Understanding HCBS utilization: The role of disability onset age and length of disability.

Abstract

Background: Younger adults aging with and older adults aging into disability often need support to remain in their homes and communities. However, researchers and policymakers lack sufficient understanding of their differing needs for home and community-based services (HCBS), largely due to limitations in existing data.

Objectives: This study addresses this gap by exploring select HCBS utilization among adults with disability onset before age 60 and those with onset after age 60, focusing on how aging and disability intersect.

Methods: We used data from multiple waves of the Health and Retirement Study (HRS), the HCBS HRS module and the Health Care Mail Survey. Using these data, we identified individuals by their disability onset (before and after age 60) and measured the duration of their disability. We then examined the use of select HCBS and its association with the onset and duration of disability.

Results: Multivariate regression analysis found no significant differences in service utilization based on the timing of disability onset. Instead, a longer disability duration was associated with increased odds of utilizing HCBS, regardless of when the disability began.

Conclusion: As the population continues to age, more individuals will live with disabilities, including both those who acquire them earlier in life and older adults who develop them in later years. This analysis emphasizes the critical role of disability duration in understanding service needs and resource allocation. By combining perspectives from aging and disability research, this study underscores the need for integrated policies and programs that address shared challenges. Such an approach can bridge existing gaps, leading to better outcomes for all individuals living with disabilities.