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The Future of Population Health
Centennial Issue Aging
Apr 25, 2023
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In principle, older adults have access to a wealth of health-promoting upstream, midstream, and downstream policy supports, which improve economic security, increase access to a wide array of long-term care services, and ensure access to basic medical care. Although considerable attention has been focused on threats to the old-age welfare state, ranging from long-term financing problems to attempts to roll back benefits, administrative barriers to these programs already threaten their effectiveness. In practice, although profoundly generous in their scope, policy supports for older adults can be difficult and even impossible to access, which substantially undermines their success. Older adults can face everything from confusing eligibility standards and benefit choices to complicated paperwork and required interviews. These administrative burdens are also not distributed equally, with women, low-income, disabled, and racially marginalized groups hit hardest. Indeed, only 40%-50% of eligible older adults participate in key nutrition, income support, and health insurance programs for low income populations (e.g., Supplemental Nutrition Assistance Program [SNAP], Supplemental Security Income [SSI], and Medicaid).1 Reducing administrative burden is a viable way to improve population health among older adults going forward over the next decade. Indeed, President Biden has explicitly made burden reduction a priority for his administration. In the following sections, I will provide an overview of health trends among older adults, detail how key social welfare policies and programs can improve older adults’ health, how these policies are undermined by administrative burdens, and the reforms that could reduce burden and improve the health and well-being of older adults in the coming years.
1. Herd P, Moynihan D. Administrative Burden: Policymaking by Other Means. Russell Sage Foundation; 2019.
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