From medical and dental care to medications, insurance, and nursing homes, health-related costs weigh heavily on the minds of older Americans of all backgrounds, a new poll suggests.

Asked to rate their level of concern about 26 different health-related topics for people over 50 in their community, five of the six issues that the most people cited as very concerning involved health costs.

The sixth—financial scams and fraud—also had to do with money. 

Those same six topics rose to the top no matter what age group, gender, race, ethnic group, region of the country, size of community, political ideology, or income group older adults came from, according to new findings from the University of Michigan National Poll on Healthy Aging.

Top Concern Details Across the Board

Overall, 56% of people over 50 say they’re very concerned about the cost of medical care for older adults in their community.

An equal percentage say they’re very concerned about the cost of home care, assisted living, or long-term care, which the poll grouped together as one topic.

Further Reading: Many Aging Seniors Are Critically Unprepared for Future Healthcare Needs, Survey Suggests

Nearly as many said they’re very concerned about the cost of prescription medications (54%), about scams and fraud (53%), and about the cost of health insurance or Medicare (52%). Nearly half (45%) called the cost of dental care very concerning.

“In this election year, these findings offer a striking reminder of how much healthcare costs matter to older adults,” says John Z. Ayanian, MD, MPP, a healthcare researcher, U-M physician, and director of U-M Institute for Healthcare Policy and Innovation, where the poll is based. The poll is supported by AARP and Michigan Medicine, U-M’s academic medical center.

Michigan Matters of Concern

“We also saw that healthcare costs are top concerns for older adults living in Michigan,” he added.

Those results, presented as part of the new Michigan Poll on Healthy Aging supported by the Michigan Health Endowment Fund, are available at www.healthyagingpoll.org/Michigan.

Additional Topics in Top 10

Other topics rounding out the top 10 health issues that were rated very concerning by the highest proportion of older adults nationally included access to quality home care, assisted living, or nursing home care (38%); overall healthcare quality (35%); inaccurate or misleading health information (34%); and access to affordable healthy foods (33%). 

When it came to these issues, and others, differences emerged between people from different demographic groups.

Demographic Differences

For instance, women were more likely than men to say they’re very concerned about access to quality home care and assisted living or nursing home care (44% vs. 32%), and more likely to say they’re very concerned about social isolation and loneliness (34% vs. 22%), as well as aging in place (33% vs. 22%).

Meanwhile, 50% of Black older adults said they were very concerned about racial or ethnic discrimination faced by older adults in their community, compared with 26% of Hispanic and 15% of white older adults.

Black older adults were also more likely than the other two groups to say they are very concerned about age-based discrimination affecting adults in their community, as well as unequal access to care in general and unequal access to mental health care specifically.

The poll team also analyzed the results by income, comparing those with annual household incomes below $60,000 with those who had incomes above this level. The cost of dental care was the only issue on which people in the lower-income group were more likely than their higher-income peers to say they are very concerned (49% vs. 40%).

“As our society strives to improve the health and well-being of people as they age, it’s important to understand to what extent different health-related topics are of concern for older adults and how perspectives vary,” says poll director Jeffrey Kullgren, MD, MPH, MS. “The high level of concern about cost-related issues across demographic groups points to a particularly important opportunity for action.”

Ayanian and Kullgren are both on the faculty in the Division of General Medicine of the U-M Medical School’s Department of Internal Medicine. Ayanian provides care at University of Michigan Health, the clinical arm of Michigan Medicine, while Kullgren provides care within the VA Ann Arbor Healthcare System. Both have studied how out-of-pocket costs for insurance and care affect health-related decisions.

“This survey validates AARP research that shows affording healthcare is a kitchen table issue among older adults, their families, and their caregivers,” says Indira Venkateswaran, AARP senior vice president of Research. “It is critical that we continue improving healthcare access and affordability for the millions of Americans struggling to pay for insurance premiums and copays, prescription drugs, and long-term care while putting food on the table and paying bills.”

Methodology and More

For each of the 26 issues that older adults were asked to reflect on in the new poll report, they were given the choice of saying that an issue was very concerning, somewhat concerning, or not concerning to them.

For an interactive data visualization that gives full access to national and Michigan-specific data from the poll, visit https://michmed.org/Kkde7

The poll report is based on findings from a nationally representative survey conducted by NORC at the University of Chicago for IHPI and administered online and via phone in February and March 2024 among 3,379 adults over age 50. The sample was subsequently weighted to reflect the U.S. population.