom Steyer, entrepreneur, and Tony Thurmond, California’s superintendent of public instruction.

 

Crucial topics and issues addressed throughout the debate included housing, crime, immigration, climate change, health care and homelessness.

 

The debate was moderated by KTVU political reporter Greg Lee alongside KTVU’s Andre Senior and KTTV Fox 11’s Marla Tellez.

 

Candidates also addressed inflation and the rising costs across the state, impacting everything from groceries to childcare and health care. 

 

Thurmond vowed to generate 2.3 million units of housing by placing 12 units on each parcel of available land in the 58 counties of California. Steyer agreed that billionaires should pay their fair share of taxes.

 

Hilton wanted to cut taxes, help working-class families, and end the Democrats “climate crusade and insane regulations.”

 

Yee offered a more transparent governmental approach with accountability, given the state’s debt.

 

Gonzalez said, “This debate was a great way to see who has great ideas and who has substance.”

 

“It’s important to have the debate within a community that requires the most,” said business leader Linda Fadekye.

 

Attendees included State Controller Malia Cohen, representatives of the National Coalition of 100 Black Women, the National Coalition of 100 Black Men, the San Francisco African American Chamber of Commerce, and Black Women Organized for Political Action, among others. 

 

Event host, the Black Action Alliance (BAA) was established to amplify the voices of the Bay Area’s Black community, whose perspectives have too often been overlooked in politics and public policy.  

 

Loren Taylor, CEO of BAA, said it was important to bring the event to the Bayview in San Francisco and shared his organization’s mission.

 

“The Black Action Alliance (BAA) stands for practical, community-driven solutions that strengthen public safety, address homelessness, support small businesses, expand affordable housing, and ensure access to quality education—issues at the heart of the Black experience in the Bay Area,” said Taylor. 

 

California’s primary election will take place on June 2 and the general election will take place on Nov. 3. 

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