Good Mental Health Care for Older Adults With HIV Is Economically Sound

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New work by researchers at The Graduate Center supports the idea that older adults living with HIV should receive mental health services alongside their medical care. The study, which appears in Atlantic Economic Journal, shows that it would be cost-effective for patients 50 and above to receive both types of care, and that it would improve their quality of life.

The findings challenge the idea that there isn’t enough money to help this population.

“The casual attitude is that a lot of things can be done, but that they’re cost-prohibitive,” said Professor Christos Giannikos (GC/Baruch, Economics), a study co-author. By putting data from HIV clinics and community organizations in New York City into a standard decision-analytic model, the researchers showed that combining antiretroviral treatment with mental health care is economically beneficial. Robert Utzinger, a Graduate Center Ph.D. candidate in economics, and alumnus Andreas Kakolyris (Ph.D. ’21, Economics) were also co-authors on the paper.

Their findings are particularly important as a large population of adults with HIV are aging, and poor mental health is common among older people with HIV. In 2015, at least 47% of people with HIV were 50 or older, and a previous study estimated that by 2020 that number would have risen to 70%. The researchers hypothesized that poor mental health can also affect how closely people stick to their regimens for therapeutics, thus undermining their physical health and quality of life. But until now there haven’t been many reliable cost analyses on the subject to back up these thoughts.

“We hope that policymakers take into account the importance of mental health issues in dealing with vulnerable populations,” Giannikos said, “and we hope that more studies address this important and often overlooked issue of cost-effectiveness.”

Giannikos specializes in investments and asset pricing, but with Kakolyris, he has also done research on the choices people make when it comes to quality of life. In the new study, the choice is one made by health care providers, between mental and physical health.

“In another recent study, we used data on disability insurance to evaluate individual preferences between health and income,” he said. “We have an active research agenda on individual risk attitudes toward different aspects of well-being.”

In general, it might not be as counterintuitive as it seems for economists to be tackling public health issues.

“The pandemic has brought the issue of mental health of groups with specific struggles to the forefront,” Giannikos said, “and it’s worthwhile for economists to participate in the discussion about these overlooked populations. Economics can help develop measures of well-being that are helpful in comparing the effectiveness of different treatments and policies.”

Submitted on: APR 8, 2021

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