Gender and Money in Later Life: How Older Women Face Greater Economic Insecurity than Men

Most older women spent their working lives behind the economic curve. They were typically paid less than men when at work and more likely to provide family care that reduced employment opportunities.

Their economic situation doesn’t improve in later life. Lower Social Security and pension benefits, the result of working and earning less over decades, and the fact that women are more likely to live longer than men just extend that gender disadvantage into older age and often make it worse.

A new report by the Gerontology Institute at the University of Massachusetts Boston uses the Elder Index™to demonstrate the depth and scope of economic disadvantage experienced by older women living alone across the United States. It is documented in every state in the nation and only increases with age.

“Life-long patterns of inequality in work experiences and wealth accumulation are behind a substantial gender disparity in retirement economic security,” said Jan Mutchler, the report’s lead author and a professor of gerontology at UMass Boston. “The consequences of that disparity affect so many older women who routinely face hard choices about basic expenses they simply can’t afford.” Continue reading

The Pandemic’s Long-Term Impacts on Food Insecurity Among Older Adults, and the Benefit of Federal Help

A tragic aspect of the pandemic’s prolonged economic downturn – the rising rate of food insecurity in the United States – could impact older, poorer adults and their families for years to come, according to a study by researchers at the LeadingAge LTSS Center @UMass Boston and the National Council on Aging.

Two groundbreaking issue briefs underscore the long-lasting effects of pandemic-related food insecurity among older adults, especially older women and people of color.

The research suggests that while enhancements to the Supplemental Nutrition Assistance Program (SNAP) were likely effective in temporarily decreasing pandemic-induced food insecurity among vulnerable older adults, the increased SNAP benefits provided by the American Rescue Plan need to be made permanent and reflect increased food costs to overtake the growing number of older households expected to face food insecurity. Continue reading

Health Affairs: The Middle Ground For Fixing Long-Term Care Costs: The WISH Act

Our Marc Cohen and co-author Stuart M. Butler published the following piece this week in Health Affairs, revisiting some of the issues we wrote about earlier while taking a deeper look at this long-standing problem.

The Middle Ground for Fixing Long-Term Care Costs: The WISH Act is Copyright © 2021 Health Affairs by Project HOPE – The People-to-People Health Foundation, Inc.

WISH Act and UMass Boston’s Marc Cohen Hope to Transform American Elder Care

Marc Cohen and other academics and policy analysts saw the writing on the wall years ago. With roughly 10,000 Americans turning 65 every day, a decades-old medical and financial storm is now on the horizon when it comes to how to provide and pay for long-term services and supports (LTSS) for elders.

The number of family members available to care for aging relatives is dwindling, most families can’t afford the time or expense of caring for an older relative, and divisive, uncompromising politics in the United States – despite these long-approaching clouds – have done little to tackle the issue head on. More than half of us will need LTSS in old age, yet less than 10 percent of us have insurance to help cover the costs.

“Everyone in their gut knows that there’s this issue out there,” said Cohen, co-director of the LeadingAge LTSS Center at UMass Boston, and research director of the Center for Consumer Engagement in Health Innovation at Community Catalyst. “But very little has been done about it.”

Marc Cohen, PhD

Marc Cohen, PhD

Cohen and his peers spent years working on an idea first put forward by academics and researchers that were part of the Long-Term Care Financing Collaborative, and then expanded on this idea in a paper presented at the Bipartisan Policy Center. At times, their suggestions gained traction, but not among the people who mattered most – the politicians who could enact legislation.

On June 30th, New York Congressman Tom Suozzi, a Democrat representing sections of Long Island and Queens, introduced the Well-being Insurance for Seniors to be at Home (WISH) Act, which addresses how to finance long-term care for older adults, the first new solution put forth in almost a decade.

“With the number of disabled elders expected to double in the coming years, fewer family caregivers are available for these aging Americans, and the market for long-term care insurance is not currently sufficient to address these demographic challenges,” Suozzi said in a press release when the legislation was released. “The WISH Act would save the Medicaid program and millions of Americans from financial ruin, would allow people to age at home with dignity, and would create millions of good-paying, middle-class jobs in the home health care industry.”

Private and public interests had always stood in the way of past legislation aimed at this issue. The WISH Act attempts to overcome this divide by creating a public-private partnership based on social insurance for catastrophic LTSS expenses, coupled with family help, savings and private long-term care insurance for early up-front costs.

The idea is that such a comprehensive insurance solution – built on well-defined public and private roles — would enable older adults to stay at home if they wish instead of needing to deplete their and their family’s life savings and enter Medicaid-funded nursing homes or access more limited Medicaid-financed home care services.

In addition, the legislation is aimed at helping low-income individuals and their families whose savings are often devastated when a loved one requires long-term care, forcing many to make tough decisions about work and incomes versus their relative’s long-term care needs.

