New Detailed Aging Report Will Help Officials, Policymakers

Published in RINewsToday on May 17,2025


By Herb Weiss

In an era of tightening budgets and shrinking federal and state resources for aging programs, legislators, service providers, and advocates now have access to vital data that can help identify and address the unmet needs of older adults in their communities.

Just over a week ago, the Gerontology Institute at the University of Massachusetts Boston released the latest Healthy Aging Data Reports (HADR), funded by the Point32Health Foundation. These reports offer a comprehensive, neighborhood-level view of aging in America—insights often unavailable from other sources.

Rhode Island’s updated report, released on May 1, 2025, follows previous editions published in 2016 and 2020. This year’s release also includes updates for Connecticut, Massachusetts, and New Hampshire, and introduces a first-time report for Maine. The HADR team is now expanding its reach to additional regions, including parts of the Deep South (such as Mississippi) and the West (including Wyoming).

“This is what’s magical about our report: we provide data at very local levels,” says Dr. Elizabeth Dugan, principal investigator and associate professor of gerontology at UMass Boston. “That empowers local advocates, helps policymakers make smarter investments, and allows philanthropists to assess the impact of their contributions,” she says.

The Rhode Island report features 41 community profiles—covering each city and town, along with two neighborhoods in Providence. Drawing on data from the U.S. Census Bureau, Medicare Summary Beneficiary Files, the CDC’s Behavioral Risk Factor Surveillance System, and state health departments, the report highlights disparities that may be hidden in broader state- or county-level statistics.

“What’s powerful about this approach is that we can observe health outcomes that vary dramatically even within a 10-minute walk in the same city,” adds Dugan.

Spotlight on Rhode Island

Several key findings emerged from the 2025 Rhode Island report:

  • Health: Rhode Island ranks highest in New England for rates of high cholesterol, diabetes, hypertension, ischemic heart disease and peripheral hearth disease, stroke, multiple chronic conditions (four or more), and anxiety disorders.
  • Gender Disparities: Women experience anxiety and depression at rates 15% higher than men and are also more likely to suffer from Alzheimer’s disease, schizophrenia, and PTSD.
  • Housing: Roughly 39% of older renters spend more than 35% of their income on housing. Additionally, 46% of Rhode Islanders aged 65 and older report annual incomes under $50,000.

“The Rhode Island Healthy Aging Data Reports are invaluable,” says Maureen Maigret, Policy Advisor for the Senior Agenda Coalition of Rhode Island and a member of several state aging commissions. “They provide essential data down to the ZIP code level, which is useful for legislative testimony, policy recommendations, program planning, and grant writing.”

With Rhode Island’s older adult population rising from 16.5% in 2020 to 18% in 2025, this data is more critical than ever. “The report shows how age and racial diversity vary widely across communities,” Maigret says, noting that in some smaller towns, older adults now make up over 30% of the population.

Maigret notes that availability of localized data helps municipalities develop comprehensive plans and adopt age-friendly strategies. Interactive maps within the report allow comparisons with state averages, making it easier to target resources where they are most needed.

The report also reveals demographic shifts, including a rise in the Hispanic older adult population—from 4.9% in 2020 to 5.9% in 2025. “There are significant racial and ethnic disparities in health outcomes,” says Maigret. “Black and Hispanic older adults are more likely to be dually eligible for Medicare and Medicaid and to be enrolled in Medicare managed care,” she says.

As lawmakers navigate complex budget negotiations and potential changes to federal programs such as the Administration for Community Living, Medicaid, and the CDC, Maigret stresses the importance of leveraging this data in decision-making.

“Despite the growth in our older population and increasing reports of elder abuse, neglect, and substandard nursing home care, the Office of Healthy Aging’s budget has remained relatively flat,” she warns. “With half of its funding coming from the federal government, proposed cuts could seriously undermine vital programs such as the Long-Term Care Ombudsman,” she adds.

The report also shines a light on mental health, showing high rates of depression and anxiety—especially among older women. Maigret believes this supports increased investment in the 988 mental health crisis line and other behavioral health services.

Another notable trend is the continued shift toward Medicare managed care, now covering more than half of Rhode Islanders aged 65 and older. While rates of arthritis and depression have increased, the report also notes a decline in nursing home stays, inpatient admissions, emergency room visits, and several chronic conditions such as diabetes, COPD, hypertension, and heart disease.

Since the 2020 report, communities have taken meaningful steps to support aging in place. “The Village Common of RI has built age-friendly communities that enable older adults to live independently with the care and resources needed to promote health and well-being,” says Maigret. “There are now 11 local villages across 14 communities, supported by trained volunteers who help members stay connected and independent.”

