Medicare may have survived the budget cuts included in congressional Republicans’ plans to repeal Obamacare.
However, even at current funding levels, there’s only so much it can do for the health of older Americans, new research shows.
The number of Americans 65 and older who report being in good health is growing, but that progress is limited to certain demographics.
And the health disparities between those demographics is growing.
Overall, 48 percent of seniors reported being in good health in 2014 compared to 42 percent in 2000.
But those gains were mostly in the wealthiest, highest educated, and white demographics.
Some other demographics — including African-Americans, Latinos, and those with less than a high school education — saw a decrease in average self-reported health status since 2000.
Those are the findings of a published in the journal JAMA Internal Medicine.
Matthew Davis, an assistant professor at the University of Michigan School of Nursing and the study’s lead author, said he was surprised to see the “widening of disparities in good health over the 15-year time period despite health insurance coverage.”
What causes the disparities?
Medicare provides near universal health coverage to older Americans.
So, that means the causes of the disparities in senior health likely lie in something other than access to healthcare.
“I believe it points to the impact of social, economic, and environmental factors. In some ways, the growing disparities in health echo the growing divide in income. Income impacts health,” Davis, who uses data science to research health services issues, told Healthline.
People with more financial resources and more education are more likely to “invest” in their health through healthy behaviors, he explained.
That might include higher priced actions such as joining a gym, buying fresher and healthier food, or living in a neighborhood with less pollution.
However, the study didn’t specifically address the reasons behind the disparities.
Davis and his team reviewed a survey of 55,000 older Americans who had self-reported their health twice over the course of a year.
It’s possible that white respondents or those with higher incomes and higher education could’ve perceived themselves as being healthier — or vice versa for people who reported being less healthy, Davis conceded.
But, he said, that possibility likely wouldn’t explain the growth in self-reported health disparities over time.
“We cannot completely rule out a potential self-reporting bias by group,” he said. “However, the question used in our study is well validated as a measure of health. Potential differences in self-reported health might impact differences at any one point, but would not likely impact changes over time.”
What can be done
Davis said there’s lots more work to be done in answering questions about how socioeconomic status relates to health and the impact of public health initiatives.
Chief among those questions may be how to close the health disparity gap.
The Department of Health and Human Services has a Disparities Action Plan that outlines a road map for addressing the gaps.
And health disparities are among the trends the Centers for Disease Control and Prevention (CDC) track in the older U.S. population.
The it’s “aware that even though life expectancy and overall health have improved in recent years for most Americans, not all older adults are benefitting equally because of factors such as economic status, race, and gender. CDC acknowledges that this is a growing problem and is trying to incorporate these issues into our work.”
But that has proven difficult for other initiatives.
The Affordable Care Act (ACA) “sharply reduced” uninsured rates for people of color and low-income Americans of all ages, according to the Kaiser Family Foundation.
However, disparities remain.
Like the ACA for the general population, Medicare may only be able to do so much to close health gaps among older Americans.
“As boomers turn 65 and go on Medicare, it is not surprising that the overall population gets healthier,” said Tricia Neuman, senior vice president of the Kaiser Family Foundation and director of its Program on Medicare Policy.
But “even a successful program like Medicare can only go so far in narrowing the disparities in health revealed by this study,” Neuman told Healthline.