Lei Chen

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.

Using representative population-level data from the 2019–2020 California Long-Term Services and Supports survey, merged with data from the California Health Interview Survey (CHIS), descriptive and conditional process analyses were applied to answer the primary research questions.

Findings: 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, while 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.

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.
 

This fact sheet reports on social characteristics of neighborhoods as perceived by Californians with needs for long-term services and supports (LTSS). Authors detail how perceptions of neighborhood safety and trust vary by race or ethnicity and income and show how a sense of neighborhood cohesion (i.e., perceptions of neighborhood safety, neighbors’ willingness to help, and trust) may be an important driver of mental health for this population. The data presented were taken from the 2019–2020 California Long-Term Services and Supports (CA-LTSS) study, a follow-on survey of the 2019–2020 California Health Interview Survey (CHIS).

Findings: Most Californians with LTSS needs report high levels of neighborhood cohesion, but there are significant differences by racial/ethnic group. Significant differences in perceptions of neighborhood cohesion by income were also found. For Californians with LTSS needs, neighborhood cohesion may be an important driver of mental health. 
 

This fact sheet uses statewide population–level data to describe the financial worries experienced by California adults who have needs for Long-Term Services and Supports (LTSS) and to assess the extent of these worries by race or ethnicity and by employment status. Data were obtained from the 2019–2020 California Long-Term Services and Supports (CA-LTSS) study, a follow-on survey of the 2019–2020 California Health Interview Survey (CHIS).

Findings: The experience of financial worries among California adults who have LTSS needs varies depending on race or ethnicity and employment status. Having financial worries among this group has implications for health outcomes. Among adults with LTSS needs, lower income is associated with poorer health outcomes.
 

This policy brief presents data on the health and well-being of adults with a disability or with long-time chronic conditions who have needs for Long-Term Services and Supports (LTSS) and compares their health status with that of the general California population. It further examines how health outcomes vary by race and ethnicity, employment status, unmet needs for LTSS, and access to health care. The data are from the 2019–2020 California Long-Term Services and Supports (CA-LTSS) study, a follow-on survey of the 2019–2020 California Health Interview Survey (CHIS).

Findings: Adults with disabilities who have needs for LTSS are three times more likely to report fair or poor health and to experience serious psychological distress than the general adult population in California. The psychological well-being of adults with needs for LTSS varies by race and ethnicity. Employment status is a potential driver of health and well-being among adults with LTSS needs. Access to both LTSS and clinical health care is a potential driver of health and well-being. 

The findings can inform the development of policies and programs that improve the identification and assessment of need, access to appropriate care, and the allocation of resources to better address the ongoing care needs of individuals living with disabilities particularly for those who are at greatest risk of experiencing poor health and well-being.