Posts Tagged "health"

Medicare to Cover 3 New Dental Procedures

“Is it medically necessary for a person to be able to chew?” Dr. Lisa Simon, a physician and dentist at the Harvard School of Dental Medicine, asks.

This is a serious question for older Americans in fragile health. I know a 93-year-old man whose teeth problems make it extremely difficult for him to eat meat and many other foods on the dinner table.

Two-thirds of retirees do not have dental insurance, which means they may decide to forgo getting expensive dental care. The importance of dental care to nutrition and health is also an equity issue for older Blacks and low-income retirees, who are more likely to be missing all of their teeth.

Medicare has historically paid for very few dental procedures. But the Centers for Medicare and Medicaid Services has expanded its existing, limited coverage to include treating patients who have oral infections prior to an organ transplant and patients who need a cardiac procedure or treatment of head and neck cancers.

Simon, who advocates for integrating dental care into overall medical care, argues in the journal Health Affairs that Medicare’s expansion of coverage for medically necessary procedures does not go far enough.

“These provisions are an overly narrow interpretation of what makes a health care service          ‘necessary,’ ” Simon writes.

She lists several examples of medically necessary conditions that don’t seem to fit Medicare’s updated definition. They include cancer patients who have oral inflammation during chemotherapy, diabetes patients with periodontal disease, and elderly women being treated for osteoporosis with injections that put them at risk of painful jaw deterioration. …Learn More

Great Depression Holds Lesson for Our Time

Photograph by Lewis Hines, West Virginia 1937

Photograph by Lewis Hines, West Virginia 1937.

The Great Depression, sparked by a devastating collapse in stocks followed by 25 percent unemployment, remains the deepest recession in U.S. history.

A new study laying out the long-term negative impacts to Americans born during that time might be consequential for today’s youngest citizens –  teenagers born during the Great Recession of 2008 and 2009 and toddlers born in the midst of the steep COVID downturn in 2020.

The researchers found that the stresses and financial strains on parents from the Depression’s extraordinarily high unemployment over a protracted period of time did long-term damage to the health and careers of their children that persisted late into their lives. In a separate but related paper, they also found that people exposed to the Depression in utero experienced an acceleration in the aging process after age 75.

“The shock of the Great Depression was massive and everyone, no matter what group they belonged to, was to some extent impacted,” concluded the researchers, Valentina Duque and Lauren Schmitz.

For a whole host of reasons, a parent’s loss of income and joblessness have a huge impact on their children’s development and socioeconomic status, which in turn determine how they will do when they grow up. Prenatal stress on mothers, for example, has been linked to lower earnings for their offspring as adults. In utero stress also contributes to cognitive and behavioral problems late in life.

A father’s financial distress can harm the long-term health of children if the family can’t afford to buy nutritious groceries and quality healthcare or isn’t able to relocate to another part of the country with better job prospects.

To assess the Depression’s impact on health and careers, this study used a survey of older Americans. The researchers identified adults born in the 1930s to analyze how they fared late in their careers based on how severe the Depression was in the state where they were born or lived as young children.

The analysis, using IRS tax records, indicated that the offspring of the Depression’s parents living in states with larger declines in wages earned less throughout their careers – the impact in utero was larger than for the workers exposed to the Depression as young children.

The Depression created other deficiencies too: by the time the people born in more depressed states reached their 50s and early 60s, they were less productive and less attached to the labor force than their counterparts who grew up in states with stronger economies during that difficult time. They also had poorer health, were more often disabled, and had higher mortality due to health problems like diabetes and cardiovascular disease.Learn More

Too Much Debt Taxes Baby Boomers’ Health

work related stress

Staying healthy is becoming a preoccupation for baby boomers as each new medical problem arises and the existing ones worsen.

The stress of having too much debt isn’t helping.

The older workers and retirees who carry debt are less healthy than the people who are debt free, and higher levels of debt have worse health effects, according to Urban Institute research. The type of debt matters too. Unsecured credit cards have more of an impact than secured debt – namely a mortgage backed by property.

Debt can erode an individual’s health in various ways. The stress of carrying a lot of debt has been shown to cause hypertension, depression, and overeating. And it can be a challenge for people to take proper care of themselves if they have onerous debt payments and can’t afford to buy health insurance or, if they are insured, pay the physician and drug copayments.

This is an issue, say researchers Stipica Mudrazija and Barbara Butrica, because the share of people over age 55 with debt and the dollar amount of their debts, adjusted for inflation, have been rising for years. In this population, increasing bankruptcies – a high-stress event – have been the fallout.

In an analysis of two decades of data comparing older workers and retirees with and without debt, the researchers found that having debt is tied to the borrowers’ declining self-evaluations of their mental and physical health. Older people who are in debt are also more likely to be obese, to have at least two diagnosed health conditions, or to suffer from dementia or various ailments that limit their ability to work.

The bulk of their debt is in the form of mortgages, which increasingly have strained household budgets in recent decades as home prices have outpaced incomes. Piled on top of the larger mortgage obligations can be payments for credit card debt, medical debt, car loans, and college loans – often for the boomers’ children. …Learn More

retired couple on a boat

Health and Wealth Drive Retirees’ Spending

Previous research has shown that spending drops immediately at the moment the paychecks stop, and a few studies have found that households, once retired, reduce their consumption over time.

