On Thursday, October 16, 2025 at 8am US Pacific Time (1am US Eastern Time, and 5pm Central European Time) David Knapp, (University of Southern California), in collaboration with Maya Fransz-Myers, Sarah Gao, and the Gateway LTC Policy Team, will be presenting "Differences in Access to Publicly Provided Long-term Care in the United States." The abstract is provided below.
Please join our seminar using the following Zoom link.
For information about the Long-Term Care Seminar Series, including a schedule of upcoming presentations and list of past presentations, visit our Seminar Series page.
Abstract: In the US, most long-term care (LTC) services are provided by Medicaid, a federal, financial needs-based health insurance program administered by state governments. States have significant flexibility in how they administer their Medicaid programs, which results in distinct eligibility requirements, populations covered, and services provided. However, state Medicaid programs must provide institutional care services for people requiring a nursing facility level of care (NFLOC). Most home and community based care is provided through optional benefit programs offered by states, known as 1915(c) waivers, which must also satisfy NFLOC. These waivers for people age 65 and older are available in 46 states. As part of the Gateway to Global Aging Data’s LTC Policy Explorer, we document 30 state assessments for NFLOC. Using the nationally-representative data from the 2018 Health and Retirement Study (HRS) sample, we apply survey responses to each state’s care needs assessment using a common framework to estimate the proportion age 65 and older satisfying a state’s minimum eligibility for NFLOC. We find: (1) there exists substantial variation across state NFLOC assessments in terms of what fraction of the HRS sample would be prospectively eligible for care benefits based on personal need, (2) that state variation is reduced but persists when applying state financial need requirements, and (3) states with similar predicted eligibility often differ substantially in the care needs reported by those eligible. Our results have implications for Medicaid policy and funding, namely that NFLOC is assessed in an inconsistent manner and that care needs assessments are a viable mechanism for expanding or contracting care access and, consequently, for changing Medicaid spending.
The Gateway to Global Aging team is extending the call for applications for a half-day exposome research development workshop at the Gerontological Society of America (GSA) Annual Meeting on November 12, 10:30 a.m.–3:00 p.m., in Boston, MA.
This workshop is designed to jumpstart innovative research on the exposome, leveraging the rich data resources available in the Gateway Data Enclave.
Participants will benefit from: Direct feedback and hands-on guidance from the Gateway team on their projects Opportunities to network with leading researchers in the field Complimentary lunch during the session A $300 travel stipend Applications are now due by Monday, September 8th. To apply, submit a brief proposal for a research project to be advanced during the workshop. Proposals should explore the role of the exposome (including social, lifestyle, and environmental factors) in shaping late-life health. Research should leverage data available in the Enclave, and may include newly available data on air pollution.
Available resources that will be highlighted in this workshop will include analysis-ready datasets and newly available data on fine particulate matter air pollution (PM2.5) linked to the Longitudinal Aging Study in India – Diagnostic Assessment of Dementia (LASI-DAD) and the English Longitudinal Study on Aging (ELSA), and ELSA – Harmonized Cognitive Assessment Protocol (ELSA-HCAP). These physical environment datasets will be available in the Gateway Data Enclave by September 2025. Additional data sources available in the Enclave at that time may include Health and Retirement Study (HRS), HRS-HCAP, Chilean Social Protection Survey (SPS), Chile Cognitive Aging Study (Chile-Cog), and/or Northern Ireland Cohort for the Longitudinal Study of Aging (NICOLA), and NICOLA-HCAP.
To learn more about our Enclave Workshop as well as how to apply use this link: https://forms.gle/FeEbinCY8MbsdS397
You can learn more about the Gateway to Global Aging Data Enclave here: https://g2aging.org/enclave
We are pleased to announce a major update to two Gateway Harmonized datasets from the Korean Longitudinal Study of Aging (KLoSA): the Gateway Harmonized KLoSA and the Gateway Harmonized KLoSA End of Life (EOL). Both now include Wave 9 data, collected in 2022.
Gateway Harmonized KLoSA, Version F
This version incorporates Wave 9 variables and introduces new measures, including dementia diagnosis, parental education, and child contact. It also features improvements and corrections from the previous release.
You can generate the updated Gateway Harmonized KLoSA dataset by running a Stata script provided by the Gateway team. A codebook detailing the dataset structure and all included variables is available.
Create the Gateway Harmonized KLoSA Data
Download the Gateway Harmonized KLoSA Codebook
Gateway Harmonized KLoSA End of Life (EOL), Version C
Alongside the addition of Wave 9 variables, this version introduces new measures, enhancements, and corrections over the prior release.
To generate the updated dataset, run the Stata script provided by the Gateway team after you have already generated the Gateway Harmonized KLoSA, Version F. A comprehensive codebook outlining the dataset structure and variables is also available.
We are pleased to announce a major update to two of our Gateway Harmonized datasets for the Mexican Health and Aging Study (MHAS): the Gateway Harmonized MHAS and the Gateway Harmonized MHAS End of Life (EOL). Both datasets now include Wave 6 of MHAS, conducted in 2021.
Both datasets are available in Stata, SAS, and SPSS formats. They are accompanied by a codebook detailing the dataset structure and all included variables. You can download the data directly from the MHAS website: mhasweb.org/DataProducts/HarmonizedData.aspx
We’re excited to announce the release of our latest research product: the Gateway Harmonized HRS Life History Data. This user-friendly dataset is derived from the HRS Life History Mail Surveys conducted in 2015, 2017, and 2019. It offers richly detailed information for over 14,000 respondents’ life histories prior to entering the HRS, enabling valuable insights into how earlier life events impact outcomes in later life.
This life history data contains age-sequenced variables from age 15 to 80 across the following domains: Work History, Partnership History, Children History, Caregiving History, Health History, and Accommodation History.
The Gateway Harmonized HRS Life History Data file is distributed through the Health and Retirement Study (HRS) website, alongside the original HRS data. Download from the HRS here: hrsdata.isr.umich.edu/data-products/contributed-projects.
The dataset is also available through the Gateway Data Enclave, a secure, remote-access environment hosted on the NIA’s LINKAGE platform. Join the Gateway Data Enclave here: g2aging.org/enclave: