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POVERTY

Including out-of-pocket medical expenses, about one in seven seniors lives in poverty. Poverty influences environmental exposures and health-related behaviors, and is associated with increased risk of mortality and chronic disease. Low-income seniors have a harder time paying for appropriate chronic disease management and preventive care, and often have low health literacy. Many seniors live on limited incomes, have modest savings, and struggle with rising costs of housing and health care as well as access to healthy food and reliable transportation. Among seniors, poverty rates increase with age, are higher for women than men, and for blacks and Hispanics versus whites.


Data source: American Community Survey, 2014 For details: http://www.americashealthrankings.org/ALL/poverty_sr


Measure: Poverty - Ages 65+, 2016 Senior Report
Measure: Poverty - Ages 65+, 2016 Senior Report

Why does this matter?

Poverty is associated with poor health outcomes. It influences environmental exposures and health-related behaviors and increases the risk of chronic disease and mortality. Among older adults, poverty is linked to an increased risk of disability, physical and cognitive decline and homelessness

Many older adults subsist on limited incomes and modest savings that restrict their ability to afford basic medical care. Further, 63% of adults ages 65 and older have at least two chronic conditions, leading to increased out-of-pocket expenses. 

The official poverty measure is only one measure of poverty. The Supplemental Poverty Estimate, introduced in 2011, is another measure of poverty that adjusts for government programs related to food, housing and utilities as well as other expenses such as taxes and out-of-pocket medical expenses.

Source:
  • U.S. Census Bureau, American Community Survey, 2014



VOLUNTEERISM



Retirement provides increased free time that some seniors fill with volunteering. Volunteering provides a service for communities and organizations. It provides seniors with positive social interactions, a greater level of social support, and often a sense of purpose. Studies show that older adults who volunteer have better cognitive performance, fewer depressive symptoms, higher activity levels, and better mental health than seniors who do not volunteer. The health benefits of volunteering may extend beyond psychological well-being; higher rates of volunteerism are associated with lower rates of mortality and heart disease, and a longer life span.


Data source: Cooperation for National & Community Service, 2012-2014 For details: http://www.americashealthrankings.org/ALL/volunteerism_sr


Measure: Volunteerism, 2016 Senior Report
Source:
  • Corporation for National & Community Service, 2012-2014



NURSING HOME QUALITY

Poor quality care in nursing homes, including elder abuse and exploitation, has an enormous impact on the health and finances of US nursing home residents and taxpayers. Millions of dollars are spent yearly for medical treatments and hospitalizations related to falls, pressure ulcers, urinary incontinence, malnutrition, dehydration, and ambulatory care-sensitive diagnoses. Quality nursing home practices can largely prevent these negative health outcomes, and nursing homes nationwide are making efforts toward systematic quality improvement. The Centers for Medicare & Medicaid Services amended the Nursing Home Compare rating scale in 2015, raising quality standards in nursing homes across the country.


Data source: Centers for Medicare & Medicaid Services Nursing Home Compare, 2016 For details: http://www.americashealthrankings.org/ALL/nursing_home_quality_sr


Measure: Nursing Home Quality, 2016 Senior Report
Source:
  • U.S. HHS, Centers for Medicare & Medicaid Services, Nursing Home Compare, 2016



HOME-DELIVERED MEALS


Access to healthy food is a struggle for some older adults and is of particular concern for seniors living at home. The Elderly Nutrition Program provides grant funding to states to administer home- and community-meal services. These programs target seniors at high risk for undernutrition and food insecurity due to illness, disability, isolation, or poverty. Home-delivered meal programs can enhance quality of life, provide a stable source of nutrition, increase nutrient intake, and help older adults remain independent and in their homes despite functional limitations, resulting in a projected cost savings of $109 million.


Data source: Administration on Aging, State Program Reports, 2013 For details: http://www.americashealthrankings.org/ALL/home_delivered_meals





FOOD INSECURITY

An estimated 9.6 million seniors faced the threat of hunger in 2013. Compared with younger adults, seniors living at home are at increased risk of hunger due to health conditions, poor food-management skills, limited mobility, lack of reliable social support, and poverty. Food-insecure seniors may have signifcantly reduced intakes of vital nutrients, which could have negative implications for overall health. There are numerous food assistance programs and community meal-delivery options that can help older adults maintain food security. Hunger among all Americans was estimated to cost the nation at least $167.5 billion in 2010.


Data source: The State of Senior Hunger in America 2013: An Annual Report, April 2015 For details: http://www.americashealthrankings.org/ALL/food_insecurity_sr


Measure: Food Insecurity - Ages 60+, 2016 Senior Report
Measure: Food Insecurity - Ages 60+, 2016 Senior Report

Why does this matter?

Food insecurity is a socioeconomic condition where access to food is limited or uncertain. It differs from hunger in that hunger is a physiological feeling. Older adults with food insecurity may have significantly reduced intakes of vital nutrients, which could adversely affect overall health. Research indicates that food insecurity is associated with a higher prevalence of health problems such as heart attack, congestive heart failure, diabetes, asthma and depression, and limited physical functioning in daily living

Older adults living at home report sometimes missing or skipping meals due to factors that impact their ability to obtain or prepare food, including disability or functional limitations, lack of reliable social support, lack of reliable transportation and inability to afford food.

Older adults with chronic conditions who experience food insecurity have higher health care costs compared with those who have the same conditions but are not food insecure. A 2019 study by the Centers for Disease Control and Prevention found that adults experiencing food insecurity had annual health care expenditures $1,834 higher than food-secure adults, for a cumulative median cost of $687 million per state.

Source:
  • Feeding America, The State of Senior Hunger in America, 2013





COMMUNITY SUPPORT


States receive federal funding and allocate state resources to help older adults remain at home using home- and community-based services. Specifically, states may support senior programs that address services such as personal care, congregate meals, transportation, and health promotion. The Older Americans Act (OAA), governed by the Administration on Aging, has provided funding for home- and community-based services since 1965. Community public health spending varies substantially by state and is associated with reducing preventable mortality, especially in low-resource communities. Increased OAA spending in a state is associated with fewer low-care nursing home residents.


Data source: Administration on Aging, State Program Reports, 2013 For details: http://www.americashealthrankings.org/ALL/community_support_sr



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