Contact: Sharon Keeler, 603-862-1566 [email protected]
DURHAM, N.H. -- Older people living in poverty are more likely than their middle or upper class peers to experience declining health as they age, according to a new study in the November issue of the Journal of Gerontology. This more rapid decline in health not only threatens the quality of life of these older persons, argue the researchers, but also increases significantly their risk of entering a nursing home.
According to Raymond Coward, dean of the University of New Hampshire School of Health and Human Services and leader of the research team that completed the study, low-income elders are at much higher risk of developing difficulties performing routine activities of daily living, like bathing, preparing and eating meals, doing light housework or shopping for groceries.
Less education and increasing age were also found to contribute to the increased risk of health; but, the researchers demonstrated that having a low income had the most powerful influence.
Coward, along with colleagues from the University of Florida and the University of North Carolina, monitored the health of a panel of more than 800 adults over a 30-month period. Each of the subjects in the study were 65 years of age or older at the beginning of the study, lived in a community setting, and were in "good" health. Specifically, none reported any difficulties performing normal activities of daily living. Half of the sample, however, had incomes below the federal poverty threshold.
According to the U.S. Bureau of Census, there are nearly 4 million elders in the United States living in poverty.
"At the same time that low-income elders are experiencing greater declines in their health, they also have fewer financial resources with which to cope with this poorer health," says Coward. "Because most elders who are poor have had low incomes most of their adult lives; that is, they have not suddenly become poor in old age, the debilitating consequences of a lifetime of poverty can manifest itself in poor health in old age."
Coward adds it is not simply a lack of access to quality health care that contributes to the poor health of low-income elders. "Poor diets and nutrition, the greater likelihood of poor health habits, including smoking, greater exposure to occupational hazards and unsafe work places, and unsanitary living conditions can accumulate and take their toll in life."
Coward and his colleagues had originally focused their study on differences in the decline of health over time between racial groups -- half of their sample was African American and half white. While they did find that African American elders were more likely than whites to experience a decline in their health as they aged, the difference could be explained by the greater number of African American elders who lived in poverty.
"Once the differences in income between racial groups was controlled, the rate of decline between African American and white elders of the same social class were essentially the same," says Coward.
Unfortunately, he says, poverty is not uniformly distributed across all elders, rather it is concentrated in certain subgroups of the elderly, like racial minorities and residents of sparsely populated and geographically remote rural areas.
"Our concern should be for the health and welfare of older persons with inadequate incomes, regardless of their race," says the UNH researcher, "and we should be targeting publicly supported health programs to low-income elders."
Coward and his colleagues argue that for elders who currently live in poverty, society must develop a better understanding and appreciation of the consequences of these more rapid declines in the quality of life of the involved elders and for the cost of their health care.
The Health Care Financing Administration (HCFA) estimates that nearly 3 of 5 public health care dollars (58 percent) are spent on the elderly, and the most recent edition of the Encyclopedia of Aging states that "persons age 65 and older account for about one-third of annual U.S. health care costs; in 1994, this amounted to about $300 billion."
Thus, the more rapid decline of health among low-income elders may unduly contribute to rising national health care costs and is a significant concern to public officials who monitor health care programs for the poor.
"To improve the circumstances of future cohorts of elders, we must act now to reform social and economic circumstances in the United States, so that current generations of low-income persons do not suffer a lifetime of deprivation," says Coward, "inevitably leading to increased poor health in old age." -30-
Dean Raymond Coward can be reached at 603-862-1177. He will be leaving his University of New Hampshire office mid-morning on Friday, Nov. 14, to attend the Gerontological Society of America conference in Cincinnati, Ohio. He will be staying at the Westin Hotel and can be reached at 513-621-7700 (estimated arrival time is 3:30 p.m.). He will be back in his office on Monday.
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