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Journal of Aging & Social Policy

Wayne L Anderson, Sharon K Long, Zhanlian Feng
Individuals dually eligible for Medicare and Medicaid often receive fragmented and inefficient care. Using Minnesota fee-for-service claims, managed care encounters, and enrollment data for 2010-2012, we estimated the likely impact of Minnesota Senior Health Option (MSHO)-seen as the first statewide fully integrated Medicare-Medicaid model-on health care and long-term services and supports use, relative to Minnesota Senior Care Plus (MSC+), a Medicaid-only managed care plan with Medicare fee for service. Estimates suggest that MSHO enrollees had significantly higher use of primary care and, potentially, of community-based services, combined with lower use of hospital-based care than similar MSC+ enrollees...
July 6, 2018: Journal of Aging & Social Policy
Tao Kong, Po Yang
Facing a rapidly aging population, China has recently started to formulate and implement policies with the aim to provide old-age care. While well-developed old-age care policies commonly include a built-in component that assesses eligibility based on vulnerability, no such process is established in the context of China. Here, based on data from the China Health and Retirement Longitudinal Study collected in both 2011 and 2013, we (a) developed a simple and effective strategy for identifying vulnerable Chinese elderly, which can serve as a basis for policy targeting; and (b) improved the policy relevance and targeting efficiency of this vulnerability measure by including additional health indicators...
July 6, 2018: Journal of Aging & Social Policy
Michael Lepore, Angela M Greene, Kristie Porter, Linda Lux, Emily Vreeland, Catherine Hawes
Residential care facilities operating without a state license are known to house vulnerable adults. Such unlicensed care homes (UCHs) commonly operate illegally, making them difficult to investigate. We conducted an exploratory, multimethod qualitative study of UCHs, including 18 subject matter expert interviews and site visits to three states, including a total of 30 stakeholder interviews, to understand UCH operations, services provided, and residents served. Findings indicate that various vulnerable groups reside in UCHs; some UCHs offer unsafe living environments; and some residents are reportedly abused, neglected, and financially exploited...
June 11, 2018: Journal of Aging & Social Policy
Yue Li, Xueya Cai, Charlene Harrington, Michael Hasselberg, Yeates Conwell, Xi Cen, Helena Temkin-Greener
This study aimed to examine racial and ethnic differences in significant depressive symptoms among long-term nursing home residents. We analyzed the 2014 national Minimum Data Set linked to a nursing home file and estimated multivariable logistic regressions to determine the associations of race and ethnicities with significant depressive symptoms (score ≥ 10 on the 9-item Patient Health Questionnaire [PHQ-9] scale) and whether associations were explained by resident and nursing home covariates. Stratified analyses further determined independent associations in subgroups of residents...
June 8, 2018: Journal of Aging & Social Policy
Mohamed Ismail, Shereen Hussein
Population aging is a phenomenon occurring across the globe including in countries traditionally exhibiting population dividends and "youth bulges." The Gulf Corporation Council countries are no exception as they currently experience a process of population aging, albeit at a different stage from many developed countries. However, due to historically high fertility rates and fast-paced epidemiological transition, some of these countries will experience population aging at a higher pace than what has been observed in Europe and the United States...
June 8, 2018: Journal of Aging & Social Policy
Kylie Meyer, Laura Rath, Zach Gassoumis, Natalie Kaiser, Kathleen Wilber
Family caregivers are the cornerstone of the long-term supports and services infrastructure in the U.S., yet often contend with many challenges related to this role. Public policy has been slow to change, leaving many caregivers vulnerable to health and economic consequences. Using models of policymaking, we identify barriers to advancing policies that support family caregivers and overcome policy drift. We draw on discussions from the California Task Force on Family Caregiving as it prepares state policy recommendations...
