Top 3 Social Determinants of Health Barriers Among Seniors

Three major social determinants of health factors are particularly predominant barriers to care for America’s seniors: economic instability, loneliness, and food insecurity, according to a study sponsored by Alignment Healthcare.

Researchers from Toluna conducted an online survey from July 24 to August 13, 2022, which reached 2,600 seniors ages 65 and older. Most respondents identified as white. Half were in Medicare Advantage and this population was divided primarily between preferred provider organizations and health maintenance organizations.

Economic instability—specifically, challenges in paying medical bills—was a widespread issue for respondents. One out of six seniors shouldered medical debt and one out of five reported that finances were their biggest barrier to care.

For many seniors, financial barriers to care were tied to competing priorities. Over a third of individuals said that other responsibilities would take precedence over the health in the next year.

Additionally, nearly a quarter of individuals said that challenges in covering medical bills, prescriptions, and medical supplies were a major financial barrier to care in the next year. Other barriers included unresponsive providers, lack of in-home support, transportation access issues, lack of nutritious foods, and technology troubles.

Sixteen percent of seniors said that they had outstanding medical debt, of which more than half reported having medical debt amounting to one month of living expenses or more. These financial difficulties contribute to a lot of uncertainty around seniors’ ability to cover medical expenses in the next year.

Loneliness is another predominant social determinant of health factor that can become a barrier to care for seniors. A fifth of seniors reported that their loneliness had increased in the past year. While nearly seven out of ten seniors see a family member, friend, or another companion often throughout the week, 16 percent of seniors only see a companion every two to three weeks.

Food insecurity is the third social determinant of health that often impedes seniors’ access to care and ability to adhere to treatment.

The survey found that 15 percent of seniors expected to experience barriers to food access in the next year. An even greater number of seniors reported that grocery assistance was their top need for support. Nearly seven out of ten seniors said that they would use a monthly grocery allowance. More seniors ranked monthly grocery allowances as their most prized benefit than 24/7 telehealth or virtual care access.

To Alignment Healthcare’s leadership, these results are particularly timely and informative.

“With 10,000 adults turning 65 every day, it’s more urgent than ever to understand the issues seniors face that impede their path to health, wellness and happiness,” Dinesh Kumar, MD, chief medical and operating officer of Alignment Healthcare, said in the press release.

“This study offers insights into those barriers and provides a window into the solutions we should consider to best address those needs. With this valuable information, we can help ensure our elders receive the attention, respect and care they need and deserve while raising expectations of what health care can be.”

Separate reports have underscored the decline in mental health among seniors along with a rise in drug-related deaths and early death rates.

Payers have taken on social determinants of health barriers in a variety of ways. Major payers have partnered with and donated to community-based organizations to address food insecurity. Others partnered with companies to establish affordable housing units and diminish the barriers to housing access.