May 10, 2022

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

Research

March 2, 2021

Blue-collar workers who end up applying for federal disability benefits find themselves in that position for a variety of interrelated reasons.

A dangerous or physically demanding job can either cause an injury or exacerbate a medical condition that could lead to a disability. And people with limited resources in childhood often develop health problems earlier in life, and their circumstances can limit their access to job opportunities, making them more likely to end up in dangerous or physically demanding jobs.

A new NBER study untangles all these factors to clarify who applies for disability and which applicants ultimately receive benefits through Social Security’s rigorous approval process.

Researchers at Stanford and the University of Wisconsin linked a survey of Americans 50 and older to occupational data describing the level of environmental and physical hazards they’ve faced during decades of working. Next, socioeconomic measures of their upbringing – the adults’ descriptions of their childhood health, education, and parents’ financial resources – were layered into the analysis. Finally, the researchers repeated the process, replacing childhood health with genetic data on their predispositions to various disabling illnesses.

Blue-collar and service workers are known to apply for federal disability benefits at higher rates than white-collar workers. But the researchers showed that low socioeconomic status in childhood – by limiting the options for less strenuous jobs – played an even bigger role than workplace demands in whether the workers applied for the benefits.

However, when it comes to who is approved for benefits, physical and mental job requirements were key – and socioeconomic status plays no role. This makes sense because the heart of Social Security’s approval process is a determination that a disabled person is unable to do his previous job or another job appropriate to his age and experience.

An applicants’ health is, by definition, always central to whether he qualifies for disability. The final step in the researchers’ analysis used genetic data to get a picture of the applicants’ underlying health – as distinct from the health problems originating from a disadvantaged childhood. …Learn More

Behavior

September 22, 2020

A danger for working-age people with disabilities is that they become socially isolated, which can cause a further deterioration in their health and ability to function.

A good example of this vicious cycle is people with severe arthritis. If joint pain makes walking more difficult, it can limit one’s ability to do things with friends or be out in public, which means more social isolation and less exercise to ease the pain’s disabling effects.

A new Mathematica study connects this phenomenon to the sharp rise in the share of Social Security disability awards going to people with arthritis, back pain, and other musculoskeletal conditions.

Between 1997 and 2017, there was a slight increase, to 13.4 percent, in the share of Americans with musculoskeletal conditions who reported being socially isolated, according to the study, which was conducted for the Retirement and Disability Research Consortium.

Discomfort in social settings is also present in the general population – but at about half the rate, or 6 percent of adults.

Another contributor to social isolation is cognitive impairment, which includes confusion and poor memory. Cognitive impairments are also on the rise among people with arthritis and related conditions. The increase can’t solely be attributed to the aging of the U.S. population either, because the analysis controlled for age in order to eliminate its effects.

To understand the role of social isolation in disability, the researchers point to the vicious cycle between the two.

“Whether social isolation is exacerbating disability or disability is exacerbating social isolation,” they said, “the contributing limitations are risk factors” that will worsen a disability that already exists. …Learn More

Research

September 10, 2020

The mix of disabilities for people receiving federal disability insurance has changed in important ways that often reflect trends in the health of the population as a whole.

Two disabling conditions that have become a growing share of Social Security’s benefit awards in recent decades are mood disorders and various musculoskeletal problems, which include arthritis and back pain.

First, consider mood disorders. They range from depression and bipolar disorder to irritability and seasonal affective disorder, and they can hamper someone’s ability to work. Mirroring the rising share of awards for mood disorders, their prevalence in the population has edged up from 54.6 percent of adults in 1997 to 56.2 percent in 2017, according to a study by Mathematica, a research organization.

Second, disability awards to people with musculoskeletal problems like arthritis and back pain have increased dramatically. These conditions are often aggravated by carrying excess weight, so the rise in cases aligns with the researchers’ estimate that the adult obesity rate has surged from about 20 percent to 31 percent. 

But a related finding about musculoskeletal conditions is more difficult to explain. Despite the growth in disability awards involving these conditions, the share of the population afflicted by them – about a third – hasn’t changed much, according to the study, which was conducted for the Retirement and Disability Research Consortium.

The researchers found one clue to this apparent contradiction in a separate analysis indicating that this population’s ability to work may be deteriorating over time. …Learn More

On the Web

June 16, 2020

The share of people in their late 50s with the second most severe form of obesity has tripled since the early 1990s. This grim fact, featured in a recent Squared Away article, clarifies COVID-19’s danger to older Americans.

