Racial-Ethnic Gaps in Pandemic-Related Economic Hardship: Age Differences Among Older Adults.

OBJECTIVES: Racial-ethnic disparities in experiences of economic hardship during the pandemic are well documented in the population overall and among older adults. Existing research shows that this economic hardship was much less common at older than younger ages. Little is known about the intersection of racial-ethnic and age disparities in pandemic-related hardship in later life. This research report investigated racial-ethnic gaps in economic hardship by age group among older adults. METHODS: Data were from the 2018 and 2020 U.S. Health and Retirement Study (HRS) including the 2020 coronavirus disease 2019 module. We estimated Heckman-corrected linear probability models to examine differences in experiences of pandemic-related economic hardship in the 2020 HRS by race-ethnicity (non-Hispanic White, non-Hispanic Black, U.S.-born Hispanic, foreign-born Hispanic) across age groups (55-64, 65-74, 75+). In the multivariable analysis, we controlled for sociodemographic characteristics, participation in social programs, pre-existing health conditions and behaviors, and economic resources from the 2018 HRS. RESULTS: Experiences of economic hardship declined with age within each racial-ethnic group. Racial-ethnic gaps in hardship remained at older ages without any controls. However, when all controls were added, racial-ethnic gaps in economic hardship were eliminated for those ages 75+. Individual characteristics prior to the pandemic explained racial-ethnic differences in hardship for the oldest adults (75+) but did not explain gaps for those ages 55-74. DISCUSSION: Results point to structural factors generating new racial-ethnic gaps in pandemic-related economic hardship among those approaching retirement (ages 55-74) that did not affect the oldest adults (ages 75+).

State COVID-19 Policies and Drug Overdose Mortality Among Working-Age Adults in the United States, 2020.

Objectives. To identify relationships between US states' COVID-19 in-person activity limitation and economic support policies and drug overdose deaths among working-age adults in 2020. Methods. We used county-level data on 140 435 drug overdoses among adults aged 25 to 64 years during January 2019 to December 2020 from the National Vital Statistics System and data on states' COVID-19 policies from the Oxford COVID-19 Government Response Tracker to assess US trends in overdose deaths by sex in 3138 counties. Results. Policies limiting in-person activities significantly increased, whereas economic support policies significantly decreased, overdose rates. A 1-unit increase in policies restricting activities predicted a 15% average monthly increase in overdose rates for men (incident rate ratio [IRR] = 1.15; 95% confidence interval [CI] = 1.09, 1.20) and a 14% increase for women (IRR = 1.14; 95% CI = 1.09, 1.20). A 1-unit increase in economic support policies predicted a 3% average monthly decrease for men (IRR = 0.97; 95% CI = 0.95, 1.00) and a 4% decrease for women (IRR = 0.96; 95% CI = 0.93, 0.99). All states' policy combinations are predicted to have increased drug-poisoning mortality. Conclusions. The economic supports that states enacted were insufficient to fully mitigate the adverse relationship between activity limitations and drug overdoses. (Am J Public Health. 2024;114(7):714-722. https://doi.org/10.2105/AJPH.2024.307621).

Age Differences in Experiences of Pandemic-Related Health and Economic Challenges Among Adults Aged 55 and Older.

BACKGROUND AND OBJECTIVES: The oldest adults faced the highest risk of death and hospitalization from coronavirus disease 2019 (COVID-19), but less is known about whether they also were the most likely to experience pandemic-related economic, healthcare, and mental health challenges. Guided by prior research on vulnerability versus resilience among older adults, the current study investigated age differences in economic hardship, delays in medical care, and mental health outcomes among adults aged 55 and older. RESEARCH DESIGN AND METHODS: Data were from the COVID-19 module and Leave Behind Questionnaire in the 2020 Health and Retirement Study (HRS). We estimated linear probability models to examine differences in experiences of pandemic-related economic and health challenges by age group (55-64, 65-74, 75+) with and without controls for preexisting sociodemographic, social program, health, and economic characteristics from the 2018 HRS. Models accounting for differential mortality also were estimated. RESULTS: Adults aged 65-74 and 75+ experienced fewer economic and mental health challenges and those aged 75+ were less likely to delay medical care than adults aged 55-64. Age gradients were consistent across a broad range of measures and were robust to including controls. For all age groups, economic challenges were less common than delays in medical care or experiences of loneliness, stress, or being emotionally overwhelmed. DISCUSSION AND IMPLICATIONS: Even though the oldest adults were at the greatest risk of death and hospitalization from COVID-19, they experienced fewer secondary pandemic-related challenges. Future research should continue to explore the sources of this resilience for older adults.

