Economic Status and Transitions to Seniors’ Housing: An Analysis Using the Canadian Longitudinal Study on Aging

Abstract

Background: As of January 2024, 6.2 million seniors make up 18% of the population of Canada, and it is expected to have an impact on healthcare demand and cost. Seniors may face economic challenges in affording healthcare, particularly while choosing formal home care or transitioning to seniors’ housing. This study investigated the association between economic status and transitions to seniors’ housing among seniors in Canada. Methods: This retrospective longitudinal analysis used data from the Canadian Longitudinal Study on Aging, including 50919 seniors. The primary outcome was the transition from own homes to seniors’ housing, with "total savings and investments" as the primary exposure of interest. The potential co-variates included age, sex, number of people living with the participant, general health status, eyesight rating, social support availability, received formal home care, ADL (activities of daily living) impairment, and chronic diseases. The statistical analyses included descriptive statistics such as frequencies, percentages, mean, and standard deviation and the inferential statistics included bivariate and multivariable Generalized Estimating Equation (GEE) models. Results: We observed that the incidence of transitions to seniors' housing was 1.12% (n=522) at Time Point 1 (2015-2018), increasing to 1.49% (n=590) at Time Point 2 (2018-2022). Time Point 1 represented the baseline and first follow-up of the CLSA, while Time Point 2 represented the first follow-up of CLSA as its baseline and the second follow-up of CLSA as its follow-up. At Time Point 1, the average age for individuals who experienced a transition was 76.50 years (SD = 7.50), while the average age for those who did not transition was 62.30 years (SD = 10.10). At Time Point 2, the average age for the transition group was 78.70 years (SD = 7.50), while the average age for the non-transition group was 65.10 years (SD = 9.70). Females had higher transitions at Time Point 1 (60.334%) and Time Point 2 (64.01%). Our main GEE model showed that the seniors with higher economic status had lower odds of transitioning to the seniors’ housing compared to those with lower economic status. We found that the increase in age, living alone, poor health status, living in certain provinces, receiving formal home care, ADL impairment, and having chronic diseases were significantly associated with higher odds of transition. In contrast, social support availability and better eyesight ratings were associated with lower odds of transitioning. In our provincial model, we also found that the seniors living in Alberta and Quebec with higher economic status had significantly lower odds of transitioning. In British Columbia, higher economic status was associated with lower odds of transitioning, although these findings were not statistically significant. On the other hand, in Ontario, higher economic status was associated with higher odds of transitioning, but this was also not statistically significant. Conclusion: The higher economic status was significantly associated with lower odds of transitioning to seniors’ housing in the overall sample, but these findings were not consistent at the provincial level, highlighting the differential importance of financial resources in enabling Canadians to transition to seniors’ housing. These findings underscore the need for policies addressing financial inequalities in seniors’ housing across Canada.