Number of homebound adults more than doubles during pandemic, study finds

The number of homebound individuals in the U.S. more than doubled during the past decade, according to a paper published in JAMA Internal Medicine Monday.

The share of the population that rarely or never leaves their homes rose held steady at about 5% from 2011 to 2019 but leaped to 13% last year, likely driven by isolation during the COVID-19 pandemic, Mount Sinai researchers found.

The greatest increases were among Blacks and Hispanics, who also experienced poorer health and less digital access, the study shows.

“We’ve known that the COVID-19 pandemic has disproportionately impacted older adults from communities of color in terms of illness and death, but this study shows the large disparities in rates of being homebound,” Dr. Claire Ankuda, one of the paper’s authors and a professor at Mount Sinai’s Icahn School of Medicine in New York, said in a news release. “It is important that we understand the impacts that being homebound might have for years to come.”

The study shows that 65% of Hispanic people, 44% of Black people and 35% of white people reported fair or poor health. Seventy-seven percent of Hispanic respondents do not own computers compared to 57% of Blacks and 42% of whites.

“We are greatly concerned about all of our patients who are both homebound and poorly connected, particularly among Hispanic populations in light of their higher levels of poor health and self-reported anxiety and depression,” Ankuda said. “Much lower rates of technology use among Hispanics and Blacks likely heighten barriers to accessing digital supports, such as healthcare through telemedicine and signing up for vaccine registrations as well.”

Being homebound is associated with negative health outcomes like increased mortality, and can worsen both mental and physical health, the study authors wrote.

“Aging in place in the community is a goal for Americans and their families. But we must make sure that our health and long-term care systems can support the needs of homebound patients and their caregivers so they can be safe and comfortable at home. This includes access to home-based medical care and expanded resources for caregiving families,” Dr. Katherine Ornstein, senior author of the study and director of Mount Sinai’s Institute for Care Innovations at Home, said in a news release.

The researchers used data from the National Health and Aging Trends Study, which includes information on the homebound status, household, health and digital access of 10,785 older adults from 2011 to 2020.