Age Differences in Determinants of Self-Rated Health among Recipients of Publicly Funded Home-and-Community-Based Services

ABSTRACT

This research examined determinants of self-rated health (SRH) of publicly funded home-and-community-based services (HCBS) recipients and tested if the effects of determinants differ between older recipients and younger recipients with disabilities. Using Minnesota’s data of 2015–2016 National Core Indicators – Aging and Disabilities survey (n = 3,426), this study revealed that functional status and community inclusion had both direct and indirect effects on SRH, with negative mood as a mediator. Community inclusion had a more pronounced effect on SRH in younger recipients than in older recipients. HCBS should address psychosocial needs and be tailored for recipients of different age groups.

KEYWORDS:

• Home-and-community-based services
• self-rated health
• older adults
• adults with disabilities
• long-term services and supports
• medicaid
• medicaid waiver

Key points

• Home-and-community-based services recipients report low self-rated health.

• Self-rated health is associated with functional and psychosocial determinants.

• Younger recipients largely rely on community inclusion to maintain well-being.

• Home-and-community-based services should address the psychosocial needs of recipients beyond assistance with activities of daily living and instrumental activities of daily living.

• Home-and-community-based services should focus on promoting community inclusion, especially for younger recipients with disabilities.

• Home-and-community-based services need to be tailored for people of different age groups.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.