Embargo Period


Degree Name

MA in Global Health

First Advisor

Dr. Chris Kurian


Despite the rapid growth in the aging population in the United States, insufficient resources and attention are invested in improving the support systems this population relies on. This discussion explored the question of how the United States as a high-income country fails to operate an aging care support infrastructure that has comparable comprehensiveness, availability, affordability, and overall quality to other high-income countries. Comparing financing structures, long-term care models, and various aging care supports is important for answering this question. This paper approached exploring this question by analyzing specified indicators from publicly available data across the United States, Germany, and Denmark. Moreover, these data were contextualized through historical evaluations of connections between aging care policies and sociopolitical dynamics. By creating a self-defined matrix of aging care system quality factors, this study found that the United States lags far behind Denmark and Germany in areas such as reimbursing family caregivers, supporting people in staying at home, care affordability, and technology adoption that encourages independence. This analysis contributes to the existing body of knowledge by concluding that although it is infeasible to directly implement another country’s model, differences in critical aging care elements highlight opportunities for the United States. These are used to propose politically viable solutions for the United States, while also creating an appreciation of the shared challenge of normalizing discussions around mortality to have end-of-life care outcomes better match end-of-life wishes; this is a critical challenge in improving system quality while also driving down costs, which lies ahead for each country. Moreover, by focusing on systems rather than the quality of care, this paper brings the discussion of aging care into political discourse and imparts upon the reader a sense of urgency for change.

Keywords: aging care, path dependency, health systems, long-term care


Community Health | Community Health and Preventive Medicine | Geriatrics | Health and Medical Administration | Health Policy | Health Services Research | Other Public Affairs, Public Policy and Public Administration | Public Health Education and Promotion