Geographic Disparities in Mortality and Hospital-Based Health Care Utilization Among Low-Income Older Adults with Dementia​

This project examines whether where low-income older adults with dementia live affects their chances of staying healthy and avoiding unnecessary hospital use. Many older adults with dementia need regular medical care, supportive services, and help aging safely at home. However, these resources are not equally available across communities. Some neighborhoods may have fewer healthcare providers, limited homebased services, transportation barriers, or higher levels of poverty, making it harder to get needed care. Using iPHD hospital discharge and mortality data, the project will first identify whether hospital use and deaths 
among this population are concentrated in certain ZIP code areas rather than evenly distributed across the state. It will then examine whether communities with fewer healthcare providers, greater socioeconomic disadvantage, and higher levels of population need also experience higher mortality and greater reliance on hospital-based care. Finally, the project will identify areas where high care needs coincide with limited local service availability, suggesting a mismatch between what residents need and what their communities can provide. The goal is to better understand whether differences in local service environments contribute to unequal health outcomes. The project will also identify “high-need, low-resource” communities where older adults face greater health risks but have fewer available supports. Findings can help policymakers, healthcare systems, and community organizations better target resources to the places where they are most needed. By identifying gaps in care, the project aims to support healthier aging, reduce preventable hospital use, and improve quality of life for vulnerable older adults and their families.