Dr. Eunsun Kwon, PhD

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Dr. Eunsun Kwon, PhD
Associate Professor, Master of Social Work Program
College of Pharmacy and Health Sciences
Fairleigh Dickinson University

Project Title

Geographic Disparities in Mortality and Hospital-Based Health Care Utilization Among Low-Income Older Adults with Dementia

Project Details

Principal Investigator

Dr. Eunsun Kwon, PhD
Associate Professor, Master of Social Work Program
College of Pharmacy and Health Sciences
Fairleigh Dickinson University

External Partner(s)

Dr. Takashi Amano, PhD
Associate Professor, Social Work
Rutgers University–Newark

Project Period

July 1, 2026 to June 30, 2027

Project Description

Older adults living with dementia often need consistent access to medical care, supportive services, and community resources to remain healthy and safely age in place. For low-income older adults, however, access to these services can depend heavily on where they live. Some communities have a strong network of health care providers and resources, while others have far fewer options. This project examines how these differences across communities may contribute to disparities in health care use and mortality among low-income older adults with dementia in New Jersey. Using our newly approved access to restricted New Jersey hospital discharge and mortality data through the Integrated Population Health Data (iPHD) system, we will link these records with ZIP code–level data on local health care provider availability from the National Provider Identifier (NPI) Registry and community socioeconomic and demographic characteristics from the American Community Survey (ACS). This combination of administrative health and community-level data will allow us to examine whether those living in areas with fewer health care resources and greater socioeconomic disadvantage experience greater reliance on hospital-based care or poorer health outcomes.

Problem Addressed

Research on dementia has traditionally focused on individual factors such as health conditions, income, and caregiver support. While these factors are important, they do not fully capture the role of the communities in which people live. Low-income older adults may be particularly affected by local conditions because they often have fewer resources to travel farther for care or overcome gaps in local services. When appropriate care is not readily available, they may be more likely to delay needed care or rely on hospitals and emergency services. Yet we still know relatively little about where these geographic disparities occur and whether local health care resources are sufficient to meet the needs of older adults with dementia.

Who Will Benefit

The project is intended to benefit low-income older adults with dementia and the families and caregivers who support them, particularly those living in communities with limited access to health care and supportive resources. The findings may also help health care providers, community organizations, policymakers, and public agencies better understand where gaps between community needs and available services exist and where additional resources may be most needed.

The project will also create opportunities to strengthen research and collaboration within FDU Health around aging, dementia, and health care access. We hope the work will foster new connections among faculty, students, health care providers, community organizations, and other partners with shared interests in improving the health and well-being of older adults.

Goals During the Grant Period

During the SEED Grant period, our primary goal is to develop a clearer picture of where disparities in dementia-related health outcomes are concentrated across New Jersey and where local resources may not adequately match community needs. We will identify geographic patterns in hospital-based care and mortality and pinpoint communities where high levels of need coincide with limited health care resources and greater socioeconomic disadvantages.

The project will establish a place-based analytic framework and generate preliminary evidence that can serve as a foundation for the next stage of this research. We hope to use these findings to refine future research questions, pursue larger external funding opportunities, and develop collaborations aimed at improving access to care and supporting aging in place for vulnerable older adults.

Broader Impact

Ultimately, this project aims to shift attention from asking only who is at risk to also asking where people are at risk and whether the resources available in their communities match their needs. By identifying geographic areas where low-income older adults with dementia face both high levels of need and limited access to services, the study can provide evidence to guide more equitable resource allocation and community-based interventions.

In the longer term, we hope this project will help build a stronger foundation for aging-related research at FDU Health. The data infrastructure, analytic framework, and partnerships developed through this work can create opportunities for interdisciplinary research, future external funding, and collaboration with health care and community organizations. We also hope the project will strengthen FDU Health’s engagement with surrounding communities by connecting research with locally identified needs and supporting future university-community partnerships focused on healthy aging.