Aging in place, medical care access and economic insecurity are the top three social factors that affect aging experience, according to Alignment Health’s “2025 Social Threats to Aging Well in America Survey.”
Over 2,200 adults age 65 or older completed online surveys outlining their concerns as they age. The vast majority indicated at least one social threat to aging well, with aging in place taking the top spot and economic insecurity in third place for the second year in a row. Chief Medical Officer Ken Kim, MD, elaborated on these results for Becker’s, highlighting what insurers need to think about.
“Many of them [the insurers] do understand that they can’t lower the medical loss ratio or utilization without really impacting social determinants of health,” he said. “I don’t think they figured out how to do it yet.”
Dr. Kim said Alignment Health has been experimenting with interventions — from installing motion sensors to monitor those aging at home to partnering with Instacart in 2023 — that focus on these social determinants of health. Alignment Health said it also tailored plans for older Hispanic and Asian adults that offer in-language providers and ethnic grocery store benefits.
Social determinants of health are inherently clinical, Dr. Kim said, seeping into outcomes. Other observed social threats include a lack of support, transportation, mental health, loneliness, cultural barriers and food insecurity.
“As our society gets older, I think the loneliness issue will become a bigger problem,” Dr. Kim said. He also thinks aging in place will be a persistent concern. Some Alignment plans have collaborated with Papa Pals to provide companionship for members and expand transportation for medical appointments.
While individual interventions can alleviate some stresses, Dr. Kim emphasized focusing on the whole person. Alignment has an internal case management team to handle these considerations.
“You can’t just address one [issue] … and expect it to improve loneliness issues or aging in place issues,” he said. “You just got to be taking care of a patient as a whole,” fusing clinical, social, psychological and pharmacological elements.
Here are six other things to know from the study:
- Aging in place is a top worry with nearly 7 out of 10 older adults concerned. It affects older adults regardless of health or wealth.
- Over one-quarter of those with medical debt owe at least four months’ worth of living expenses, up from last year.
- One in 5 older adults feel depressed sometimes or often, with 22% feeling worse than last year.
- Women reported higher impact in the transportation, lack of support, mental health and loneliness categories.
- Black survey respondents struggled more with economic challenges and food insecurity.
- These issues are bound to become more pressing as the older adult population grows, projected to reach 82 million by 2050.
