TY - JOUR T1 - Chronic Disease and Workforce Participation Among Medicaid Enrollees Over 50: The Potential Impact of Medicaid Work Requirements Post-COVID-19 JF - medRxiv Y1 - Forthcoming A1 - Rodlescia S. Sneed A1 - Stubblefield, Alexander A1 - Gardner, Graham A1 - Jordan, Tamara A1 - Briana Mezuk KW - Chronic disease KW - COVID-19 KW - health policy KW - Medicaid AB - As the COVID-19 pandemic wanes, states may reintroduce Medicaid work requirements to reduce enrollment. Using the Health and Retirement Study, we evaluated chronic disease burden among beneficiaries aged >50 (n=1460) who might be impacted by work requirements (i.e. working <20 hours per week). Seven of eight chronic conditions evaluated were associated with reduced workforce participation, including history of stroke (OR: 7.35; 95% CI: 2.98-18.14) and lung disease (OR: 4.39; 95% CI: 2.97-7.47). Those with more severe disease were also more likely to work fewer hours. Medicaid work requirements would likely have great impact on older beneficiaries with significant disease burden.Key PointsChronic disease linked to reduced work among older Medicaid beneficiaries.Work requirements would greatly impact those aged >50 with chronic conditions.Coverage loss would have negative implications for long-term disease management.Competing Interest StatementThe authors have declared no competing interest.Funding StatementThis work was supported by the Robert Wood Johnson Foundation’s (RWJF) Policies for Action program under grant number 77342. This is a secondary analysis that uses data from the Health and Retirement Study, (2016 HRS Core and RAND HRS Longitudinal File 2018), sponsored by the National Institute on Aging under grant number NIA U01AG009740 and conducted by the University of Michigan.Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.YesThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:This study involved only openly available human data, which can be obtained from: https://hrsdata.isr.umich.edu/data-products/rand-hrs-longitudinal-file-2018 and https://hrsdata.isr.umich.edu/data-products/2016-hrs-coreI confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).YesI have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.YesAll data are available online at: https://hrsdata.isr.umich.edu/data-products/rand-hrs-longitudinal-file-2018 and https://hrsdata.isr.umich.edu/data-products/2016-hrs-core ER - TY - JOUR T1 - Food Insecurity Among Older Adults with a History of Incarceration JF - Journal of Applied Gerontology Y1 - 2023 A1 - Jordan, Tamara A1 - Rodlescia S. Sneed KW - Food insecurity KW - incarceration KW - justice involvement AB - Objectives To examine the association between history of incarceration (HOI) and food insecurity (FI) among older adults.Methods This is a secondary analysis utilizing data from 12,702 respondents aged 51+ who participated in the 2012 and 2014 waves of The Health and Retirement Study. Multiple logistic regression was used to estimate the association between HOI and FI, adjusting for demographic variables using odds ratios (OR) and 95% confidence intervals (CI).Results In our sample, 12.8% of participants reported FI. Having a HOI increased odds of FI (OR 1.83; 95% CI 1.52-2.21), especially among Blacks (OR 1.78; 95% CI 1.29-2.46) and Whites (OR 2.27; 95% CI 1.74-2.97), but not Hispanics (OR 1.11; 95% CI 0.69-1.77) or other racial/ethnic groups (OR 1.79; 95% CI 0.71-4.52).Discussion FI is an important issue among older adults with a HOI. Stronger linkages between formerly incarcerated older adults and existing food assistance programs are needed.Competing Interest StatementThe authors have declared no competing interest.Funding StatementThis project was funded by Michigan Center for Urban African-American Aging Center through a grant from the National Institutes of Health (grant number P30 AG015281). This analysis uses data from the Health and Retirement Study (2012 HRS Core, 2014 HRS Core, and RAND HRS Longitudinal File 2018), sponsored by the National Institute on Aging (grant number NIA U01AG009740) and conducted by the University of Michigan.Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.YesThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:This current study was exempt from Michigan State University IRB review (STUDY00006614).I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).YesI have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.YesAll data are available online at: https://hrsdata.isr.umich.edu/data-products/2012-hrs-core, https://hrsdata.isr.umich.edu/data-products/2014-hrs-core, and https://hrsdata.isr.umich.edu/data-products/rand-hrs-longitudinal-file-2018 VL - 42 IS - 5 ER - TY - JOUR T1 - Chronic Disease Burden Among Medicaid Beneficiaries over 50: The Potential Impact of Medicaid Work Requirements JF - Health Services Research Y1 - 2021 A1 - Rodlescia S. Sneed KW - Chronic disease KW - medicaid beneficiaries KW - Workforce AB - Research Objective Since 2018, several states have proposed modifications to their Medicaid programs that require participation in employment or other community engagement activities as a condition of receiving Medicaid benefits. Proponents say that these requirements promote financial independence for families and individuals, while opponents argue that these requirements would disenfranchise the nation's most medically vulnerable citizens. While some studies have evaluated the impact of impact of work requirements on the general Medicaid population, there has been little inquiry into the impact of such policies on Medicaid recipients over 50, who likely have high chronic disease burden and who may face difficulties in maintaining employment. The purpose of our study was to describe the prevalence and burden of chronic disease among Medicaid beneficiaries over 50 who might lose Medicaid benefits based on these new requirements. Study Design To address our research question, we conducted cross-sectional secondary analyses of data from the 2016 wave of the Health and Retirement Study, a large-scale, nationally representative, population-based study of community-dwelling adults aged >50. We used logistic regression models to examine the association between several chronic health conditions and reduced workforce participation (e.g. working <20 hours per week). All analyses adjust for age, race/ethnicity, sex, education level, and marital status. Population Studied Our population of interest included individuals over 50 who were not Medicare-eligible and not receiving Social Security Income. We compared those working >20 hours per week to those working <20 hours per week. We chose <20 hours per week as our employment cutoff, as most states have used this cutoff as the threshold for determining continued Medicaid eligibility. Our sample included 1028 participants who were 47.69% Non-Hispanic White, 23.29% Hispanic, 18.87% Non-Hispanic Black, and 10.14% other racial/ethnic backgrounds. Participants were ages 51–64 (mean age 57.18; SD 0.212) and 55.47% female. Principal Findings Individuals with reduced workforce participation had greater prevalence of several chronic health conditions, including higher rates of diabetes, hypertension, arthritis, and lung disease. Further, among those with chronic health conditions, those working <20 hours per week reported more worsening of their chronic conditions in the past 2 years, greater use of disease-related medications, more hospital and emergency department visits, and more functional limitations than their counterparts working at least 20 hours per week. Conclusions Taken together, these findings suggest that Medicaid work requirements in this population would have great impact on the most medically vulnerable individuals in this age group. Further, they suggest that reduced workforce participation may be a proxy for poor health. Implications for Policy or Practice Policymakers should consider these findings as they enact policies impacting Medicaid eligibility in this population. Enacting work requirements as a condition of Medicaid eligibility among individuals in this age group may have negative impact on chronic disease management. Primary Funding Source The Robert Wood Johnson Foundation. VL - 56 IS - S2 ER - TY - JOUR T1 - Grandparent Caregiving, Race, and Cognitive Functioning in a Population-Based Sample of Older Adults JF - Journal of Aging and Health Y1 - 2019 A1 - Rodlescia S. Sneed A1 - Schulz, Richard KW - Caregiving KW - Cognitive Ability KW - Grandparents KW - Intergenerational ties KW - Race/ethnicity AB - Objective: The aim of this study was to evaluate the association between noncustodial grandparent caregiving and cognition using the Health and Retirement Study (HRS), a population-based study of older adults. Method: Participants were White and African American grandparents aged ≥65 years. Only noncustodial grandparents who reported not living with their grandchildren over the three waves were included in our analyses. Grandparent caregiving status and cognition were assessed in 2006, 2008, and 2010. Analyses controlled for demographics, baseline health, depressive symptoms, and baseline cognition. Results: