The LTSS Center’s preliminary study, conducted for the National Council on Aging, involves analysis of health and economic data from 2014 Health and Retirement Study.

Center researchers found that 43 percent of people aged 55 or older with incomes below 250 percent of the federal poverty level reported their health condition as “fair” or “poor.” Individuals in this income group were 3 times more likely to characterize their health as fair or poor than similarly aged people who were at least 400 percent above the poverty level.

The current federal poverty level is $16,460 for a family of 2, and $12,140 for a single-person household.

“The links between health and income and health and age are well documented and understood, but the magnitude of income-related disparities is of great concern,” says Marc Cohen, co-director of the LTSS Center and lead researcher on the project. “We tend to focus on the effects of income inequality on living standards and purchasing power, but there is a cascading and sometimes hidden impact in terms of the additional costs associated with poor health.”

HEALTH AND AGE

While the study showed a clear link between age and self-reported health among older Americans, differences in the percentage of people reporting fair or poor health status did not vary greatly across the age spectrum.

People aged 85 and over were only 1.5 times more likely to report their health as fair or poor, compared to younger adults aged 50 to 59. More than a quarter (28 percent) of all people over age 65 reported that they were in fair or poor health. Within that age group, fair or poor health was reported by:

  • 23 percent of those aged 55 to 59,
  • 26 percent of people aged 70 to 74,
  • 29 percent of people aged 75 to 79, and
  • 34 percent of those over age 85.

HEALTH AND INCOME: A CLOSER LOOK

The study identified relationships between income and several specific health-related issues, including:

Functional Status: The study found a variation in the percentage of people over age 55 who reported 2 or more limitations in the Activities of Daily Living (ADL). ADL limitations are often associated with a need for some level of long-term services and supports. The study found that:

  • 13 percent of people with incomes below 250% of the federal poverty level reported ADL limitations, while
  • 4 percent of individuals with incomes greater than 400 percent of the federal poverty level reported these limitations.

A similar relationship can be observed for limitations in Instrumental Activities of Daily Living.

Depression: About 31% of people with incomes below 250% of the federal poverty level were found to be depressed. This rate was about 2.5 times higher than the rate for older Americans living at more than 400% of the poverty level.

In contrast, rates of depression did not vary nearly as much by age group. The rates of depression across the age spectrum ranged from 17% for younger people to 24% for older people.

Cognitive impairment: Significantly higher rates of cognitive impairment were reported among older people with incomes below the federal poverty level.

Weight: Issues with weight did not appear to be related to income. Almost three-quarters (72 percent) of older adults across all income groups are overweight, which is defined as having a body mass index greater than 25.

NEXT STEPS IN PROFILE RESEARCH

Additional research by the LTSS Center is expected to focus on the relationship between sociodemographic variables—such as gender, race, and marital status—and a variety of wealth measures, including home ownership, retirement income, and financial holdings. The study will also look at the relationship between income levels and views on retirement planning.

“It is important to invest the time to get an accurate and comprehensive financial and health picture of older Americans,” says Cohen. “That will help us project future needs and undertake appropriate planning. Public resources are becoming more constrained, so it’s essential to develop policies based on empirical evidence and analysis.”