How Can Systems Better Support Health and Well-Being for All?
THE CHALLENGE
Existing health and aging systems are not designed with the perspectives and experiences of those that use the services in mind. As a result, systems may not adequately reflect people’s needs and preferences. At the same time, demand for health and aging services continues to grow. Many people, particularly those from marginalized communities, are not able to afford care.
Data Series
Health inequities contribute to stark differences in who is more likely to receive health care that aligns with personal wishes and preferences.
The Opportunity
The SCAN Foundation (TSF) seeks to ensure that the systems supporting our health and well-being are affordable, accessible, and reflective of the needs and preferences of older adults. We place particular emphasis on priority populations: older people of color, older adults with lower incomes, and older residents of geographically underserved communities.
To advance efforts, we catalyze and champion policies, programs, and investments that:
- Standardize seamless, coordinated, integrated experiences across the continuum of health and aging services, regardless of source of coverage;
- Reform long-term care financing; and
- Increase cross-sector partnerships among the public and private sectors to scale innovative solutions for continued living and thriving in home and community.
LeadingAge LTSS Center @UMass Boston | Community Catalyst
Data Series on U.S. Adults Age 50+
… The United States still has a long way to go to ensure its health care system serves all older adults equitably and considers their unique care preferences.”
Are we listening to people’s care preferences?
In 2014, the Health and Retirement Study (HRS) measured older adults’ perceptions of how the health care system took into account their care preferences. The LeadingAge LTSS Center @UMass Boston conducted analyses of the 2014-18 data and found large disparities based on race, income, and other factors.
We know that care quality and satisfaction improve when people’s wishes are asked and acted upon. One analysis, inclusive of 2018-2020 data, shows:
- Race matters. Black and Hispanic adults age 50 and older were less likely to report that their care preferences were always or usually considered, compared to white adults. (51.8% -Hispanic; 61.8% -Black; 83% -white).
- Income matters. Adults age 50 and older with household incomes less than $30,000 were less likely to say that their care preferences were always or usually considered (66.1%) compared to those with incomes greater than $75,000 (85.1%).
- Geography matters. Adults age 50 and older in the South were less likely to report care preferences were always or usually considered (71.9%) compared to those in the Northeast (76.4%), West (76.5%) and Midwest (80.2%).
The pandemic highlighted racial inequities in telehealth, care, and health status
The second in a series of 2014-2020 HRS data analyses conducted by The LeadingAge LTSS Center @UMass Boston examined the effects of race and other social determinants on telehealth use and technology access during the first year of the COVID-19 pandemic. In 2020, Black and Hispanic adults age 50 and older:
- Used less telehealth;
- Delayed care more often; and
- Had lower self-reported health status than their white counterparts.
These inequities contribute to stark differences in who is more likely to receive health care that aligns with personal wishes and preferences—and as a result, may lead to worse health outcomes.
The data highlight the significant need for equitable solutions to address systemic issues that affect the health and well-being of America’s diverse older adult population.
Better Care Playbook
The Better Care Playbook provides users with the best available knowledge about promising approaches to improve care for people with complex needs.
Making the Business Case
Older adults with chronic health conditions and daily living challenges often need support from a variety of providers to live well in the place they call home. Person-centered care works for older adults with chronic health conditions and daily living needs, but how does it apply to health care organizations? Is it financially sustainable?
Making the business case for new models of care requires a comprehensive financial analysis that includes a return on investment (ROI).
The SCAN Foundation ROI Calculator is designed to help health care organizations develop and operate person-centered care models that serve high-need older adults.