Persistence in health behaviors among Medicare beneficiaries

We examined persistence in seven common preventive health practices for a nationally representative sample of Medicare beneficiaries over 4-year observation periods. Six panels from the 1997-2005 Medicare Current Beneficiary Survey (MCBS) were used resulting in 13,913 unique individuals with ages ranging from below 65 (disabled) to over 80 years old. Persistence in behavior was defined as the proportion of the observation period beneficiaries participated in each activity. We estimated behavioral persistence as a function of baseline demographic, socioeconomic, and health characteristics using multivariate regression analysis. Beneficiaries were most persistent in smoking abstinence (81% reported not smoking) and least persistent with routine exercise (47% reporting none). From multivariate regression results, there was greater persistence among beneficiaries who were married when compared to those living alone (p < 0.01 except for weekly exercise, p < 0.05 and cholesterol screening, ns), with at least a high school education compared to no high school (p < 0.01 for weekly exercise, prostate cancer screening, pap smear, p < 0.05 for influenza vaccination and mammography, but ns for smoking cessation and cholesterol screening), and of higher income (>300% FPL compared to <100% FPL all p < 0.01). Increasing age (greater than 80 compared to 65 - 69) was associated with increased compliance in influenza vaccination and smoking cessation (p < 0.01) while negatively associated with weekly exercise and cancer screenings (p < 0.01). Medicare beneficiaries are inconsistently persistent with common preventive health practices.