Nine in 10 U.S. seniors report at least one barrier that affects their health, independence or access to care, with aging-in-place challenges, support gaps and medical debt all worsening in 2026, according to Alignment Health’s fifth annual Social Threats to Aging Well in America survey conducted with Ipsos.
The nationwide study, which polled more than 2,200 adults ages 65 and older, underscores growing pressure on systems that support older Americans as they try to remain at home and manage rising health and living costs, Alignment Health said in its announcement.
For housing and healthcare stakeholders, the findings point to increasing demand for services that enable seniors to safely age in place, from home modifications and transportation to food support and telehealth, along with rising risk that financial strain and limited support networks will push more seniors into institutional care or housing instability.
Key findings
For the third consecutive year, seniors identified aging-in-place challenges, healthcare access and economic instability as the three greatest threats to healthy aging.
Ninety percent reported at least one social barrier affecting their health, well-being or access to care. Nearly 70% reportedly face challenges that affect their ability to remain safely and independently in their homes — the most commonly cited barrier and up 4 percentage points from 2025.
Nearly two-thirds of respondents say they face barriers to accessing needed healthcare services, including long waits for appointments. And more than half (54%) cite economic instability. Within that group, 16% carry medical debt and 22% are unsure they can cover future medical expenses.
Support gaps are reportedly widening, with 38% saying they lack sufficient support systems, a 4-point increase from 2025, while 57% say they experienced mental health issues such as stress or anxiety in the past 12 months.
Care is being delayed
More than one-quarter of surveyed seniors (26%) reported skipping needed medical care over the past year. Among these respondents:
- 57% cited access-related barriers, such as difficulty finding care, obtaining appointments or reaching providers.
- 34% cited aging-in-place challenges, a 7-point increase from 2025, indicating that difficulty maintaining independence and mobility is increasingly keeping seniors from care.
The data suggests that social and economic obstacles are feeding directly into higher health risk by discouraging or preventing seniors from seeking timely treatment. For insurers, health systems and care coordinators, reducing missed appointments tied to transportation, mobility and cost could be a key lever for managing utilization and outcomes.
Demand for non-medical supports
The survey also asked seniors which benefits and services they would use if offered through their health plan, highlighting strong interest in supports that go beyond traditional clinical care:
- 59% would use personalized wellness recommendations based on their medical history and information shared with their health plan.
- 57% would use 24/7 access to doctors by phone or video.
- 49% would use help paying for groceries.
- 47% would use fresh food delivery.
- 43% would use a personal medical safety alert system.
- 42% would use memory exercises or other memory care support.
These preferences align with how Medicare Advantage plans and some Medicaid and commercial products are increasingly using supplemental benefits — such as food, transportation and home-based supports — as tools to manage risk for older and medically complex members.
State-level differences in needs
The survey found that seniors in some states report higher demand for specific supports than the national average, signaling regional variation that could inform benefit design and local partnerships.
- North Carolina: More than half of surveyed seniors would use help paying rent, mortgage or utilities (52% vs. 44% nationally) and help paying for gas (54% vs. 42%). They also reported higher interest in home safety modifications (50% vs. 39%) and memory-care support (54% vs. 42%).
- Nevada: Surveyed seniors showed similarly elevated interest in help paying rent, mortgage or utilities (54%) and gas (49%).
For housing providers, community-based organizations and health plans operating in these markets, the findings point to heightened demand for rental assistance, utility support and home modification programs that allow seniors to remain in their homes safely.
Why it matters for housing professionals
The survey reinforces an ongoing shift in senior care: Medical services alone are not enough to keep older adults healthy and housed. As aging-in-place challenges and support gaps widen, stakeholders across healthcare, insurance and housing will likely face:
- Higher demand for age-friendly housing: Homes with accessibility features, proximity to services and options for in-home supports are poised to see increased interest.
- Growth in home- and community-based services: Transportation, food support, caregiver services and home modifications are central to maintaining independence and preventing higher-cost institutional care.
- Pressure on affordability: With more than half of seniors reporting economic instability and many uncertain about covering future medical expenses, affordability of both housing and care remains a central risk factor.
- Opportunities for cross-sector partnerships: Payers, providers, housing operators and local agencies may find value in joint programs that address transportation, safety modifications and social isolation, particularly in high-need states such as North Carolina and Nevada.
This article was generated using HousingWire Automation and reviewed by a HousingWire editor before publication.