Health and aging: gaps in public policy for older adults

Abstract

The study aimed to analyze the effectiveness of public health policy directed at older adults in the canton of Santo Domingo during the year 2024. It sought to identify existing gaps between the legal framework and its practical application, as well as to evaluate the capacity of these policies to guarantee the fundamental right to health for this age group. A mixed-methods approach was adopted, incorporating both qualitative and quantitative methodologies. On the qualitative level, the national and international regulatory frameworks were analyzed, along with relevant case law. On the quantitative level, empirical data were collected through surveys administered to older adults and interviews with key stakeholders. The research design was non-experimental, cross-sectional, and descriptive in scope, allowing for the characterization of the local and social context in which these policies are implemented. The results revealed a sustained growth in the older adult population, both nationally and in Santo Domingo, with a notable feminization of aging. Despite normative and programmatic advances identified in the Development Plan for the New Ecuador 2024–2025, weak implementation of public health policies was observed, characterized by budgetary shortfalls, a shortage of human resources, and limited coverage. It was found that 75% of older adults lacked health insurance, and 22% did not access health services. The study concluded that although the legal framework is solid, structural vulnerabilities persist that limit access to dignified healthcare. It recommended strengthening funding, decentralizing services, and creating effective oversight mechanisms to guarantee the rights of this vulnerable population.