Data Driving Policy and Innovation

Marie E. Cimini, MSW, Director of the Rhode Island Office of Healthy Aging, says the HADR report has broad implications. “As a state agency, we must lead with policies that prioritize inclusion, access, and dignity throughout the aging journey.”

“The report reinforces our commitment to advancing the goals outlined in the RI 2030 Plan, especially around expanding in-home care, supporting workforce development, and strengthening behavioral health services,” Cimini continues. “But it also challenges us to go further—to integrate aging into every aspect of public life and ensure that the voices of older adults inform policy at every level.”

For Meghan Grady, Executive Director of Meals on Wheels of Rhode Island (MOWRI), one of the most important takeaways is the persistence of health disparities, particularly in managing chronic conditions. Grady supports legislation introduced by Sen. Victoria Gu (D-Dist. 38) and Rep. Justine Caldwell (D-Dist. 30) to integrate medically tailored meals into healthcare delivery. “This report validates our advocacy,” she says. “Food is a fundamental part of care, especially for aging populations facing health disparities.”

The HADR report is also proving instrumental for nonprofit organizations. “We use the data in community presentations, grant proposals, and to guide our work in promoting health equity,” says Debra Burton, Executive Director of RI Elder Info. “With so much uncertainty around policy and funding for programs that impact older adults and caregivers, this data helps us identify where changes will have the greatest impact,” she says.

James Connell, Executive Director of Age-Friendly RI, agrees. “The Healthy Aging Data Report is extraordinarily helpful for nonprofits across sectors. I used it to support funding for a home-share program that pairs older homeowners with individuals facing housing insecurity—a creative approach to our state’s housing crisis,” he says.

“The ’25 Healthy Aging Report provides vital indicators of older adult well-being that are essential for policymaking, intentional planning, and program development,” says Connell. “The data highlight serious concerns about the mental and emotional health of our community, with one in three Rhode Islanders experiencing anxiety and/or depression.” Connell also emphasizes the report’s finding that women are disproportionately affected, calling it “a clear call to action for improved screening and more accessible treatment options.”

Greg Shell, Chair of the Point32Health Foundation Board of Directors, emphasizes the value of data in shaping policy. “When we use data to guide our work, we can change policies and practices, engage communities, and highlight what truly matters,” he says. “These reports are essential tools in making New England a better place to grow up and grow old.”

The research team behind the Healthy Aging Data Reports includes: Principal Investigator Elizabeth Dugan, PhD, along with Nina Silverstein, PhD; Qian Song, PhD; Taylor Jansen, PhD; Jay Lee, PhD; Yan-Jhu Su, PhD; Han Lin, PhD; Shan Qu, MS; Tiffany Tang, BS; Jeannine Johnson, PhD; Amanda Cox, MS; and Mengshi Liu.

To access the 2025 Rhode Island Healthy Aging Data Report, visit https://healthyagingdatareports.org/ri/rhode-island-healthy-aging-data-report.

Meals on Wheels Should Be Expanded

 Published in Pawtucket Times, October 25, 2013

            A warm, nutritious meal combined with social interaction can go a long way to putting the brakes to a state’s spiraling Medicaid costs.  According to new study findings detailed in this months issue of Health Affairs by Brown University public health researchers, expanding programs like Meals on Wheels, would save 26 of 48 states money in their Medicaid programs, just by allowing a person to stay in their own homes. 

            Kali Thomas, Assistant Professor of Research in the Brown University School of Public Health, says that if every U.S. state in the lower 48 expanded the number of seniors receiving meals by just 1 percent, 1,722 more Medicaid recipients avoid living in a nursing facility and most states would experience a net annual savings from implementing the expansion.

Put the Brakes to Medicaid Costs

            According to the study’s findings, Medicaid cost savings would be different in every state.  For instance, Pennsylvania would see the greatest net savings – $5.7 million – as Medicaid costs for nursing facility care decrease more than costs rose for delivering the additional meals.  Meanwhile, Florida would see a net cost of nearly $11.5 million instead. Overall, 26 states would stand to see a net savings according to the Brown University Public Health analysis, while 22 would end up spending more.

            Every state would enable more seniors, who could live independently except for meals, to remain in their homes regardless of whether they are on Medicaid.

            Thomas, the study’s lead author, believes the study’s findings can provide guidance for state lawmakers and state policymakers as they hammer out budget funding for home-delivered meals programs, which are conducted under the Older Americans Act.

