How Does Age Matter? Investigating Financial Strain, Health, and Well-Being Among Adults Who Need Long-Term Services and Supports.

Abstract

Background and objectives: Being or becoming disabled over the life course can have profound effects on one's financial well-being and health-related quality of life. Adults of different ages and abilities who need long-term services and supports (LTSS) may perceive and experience financial strain and its impact on their health and well-being differently. Yet research on LTSS has typically studied defined age groups separately. This study explores how age may differentiate the associations between disability status, financial strain, and the subjective health and well-being of adults with LTSS needs in California.

Research design and methods: Using representative population-level data from the 2019 to 2020 California Long-Term Services and Supports survey, merged with data from the California Health Interview Survey (N = 2,030), descriptive and conditional process analyses were applied to answer the primary research questions.

Results: Findings indicate that young and middle-aged adults with LTSS needs struggled more than older adults to make financial ends meet. Middle-aged and older adults reported worse self-rated health, whereas younger adults were more likely to experience serious psychological distress. The indirect effects of difficulty in performing instrumental activities of daily living and the experience of serious psychological distress through financial strain were significant for young and middle-aged adults but not significant for older adults.

Discussion and implications: These findings suggest the need to calibrate services to be more responsive to diverse experiences of disability, and to reset aging and disability silos to create coordinated LTSS networks for people with disabilities of all ages.