Date Presented 03/23/24

This research explored older adults living in affordable housing and their views of social determinants of health and health management. The findings provide a better understanding of the role of personal factors of age and socioeconomic status on health management.

Primary Author and Speaker: Kathleen (Kay) Cahill Graham

Contributing Authors: Bailey Lester, Ziwang Long, Michaela Williams, Lanisha Mitchell

BACKGROUND: Older adults with chronic conditions often have complex health management needs. About one in three has inadequate health literacy, increasing their risk for poor health outcomes. Limited literature explores low-income older adults’ health perspectives related to Social Determinants of Health (SDOH), such as finances, which can lead to negative health outcomes.

PURPOSE: This research sought to enhance understanding of older adults living in affordable housing and their perceptions of aspects of SDOH on health management. Research question: How do older adults living in affordable housing perceive their health management based on SDOH?

DESIGN: We used grounded theory methodology with purposive sampling to gather 6 older adults living in affordable housing in northeast Georgia with at least one chronic condition.

METHOD: We conducted individual semi-structured interviews. Researchers used action coding (phrase-by-phrase) for initial codes and moved to develop focus codes, subcategories, and categories.

FINDINGS: Quality healthcare and external supports influenced participant health management in making health-related choices for action or inaction. Drivers toward action included knowledge, confidence, and motivation. In contrast with other research, these older adults with low incomes did not find SES a current barrier due to supports provided by affordable housing and Medicare.

CONCLUSION: Despite potential barriers associated with SDOH, older adults living in affordable housing displayed motivation and autonomy in managing their health. When discussing influences on health management, participants were able to manage their health effectively given the many resources and supports within the local area, affordable housing community, and Medicare.

IMPACT STATEMENT: This research helps OT’s to better understand the role of context especially around the personal factors of age and SES in the occupation of health management.

References

Blancafort Alias, S., Monteserín Nadal, R., Moral, I., Roqué Fígols, M., Rojano i Luque, X., & Coll-Planas, L. (2021). Promoting social capital, self-management and health literacy in older adults through a group-based intervention delivered in low-income urban areas: Results of the randomized trial AEQUALIS. BMC Public Health, 21(1), 84, 1–12. https://doi.org/10.1186/s12889-020-10094-9

Carter, D. H., Faubert, S. J., & Henschel, E. (2021). A novel partnership with low-income housing to support healthy aging. Journal for Nurse Practitioners, 17(6), 718–722. https://doi.org/10.1016/j.nurpra.2021.01.008

Schillinger, D. (2020). The intersections between social determinants of health, health literacy, and health disparities. Studies in Health Technology and Informatics, 269, 22–41. https://doi.org/10.3233/SHTI200020