Both the number of waves of grandparent caregiving and the total number of grandparent caregiving hours across the three waves were associated with better cognitive functioning at 4-year follow-up in 2010. Associations were observed among Whites, but not among African Americans. Discussion: This study uses longitudinal data to evaluate the association between grandparent caregiving and cognitive functioning. Findings suggest that providing care may be beneficial for some grandparents. VL - 31 IS - 3 ER - TY - JOUR T1 - Negative Social Interactions and Incident Hypertension Among Older Adults JF - Health Psychology Y1 - 2014 A1 - Rodlescia S. Sneed A1 - Cohen, Sheldon KW - Demographics KW - Health Conditions and Status AB - Objective: To determine if negative social interactions are prospectively associated with hypertension among older adults. Method: This is a secondary analysis of data from the 2006 and 2010 waves of the Health and Retirement Study, a survey of community-dwelling older adults (age 50 years). Total average negative social interactions were assessed at baseline by averaging the frequency of negative interactions across 4 domains (partner, children, other family, friends). Blood pressure was measured at both waves. Individuals were considered to have hypertension if they reported use of antihypertensive medications, had measured average resting systolic blood pressure of 140 mmHg or higher, or measured average resting diastolic blood pressure of 90 mmHg or higher. Analyses excluded those who were hypertensive at baseline and controlled for demographics, personality, positive social interactions, and baseline health. Results: Twenty-nine percent of participants developed hypertension over the 4-year follow-up. Each 1-unit increase in the total average negative social interaction score was associated with a 38 increased odds of developing hypertension. Sex moderated the association between total average negative social interactions and hypertension, with effects observed among women but not men. The association of total average negative interactions and hypertension in women was attributable primarily to interactions with friends, but also to negative interactions with family and partners. Age also moderated the association between total average negative social interactions and hypertension, with effects observed among those ages 51-64 years, but not those ages 65 or older. Conclusion: In this sample of older adults, negative social interactions were associated with increased hypertension risk in women and the youngest older adults. PB - 33 VL - 33 IS - 6 N1 - Times Cited: 1 Si U4 - Hypertension/social Interaction/gender/health risk/Antihypertensive Agents ER - TY - JOUR T1 - A prospective study of volunteerism and hypertension risk in older adults. JF - Psychol Aging Y1 - 2013 A1 - Rodlescia S. Sneed A1 - Cohen, Sheldon KW - Aged KW - Aged, 80 and over KW - Female KW - Health Surveys KW - Humans KW - Hypertension KW - Male KW - Middle Aged KW - Prospective Studies KW - Risk Assessment KW - Time Factors KW - Volunteers AB -

The purpose of the current study was to determine whether volunteerism is prospectively associated with hypertension risk among older adults. Participants provided data during the 2006 and 2010 waves of the Health and Retirement Study, a longitudinal panel survey using a nationally representative sample of community-dwelling older adults (age > 50 years). Volunteerism and blood pressure were measured at baseline and again 4 years later. Analyses excluded individuals hypertensive at baseline and controlled for age, race, sex, education, baseline systolic/diastolic blood pressure, and major chronic illnesses. Those who had volunteered at least 200 hr in the 12 months prior to baseline were less likely to develop hypertension (OR = 0.60; 95% CI [0.40, 0.90]) than nonvolunteers. There was no association between volunteerism and hypertension risk at lower levels of volunteer participation. Volunteering at least 200 hr was also associated with greater increases in psychological well-being (B = 0.99, β = .05, p = .006) and physical activity (B = 0.21, β = .05, p = .04) compared with nonvolunteers; however, these factors did not explain the association of volunteerism with hypertension risk.

PB - 28 VL - 28 IS - 2 N1 - Copyright - Copyright American Psychological Association Jun 2013 Last updated - 2013-06-30 U1 - http://www.ncbi.nlm.nih.gov/pubmed/23795768?dopt=Abstract U2 - PMC3804225 U4 - Psychology/Hypertension/Older people/Volunteers/Mental health/psychological well-being ER -