The Top Three Social Barriers to U.S. Senior Health

Alignment Health released its 2024 Social Threats to Aging Well in America survey on August 21, exploring the primary social and environmental factors, known as social determinants of health, preventing U.S. seniors from living healthier lives.

In an online survey of more than 2,000 U.S. seniors ages 65 or older, aging in place (69%), lack of transportation and access to medical care (64%), and economic insecurity (56%) were the top three most-cited social barriers to their overall health.

"As an industry, we must pay close attention to what our nation's seniors are telling us are the major roadblocks that impede their health so we can pinpoint solutions that help remove as many of those barriers as we can and ensure they thrive in their later years," said Dr. John Kim, senior vice president, market management at Alignment Health and chief medical officer at Alignment Health Plan in California. "Our past research has informed the need to accelerate innovative partnerships for our growing member base, such as ones that address food insecurity or benefits that support at-home care."

Highlights and Key Findings

No. 1 Social Threat: Aging in Place

As more seniors choose to live independently and longer in their own homes, aging in place brings its own set of challenges. Nearly seven out of 10 consider aging in place a top social barrier to their health and well-being.

Among respondents who reported experiencing stress and anxiety in the past year, 22% ranked aging in place as the factor causing the most stress or anxiety, while 45% ranked it among their top three stressors.

A majority of survey respondents (67%) said they would use benefits that support aging in place in the next 12 months if their health plan offered them. These benefits include making their homes safer, personal medical alerts, in-home health care visits and non-medical companion care.

No. 2 Social Threat: Lack of Transportation and Access to Care

The inability to physically get to and from doctor appointments and medical services poses a significant threat to health, with almost two-thirds of seniors citing lack of reliable transportation and access as a top barrier.

An even higher percentage of respondents, 71%, indicated they would use transportation benefits if their health plan offered them in the next year. Lack of transportation and access to care was the top reason for those who skipped medical care, with 64% citing this issue.

Of those who never skipped medical care, 50% said they may in the future due to lack of transportation and access to care.

No. 3 Social Threat: Economic Insecurity

With seniors on fixed incomes and rising housing, healthcare and daily expenses, it's no surprise that more than half of respondents (56%) ranked economic insecurity as a top concern, while 15% reported it as their top driver of stress or anxiety in the next 12 months.

More than four out of 10 (44%) seniors facing economic barriers said they were burdened by medical debt. Of those with medical debt, 59% owed an amount equivalent to one month or more of living expenses. The survey also found that 21% of seniors did not have or were unsure they had enough money to pay their medical expenses in the next year.

Other Notable Findings

• Lack of support (38%), mental health (33%) and loneliness (30%) ranked as the next most significant social and environmental factors weighing heavily on today's seniors in terms of their health and wellness.

• One in five seniors also cited cultural barriers (21%) and food insecurity (18%) as barriers to their health and well-being.

• One in four (26%) seniors admitted to skipping medical care, with 13% missing at least once in the past year.

• The top reasons for seniors skipping medical care: lack of transportation and access to medical care (64%) and economic insecurity (35%)

• Interestingly, seniors suffering from food insecurity and loneliness were more likely to live in an urban setting.

• Among the six states where additional polling was conducted, Nevada and North Carolina seniors in this survey seemed to be most impacted by social determinants of health, reporting higher numbers in all eight categories studied in the survey.

• And, while California is home to the greatest number of seniors of any U.S. state, it seemed to be faring relatively well among the states surveyed. Californians over 65 in this survey were less impacted by three of the eight social determinants studied and were on par with seniors across the U.S. on the other five.

About the Survey

While this is the third consecutive year that Alignment Health has studied the social issues affecting senior health, the 2024 report is the first time it has partnered with Ipsos, one of the world's largest market research and polling companies.

The survey was conducted via an online poll of 2,051 Americans aged 65 and older between April 30 and May 21.

Additional surveys were collected in Arizona, Nevada and North Carolina to reach a minimum sample size of 100 per state for analysis purposes. These additional "boost" surveys were weighted down to avoid over-representation within the general population.

The states of California, Florida and Texas were also part of the state analysis, however, boost samples were not necessary in these states. Weights were only applied at the national level (individual states were not weighted separately) and insights are representative of the 65+ age group. State-level findings reflect the opinion of these respondents only.

To read the full report, visit http://www.alignmenthealthcare.com/survey2024.