Tracking what’s happening with the aging

A study reported in Milbank Quarterly, a journal on health care policy, shows that U.S. states vary widely in how well they are adapting to their aging populations. While the data used in the study now has aged just as the populations continue to age, it does provide some clues about where in the country one can find support from states for the process of  aging.

To conduct the study, researchers at Stanford University School of Medicine, University of Pennsylvania and Columbia University Mailman School of Public Health modified an index previously used to assess adaptation to successful aging in developed countries and applied it to U.S. states between 2003 and 2017

Five key areas were analyzed: productivity and engagement, security, equity, cohesion and well-being.

The highest-ranked states were Vermont, Hawaii, Iowa, Colorado, and New Hampshire. The lowest-ranked states were Louisiana, Arkansas, Kentucky, West Virginia and Mississippi.

“We found that no one domain is driving the bus here: it”™s not all about education, it”™s not all about income,” said author John Rowe, who is the Julius B. Richmond Professor of Health Policy and Aging at the Columbia Mailman School of Public Health. “You need a multidimensional perspective.”

The study found no national trends in successful aging, suggesting that in aging it is state policy that determines whether any particular place is going to be a good place to grow older. It is state policies that will reflect whether a state is adapting to its aging population.

“We wanted to think broadly about all the things that go into making a state a place that gives people the best opportunity to age successfully,” said lead author David H. Rehkopf of Stanford University School of Medicine. “There wasn”™t previously a way for people, especially policymakers at the state level, to look at how well they were doing as a state. We hope this will help them think more holistically about what the impacts of their policies are and the connections between health and well-being and all policies.”

Key items that helped in the analysis of what states were doing included: Supplemental Nutrition Assistance Program spending; retirement benefit spending, public welfare spending, proportion of taxes paid by the top 15% of taxpayers; proportion of taxes paid by the bottom 20% of taxpayers, number of physicians and Medicaid spending.

“More work is needed to establish the type of factors that would act as drivers of our index, and our index may be more impacted by broader policy trends over a longer period of time,” the authors wrote.