Older Americans living in poverty die nearly nine years earlier than their wealthier peers, according to a new report from the National Council on Aging and the LeadingAge LTSS Center at UMass Boston. Researchers say these findings expose how financial insecurity literally cuts lives short.
This report provides context for journalists interested in covering how the economy is impacting older adults in their communities.Reporters can use The Elder Economic Security Standard™ Index, a tool that measures the income older adults need to meet their basic needs and age in place by state, city, and county, to find out thetrue cost of living, and how cities and states are addressing wealth disparities to ease the burden on vulnerable adults.
Key findings
The analysis found that mortality rates among older adults in the bottom 60% of wealth were nearly double those of people in the top 20%. Those in the lowest wealth bracket — with annual incomes of $20,000 or less — died on average nine years sooner than those earning $120,000 or more. The findings were based on data from more than 10,000 U.S. households in the Health and Retirement Study between 2018 and 2022.
The Health and Retirement study is an ongoing longitudinal survey of a representative sample of U.S. older adults segmented by wealth quintiles. Each quintile represents approximately 9 million older households.
“It was shocking to me that you are likely to die nine years sooner if you are poor than if you’re wealthy,” said Jessica Johnston, senior director for the Center for Economic Well-Being at NCOA.
Why this matters
The impact of higher food and health care costs is widespread. Older adults with lower incomes may be forced to choose between paying for their medications or for food, Johnston noted.
Researchers found that over 19 million older adult households — 45% of all seniors — lack sufficient income to cover basic living costs. Using Elder Index figures, they estimated that an older adult living alone in a paid-off home still needs $24,000 annually to cover essentials. For couples, that figure rises to $36,000.
The bigger picture
These estimates far exceed the federal poverty limit of $15,650 for one person, ($21,150 for a couple), meaning many older people struggle financially without qualifying as officially “poor” and often remain ineligible for assistance programs, according to Johnston.
“We think about older adults making $15,000 or less as living in poverty, when in reality, those older adults at $24,000 can’t even cover the basic cost of living,” she said.
Many older adults believed Social Security would carry them through retirement, but “Social Security has just not kept pace with inflation, with cost of living,” Johnston said. “And so, we are seeing a lot of older adults who thought maybe Social Security would go farther than it actually does.”
Income impacts longevity
The study findings also emphasize how health and finances are inextricably linked. Financial strain prevents many older adults from affording medications, accessing health care, or maintaining adequate nutrition — creating a vicious cycle that accelerates health decline, researchers said.
The report also found that 80% of older households — about 34 million — are unable to weather major financial shocks such as widowhood, serious illness, or the need for long-term care. More than half of older adults will require long-term services and support in their lifetime, yet Medicare doesn’t cover these expenses. The average annual cost of a private nursing home room exceeds $100,000 — out of reach for most.
Assistance designed for the general population often fails older adults, according to Johnston. Many seniors receiving SNAP benefits get just $23 monthly — barely enough for milk, eggs, and bread — and they must re-certify their eligibility every six months.
“For an older adult, SNAP is not a bridge program. SNAP is a lifeline,” Johnston said. “We need benefit-specific programs that address the financial insecurity of older adults, not just lump them in with the general population.”
Disparities persist
The COVID-19 pandemic deepened these disparities. During the pandemic, 11% of people 65 and older who lost their jobs couldn’t reenter the workforce, Johnston noted. Meanwhile, the wealthiest 20% of older adults saw substantial asset gains between 2018 and 2022, while most households experienced little to no improvement in financial security.
The crisis extends beyond individual seniors. Generation X and millennials increasingly find themselves financially supporting aging parents while raising children that costs an estimated $600 billion in lost productivity, wages and expenses.
Researchers warn that the U.S. is only at the beginning of a major demographic shift. Some 11,000 Americans turn 65 daily, and without policy interventions, the gap between the 20% who can age with dignity and the 80% at risk of aging without it will continue to widen.
“Adequate income isn’t about just being comfortable in retirement. It’s about survival,” Johnston said. “We are cutting short the lives of millions of older adults by not having the bare minimum safety net programs in place for them to age in dignity.”
Some states are taking steps to address the crisis. Johnston noted that Washington and Connecticut are among several states that have removed asset limits or raised income thresholds for benefits, recognizing that federal poverty guidelines don’t reflect actual living costs. She hopes these changes eventually impact life expectancy by providing greater financial security.
“Your health and your finances are deeply intertwined,” she said. “If we can provide a little bit more financial security for older adults, we’re going to see better health outcomes.”
Resources
- The Elder Index, Umass Boston
- Cost of Care Survey, 2024, Genworth Financial and CareScout
- Medicaid Eligibility Income Level by State (July, 2025)
- Asset limits are a barrier to economic security and mobility, Center for American Progress
- Current and Future Replacement and Opportunity Costs of Family Caregiving for Older Americans With and Without Dementia, Innovations in Aging, 2025
- How the budget bill will impact older adults: What journalists should know, AHCJ webinar, October 2025
- Medicare, Medicaid and the Older Americans Act turn 60. Will they survive the next 60 years?, AHCJ, July 2025
