The vital role of social drivers for seniors

Health-related social needs can be especially acute for seniors. Nearly 10% of older adults live in poverty and experience food insecurity, and nearly 10 million are affected by economic insecurity due, in part, to things like high housing costs.

Unfortunately, those numbers are expected to increase in the wake of a “silver tsunami.” By 2040, older adults are expected to reach 81 million people – or 22% of the total U.S. population.

A report by UnitedHealthcare and STAT Brand Studio, conducted by Zogby Analytics titled, “How social drivers of health are affecting Americans 65+,” surveyed nearly 1,000 respondents. More than 40% report that a social need, primarily financial, could affect their health.

“It makes intuitive sense – the way you spend your life and the choices you have clearly have a huge impact on health and well-being,” said Dr. Alex Billioux, chief medical officer, UnitedHealthcare Community & State and senior vice president for Population Health and Social Care. “For a long time, health care was focused on acute illness, then chronic, and finally we’re coming to a holistic view.”

Here are three challenges for older adults that are tied to social drivers of health.

Social isolation

About 9% of respondents say they’re affected by a lack of social connection. This is especially true for seniors in urban environments, retirees, and older adults who are divorced, separated, and widowed.

The U.S. Surgeon General has already raised the alarm about an epidemic of loneliness. The public health crisis especially impacts seniors, who may be homebound and almost a quarter of whom live alone.

“Especially for those with a particular challenge in leaving the home, such as access to transportation or mobility issues, that can bring social isolation,” Dr. Billioux said.

Financial challenges

More than a third of survey respondents said they face financial insecurity, including:

  • Trouble paying essential bills
  • Canceling a health care appointment due to no transportation or mobility issues
  • Skipping meals because of food costs

These common challenges were also subject to racial disparities. For example, 41% with financial challenges are Black, compared with 26.6% who are white.

“The differences in the senior population can be significant, certainly by race and ethnicity,” Dr. Billioux said. “And especially as we consider the rising cost of living, when you think of older adults without a salary, that really hits this population hard. Their needs are very volatile and changing, unlike a chronic health condition.”

Role of insurance

More than half of the Medicare population – 32 million seniors and growing – choose Medicare Advantage for their health care coverage, with enrollment doubling in the last decade.

“The sheer volume of enrollment helps us learn more about seniors’ needs and address health equity for individuals and the nation,” Dr. Billioux said. “We think the most important thing is to learn from our members themselves. In any community, needs vary, and we don’t want to guess. This helps us understand how to help them. Our members set our North Star.”

In 2023, UnitedHealthcare screened 6.9 million members enrolled in its plans – including more than 540,000 veterans.

For the 1.4 million members who requested help for unmet social needs, UnitedHealthcare made 2.5 million referrals to local and national services. For example, seniors experiencing food insecurity were referred to various resources that help older adults apply for SNAP (Supplemental Nutrition Assistance Program).

Since many members identified financial well-being as a challenge, UnitedHealthcare helped many of those eligible to enroll in government programs to reduce premiums and lower costs for prescription drugs. It’s a critical support, as the report found a strong correlation between lower incomes and difficulty independently navigating community health resources.

In follow-ups, it was verified that 917,000 UnitedHealthcare enrollees were connected to services that addressed a social need, with an average per enrollee savings of:

  • $1,436 for social services
  • $2,099 for the Medicare Savings Program
  • $5,300 for the Low-Income Subsidy Program to reduce drug costs

“There are a wealth of resources, but it can be challenging for people to find or follow through,” Dr. Billioux said. "So we’re going that extra step to coordinate and connect, while also advocating at national and state levels with respect to eligibility for these programs.”

Read the full report: “How Social Drivers are Impacting Americans Age 65+.”

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