But a new study that also takes the long view suggests that the spending decline is not what retirees want to do but what is necessitated by their financial and health constraints.

The analysis, which used data from two national consumption surveys, divided retired households into groups to get a sense of what goes into their spending decisions. The researchers compared the consumption patterns of retirees at three different wealth levels over a 20-year period and then compared consumption for three states of health.

The evidence that financial resources drive behavior is that the wealthier households’ consumption was relatively constant, declining just one-third of 1 percent a year.

While these retirees have the financial wherewithal to largely maintain their spending, retirees in the bottom wealth tier saw bigger drops of 1 percent a year. When accumulated over 20 years, the declines produced much lower spending levels than when they first retired.

Health is a second factor in retirees’ decisions. Again, the extremes tell the story. Spending in the top tier – very good or excellent health – held fairly flat, while the retirees in fair or poor health saw relatively large declines. Even if they can afford to travel or eat out frequently, health problems may be preventing them from enjoying their money. …Learn More

Using Home Equity Improves Retiree Health

Retirees spend $1,500 more per year, on average, for medical care after a diagnosis of a serious condition like lung disease or diabetes.

Often, the solution for individuals who can’t afford such big bills is to scrimp on care or avoid the doctor altogether. But older homeowners can get access to extra cash if they withdraw some of the home equity they’ve built up over the years.

While the money clearly provides financial relief for retirees, a new study out of Ohio State University finds that it is also good for their health. Every $10,000 that Medicare beneficiaries extracted from their homes greatly improved their success in controlling a chronic or serious disease.

Among the retirees who had hypertension or heart disease, for example, one standard used to determine whether the condition was under control was whether blood pressure levels stayed below 140/90, which the medical profession deems an acceptable level. The people who tapped their home equity were more likely to stay below these levels than those who did not.

This is one of several studies in recent years to tie financial security to home equity, a resource many retirees are reluctant to tap. A study in 2020 found that older homeowners were less likely to skip medications due to cost after they had extracted equity through a refinancing, home equity loan, or reverse mortgage.

But this new research is the first attempt to connect the strategy to retirees’ actual health. The analysis followed the health of more than 4,000 homeowners for up to 15 years after they were diagnosed with one of four conditions – lung disease, diabetes, heart conditions, or cancer. …Learn More

newborn baby at hospital

Newborns’ Health Issues Affect Moms’ Work

One in five babies born in U.S. cities is in poor health, with profound and lasting impacts on their own and their mother’s lives.

Researchers reached this conclusion after following nearly 3,700 infants and their mothers through Princeton’s Fragile Families Survey, which checked in on the families six times between the child’s birth and age 15. The survey was fielded in cities with a 200,000-plus population, and the babies’ most common medical conditions were low birth weight, premature birth, and genetic or other abnormalities, such as difficulty breathing.

A body of research on the long-run prospects for children with disadvantages – whether medical or socioeconomic – has established that they have far more problems as adults. Consistent with other prior research, a study by Dara Lee Luca and Purvi Sevak at Mathematica also found an immediate consequence for newborns in poor neonatal health: a greater likelihood of having a disability such as a motor or speech disorder or neurodevelopmental problems such as ADHD and autism.

Within their first year, the infants often qualified for federal cash payments to their mothers under Supplemental Security Income for Children (SSI).

The inordinate amount of time spent caring for babies in poor neonatal health takes an enormous toll on the mothers, the researchers found. While caregiving didn’t seem to impact their mental health, their ability to hold down a job was significantly compromised. The mothers of babies in poor health worked fewer hours, especially when the children were very young, and were more likely to drop out of the labor force entirely. …Learn More

Pain in different areas of the body

Opioids: Cause or Consequence of Disability?

Opioid painkillers are a double-edged sword for older workers. The medications allow them to keep working through their joint or back pain. But a slide into addiction would interfere with doing their jobs.

A new RAND study of workers over age 50 has identified some of the negative consequences of relying on opioids. Rather than promoting work, the researchers found that opioids can cause or exacerbate disabling health conditions, hindering users’ ability to work and making them increasingly dependent on federal disability benefits over time.

Bad results from opioid overuse may seem predictable, given that doctors prescribe them to people who are in worse physical condition in the first place. But older workers’ health is already in decline, just by virtue of their age, so it’s not always clear how, or to what extent, opioids are affecting them.

The researchers sorted this out using a 2009 survey of older Americans in the long-running Health and Retirement Study (HRS). They matched people who didn’t take the medications with similar people who did – similar in everything from their functional limitations and sociodemographics to their labor market histories. The HRS continued to interview both groups over the next decade, allowing the researchers to compare the opioids’ effects over a longer period than prior studies.

For example, although the opioid users and non-users were in similar health in 2008, things changed dramatically – and quickly – the researchers found. As early as 2012, the opioid users were significantly more likely to have developed a disabling condition that limited their work capacity.

Opioid use or abuse is linked to myriad health problems. Overuse can exacerbate autoimmune conditions such as rheumatoid arthritis. Users also have less healthy lifestyles and are prone to infectious diseases and mental illness, and opioids can impair lung function. …Learn More