In mending this dangerous trend, the legislation would also promote health equity by providing a financial parachute to those families that would suffer most under the current system – a system which leaves the Medicaid program financially stretched and unable to meet the needs of its beneficiaries and pay rates necessary to support a high-performing workforce.

Cohen also views the legislation through a feminist lens. For decades, working women – who are the primary family caregivers of disabled elders — have been forced to weigh their careers and income versus staying at home to care for an elderly relative. If successful, the WISH Act would empower more working women to stay in the workforce, because the costs associated with bringing in home care aides, for example, would be paid for through the insurance program.

The legislation would create a new Long-Term Care Insurance Trust Fund that would be used to pay for the “catastrophic” period of long-term care for adults requiring many years of help. At the same time, the legislation would have private insurance companies offer affordable coverage plans for older adult’s initial years of disability. And it would be paid for with a social insurance contribution by all workers and their employers, each contributing about 0.3 percent of wages.

The legislation was largely inspired by the 2018 paper written by Cohen, Judith Feder of Georgetown University and Melissa Favreault of the Urban Institute. Their work was funded in part by the Office of the Assistant Secretary for Planning and Evaluation at the Department of Health and Human Services, among others.

The way that work came about mirrors the political headwinds the WISH Act legislation will face on a very divided Capitol Hill.

“We went back and forth for two years,” Cohen said. He came to the issue with a perspective shaped by his work with the private insurance sector, while Feder came from the public policy side, a big philosophical divide concerning what private industry and the government could and should do when it comes to such a challenging and difficult issue like long-term care financing.

“Very early on when we butted heads, we both agreed that we would not let “the enemy of the good be the best” and that ideological purity would have to be put aside so that we could focus on a practical solution that could do a lot of good,” Cohen said.

Their paper was published in January 2018, got some attention, but then languished until just before the pandemic hit in 2020. In late November 2019, Dr. Joanne Lynn, a geriatrician and hospice physician who is a senior analyst at Altarum and who was working at Congressman Thomas Suozzi’s office, invited Cohen to fly down to Washington, D.C., to meet with the Congressman and his team, where the initial sketches of the WISH Act were discussed. Throughout 2020 and the first six months of 2021, there were multiple meetings which were led by Dr. Lynn responding to concerns of stakeholders and dealing with the minute details that come with developing a new and major piece of legislation.

After a career spent touting the rationale for such legislation, this was the first time Cohen played a direct role in helping to shape legislation. “During that process it became clear to me that this is not a rich versus poor or Democrat versus Republican issue, but rather, a human issue that affects us all and really needs to be addressed,” Cohen said.

Elder Index at Work: Helping Boston’s Age-Friendly Plan Take Aim at Economic Insecurity

This article is one in a series of stories about how people across the country are using the Elder Index to understand the true cost of living for older adults and its economic implications. If you know someone who would like to receive information about these stories, send us a note at gerontologyinstitute@umb.edu.

Go to any city across America and you will find older adults struggling to make ends meet. Go to Boston and you will see some of the most serious elder economic insecurity problems in the nation.

This is not news at Boston’s Age Strong Commission, which first launched an ambitious age-friendly plan in 2017. The commission is now developing a Step 2 blueprint with a focus on the problem of economic security among older residents. A critical tool for that job: The Elder Index. Continue reading

Boston’s Older Population: Increasing in Racial Diversity, but Quality of Life is Shaped by Racism, Discrimination

A new report from UMass Boston identifies aging equity among Boston residents

The number of Boston residents aged 60 and older has increased by more than one-third in the last eight years and more than half of older residents are persons of color. However the experiences of these older residents differ substantially depending on race, ethnicity and gender, and challenges their abilities to thrive.

A new report, “Aging Strong for All: Examining Aging Equity in the City of Boston,” by researchers at the University of Massachusetts Boston, documents disparities across three dimensions that impact quality of life — economic security, health, social engagement — and identifies opportunities for stakeholders to ensure an environment in which “aging strong” is possible for all Boston residents. Jan Mutchler

“It has never been more critical to strategically pursue greater equity in the aging experience of Boston residents,” says Jan Mutchler, PhD, director of the Center for Social and Demographic Research on Aging at UMass Boston, a professor in the Department of Gerontology and one of the study’s authors. “The numbers of older adults are increasing and stakeholders share a growing recognition of the powerful ways in which inequity, racism, and discrimination shape health outcomes and the aging experience, amplifying the need to examine and remediate disparities in aging.”

The report identifies substantial disparities across racial and ethnic groups, such as:

Economic security

  • Poverty rates are especially high among Asian Americans and Latinos, and more than one-third of these residents age 60 or older live in households with incomes below the federal poverty line.
  • Sizable gaps differentiate racial groups. For example, while a similar share of non-Hispanic White, Black and Native American people aged 66 or older receive Social Security benefits, percentages receiving Social Security are considerably lower for Latinos and Asian Americans.
  • Housing costs in Boston place a heavy burden on older residents and half or more of renters age 60 or older pay more than 30% of their incomes for housing. Fewer homeowners bear such a heavy cost burden for housing, but older Black, Latino and Native American homeowners are at amplified risk for being cost-burdened.