            “We wanted to provide a roadmap for people,” Thomas said.

             To calculate Medicaid savings, Thomas and co-author Vincent Mor, Brown’s Florence Pirce Grant Professor of Community Health, examined data, including how many seniors in each state receive home-delivered meals and how much it costs each state to provide those meals. She and Mor also took a look at nursing facility and Medicaid data to estimate the number of seniors that Medicaid maintains in nursing facilities who are “low-care,” meaning they may have the functional capabilities to live at home. Finally they looked at the per diem Medicaid pays in each state for seniors to live in nursing facilities.

 Keeping Seniors at Home

             The study findings allowed them to estimate the incremental cost of providing meals to 1 percent more seniors in each state, the number of additional seniors on Medicaid who would no longer need to live in nursing facilities, and how much less Medicaid would have to pick up for the higher level of care in each state.

            The researchers found that the 1 percent expansion nationwide would bring meals to 392,594 more seniors at a cost of more than $117 million. Because 1,722 seniors would no longer have to live in costly nursing facilities paid for by Medicaid, total program savings would total $109 million.

            The reason why the study’s findings indicate that additional food delivery costs outstrip Medicaid savings nationwide, even though most states would save money on a net basis, is that in some very large states with relatively few low-care seniors or relatively low Medicaid per diems, food costs outweighed the resulting Medicaid savings on a relatively large scale.

            “In states like California and Florida where a 1-percent increase in the 65-plus population is a lot of people, it will cost those states a lot more to feed them,” Thomas said.

            But, as she and Mor wrote in Health Affairs, “Our analyses suggest that 26 states with high Medicaid nursing home per diem reimbursement rates, a large proportion of low-care [nursing home residents on Medicaid], and a relatively small population of older adults, could save money.”

            Thomas said states projected to lose money can opt to focus their efforts in ways that are more precise than an across-the-board expansion.

            “We’re not proposing that all states simply increase the proportion of age 65 plus receiving meals by 1 percent,” she said. “But if they were to target these vulnerable people who are at risk for nursing home placement they would likely see more savings. This is a program that has the potential to save states a lot of money if it’s done correctly.”

            Policymakers should consider not only the fiscal implications of providing home-delivered meals, which the study quantifies, but also the impact on individual seniors, said Thomas, who has seen the benefits anecdotally as a Meals on Wheels volunteer in both Florida and Rhode Island.

            Thomas’s research, detailed in this month’s issue of Health Affairs, which was completed last December, is featured in AARP Rhode Island’s award-winning documentary Hungry in the West End. Creator and director John Martin of the AARP

             Rhode Island state office screened the documentary in August at the Meals on Wheels Association of America National Conference in Boston. You can watch Hungry in the West End online at www.aarp.org/hungry.

             Although the quality of life argument is easy to see, other researchers, like Thomas, are closely looking at how the Meals on Wheels program can lower Medicaid costs.

             Based on a study by the Washington, D.C. based Center for Effective Government released in April 2013, every dollar invested in Meals on Wheels today could save taxpayers up to $50 in Medicaid costs down the road.

 Other Benefits of Meals on Wheels  

             Ellie Hollander, President and CEO of the Meals on Wheels Association of America, observes that both Brown University and the Center for Effective Government studies specifically focused on Medicaid savings attributable to nursing homes, but do not take into consideration significant savings that would be realized through reduced Medicare costs as well, through fewer visits to physicians and the emergency room and less hospitalization or reduced readmissions.

             Hollander says, “We have long known that the value of Meals on Wheels goes beyond the social and moral imperative of helping to address the epidemic of senior hunger in America.  “The friendly visit and a safety check are a lifeline enabling seniors to live more independently and healthy in their own homes, which in turn avoids far more costly health care alternatives often paid through Medicare and Medicaid,” she says.

             “The Brown University research proves what our work has long suggested to us: the Home Delivered Meals Program not only makes a positive impact for the senior, it is a good investment for the state as well,” says Executive Director Heather Amaral, Meals on Wheels of RI.

            Another study is in the works to support Thomas’ efforts to closely look at the impact of nutritious home delivered meals.  According to Hollander, a $350,000 grant from the AARP Foundation and the Meals on Wheels Association announced on Oct. 6 will enable Thomas to begin her randomized controlled trial of 600 seniors representing a cross-section of rural, urban, low income and minority populations across the country and a majority of the grant will be used to feed these seniors.            

