Including out-of-pocket medical expenses, about one in seven seniors lives in poverty. Poverty influences environmental exposures and health-related behaviors, and is associated with increased risk of mortality and chronic disease. Low-income seniors have a harder time paying for appropriate chronic disease management and preventive care, and often have low health literacy. Many seniors live on limited incomes, have modest savings, and struggle with rising costs of housing and health care as well as access to healthy food and reliable transportation. Among seniors, poverty rates increase with age, are higher for women than men, and for blacks and Hispanics versus whites.

Retirement provides increased free time that some seniors fill with volunteering. Volunteering provides a service for communities and organizations. It provides seniors with positive social interactions, a greater level of social support, and often a sense of purpose. Studies show that older adults who volunteer have better cognitive performance, fewer depressive symptoms, higher activity levels, and better mental health than seniors who do not volunteer. The health benefits of volunteering may extend beyond psychological well-being; higher rates of volunteerism are associated with lower rates of mortality and heart disease, and a longer life span.

Poor quality care in nursing homes, including elder abuse and exploitation, has an enormous impact on the health and finances of US nursing home residents and taxpayers. Millions of dollars are spent yearly for medical treatments and hospitalizations related to falls, pressure ulcers, urinary incontinence, malnutrition, dehydration, and ambulatory care-sensitive diagnoses. Quality nursing home practices can largely prevent these negative health outcomes, and nursing homes nationwide are making efforts toward systematic quality improvement. The Centers for Medicare & Medicaid Services amended the Nursing Home Compare rating scale in 2015, raising quality standards in nursing homes across the country.

Access to healthy food is a struggle for some older adults and is of particular concern for seniors living at home. The Elderly Nutrition Program provides grant funding to states to administer home- and community-meal services. These programs target seniors at high risk for undernutrition and food insecurity due to illness, disability, isolation, or poverty. Home-delivered meal programs can enhance quality of life, provide a stable source of nutrition, increase nutrient intake, and help older adults remain independent and in their homes despite functional limitations, resulting in a projected cost savings of $109 million.

An estimated 9.6 million seniors faced the threat of hunger in 2013. Compared with younger adults, seniors living at home are at increased risk of hunger due to health conditions, poor food-management skills, limited mobility, lack of reliable social support, and poverty. Food-insecure seniors may have signifcantly reduced intakes of vital nutrients, which could have negative implications for overall health. There are numerous food assistance programs and community meal-delivery options that can help older adults maintain food security. Hunger among all Americans was estimated to cost the nation at least $167.5 billion in 2010.

States receive federal funding and allocate state resources to help older adults remain at home using home- and community-based services. Specifically, states may support senior programs that address services such as personal care, congregate meals, transportation, and health promotion. The Older Americans Act (OAA), governed by the Administration on Aging, has provided funding for home- and community-based services since 1965. Community public health spending varies substantially by state and is associated with reducing preventable mortality, especially in low-resource communities. Increased OAA spending in a state is associated with fewer low-care nursing home residents.