Identification of Protective Factors (R1)

Identification of Protective Factors (Research Project 1)

Analyses of Existing National, Longitudinal Database

This project will explore the interactions between personal and environmental factors that promote or inhibit healthy aging of individuals with long-term physical disabilities, by analyzing existing national longitudinal databases.

There are three parts to this project:

Woman in wheelchair in city

Part A –Aging trajectories of chronic disease, psychological morbidity, and mortality

Project Directors: Elham Mahmoudi, PhD & Mark Peterson, PhD, MS

Despite the well-established interrelationships between access to healthcare and age-related multimorbidity, adverse health events, and cost of care among the population, the extent to which health outcomes and healthcare costs for adults with disabilities interact with a wide range of social factors, including type and depth of insurance coverage, has received little attention. There is also a paucity of evidence regarding the aging trajectories of chronic diseases and psychological morbidities among adults with these conditions, as well as how these factors contribute to healthcare costs and adverse health events, including early mortality. Three specific aims guide this research investigation

  1. Determine the longitudinal trends of cardiometabolic diseases, multimorbidity, diagnosed physiological conditions, and musculoskeletal diseases common among individuals diagnosed with a physical disability stratified by type of insurance (public vs. private). 
  2. Identify the independent and joint contributions of medical factors (e.g., age, multi-morbidity, disease severity, etc.) and social and environmental factors (e.g., income, education, and insurance) on adverse health events (including mortality), healthcare use, and costs.
  3. Quantify how changes in medical and social factors predict or mediate adverse health events and healthcare costs among individuals with specific diagnoses of physical disabilities.

Part B: Effect of variation in health coverage, employment, and community resources on adverse events and healthcare costs and utilization

Project Directors: Elham Mahmoudi, PhD & Mark Peterson, PhD, MS

This study makes use of existing national databases to examine various health outcomes among individuals with disability. Using 2007-2016 Medicaid and Medicare Data, we will conduct three separate types of analyses:

  1. Examine the effect of interstate variation in health coverage and related health policies on adverse health events and health outcomes among youth and adults with disability;
  2. Examine the effect of county-level variation in employment and community participatory living on adverse health and health outcomes among youth and adult with disability;
  3. Examine the effect of interstate variation in Medicaid long-term care and community centers on health outcomes among youth and adult with disability. 

Part C: Evaluation of Affordable Care Act (ACA) and Medicaid managed long-term services and supports (MLTSS) policies on health care and community living outcomes for individuals with long-term physical disabilities.

Project Director: Robyn Rontal, MHSA

This study will provide information about the effect of recent federal and state policies on the health and community living outcomes for individuals with physical disabilities. The intersection between research and policy is significant because it helps inform specific program interventions and supports future policy decision-making that impacts this vulnerable population. This study has two components:

  1. Examine the effect of the Affordable Care Act (ACA) on the use of preventive services, adverse health events, and cost and utilization of health care services among individuals with physical disabilities.
  2. Examine the effect of various state-level programs, implementing Medicaid managed long-term services and supports (MLTSS) policies, on individuals with physical disabilities.