The Massachusetts Healthy Aging Data Report came at the urging of Collaborative members who noted the lack of comprehensive data on healthy aging that could be used by local communities to effectively understand their 60+ populations. The Gerontology Institute at the University of Massachusetts Boston conducted the research for the Data Report with funding from the Tufts Health Plan Foundation.
Three primary data sources were used to develop the Community Profiles: Census data, Behavioral Risk Factor Surveillance Survey (BRFSS) data, and Centers for Medicare and Medicaid Services (CMS) data.
While the BRFSS data represent community-residing respondents, the CMS Medicare Master Beneficiary Summary File contains both community-residing and older adults who are institutionalized. About 5 percent of aged Medicare beneficiaries in the state are institutionalized. Available data did not permit all indicators to be reported for individual cities and towns. Since annual service utilization and chronic condition prevalence data were available for more than 600,000 individual Medicare beneficiaries 65 years or older in Massachusetts who received care from fee-for-service medical providers in 2011, it was possible to report CMS indicators for all but the least populated individual towns in the state, as well as subareas within Boston. This was not possible with BRFSS indicators because fewer than 9,000 respondents age 60 years or older are surveyed by the BRFSS in Massachusetts each year.
These data limitations led us to stratify indicators into three geographic tiers related hierarchically. At the lowest tier, indicators derived from CMS data are reported for 310 communities, the great majority of which were individual cities or towns. The second tier of indicators derived from Massachusetts BRFSS data are computed for 33 larger areas defined by aggregating communities served by Massachusetts Aging Service Access Points (ASAPs). The same BRFSS indicator values are reported for each city and town within these aggregated service areas. The third tier is comprised of a few healthy aging indicators where data were only available for counties. The same county-level indicator values are reported for all cities and towns within the same county.
While these geographic tiers help to partially address small sample size problems, this limitation cannot be overcome with existing data sources. A large-scale primary survey data collection effort would be needed to compute reliable estimates for all healthy aging indicators for all individual cities and towns.
We are not aware of any other public source where healthy aging indicators are reported for geographic areas smaller than counties as they are here. We believe that our pragmatic approach achieved a balance between competing goals of geographic specificity, timeliness, and the breadth of healthy aging indicators.
A variety of factors contribute to making communities relatively better places to age well. The Highlights Report does not summarize the community variable data in each Community Profile. However, for each Community Profile we report a wide range of variables including cost of living, safety, walkability, and resources that contribute to healthy aging. The community’s “walkability score” is derived from a measure of access to restaurants, shops, grocery stores, parks, and other community locations (see www.walkscore.com).
Each Community Profile also includes some preliminary data on older adults’ access to transportation, such as the MBTA’s The Ride, ITNGreaterBoston and other supplemental transportation options. According to the National Highway Traffic Safety Administration (2013), adults age 65 or older comprise 16 percent of all licensed drivers in the U.S. today. More and more older adults will face retirement from driving due to medical conditions that impact critical driving skills. It is likely that the impairments that cause an individual to cease driving are the same impairments that may make it difficult to navigate public transportation. Rather than a “curb-to-curb” alternative, many will need “door-through-door” transportation.
Communities in Massachusetts are beginning to recognize the need for supplemental transportation programs and some strategies are emerging utilizing both paid and volunteer drivers as well as public and private transit. We need to build on these strategies to assure that older adults in Massachusetts can get to where they need or want to go, when they want to go there.
As other indicators of mobility, the Community Profiles further note if the community is a Department of Public Health (DPH) Mass in Motion Community or if the community has a Keep Moving Walking Club. We also include county-level data from the Elder Economic Security Index on income needed for older individuals or couples in good health who own or rent to be able to maintain a modest standard of living. Finally, we note if the community has a Council on Aging, Senior Center or other opportunities for lifelong learning.
Choose a community to view its community profile with confidence intervals for each healthy aging indicator.