The article, “Our Parents Were Healthier at Ages 54-60,” summarized research establishing that baby boomers are less healthy than their parents’ generation due to several conditions related to obesity, including diabetes, pain levels, and difficulty performing daily activities. The poorest Americans’ health deteriorated the fastest – and COVID-19 is preying on them.

“This decline in markers of metabolic health seems to correlate with increased vulnerability to the pandemic,” wrote one reader, Dan O’Brien, who was among several who commented on recent health-related blogs.

That’s what happened during the H1N1 flu pandemic in 2009. Hospitalizations – and possibly death rates – were tied to obesity in adults with multiple health conditions, according to the National Institutes of Health.

“The vast majority of [COVID-19 patients] who reach the ICU suffer from comorbidities. My takeaway is that metabolic dysfunction is tied to immune-system failure in ways we don’t yet understand,” O’Brien said.

Another reader, Lorraine Porto, advocated a simple way for people to keep their weight in check: walk. An elderly woman she knows “walked miles every week.” Porto believes this healthy habit saved the woman’s life when she broke her hip in her 80s and was “walking around, sprightly as ever, less than two months later.” The woman lived into her 90s, Porto said.

A second health-related blog popular with readers looked at the unexpected costs of treating medical conditions that become more common in old age.

Older workers and retirees who try to anticipate their future medical expenses might feel a bit like they’re throwing a dart at a dartboard. The researchers did the work for them in a study described in the blog, “Unexpected Retirement Costs Can be Big.” …Learn More

Research

April 7, 2020

Baby boomers aren’t as healthy as their parents were at the same age.

This sobering finding comes out of a RAND study that took a series of snapshots over a 24-year period of the health status of Americans when they were between the ages of 54 and 60.

The researchers found that overall health has deteriorated in this age group, and they identified the specific conditions that are getting worse, including diabetes, pain levels, and difficulty performing routine daily activities.

Obesity is an overarching problem: the share of people in this age group with class II obesity, which puts them at very high risk of diabetes, tripled to 15 percent between 1992 and 2016.

In addition to declining health, the study for the Retirement and Disability Research Consortium uncovered strong evidence of growing health disparities among 54 to 60-year-olds: the poorest people are getting sicker faster than people with more wealth.

The increase in women’s pain levels has been starkest over the past 24 years. The wealthiest women have seen an increase of 6 percentage points in the share experiencing moderate to severe pain from conditions like joint or back pain. But the poorest women saw a 21-point leap. The disparity for men was also large: up 7 points for the wealthiest men versus 15 points for the poorest men.

The bottom line: today’s 54 to 60-year-olds are not as healthy as their parents were, and the study suggests that the disparities between rich and poor will continue to grow.

To read this study, authored by Peter Hudomiet, Michael D. Hurd, and Susann Rohwedder, see “Trends in Health and Mortality in the United States.”Learn More

February 4, 2020

Life expectancy for 65-year-olds in the United States is less than in France, Japan, Spain, Italy, Australia, Canada, the United Kingdom, the Netherlands, and Germany.

Fifty years ago, we ranked third.

First, some perspective: during that time, the average U.S. life span increased dramatically, from age 79 to 84. The problem is that we haven’t kept up with the gains made by the nine other industrialized countries, which has caused our ranking to slide.

A troubling undercurrent in this trend is that women, more than men, are creating the downdraft, according to an analysis by the Center for Retirement Research. The life expectancy of 65-year-old American women is 2½ years less than women in the other countries. The difference for men is only about a year.

The center’s researchers identified the main culprits holding us back: circulatory diseases, respiratory conditions, and diabetes.  Smoking and obesity are the two major risk factors fueling these trends.

Americans used to consume more cigarettes per capita than anyone in the world. That’s no longer true. In recent years, the U.S. smoking rate has fallen sharply, resulting in fewer deaths from high blood pressure, stroke, and other circulatory diseases.

But women haven’t made as much progress as men.  Men’s smoking peaked back in the mid-1960s, and by around 1990, the delayed benefits of fewer and fewer smokers started improving men’s life expectancy. Smoking didn’t peak for women until the late-1970s, and their death rate for smoking-related diseases continued to rise for many years after that, slowing the gains in U.S. life expectancy overall.  More recently, this pattern has reversed so that women are now beginning to see some improvement from reduced smoking.

Obesity is a growing problem across the developed world. But in this country, the obesity rate is increasing two times faster than in the other nine countries. Nearly 40 percent of American adults today are obese, putting them at risk of type-2 diabetes and circulatory and cardiovascular diseases. …Learn More