HOW FINANCIAL CHALLENGES AFFECT HEALTH AND LIVED EXPERIENCES OF ADULTS WITH LONG-TERM SERVICES AND SUPPORTS NEEDS

Sep 28, 2026

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Study investigates how financial challenges shape health and daily life among California adults with Long-Term Services and Supports (LTSS) needs who live at home with chronic care requirements. Using a sequential mixed-method design, it analyzes 2019–2020 survey data (n=2030) and 2023–2025 qualitative interviews (n=90), applying descriptive statistics and grounded theory. Results show 61% reported financial worries linked to self-rated health and serious psychological distress, with lower income associated with worse outcomes. Interviews identify barriers to public benefits, insufficient caregiving hours, uncovered services, high housing costs, and heightened financial insecurity, informing policy refinement and inclusive programs.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

Study purpose

Data sources and sequential mixed-method design

Quantitative results: financial worries and health

Associations with income and health outcomes

Qualitative findings: barriers and service gaps

Policy implications and inclusive program needs

Innovation in Aging, 2025, Vol. 9, No. S2 1181 Abstract citation ID: igaf122.3956 HOW FINANCIAL CHALLENGES AFFECT HEALTH AND LIVED EXPERIENCES OF ADULTS WITH LONG-TERM SERVICES AND SUPPORTS NEEDS Lei Chen1, Qianyun Wang2, and Kathryn Kietzman3, 1. University of California, San Francisco, San Francisco, California, United States, 2. University of California, Los Angeles, Los Angeles, California, United States, 3. UCLA Fielding School of Public Health, Los Angeles, California, United States Older adults and people with disabilities living at home with chronic care needs may require Long-Term Services and Supports (LTSS) . However, little is known about the diverse financial challenges they face due to these care needs, and how these challenges may impact their health and daily lives. This study draws on analyses of population-level quantitative survey data (2019-2020, n = 2030) and a subgroup of 18 in-depth qualitative interviews (2023-2025, n=90) collected as part of the California Long-Term Services and Supports study. Employing a sequential mixed-method approach, we used descriptive statistics and grounded theory to identify financial challenges experienced by adults with LTSS needs and examine how these challenges affected their health and well-being. Survey findings show that 61% of California’s adults with LTSS needs experienced financial worries that were associated with their self-rated health and serious psychological distress. We also found an association between lower incomes and poorer health outcomes. Qualitative interview participants identified key financial challenges including: barriers to accessing public benefits (e.g., age, employment, or education restrictions); inadequacies in caregiving and LTSS services (e.g., insufficient caregiving hours); services, supports, and equipment not covered by insurance; high housing cost and poor housing quality; and heightened vulnerability to financial insecurity. These results highlight the urgent need to refine LTSS eligibility criteria and integrate appropriate age, housing, employment, and income considerations into policy development. Findings also underscore the importance of developing inclusive programs that reduce financial disparities and strengthen the quality of care provided to people with LTSS needs.

FAQs

What populations and data sources were used to study financial challenges in adults with LTSS needs?

The study analyzes California population-level survey data from 2019–2020 (n=2030) and includes 18 in-depth qualitative interviews conducted from 2023–2025 (n=90). Participants were adults and people with disabilities living at home with chronic care needs requiring LTSS.

How did financial worries relate to health outcomes in the survey findings?

Survey results show 61% of California adults with LTSS needs experienced financial worries. These worries were associated with poorer self-rated health and serious psychological distress.

What key financial challenges did interview participants describe?

Interview participants described barriers to accessing public benefits, inadequacies in caregiving and LTSS services such as insufficient caregiving hours, services and equipment not covered by insurance, high housing costs and poor housing quality, and increased vulnerability to financial insecurity.

Sep 28, 2026

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