June 8, 2018: Journal of Aging & Social Policy
Sarah Gibney, Eithne Sexton, Sinead Shannon
The objective of this study was to measure consensus among expert stakeholders on a set of positive aging outcome indicators in Ireland. Stakeholders from academic, public, and voluntary sectors and older people participated in a 3-round, online Delphi study to evaluate indicators for participation, security, healthy aging, attitudes to aging, and information access. Evaluation criteria included: acceptability, utility, accessibility, ranking, and balance and coherence. Consensus was achieved on 56 key indicators that are aligned with action areas in the National Positive Ageing Strategy...
June 8, 2018: Journal of Aging & Social Policy
Anja K Leist, Rafael Novella, Javier Olivera
Maintaining cognitive function is a prerequisite of living independently, which is a highly valued component in older individuals' well-being. In this article we assess the role of early-life and later-life nutritional status, education, and literacy on the cognitive functioning of older adults living in poverty in Peru. We exploit the baseline sample of the Peruvian noncontributory pension program Pension 65 and find that current nutritional status and literacy are strongly associated with cognitive functioning for poor older adults...
June 8, 2018: Journal of Aging & Social Policy
Edward Alan Miller, Pamela Nadash, Michael K Gusmano, Elizabeth Simpson, Corina R Ronneberg
The surprise election of Donald J. Trump to the presidency of the United States marks a singular turning point in the American republic - not only because of his idiosyncratic approach to the office, but also because the Republican Party now holds the Presidency and both houses of Congress, presenting an historic opportunity for change. The role of older Americans has been critical in both shaping and reacting to this political moment. Their political orientations and behaviors have shaped it through their electoral support for Republican candidates, but they also stand as highly invested stakeholders in the policy decisions made by the very officials they elected, and as beneficiaries of the programs that Republicans have targeted...
May 25, 2018: Journal of Aging & Social Policy
Yuan Yuan Fu, Ernest Wing-Tak Chui, Chi Kin Law, XinYi Zhao, Vivian W Q Lou
Because of its rapidly aging population, Hong Kong faces great challenges in the provision and financing of long-term care (LTC) and needs to explore sustainable funding mechanisms. However, there is a paucity of research on older people's willingness to pay (WTP) for LTC services in Hong Kong. This study utilizes data collected in Hong Kong in 2011 (N = 536) to investigate older people's receptivity to this financing mode by assessing their co-payments for a community care service voucher scheme and then testing how potential factors affect respondents' amount of co-payment...
May 10, 2018: Journal of Aging & Social Policy
Xue Bai
Despite being one of the world's wealthiest cities, approximately one-third of Hong Kong older adults live below the poverty line. Innovatively using the Photovoice research method, this study invited 36 Hong Kong Chinese aging adults to photograph images and voice their concerns and expectations regarding financial care. Insufficient government support, diminishing family support, insecurity and fear regarding future finances, and strong desire for self-sufficiency through early preparation and bridge employment were recurring themes observed in the participants' photographs and narratives...
April 30, 2018: Journal of Aging & Social Policy
Esteban Calvo, Maureen Berho, Mónica Roqué, Juan Sebastián Amaro, Fernando Morales-Martinez, Emiliana Rivera-Meza, Luis Miguel F Gutiérrez Robledo, Elizabeth Caro López, Bernardita Canals, Rosa Kornfeld
This investigation uses case studies and comparative analysis to review and analyze aging policy in Argentina, Chile, Costa Rica, and Mexico and uncovers similarities and relevant trends in the substance of historical and current aging policy across countries. Initial charity-based approaches to poverty and illness have been gradually replaced by a rights-based approach considering broader notions of well-being, and recent reforms emphasize the need for national, intersectoral, evidence-based policy. The results of this study have implications for understanding aging policy in Latin America from a welfare regime and policy makers' perspective, identifying priorities for intervention and informing policy reforms in developing countries worldwide...
April 16, 2018: Journal of Aging & Social Policy
Jiby Mathew Puthenparambil
The early 1990s economic setback brought significant reforms favoring the outsourcing of care in Finnish municipalities. Here, outsourcing refers to the practice of municipalities employing private organizations through different means (e.g., open tendering) to deliver public care services. In this context, this study examines the growth in the outsourcing of service housing and home-help services in 311 municipalities from 2001 to 2015 and investigates the municipal factors associated with outsourcing using four dimensions: care needs, population size, economic situation, and political ideology of the municipality...
