In a recent study published in JAMA, researchers surveyed adults aged ≥50 years to identify the most salient health concerns before the 2024 elections in the United States.
Background
In the 2020 US election, individuals aged ≥50 years cast greater than 50% of ballots. Health and healthcare issues are frequently crucial for voters, especially older individuals with higher health demands than their younger counterparts. As a result, it is critical to identify the most pressing health challenges in the older adult population of the United States.
About the study
In the present study, researchers explored leading health concerns among older individuals before the 2024 elections.
Michigan University conducted the National Poll on Healthy Aging survey online and telephonically, focusing on health concerns, including adults aged between 50 and 101 years, between 22 February and 12 March 2024. For each health concern, researchers asked participants to classify their concern level as very, somewhat, or not concerning. Researchers obtained participant demographic characteristics via surveying NORC AmeriSpeak panel-supplied information.
Health concerns included medical care costs, assisted living and nursing home service expenses, financial fraud, prescription medication costs, dental expenses, Medicare and health insurance costs, and accessibility to high-quality assisted living, home care, and nursing home services. Other concerns were healthcare quality, misleading or inaccurate health data, accessibility to cost-effective healthy food items, poverty, accessibility to high-quality psychiatric care, loneliness or social isolation, ability to age at their place, obesity, unequal healthcare accessibility, and neighborhood safety.
In addition, researchers explored concerns such as fentanyl or opioid use, age discrimination or ageism, anxiety or stress, vaccine hesitancy, risks associated with air and water pollution, and racial or ethnic discrimination. They also investigated older adult concerns regarding accessibility to recreational and social activities, alcohol use, and cannabis or marijuana use.
Researchers calculated weighted proportions for individuals reporting being highly worried about every issue. They used logistic regressions to estimate weighted proportions of adult individuals extremely worried regarding the expense of medical services and medications, controlling for demographic characteristics. Researchers excluded missing observations from the study.
Results
Among 3,626 individuals receiving invitations, 2,576 (71%) filled out the survey, including 1,385 females (53%) and 1,176 males (47%), and the mean participant age was 65 years. In total, 1,192 individuals (54%) were 50 to 64 years old, and 1,384 were 65 to 101 years old. Most participants were non-Hispanic and white (77%), had attained high school-level education (40%), earned ≥60,000 $60,000 annually (51%), had moderate political ideology (47%), and resided in metropolitan regions (84%).
Most individuals were concerned regarding the cost of home care, assisted living, or nursing home care (56%), medical care expenses (56%), prescription medication costs (54%), financial scams and fraud (53%), cost of health insurance and Medicare (52%), and dental expenses (45%). Other top concerns were access to quality assisted living or nursing home care (38%), healthcare quality (34%), inaccurate or misleading data (33%), access to affordable healthy foods (32%), and poverty (31%). Less concerning issues were marijuana, cannabis, or alcohol use (11%), access to social or recreational activities (15%), racial or ethnic discrimination (18%), and risks from polluted water and air (18%).
Five out of the top six concerns were associated with health insurance and healthcare expenses, with 45% to 56% of participants reporting that they were highly worried regarding these health problems; the other leading concern was financial fraud and scams (53% very concerned). Significantly smaller percentages (11% to 38%) of elders were very worried regarding other health issues.
The adjusted analyses showed that the weighted proportions of older adult individuals reporting being highly worried regarding medical service expenses were significantly different between individuals aged 50 to 64 years (60%) and those 65 to 101 years of age (53%); females (59%) and males (54%); liberal (68%) versus moderate (56%) individuals, and moderate versus conservative individuals (51%); and adults from metropolitan (56% and non-metropolitan areas (62%). Regarding prescription medication expenses, the proportions differed by biological sex, Hispanic background, United States Census area, and political ideologies.
Conclusions
The study findings revealed that older individuals are most concerned regarding the price of health insurance and healthcare in their communities and financial fraud or scams. Over half of the older population across demographic categories expressed extreme anxiety about the expense of health care and medicines, with significant variances based on political ideology and gender.
Females were more anxious than males, and liberals and moderates were more frightened than conservatives. The present study's limitations include a lack of information concerning personal health-related issues and non-health problems that might affect the views of older voters. To involve older voters, presidential and congressional candidates should prioritize discussing their ideas to lower healthcare costs.