TY - JOUR T1 - Chronic Disease and Workforce Participation Among Medicaid Enrollees Over 50: The Potential Impact of Medicaid Work Requirements Post-COVID-19 JF - medRxiv Y1 - Forthcoming A1 - Rodlescia S. Sneed A1 - Stubblefield, Alexander A1 - Gardner, Graham A1 - Jordan, Tamara A1 - Briana Mezuk KW - Chronic disease KW - COVID-19 KW - health policy KW - Medicaid AB - As the COVID-19 pandemic wanes, states may reintroduce Medicaid work requirements to reduce enrollment. Using the Health and Retirement Study, we evaluated chronic disease burden among beneficiaries aged >50 (n=1460) who might be impacted by work requirements (i.e. working <20 hours per week). Seven of eight chronic conditions evaluated were associated with reduced workforce participation, including history of stroke (OR: 7.35; 95% CI: 2.98-18.14) and lung disease (OR: 4.39; 95% CI: 2.97-7.47). Those with more severe disease were also more likely to work fewer hours. Medicaid work requirements would likely have great impact on older beneficiaries with significant disease burden.Key PointsChronic disease linked to reduced work among older Medicaid beneficiaries.Work requirements would greatly impact those aged >50 with chronic conditions.Coverage loss would have negative implications for long-term disease management.Competing Interest StatementThe authors have declared no competing interest.Funding StatementThis work was supported by the Robert Wood Johnson Foundation’s (RWJF) Policies for Action program under grant number 77342. This is a secondary analysis that uses data from the Health and Retirement Study, (2016 HRS Core and RAND HRS Longitudinal File 2018), sponsored by the National Institute on Aging under grant number NIA U01AG009740 and conducted by the University of Michigan.Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.YesThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:This study involved only openly available human data, which can be obtained from: https://hrsdata.isr.umich.edu/data-products/rand-hrs-longitudinal-file-2018 and https://hrsdata.isr.umich.edu/data-products/2016-hrs-coreI confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).YesI have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.YesAll data are available online at: https://hrsdata.isr.umich.edu/data-products/rand-hrs-longitudinal-file-2018 and https://hrsdata.isr.umich.edu/data-products/2016-hrs-core ER - TY - JOUR T1 - Construct overlap between depression and frailty in later life: evidence from the health and retirement study JF - Comprehensive Psychiatry Y1 - 2013 A1 - Matthew C. Lohman A1 - Briana Mezuk KW - Disabilities KW - Health Conditions and Status AB - Background: In epidemiologic research, late-life depression and frailty are often conceptualized and modeled as independent constructs despite having shared risk factors and consequences. Ignoring the interrelationships between depression and frailty may lead to false inferences about the relative importance of these syndromes for morbidity, disability, and mortality. The goal of this study was to use confirmatory latent class analysis to examine the joint relationship between the constructs of depression and frailty among community-dwelling older adults. Method: Data come from the 2008 wave of the Health and Retirement Study, a nationally-representative sample of adults over the age of 50. Analysis is limited to participants 65 and older with complete data on depressive symptoms and frailty indicators (N = 3665). Depressive symptoms were indexed by the 8-item Centers for Epidemiologic Studies Depression (CES-D) scale, and frailty was indexed by modified Fried criteria (i.e., low weight, inactivity, slowness, exhaustion, and weakness). Latent class analysis was used to model the depression and frailty constructs, and latent Kappa coefficients were estimated from competing models to assess the chance-corrected agreement between depression and frailty. Results: Latent class analyses suggested that depression and frailty could best be modeled as distinct syndromes, each with 3 classes. In the joint modeling of depression and frailty latent constructs, 13.0 of participants were classified as high depressive symptoms, 19.0 as mild, and 68.0 as low depressive symptoms. Regarding frailty, 18.2 were classified as severely frail, 18.5 , as mild, and 63.3 with low frailty symptoms. A latent Kappa statistic representing chance-corrected agreement between depression and frailty indicated substantial construct overlap (?l: 0.56, 95 CI: 0.53 0.59). Conclusion: Findings suggest that late-life depression and frailty, as commonly defined in epidemiologic research, are substantially interrelated constructs and identify overlapping populations of older adults. Future research should explicitly examine this relationship to better understand both late-life depression and frailty, and to identify intervention strategies to delay or prevent functional decline in later life. PB - 54 VL - 54 IS - 1 U4 - depression/Depressive Symptoms/Frail Elderly/DISABILITY/DISABILITY/MORBIDITY/Mortality/CES Depression Scale/CES Depression Scale ER -