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Social services expenditures and diabetes outcomes among older adults
Methods: We conducted multivariable logistic regression to estimate associations between state OAA expenditures (AGing Integrated Database) and older adult diabetes-related outcomes (Behavioral Risk Factor Surveillance System) for 2005-2009. Models were adjusted for individual demographic factors and state-level characteristics, including Medicare spending. Time fixed effects and robust standard errors were also incorporated.
Results: OAA spending per 1,000 older adults ranged from $14,200 to $102,500 across states. Increases in total OAA expenditures were associated with lower likelihood of ever being diagnosed with diabetes (p<.001) after adjusting for covariates. This association remained significant when nutrition (p<.001) and transportation (p<.05) expenditures were analyzed separately. Associations between OAA expenditures and diabetic retinopathy were not statistically significant.
Conclusions: These findings demonstrate the potential for non-medical investments to support diabetes prevention for older adults, but suggest that these expenditures may not be as protective for complications of existing disease.
Learning Areas:
Public health or related public policyPublic health or related research
Systems thinking models (conceptual and theoretical models), applications related to public health
Learning Objectives:
Assess the association between state-level Older Americans Act expenditures and diabetes-related outcomes among adults aged 65 years and older.
Identify two social service categories for which increased expenditures are protective for older adult diabetes outcomes.
Keyword(s): Public Policy, Aging
Qualified on the content I am responsible for because: I am a pre-doctoral trainee on the federally-funded AHRQ-Yale T32 Training Grant for Health Services Research. My research focuses on the role of non-medical factors (e.g., social services) in health outcomes of adults aged 65 years and older, and the variation in state-level approaches to improving older adult health.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.