ArticleInnovation in aging2026
Middle-age healthcare spending and utilization at the intersection of comorbidities, functional limitation, and race/ethnicity.
Article in Innovation in aging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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4 authors.
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Abstract
Background and Objectives: Middle age is a pivotal developmental life stage marked by health transitions, including the onset of major chronic diseases and functional limitations. Social determinants of health, particularly race/ethnicity, can play a significant role in accentuating the effects of comorbidity and functional limitations. This study examines how comorbidity, functional limitations, and race/ethnicity influence patterns of health services use and spending among middle-aged adults. Research Design and Methods: We used pooled yearly cross-sectional data (Medical Expenditure Panel Survey, 2008-2022; excluding 2020) from middle-aged adults (ages 50-64). We derived comorbidity phenotypes using latent class analyses (LCA) and generalized linear regression to examine their associations with health services outcomes, considering the vulnerabilities introduced by functional limitations and race/ethnicity. Results: LCA supported a 3-class solution: low prevalence of chronic conditions (63.4%), hypertensive/arthritis/joint pain (29.3%), and complex cardiovascular (C-CVD, 7.3%). Individuals with C-CVD had elevated levels of healthcare spending and use, including problematically high levels of emergency department and inpatient hospitalizations, despite higher use of office-based visits (OBVs). We found that Non-Hispanic Black adults (NHBs) and Hispanic adults had lower health spending compared to Non-Hispanic White adults (NHWs) and were less likely to use OBVs. NHBs had a higher propensity for ED use, whereas Hispanic adults were less likely to be hospitalized. Physical and instrumental/activities of daily living (I/ADL) limitations increased OBVs for both NHBs and NHWs, while I/ADLs increased hospitalizations among Hispanic adults. Discussion and Implications: These findings underscore the importance of targeted healthcare for high-risk patient populations for mitigating excess health burdens.
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