Continue reading

Elder Index at Work: Helping Improve Access to Medicare Savings Programs in Massachusetts

multigeneration portraitThis article is one in a series of stories about how people across the country are using the Elder Index to understand the true cost of living for older adults and its economic implications. If you know someone who would like to receive information about these stories, send us a note at gerontologyinstitute@umb.edu.

The cost of health care is one of the most common economic problems facing older adults across America. In more serious cases, it can lead to a bleak choice between paying for medicine or affording other basic needs.

These are familiar facts of elder life to the Massachusetts Senior Action Council, a grass roots organization focused on public policy and community issues affecting the health and well-being of older adults.

Research on policy options to address the problem led the council to focus on Medicare Savings Programs, which help qualified beneficiaries with health costs. Though the programs are run by the federal government, states have the ability to change eligibility standards for their older adults.

The council launched a campaign to make the Medicare Savings Programs available to more Massachusetts elders. It took years but finally paid off when Gov. Charlie Baker signed the state’s 2020 budget, which included a policy that now offers an estimated 40,000 older adults access to more than $150 million in new annual benefits.

A key resource in the successful effort: The University of Massachusetts Boston’s Elder Index, a free online tool that provides realistic and detailed cost of living data for older adults living in every U.S. state and county. Continue reading

Pension Rights

Help is available to secure your pension

Whether your retirement is close at hand or years away, you’re likely counting on savings and other income sources you’ve maintained to provide you with a comfortable and secure life after working for years. If you’re counting on a pension, take steps now to make certain it’s in place and available when you decide to retire.

A defined benefit pension is a retirement plan that may provide monthly income for the rest of your life. Pensions are sponsored by your employer and provided to you based on your years of service, compensation and other factors. Unlike a 401(k), the employer bears all of the risk and responsibility for funding the pension plan. But, employers can make mistakes.

Take the case of William, a Pension Action Center client.

William worked for a company outside of Chicago off and on for about 20 years. He had two breaks in service that resulted from factory-wide reductions in force. After the first layoff, he was recruited back, because the factory needed someone with his specialized skills. When he was laid off again, he had worked about 12 years in total, and was fully vested in the company’s pension plan.

In the mid-1980s, the company that owned the factory decided to close it down permanently. The company again recruited William back to help with the closure. He understood that his brief return would increase his pension benefit at retirement.

But the employer made a big mistake. When personnel matters were wrapped up for the remaining factory employees, William’s service credit for his pension was recorded based on his short return to his employer to close down the factory. The employer did not credit him with the 12 years of service from earlier in his career. As a result, William was not included on the list of employees who had earned a pension. Continue reading

Elder Index Shows Limits of Social Security to Help Older Adults Afford Basic Cost of Living

Jan MutchlerSocial Security is a critical economic resource for most older Americans but those payments don’t cover even a bare-bones budget in a single county in the United States.

The degree to which Social Security payments can help elders make ends meet depends both on individual circumstances and basic geography. An updated analysis, using the Elder Index™ developed at UMass Boston’s Gerontology Institute, recently examined Social Security’s ability to cover basic elder expenses in every U.S. county and state.

“Social Security is incredibly important to older Americans as an economic safety net but it doesn’t fully cover the cost of living anywhere,” said Professor Jan Mutchler. “The effectiveness of that safety net varies a great deal across the county and among individuals. In many cases, it falls far short.” Continue reading

Nearly Two-Thirds of Older Black Americans Can’t Afford to Live Alone Without Help – and it’s Even Tougher for Latinos

Jan MutchlerThis article originally appeared on The Conversation, a non-profit independent online news organization.

By Jan Mutchler

Older Americans who want to live independently face serious economic challenges. Half who live alone don’t have enough income to afford even a bare-bones budget in their home communities, and nearly 1 in 4 couples face the same problem.

Those numbers add up to at least 11 million older adults who are struggling to make ends meet, a new analysis shows.

The numbers are worse for older people of color. Dramatically higher percentages of Black, Latino and Asian older adults live on incomes that don’t meet their cost of living, even with Social Security. That can mean skipping needed health care, not having enough food, living in unhealthy conditions or having to move in with family.

These disparities often reflect lifelong disadvantages that add up as people of color encounter structural racism and discrimination that shape their ability to buy property and save for the future.

To calculate realistic rates of economic insecurity and estimate the disparities, my colleagues and I used the Elder Index, created by the University of Massachusetts Boston to measure the true cost of living for older adults. It tracks expenses for housing, health care, transportation, food and other basics, county by county. We paired the index with state-level income data to determine the percentage of people who don’t have enough income to cover their cost of living. Continue reading