Disparities in vulnerability to complications from COVID-19 arising from disparities in preexisting conditions in the United States.

The COVID-19 pandemic has magnified U.S. health disparities. Though disparities in COVID-19 hospitalization by race-ethnicity are large, disparities by income and education have not been studied. Using an index based on preexisting health conditions and age, we estimate disparities in vulnerability to hospitalization from COVID-19 by income, education, and race-ethnicity for U.S. adults. The index uses estimates of health condition and age effects on hospitalization for respiratory distress prior to the pandemic validated on COVID-19 hospitalizations. We find vulnerability arising from preexisting conditions is nearly three times higher for bottom versus top income quartile adults and 60 % higher for those with a high-school degree relative to a college degree. Though non-Hispanic Blacks are more vulnerable than non-Hispanic Whites at comparable ages, among all adults the groups are equally vulnerable because non-Hispanic Blacks are younger. Hispanics are the least vulnerable. Results suggest that income and education disparities in hospitalization are likely large and should be examined directly to further understand the unequal impact of the pandemic.

Disparities in Vulnerability to Severe Complications from COVID-19 in the United States.

This paper provides the first nationally representative estimates of vulnerability to severe complications from COVID-19 overall and across race-ethnicity and socioeconomic status. We use the Panel Study of Income Dynamics (PSID) to examine the prevalence of specific health conditions associated with complications from COVID-19 and to calculate, for each individual, an index of the risk of severe complications from respiratory infections developed by DeCaprio et al. (2020). We show large disparities across race-ethnicity and socioeconomic status in the prevalence of conditions which are associated with the risk of severe complications from COVID-19. Moreover, we show that these disparities emerge early in life, prior to age 65, leading to higher vulnerability to such complications. While vulnerability is highest among older adults regardless of their race-ethnicity or socioeconomic status, our results suggest particular attention should also be given to the risk of adverse outcomes in midlife for non-Hispanic Blacks, adults with a high school degree or less, and low-income Americans.

New Estimates of the Sandwich Generation in the 2013 Panel Study of Income Dynamics.

Purpose of the Study: We use the Roster and Transfers Module in the 2013 Panel Study of Income Dynamics to obtain the first estimates of the prevalence of transfers to adult children and parents for United States men and women aged 35-75. Design and Methods: This article extends the current understanding of the sandwich generation by comparing recent transfers of time and money to parents and adult children for men and women and across ages between 35 and 75 years of age. Results: Over 30% of individuals with living parents and adult children provide transfers to two generations. The prevalence of transfers does not differ by age and the differences between men and women are small, though statistically significant. Conditional on providing time transfers, women provide more hours of help than men, particularly to their adult children. The number of hours given to children exceeds the number given to parents. Implications: These findings are the first to show that both men and women are likely to provide transfers to two generations and that transfers to two generations are common across adult ages. Our findings suggest a need to rethink the notion of the sandwich generation, which has focused on women in late middle age, to include men and women across younger and older ages.

The effect of unemployment on household composition and doubling up.

"Doubling up" (sharing living arrangements) with family and friends is one way in which individuals and families can cope with job loss, but relatively little research has examined the extent to which people use coresidence to weather a spell of unemployment. This project uses data from the Survey of Income and Program Participation (SIPP) to provide evidence on the relationship between household composition and unemployment across working ages, focusing on differences in behavior by educational attainment. Using the SIPP panels, I find that individuals who become unemployed are three times more likely to move in with other people. Moving into shared living arrangements in response to unemployment is not evenly spread across the distribution of educational attainment: it is most prevalent among individuals with less than a high school diploma and those with at least some college.