AgeSmart Blog

From Settlement Houses to Social Security Reform

Long before there was an Older Americans Act, senior centers, and Meals on Wheels, there were women who saw members of their community being overlooked and decided that was unacceptable.

In Chicago, Jane Addams opened Hull House in 1889. It was not labeled “social services.” It was community care in its earliest organized form. Neighbors helping neighbors. Meals shared. Health clinics established. Education offered. Advocacy pursued. The idea that people deserve dignity at every stage of life was baked into the foundation. Because of her compassion and commitment to her community, she’s often thought of as the Mother of Social Work and was awarded the Nobel Peace Prize in 1931.

Hull House became more than a building. It became a crossroads. Ideas traveled outward from its rooms and into legislation.

Hull House gathered reformers, educators, labor advocates, and future policymakers under one roof, many of whom would go on to shape national policy.

Among them was Frances Perkins, whose experience there shaped her belief that government must respond to economic insecurity. As the first woman to serve in a U.S. Cabinet, she became the driving force behind the Social Security Act, forever changing the financial stability of older Americans.

Another was Ethel Percy Andrus, who later organized retired Americans into a powerful advocacy movement. In 1958, she founded AARP. Her philosophy was clear and radical for its time: older adults are not dependents. They are contributors, consumers, and citizens.

Her advocacy helped shift the national narrative from charity to rights and security. She built the expectation that aging policy deserved national attention.

Communities Were Already Doing the Work

Long before federal funding, neighbors were caring for neighbors.

Programs like Meals on Wheels began at the grassroots level. One of the earliest U.S. programs began in Philadelphia in 1954, organized by Margaret Toy and powered by volunteers delivering meals to homebound residents.

Senior centers emerged in the 1940s and 1950s, offering programming specifically for older adults.

Communities proved the model worked. They demonstrated that nutrition, socialization, transportation, and caregiver support were not luxuries. They were lifelines.

Movements first. Law second.

Before There Was a Law, There Was Evidence

By the mid-20th century, poverty among older Americans was widespread. But problems do not become policy until someone measures them and refuses to look away. By the time Congress acted, the case had already been made.

Lenore Epstein, a Social Security Administration researcher, documented the economic vulnerability facing older adults. Her data made aging visible in a way Congress could not ignore.

At the same time, state leaders such as Mary Mulvey in Rhode Island were shaping the early administrative frameworks that would later support a national aging network.

Across the country, civil rights leaders were also pressing for economic justice that would shape aging policy. Dorothy Height, longtime president of the National Council of Negro Women, advocated for the economic security and dignity of older Black women, ensuring that conversations about poverty and public benefits reflected the realities of aging in communities of color. The movement for aging justice did not unfold separately from the broader fight for civil rights. It evolved alongside it.

By the early 1960s, the groundwork had been laid:

Researchers had documented need.
Advocates had organized constituents.
Communities had piloted solutions.
Leaders had built coalitions.

The lift had already happened.

Then the Law

In 1965, Lyndon B. Johnson signed the Older Americans Act into law. The OAA formalized and funded Area Agencies on Aging and strengthened senior centers, nutrition programs, transportation, legal assistance, caregiver support, and later the Long-Term Care Ombudsman Program.

The law did not invent the work. It scaled it.

The Older Americans Act was carried there by data, advocacy, and the persistent work of women who refused to accept neglect as inevitable.

And Then Women Kept Building

Laws do not run themselves.

The aging network requires constant advocacy, management, and modernization.

Nationally, Mary Lazare, who spent many years leading and growing long-term care and home and community-based services in the St. Louis region, serves as the senior official performing the duties of the Administrator and Assistant Secretary for Aging at the Administration for Community Living, overseeing federal aging and disability programs.

In Illinois, Mary Killough leads the Division on Aging and is guiding Engaging Illinois, the state’s multi-sector plan on aging, ensuring Older Americans Act resources reach communities across the state.

And here in Southwestern Illinois, the work continues through organizations rooted in our towns:

• Case managers at Southwestern Illinois Visiting Nurses navigate complex care systems.
• Benefits counselors at the Clinton County Senior Services secure Medicare Savings Programs and SNAP.
• Nutrition coordinators at Senior Services Plus organize congregate and home-delivered meals.
• Transportation staff at South Central Transit ensure medical appointments are kept.
• Caregiver specialists at St. John’s Community Care provide stability during crisis.

At AgeSmart Community Resources, we see this legacy unfolding every day. The women leading this work are not historical figures. They are here. They are strategic. They are steady.

Together, we carry forward the work Jane Addams, Frances Perkins, Ethel Percy Andrus, Margaret Toy, Lenore Epstein, and Mary Mulvey began and entrusted to us.

Who Will Carry It Forward?

The women who built the aging network did not wait for someone else to solve the problem. They did the research, built coalitions, organized constituents, drafted frameworks, and sustained programs.

Today, we face workforce shortages across aging services and healthcare just as demand is rising. Just this month, two respected leaders in our region, in Okawville and Belleville, announced their retirements, leaving important leadership positions to fill.

Careers in aging extend beyond social services. They include:

• Nursing and geriatric medicine
• Physical and occupational therapy
• Public health
• Nutrition science
• Health administration
• Transportation coordination
• Benefits counseling
• Policy development
• Data analysis
• Technology supporting aging in place

Illinois helped shape the early reform movement. Our region continues to produce national leadership. The next generation of professionals will determine how strong this network remains.

The women who built the aging network proved something essential: aging policy does not happen by accident. It happens because people commit to it.

This Women’s History Month and Careers in Aging Month, we honor the women who lifted this system into existence.

And we invite the next wave of women and men across Illinois to step forward.

Because movements begin with people.

Laws follow.

And the work continues.