We work to assure that aging adults have the financial means to maintain their quality of life and quality of care, and that there are policies in place to protect health insurance and public assistance programs.

By exploring poorly understood impacts of economic and policy factors on aging adults, like how altering retirement benefits can affect mental health, we are bringing insight, clarity, and solutions to the challenges of growing old.

Two major SPH centers — the Research Data Assistance Center (RESDAC) and State Health Access Data Assistance Center (SHADAC) — provide unique data that shapes Medicare and Medicaid policies.

Chronic diseases are difficult for any one, but age adds a complicating factor. Approximately 92 percent of older adults have at least one chronic disease and 77 percent have at least two.

Our school has considerable and long-term expertise in the top three chronic diseases — cardiovascular disease, cancer, and diabetes — and we are building on that foundation to prevent or reduce the challenge of these diseases on our aging population. To help people cope with chronic diseases, we designed a “cumulative complexity model,” a patient-centered approach to determine a person’s ability to manage their health care needs.

Mental illness in the elderly has been a largely unrecognized and unexplored issue, yet almost 20 percent of older Americans suffer from some sort of mental illness and the highest risk group for suicide is those in the 65-plus age range.

At SPH, we take a rigorous and holistic approach to mental health and cognition in aging adults as we explore such topics as the stigmas around diagnosis and treatment, barriers to and cost of care, and social determinants. In a recent study we found an association between persistently high depressive symptoms in middle-aged and older adults and increased stroke risk.

SPH is a research pioneer in the experience of older adults in long-term care facilities and nursing homes — quality of care has long been our concern. Now we are emerging as research leaders in quality of life, the most important thing to people as they age.

A recent landmark study from our school on racial differences in Minnesota nursing home residents’ quality of life brought a relatively unknown health equity issue to light — for a resident in a care facility, race and culture can be a complicating factor in their daily lives.

With data showing that, by 2030, minority residents will surpass white residents in care facilities, our school is compelled to make sure that everyone has an equal opportunity to age with respect.

(* asterisk marks SPH student, post-doc, or researcher at time of study)

• Alzheimer’s Disease in Nursing Homes. (Health Affairs). Joseph E. Gaugler, Fang Yu, Heather W. Davila and Tetyana Shippee. This overview clarifies the ongoing importance of nursing home care for people with Alzheimer’s; identifies the components of optimal care and highlights innovations; summarizes challenges to best practices and innovations; and explores potential policy solutions.
• Place of Death of Individuals with Terminal Cancer: New Insights from Medicare Hospice Place-of-Service Codes. (J Am Geriatr Soc). Stephanie L. Jarosek, Tetyana Shippee, Beth A. Virnig. Findings from this study using place-of-service codes include: 30 percent of the hospice users were not receiving home-based care at the time of death, and 17 percent were enrolled in hospice for less than three days.
• Characterizing Cognitive Performance in a Large Longitudinal Study of Aging with Computerized Semantic Indices of Verbal Fluency. (Neuropsychologia). Serguei Pakhomov, Lynn Eberly, David Knopman. Study findings suggest that various automatically semantic indices may be used to examine various aspects of cognitive performance affected by dementia.
• Association of Age at Menopause With Incident Heart Failure: A Prospective Cohort Study and Meta-Analysis. (J Am Heart Assoc). Duke Appiah*, Pamela J. Schreiner, Ellen W. Demerath, Laura R. Loehr, Patricia P. Chang, Aaron R Folsom. Study findings provide evidence that early age at menopause is associated with a modestly greater risk of heart failure.
• Less Intense Postacute Care, Better Outcomes For Enrollees In Medicare Advantage Than Those In Fee-For-Service. (Health Affairs). Peter J. Huckfeldt, José J. Escarce, Brendan Rabideau, Pinar Karaca-Mandic, Neeraj Sood. Study shows that Medicare Advantage Plans may encourage cost-efficient, post-hospitalization care without adversely affecting patient health.

• Lynn Eberly, 2015–2017, NIH, “Probing the Intracellular Environment in Normal Aging Using Magnetic Resonance,” Co-Investigator
• Tetyana Shippee, 2016–2021, NIH/NIMHD, “System Factors and Racial Disparities in Nursing Home Quality of Life and Care,” Principal Investigator
• James Pankow, 2016–2020, NIH, “Epigenetics of Successful Aging,” Principal Investigator
• Peter Huckfeldt, 2015–2017, Department of Health and Human Services, “Explaining the Recent Utilization Trends in Ultra-High Rehabilitation Therapy Services in Skilled Nursing Facilities”
• Katie White, 2012–2018, Allina Health System, “A Supportive Care Approach for Patients Late in Life: Creating a Sustainable Model of Systematic Care to Improve the Experience of Patients, their Families and Caregivers”​ Principal Investigator

• The Older They Are, The Higher the Fall Rate: An Increase in Minnesota Fall Mortality, Ages 65+ (Epidemiology)
• Long-Term Care Insurance in Minnesota: A Federal and State Dilemma (Public Health Administration & Policy)
• Elder Abuse in Minnesota Hospital Records: Secondary Data Analysis (Public Health Administration & Policy)
• Delayed and Unmet Needs for Medical Care Among Publicly Insured Adults with Disabilities (Health Services Research, Policy and Administration)
• Economic Model of Dementia: Projecting Costs and the Value of Non-pharmacologic Therapy to Guide Policy Making (Health Services Research, Policy and Administration)