Middle-aged Americans Underestimate Their Future Health Care Needs

sph | January 6, 2015

We may not want to think about it, let alone acknowledge it, but eventually we will all get older. But are we prepared for what getting older entails?

Photo: CC/Mark Spearman
Photo: CC/Mark Spearman

A new study published in the January issue of Health Affairs from the School of Public Health shows that middle-aged adult Americans (ages 40-65) underestimate their future health care needs for long-term care services and supports. The study found 60 percent think they are unlikely to need care, while in reality only 30 percent will not need care.

Previous research indicates that as the American population ages most middle-aged individuals are under-informed about care and have made few plans such as saving money and having proper insurance to cover care needs as they arise.

“Our study found that middle-aged Americans have unrealistically low expectations about their need for future health care, putting added pressure and strain on family members and friends,” said Carrie Henning-Smith, M.P.H., M.S.W., lead author and Ph.D. candidate in the School of Public Health. “The public needs to be aware that most will need care and there’s a need to plan ahead.”

Henning-Smith said current living arrangements were a major determinant of expectations about future care needs. She believes this is important for several reasons: 1) It may help policymakers better predict who is and who is not planning for future care needs, allowing for better targeted educational campaigns and 2) Current living arrangements may change (children grow up and move out) so it is important to better understand whether people are basing their expectations about current or future living arrangements.

In a MinnPost article, Henning-Smith said it’s also “better to think about it now, while you’re young and healthy.”

According to the study, expectations around future care needs vary by who people currently live with and respondents who live alone. Respondents who live alone are most likely to say it’s “very likely” they will need care whereas respondents living with minor children are the least likely to expect they will need care in the future.

Other key findings:

  • Nearly three in four respondents expect family to provide future care.
  • Only one in ten expect to use a home health care agency or nursing home/assisted living.
  • Having a close relative who has needed long-term care for at least a year is associated with greater expectations of expecting to need care for oneself. This finding in particular may be useful in creating educational campaigns about future care needs using personal narratives.

To rectify this growing problem, Henning-Smith recommends:

  1. Discussing your long-term care wishes with family members
  2. Saving as much money as you can
  3. Educating yourself on available care options


“Our current long-term care system is overly stressed and we need to figure out how we’re going to care for the millions of middle-aged Americans as they get older,” said Henning-Smith. “Policymakers should be concerned about this situation, especially from a budget sense. It’s important for them to encourage middle-aged Americans to make plans for future care needs, including discussing long-term care wishes with family members, saving money for care, and educating themselves on available care options.”

~ Post by Matt DePoint, Academic Health Center

© 2015 Regents of the University of Minnesota. All rights reserved. The University of Minnesota is an equal opportunity educator and employer. Privacy Statement