            In this upcoming study, 200 seniors will receive meals daily, 200 more will receive a delivery of frozen meals once a week and then another 200 will continue on the waiting list as before as a control group. The study will compare quality of life, isolation, and health care utilization among individuals before and after they begin receiving meals and across the three groups.

             Holland says, “Through our generous grant from AARP Foundation, and with Dr. Thomas and Brown University’s help, we will seek to monetize the value add of the “more than a meal” component of Meals on Wheels.”

A Call for Support

            On AARP.org, Kathleen S. Connell, Rhode Island AARP State Director, calls on state lawmakers to take a very hard look at how they fund the state’s Meals on Wheels program.  Connell urges Congress not to put the Meals on Wheels program on the budgetary chopping block as a way to chop the huge federal budget deficit.

            Connell says that “Leaders need to be reminded that Meals on Wheels recipients aren’t unemployed workers waiting to return to jobs that will accompany an economic recovery. They are older retirees living on limited fixed incomes. With the cost of prescription medicines, healthcare and utilities going up, they sometimes can’t afford to eat. Many commonly sacrifice on food because of money worries – real or feared.”

            Connell notes, “Meals on Wheels is a big deal [to seniors]. No one should take it for granted.”

            Herb Weiss, LRI ’12, is a writer covering aging, health care and medical issues. He can be reached at hweissri@aol.com.

 

 

 

Gridlock Threatens Elder Programs, Services

Published in Pawtucket Times, October 11, 2013

At press time, this week continued heated partisan bickering on Capitol Hill that threatens to unravel a fragile economy, along with putting the brakes to an economic upturn that slowly was pushing the nation out of its financial doldrums. With this stand-off, a partial shutdown of the federal government continues. The Republican-controlled House, captured by the ultra-right Tea Party, has refused to budge, opposing the passage of a continuing resolution (CR) to fund government agencies past Sept. 30. House Republican leadership has demanded that passage of the CR must be tied to either the repeal or partially dismantling of President Obama’s signature achievement, the Affordable Care Act. The Democratic President along with a Senate Democratic leadership say no.

Meanwhile, the Democratic-controlled Senate passed a “clean” CR to provide funding through Nov. 15, not putting ACA on the GOP’s chopping block. Even if both legislative chambers sort out differences and hammer out a compromise agreement to open the doors of the federal government, this would not shield the nation from the disastrous impact of the impending second round of sequester cuts and a Oct. 17 deadline for the government to raise the debt ceiling. No action means a first-ever default on the nation’s debt that could send the stock market tumbling and push the nation’s and the world’s economy into a tailspin.

Treasury officials say that congressional deadlock and no action will result in the federal government running out of cash to pay its bills if Congress does not act to raise the nation’s debt ceiling this month.

Get Your House in Order

With the debt crisis looming, AARP Executive Vice President Nancy LeaMond called on Congressional lawmakers to settle the debt ceiling debate to avoiding default on the nation’s debt, specifically to protect the retirement of seniors and future generations.

In her letter, LeaMond expressed concern that any delay in raising the nation’s debt limit may unnecessarily increase borrowing costs, negatively impact retirement savings accounts and harm the nation’s fragile economy.

“Our members are worried that the benefits they have earned may be cut as part of a deal to reduce the deficit, fund government operations, or increase the debt ceiling, and they are increasingly worried that if there is no agreement very soon, they may not receive their Social Security checks and may lose access to their health care,” noted LeaMond.

Ten days ago, the nation entered a government shutdown, forcing furloughs of 800,000 workers, without pay, and suspending services. The last time this occurred was 17 years ago during the Clinton administration. The Congressional impasse has closed national parks and monuments, federally owned museums, such as the Smithsonian, offices overseas that give visas to foreigners hoping to visit the United States, and even many federal regulatory agencies.

So, how does this impact programs and services for older Americans? Simply put, impact on programs and benefits may vary throughout the federal bureaucracy.

The U.S. Department of Health & Human Services will furlough over 40,512 of its 78, 198 employees. The largest percentage of these employees comes from “grant-making and employee-intensive agencies,” such as the Administration for Community Living. This federal agency would not be able to fund the Senior Nutrition programs, Native American Nutrition and Supportive Services, Prevention of Elder Abuse and Neglect, the Long-Term Care Ombudsman program, and Protection and Advocacy for persons with developmental disabilities.

As reported, Social Security checks will be mailed, Medicare and Medicaid benefits will continue to be paid out, because these are considered mandatory programs, not discretionary ones. Benefits under the Supplemental Nutrition Assistance Program, commonly referred to as food Stamps, will continue in October, despite the federal shutdown.

