Social Isolation and Loneliness in Older Adults

Social Isolation and Loneliness in Older Adults
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 317
Release: 2020-05-14
Genre: Social Science
ISBN: 0309671035

Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.

Retooling for an Aging America

Retooling for an Aging America
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 316
Release: 2008-08-27
Genre: Medical
ISBN: 0309131952

As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care workforce that is too small and woefully unprepared to meet their specific health needs. Retooling for an Aging America calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. The book also recommends that Medicare, Medicaid, and other health plans pay higher rates to boost recruitment and retention of geriatric specialists and care aides. Educators and health professional groups can use Retooling for an Aging America to institute or increase formal education and training in geriatrics. Consumer groups can use the book to advocate for improving the care for older adults. Health care professional and occupational groups can use it to improve the quality of health care jobs.

Health-Care Utilization as a Proxy in Disability Determination

Health-Care Utilization as a Proxy in Disability Determination
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 161
Release: 2018-04-02
Genre: Medical
ISBN: 030946921X

The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.

Health Services Utilization of Older Adults with Depression and Comorbid Chronic Health Conditions

Health Services Utilization of Older Adults with Depression and Comorbid Chronic Health Conditions
Author: Carol Jia-Di Peng
Publisher:
Total Pages: 127
Release: 2015
Genre:
ISBN:

This study examines the health services utilization of older adults in China with depressive symptoms and chronic health conditions. In older adults with chronic conditions, depression has shown to be associated with greater severity of medical illness, poorer health status and quality of life, and increased mortality. Studies in western industrialized societies have shown that individuals with depression use a higher number of physical health services. However, there have been no studies identified to date that have looked at this question for China, including for Chinese older adults in particular. The healthcare utilization patterns of Chinese residents with depression may show differential patterns from those of individuals living in western industrialized countries due to differences in culture, available forms of help, existing service systems, and policy contexts, including the rapid expansion of healthcare coverage in China in recent years due to healthcare reform. This study employs logistic regression to analyze the relationships between depression, chronic health conditions, and health services utilization among Chinese older adults. It uses nationally representative survey data from the 2011-2012 China Health and Retirement and Longitudinal Study (CHARLS) (n=17,708). The study also presents a profile of service users based on a cluster analysis of health conditions and health services used. After controlling for sociodemographic and health characteristics, depression was found to be positively associated with outpatient service utilization but not significantly associated with inpatient service utilization for the general sample of older adults in China. Among the sample of older adults with chronic conditions, also having depression was significantly associated with greater outpatient service use. Those with both chronic conditions and depression were 1.53 times more likely to use outpatient services than those who only had chronic conditions with no depression. There was no significant relationship between chronic conditions and depression with inpatient service use. Results of a cluster analysis indicate that depression levels and levels of ADLs and IADLs appear to be positively associated with both outpatient and inpatient service utilization. High utilizers of outpatient services tend to be less uninsured and to have the most Urban Employee and New Cooperative insurance, and the least Urban Resident and Government insurance relative to moderate and low users of outpatient services. High users of outpatient services are more likely to be female and rural residents. High users of inpatient services tend to be more rural and to have lower levels of social support than both moderate and low users. Findings on the healthcare usage patterns of this population have implications for improving health policy and interventions related to the treatment and prevention of depression among this population of vulnerable older adults.

Care Without Coverage

Care Without Coverage
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 213
Release: 2002-06-20
Genre: Medical
ISBN: 0309083435

Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.