Money on their minds: Health-related costs top older adults’ concerns for people their age, poll finds

From medical and dental care to medications, insurance and nursing homes, health-related costs weigh heavily on the minds of older Americans of all backgrounds, a new poll suggests.

Asked to rate their level of concern about 26 different health-related topics for people over 50 in their community, five of the six issues that the most people cited as very concerning involved health costs.

The sixth – financial scams and fraud – also had to do with money.  

Those same six topics rose to the top no matter what age group, gender, race, ethnic group, region of the country, size of community, political ideology or income group older adults came from, according to new findings from the University of Michigan National Poll on Healthy Aging.

Read the full NPHA poll report

Overall, 56% of people over 50 say they’re very concerned about the cost of medical care for older adults in their community.

An equal percentage say they’re very concerned about the cost of home care, assisted living or long-term care, which the poll grouped together as one topic.

Nearly as many said they’re very concerned about the cost of prescription medications (54%), about scams and fraud (53%) and about the cost of health insurance or Medicare (52%). Nearly half (45%) called the cost of dental care very concerning.

“In this election year, these findings offer a striking reminder of how much health care costs matter to older adults,” said John Z. Ayanian, M.D., M.P.P., a health care researcher, U-M physician and director of U-M Institute for Healthcare Policy and Innovation, where the poll is based. The poll is supported by AARP and Michigan Medicine, U-M’s academic medical center.

“We also saw that health care costs are top concerns for older adults living in Michigan,” he added.

Michigan-specific results, presented as part of the new Michigan Poll on Healthy Aging supported by the Michigan Health Endowment Fund, are available at www.healthyagingpoll.org/Michigan.

Other topics rounding out the top 10 health issues that were rated very concerning by the highest proportion of older adults nationally included access to quality home care, assisted living or nursing home care (38%); overall health care quality (35%); inaccurate or misleading health information (34%); and access to affordable healthy foods (33%).  

Differences between groups

When it came to these issues, and others, differences emerged between people from different demographic groups.

For instance, women were more likely than men to say they’re very concerned about access to quality home care and assisted living or nursing home care (44% vs. 32%), and more likely to say they’re very concerned about social isolation and loneliness (34% vs. 22%), as well as aging in place (33% vs. 22%).

Meanwhile, 50% of Black older adults said they were very concerned about racial or ethnic discrimination faced by older adults in their community, compared with 26% of Hispanic and 15% of white older adults.

Black older adults were also more likely than the other two groups to say they are very concerned about age-based discrimination affecting adults in their community, as well as unequal access to care in general and unequal access to mental health care specifically.

The poll team also analyzed the results by income, comparing those with annual household incomes below $60,000 with those who had incomes above this level. The cost of dental care was the only issue on which people in the lower-income group were more likely than their higher-income peers to say they are very concerned (49% vs. 40%).

“As our society strives to improve the health and well-being of people as they age, it’s important to understand to what extent different health-related topics are of concern for older adults and how perspectives vary,” said poll director Jeffrey Kullgren, M.D., M.P.H., M.S. “The high level of concern about cost-related issues across demographic groups points to a particularly important opportunity for action.”

Ayanian and Kullgren are both on the faculty in the Division of General Medicine of the U-M Medical School’s Department of Internal Medicine. Ayanian provides care at University of Michigan Health, the clinical arm of Michigan Medicine, while Kullgren provides care within the VA Ann Arbor Healthcare System. Both have studied how out-of-pocket costs for insurance and care affect health-related decisions.

“This survey validates AARP research that shows affording health care is a kitchen table issue among older adults, their families, and their caregivers,” said Indira Venkateswaran, AARP Senior Vice President of Research. “It is critical that we continue improving health care access and affordability for the millions of Americans struggling to pay for insurance premiums and copays, prescription drugs, and long-term care while putting food on the table and paying bills.”

For each of the 26 issues that older adults were asked to reflect on in the new poll report, they were given the choice of saying that an issue was very concerning, somewhat concerning, or not concerning to them.

For an interactive data visualization that gives full access to national and Michigan-specific data from the poll, visit https://michmed.org/Kkde7.

The poll report is based on findings from a nationally representative survey conducted by NORC at the University of Chicago for IHPI and administered online and via phone in February and March 2024 among 3,379 adults over age 50. The sample was subsequently weighted to reflect the U.S. population. 

Read past National Poll on Healthy Aging reports and about the poll methodology.

Past National Poll on Healthy Aging reports on topics related to the health concerns cited as “very concerning” by the most older adults in the new report:

Doctors and Pharmacists: An Underused Resource to Manage Drug Costs for Older Adults (June 2017)

Dental Care at Midlife – Unmet Needs, Uncertain Future (September 2017)

Dental Care and Coverage After 65: Experiences and Perspectives (March/April 2020)

Older Adults’ Experiences with Comprehensive Medication Reviews (October 2020)

Saving for Future Health Care Expenses (September 2021)

Older Adults’ Preparedness to Age in Place (April 2022)

Trends in Loneliness Among Older Adults from 2018-2023 (March 2023)

Experiences with Scams Among Older Adults (November 2023)