UCLA

Aging and disability are essential aspects of social welfare. Long-Term Services and Supports (LTSS) are a big concern for older adults and adults with disabilities. These people are usually vulnerable to financial strain, which may exacerbate their health and well-being. Drawing from Pearlin’s Stress Process Model, this study used data from the first cycle (2019-2020) California Long-Term Services and Supports survey to examine the direct and indirect associations between disability status, financial strain, and health and well-being of older adults and adults with disabilities. It also explored potential age and racial/ethnic disparities and investigated whether acute stress resulting from the COVID-19 pandemic may differentiate these associations. This study used multiple methods of descriptive analyses and Conditional Process Analysis to examine the hypothesized associations.

Significant indirect associations were found between disability status and health and well-being through financial strain. The indirect effect between having difficulty doing errands alone and serious psychological distress through financial strain was significantly stronger for young participants than middle-aged participants. People with different types of disability difficulties tended to experience various financial difficulties related to housing, food, and retirement savings and presented different reports of self-rated health and serious psychological distress. Several focal associations were significantly stronger for young participants and certain racial/ethnic groups than for middle-aged or older participants and other racial/ethnic groups. The pandemic-related stressor interacted with age and race/ethnicity to differentiate the association between having difficulty doing errands alone and serious psychological distress, and the association between financial strain and serious psychological distress.

The study contributes to the literature by applying Pearlin’s Stress Process Model to people with LTSS needs. It also provides empirical evidence for health disparities by examining people with various disability difficulties. The findings can be used to guide state funding and target social services, programs, and policies to meet the diverse financial needs of people with LTSS needs. It can also contribute to efforts to rebalance programs essential to improving the efficiency of LTSS networks. Moreover, the study findings can provide insights into other state and federal LTSS programs, such as Medicaid.