THE EFFECTS OF VOLUNTEERING ON HYPERTENSION BY HEALTH INSURANCE STATUS AMONG U.S. ADULTS AGED 50-64 - Research Findings

Sep 28, 2026

Hypertension is a major risk factor for cardiovascular disease, and blood-pressure management is harder for people without health insurance because of access barriers. Evidence suggests volunteering could function as a public health intervention that reduces hypertension, but it is unclear whether volunteering effects differ by insurance status. Using 2012–2018 Health and Retirement Study data for ages 50–64, weighted Poisson models estimated volunteering’s impact while addressing selection bias and temporal order. Volunteers had lower hypertension likelihood overall, and subgroup effects were observed for both uninsured and insured groups without significant differences between them.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

Background and Rationale

Data and Sample

Methodology

Results

Implications

62 Innovation in Aging, 2025, Vol. 9, No. S2 Hypertension is a major risk factor for cardiovascular disease, the leading cause of death in the U.S. Managing blood pressure can be challenging for individuals without health insurance due to barriers to healthcare access. Emerging evidence suggests that volunteering may serve as a public health intervention that reduces hypertension. However, it remains unclear whether the relationship between volunteering and hypertension differs by health insurance status. We analyzed data from the 2012–2018 Health and Retirement Study, restricting participants to those aged 50-64 (below Medicare eligibility age; N = 4,366) . To address selection bias and ensure correct temporal order, we created entropy-balance weights using participants’ characteristics from 2012/2014 to balance volunteers and non-volunteers in 2014/2016 . We then employed weighted Poisson regression with robust error variance to estimate the population average treatment effects of volunteering in 2014/2016 on hypertension in 2016/2018. We pooled waves because the outcome variable was measured in half the sample in consecutive waves. We ran seemingly unrelated estimations to statistically test for differences in effect sizes between insured and uninsured volunteers. Results indicate that volunteers were less likely to be hypertensive than non-volunteers in the full sample (IRR=0.91, p = 0.008) . In subgroup analyses, volunteering was associated with a lower incidence of hypertension among both uninsured (IRR=0.70, p = 0.035) and insured (IRR=0.93, p = 0.035) respondents. These effects did not significantly differ (p = 0.104), suggesting that volunteers were less likely to be hypertensive regardless of insurance status. Our findings suggest that despite limited healthcare access, volunteering may be one pathway toward reducing hypertension in uninsured older adults. Abstract citation ID: igaf122.205 THE EFFECTS OF VOLUNTEERING ON HYPERTENSION BY HEALTH INSURANCE STATUS AMONG U.S. ADULTS AGED 50-64 Byeongju Ryu1, Seoyoun Kim2, and Halvorsen Cal1, 1. Washington University in St. Louis, St. Louis, Missouri, United States, 2. University of Michigan, Ann Arbor, Michigan, United States

FAQs

What question does the study address about volunteering and hypertension?

It examines whether volunteering is associated with lower hypertension and whether that association differs between people with and without health insurance.

How was selection bias and timing handled in the analysis?

Entropy-balance weights used participant characteristics from earlier waves to balance volunteers and non-volunteers, and the modeling approach ensured correct temporal order across 2014/2016 and 2016/2018.

What do the results show about hypertension among volunteers vs non-volunteers?

Volunteers were less likely to be hypertensive in the full sample, and subgroup analyses showed lower hypertension incidence for both uninsured and insured respondents, with no significant difference in effect sizes by insurance status.

Sep 28, 2026

Uploaded by Alex Sinclair