April 16, 2018: Journal of Aging & Social Policy
Jan E Mutchler, Yang Li, Ping Xu
Older Americans rely heavily on Social Security benefits (SSBs) to support independent lifestyles, and many have few or no additional sources of income. We establish the extent to which SSBs adequately support economic security, benchmarked by the Elder Economic Security Standard Index. We document variability across U.S. counties in the adequacy levels of SSBs among older adults. We find that the average SSBs fall short of what is required for economic security in every county in the United States, but the level of shortfall varies considerably by location...
April 16, 2018: Journal of Aging & Social Policy
Robert B Hudson
In his surprise election as President, Donald Trump enjoyed disproportionate electoral support from older voters, many of whom saw in Trump a person who would work to reverse demographic, economic, and cultural forces that had transformed American life as they had long seen it. Yet, Trump's campaign and incumbency has also been very much about gutting the Washington policy establishment of officials, bureaucrats, and lobbyists (aka, the Swamp) which, for over half a century, has been instrumental in enacting and expanding legislation that has benefitted older Americans, far more than any other social policy constituency in the country...
April 13, 2018: Journal of Aging & Social Policy
David K Jones, Michael K Gusmano, Pamela Nadash, Edward Alan Miller
The ACA has survived multiple existential threats in the legislative and judicial branches, including dozens of congressional attempts at repeal and two major Supreme Court cases. Even as it seems that the ACA is here to stay, what the law accomplishes is far from settled. The Trump administration is using executive powers to weaken the law, in many cases using the same powers that President Obama used to strengthen the effects of the reform. States have responded by seeking flexibility to pursue reforms, such as work requirements, that could not pass Congress and that were not allowed by the Obama administration...
April 12, 2018: Journal of Aging & Social Policy
Leena Sharma, Carol Regan, Katherine S Villers
Over the past century, the organized voice of seniors has been critical in building the U.S. health safety net. Since the 2016 election, that safety net, particularly the Medicaid program, is in jeopardy. As we have seen with the rise of the Tea Party, senior support for health care programs-even programs that they use in large numbers-cannot and should not be taken for granted. This article provides a brief history of senior advocacy and an overview of the current senior organizing landscape. It also identifies opportunities for building the transformational organizing of low-income seniors needed to defend against sustained attacks on critical programs...
April 12, 2018: Journal of Aging & Social Policy
David Madland, Alex Rowell
Policymakers need to act to protect Americans' retirement security. A significant portion of Americans are at risk of not being able to maintain their standard of living in retirement and research suggests that this percentage is likely to grow. This commentary provides background on the current state of American retirement, highlights recent efforts to reform retirement policy, and predicts what to expect under President Donald Trump. Retirement has not been a major focus of national policymakers in recent years...
April 11, 2018: Journal of Aging & Social Policy
Robyn I Stone
Adequate housing is critical for low-income older adults, who face affordability and accessibility challenges that affect their quality of life, health, and ability to live independently in their communities. This article examines the federal policy role in meeting the housing and housing-related needs of the low-income elderly population, which is expected to grow as a proportion of all older adults over the next two decades. The availability of publicly subsidized units and vouchers is woefully inadequate to assist the current low-income elderly population in need of rental assistance...
April 10, 2018: Journal of Aging & Social Policy
Pamela Nadash, Edward Alan Miller, David K Jones, Michael K Gusmano, Sara Rosenbaum
This paper discusses Republican efforts to repeal the 2010 Patient Protection and Affordable Care Act (ACA) over President Trump's first year in office (2017), and their impact on near-elderly Americans (50-64 years old). We describe how the ACA's provisions for strengthening health care coverage were particularly advantageous for near-elderly Americans: the law shored up employer-sponsored healthcare, expanded Medicaid, and - most importantly - created the conditions for a strong individual health insurance market...
April 10, 2018: Journal of Aging & Social Policy
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