Food Program Takes Budgetary Hit

Jenny Bertolette of the Meals on Wheels Association of America charges that the Federal Government shutdown “adds insult to injury as Senior Nutrition Programs are already dealing with devastating cuts due to sequestration, funding that has never kept up with inflation, increased food and transportation costs and increased need as significantly more seniors are aging and struggling with hunger than ever before.”

Bertolette says that should a shutdown persist for any considerable length of time, local Meals on Wheels programs that rely on government funding could experience a delay in reimbursements for meals and services delivered. Facing such funding uncertainty, programs could be forced to suspend meal services, create or expand waiting lists for meals, cut the number of meals or days they serve and reduce delivery days.

Jenny Bertolette of the Meals on Wheels Association of America charges that the Federal Government shutdown “adds insult to injury as Senior Nutrition Programs are already dealing with devastating cuts due to sequestration, funding that has never kept up with inflation, increased food and transportation costs and increased need as significantly more seniors are aging and struggling with hunger than ever before.”

Bertolette says that should a shutdown persist for any considerable length of time, local Meals on Wheels programs that rely on government funding could experience a delay in reimbursements for meals and services delivered. Facing such funding uncertainty, programs could be forced to suspend meal services, create or expand waiting lists for meals, cut the number of meals or days they serve and reduce delivery days.

Heather Amaral, Executive Director of Meals on Wheels of Rhode Island, agrees, noting that her Providence-based nonprofit program, has already lost $70,970 in 2013 federal funds due to last year’s sequestration cuts.

Amaral says that as a result of these cuts, to maintain meal delivery at the same numbers as last year (360,299 meals), she had to reduce menu items that were once offered. “Although the government shutdown doesn’t have an immediate impact on our program, I am concerned that it could lead to additional cuts,” she says, noting that should the shutdown continue until year end, the nonprofit agency will be forced to rely on donations and reserves to maintain service levels.

“We provide a safety check along with each home delivered meal and are often the only contact our client has that day, adds Amaral, who stresses that her program may be the only thing keeping a senior at home. “If we are forced to reduce the number of meals we serve, these people may be forced to live with a family member or enter a nursing home,” she warns.

Meanwhile, the U.S. Housing and Urban Development (HUD) agency will be unable to fund additional payments to public housing authorities, many providing shelter to older Americans. HUD expects the 3,300 Public Housing Authorities it funds to have enough funding to get through the month of October. But, if the shutdown continues, some public housing authorities will not be able to maintain normal operation.

Also, Quarterly formula grants will not go out for the Low-Income Home Energy Assistance Program (LIHEAP), the Social Services Block Grant (SSBG), or the Community Services Block Grant (CSBG).

Nutrition programs serving older adults face a double whammy with no FY14 appropriations and no reauthorization of the Farm Bill. The Senior Farmers’ Market Nutrition Program expired along with the Farm Bill on Sept. 30. The Commodity Supplemental Food Program (CSFP) requires appropriations to continue operating.

According to well-known Aging Advocate Susan Sweet, this is a partial shutdown that hasn’t really hit aging programs yet. There are funding reductions in programs for older people, but that is due to the sequester, which will have another round of cuts in October, she says.

Sweet predicts that the negative effects of the shutdown itself will become worse with every passing day. For example, there is doubt that veterans benefits and social security will be paid in or after October absent a funding bill. Death benefits, including burial subsidies, have not been paid to the survivors of fallen armed forces members, she notes. Because of the public outcry regarding this outrage, a private charity has stepped up to pay the benefits with the promise of reimbursement when the government re-opens.

“Reduced to its true absurdity, the United States of America has lost the ability to rationally govern,” states Sweet. “The sequester cuts, previously characterized as “cuts for dummies”, have been implemented, we are in a war yet cannot bury our dead from that war, can’t even agree on a temporary fix, and are arguing whether the US should pay its bills or default,” she adds.

“It is perplexing, and we have heard many, many concerns from Rhode Island members, “ said AARP State Director Kathleen Connell. “Since the U.S. government has never failed to meet its financial obligations, we don’t know what payments it could make if the President and Congress fail to reach an agreement.

“One cannot help but wonder what effects this uncertainty has on people – many of whom struggle enough with health and financial issues,” Connell added. “We’re doing whatever we can to urge Congress and the President to act responsibly.”

Herb Weiss, LRI ’12, is a Pawtucket-based writer covering aging, health care and medical issues. His weekly commentaries can be found on his blog, herbweiss.wordpress.com. He can be reached at hweissri@aol.com.