New Survey Identifies Health Concerns Motivating Voter Choices in Key Demographic

As the 2024 US election approaches, understanding the health-related concerns of older adults—who represent a significant portion of the electorate—is crucial.

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As the 2024 US election approaches, the health-related concerns of older adults—a crucial and influential voting demographic—are coming into sharp focus. A recent research letter published in JAMA shared valuable insights into the pressing health issues in the minds of adults over the age of 50 years, who comprise more than half of ballots cast.¹

Results demonstrated this population is highly concerned about health care costs, financial scams, and fraud, with significant variations in concern based on gender and political ideology, reflecting broader national anxieties as the 2024 election approaches.

These findings have come to light at a time when a record 93.1% of the US population is covered by health insurance, according to 2023 estimates.² While this marked a significant achievement, at the same time the country is seeing an unprecedented surge in national health expenditures, which reached a historic $4.8 trillion. As health spending continues to outpace economic growth, these projections indicate that expenditures could soar to $7.7 trillion by 2032, highlighting the urgent need for sustainable health care financing.

Survey Overview

The survey conducted by the University of Michigan's National Poll on Healthy Aging was designed by the research team to include a nationally representative sample, drawing on insights from focus groups and pilot testing with older adults.¹ Conducted both online and by phone between February and March 2024, the survey utilized the NORC AmeriSpeak panel, a probability-based sample of the US household population. The primary aim was to identify the health-related concerns that resonate most with older adults as they prepare to cast their votes in the upcoming election.

The analysis involved calculating weighted percentages and 95% CIs for the participants who reported being "very concerned" about each issue, taking into account the survey's complex design. To further refine the results, the researchers used logistic regression to adjust for demographic factors and estimate the weighted percentages of adults who were particularly worried about the costs of medical care and prescription medications. Missing data, which was minimal (≤ 1.5% for each item), were excluded from the analysis. All statistical analyses were performed using Stata software version 18.1, with a significance threshold set at P < .05.

Deep Concerns on Health Care Costs

The study revealed that a significant majority of older adults are deeply concerned about the costs associated with medical care and prescription medications. Out of the 3626 adults invited to participate, 2576 completed the survey, yielding a 71.0% response rate. The survey cohort consisted of 1385 women (53.1%) and 1176 men (46.6%), with a mean age of 65.2 years.

The data revealed that 5 of the top 6 concerns among older adults were related to health care and health insurance costs, with 44.6% to 56.3% of participants reporting being "very concerned" about these issues. Another significant concern was financial scams and fraud, with 52.8% of respondents expressing high levels of concern. In contrast, smaller proportions (10.6% to 38.1%) of older adults reported being very concerned about the other 20 issues.

Demographic Variations in Concern

The survey also highlighted demographic differences in concern levels, particularly in relation to gender and political ideology. Further analysis revealed significant differences in levels of concern based on age, gender, political ideology, and geographic location. For instance, younger seniors (aged 50 to 64) were more concerned about medical care costs (59.6%) compared with their older counterparts (aged 65 to 101), who reported a 53.4% concern level.

Gender also played a role, with 59.3% of women being very concerned about medical care costs compared with 54.1% of men. Political ideology influenced concern levels as well, with liberals (68.2%) expressing the highest levels of concern, followed by moderates (56.4%) and conservatives (51.4%). Geographic differences were also noted, with nonmetropolitan residents showing higher concern levels (61.7%) than those in metropolitan areas (55.9%). Similar demographic patterns were observed regarding concerns about prescription medication costs.

Broader Context on Health Care Costs

The findings align with broader national sentiment, as evidenced by a separate 2024 survey in which 73% of adults across all age groups reported being very or somewhat concerned about health care costs. This pervasive anxiety among older adults about health care expenses underscores the critical importance of addressing these issues in the political arena. As health care costs continue to rise, the financial burden on older adults—many of whom are on fixed incomes—becomes increasingly untenable, making it a central issue in the upcoming 2024 election.

However, the study does have its limitations. It does not provide data on personal health concerns or non-health issues that may also influence the voting preferences of older adults. Despite these limitations, the research clearly indicates that healthcare costs are a dominant concern for this demographic.

Implications for Candidates

"To engage older voters, candidates for president and Congress should prioritize communicating their plans for controlling health care costs." the authors wrote.

The findings emphasized the critical role that health-related concerns play in shaping the priorities of this voting population. As the 2024 election approaches, candidates must recognize the importance of addressing these issues if they hope to connect with this influential demographic. Health care affordability remains a pressing concern that could significantly impact voter behavior, making it a pivotal issue in the upcoming election.

References

1. Ayanian JZ, Kirch M, Singer DC, et al. Leading health-related concerns of older adults before the 2024 election. JAMA. August 14, 2024. Accessed August 14, 2024. doi:10.1001/jama.2024.14353

2. Grossi G. US health spending hits $4.8 Trillion, insurance coverage peaks in 2023 projections. AJMC®. June 12, 2024. Accessed August 14, 2024. https://www.ajmc.com/view/us-health-spending-hits-4-8-trillion-insurance-coverage-peaks-in-2023-projections