A Quarterly BCJInsights Newsletter
Diabetes and heart disease puts Americans more at risk for severe illness from COVID-19
by Rachel Nania, AARP, March 20, 2020
Public health experts have warned for several weeks that older adults are more likely to experience severe symptoms of COVID-19, the respiratory disease caused by the coronavirus.
A lot of that has to do with “a gradual deterioration of their immune system” that happens as we age, says Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention (CDC).
But people of all ages with common, chronic health conditions — such as diabetes and heart disease — also are in danger of becoming seriously ill if they contract the virus that’s spreading across the globe.
The reason for this elevated risk? The body’s organs all “work in tandem together” to keep things going and to fight off infections, explains Stephen Kopecky, a cardiologist and professor in the department of cardiovascular medicine at the Mayo Clinic. And “as you start to stress one end of the system, the other part of the system has more trouble,” he adds.
Controlling diabetes critical during outbreak
Over time, high blood sugar, a defining characteristic of diabetes, can damage the body’s blood vessels, says George Rutherford, a physician and epidemiologist at the University of California, San Francisco. And damaged blood vessels can compromise an individual’s lung function, which could make a person with a respiratory infection like COVID-19 “more susceptible to complications,” he adds.
Viral infections also can increase inflammation in people with diabetes and raise the risk for a life-threatening condition where the blood becomes too acidic, the American Diabetes Association (ADA) says. Both can be life-threatening.
The key, experts say, is to keep your diabetes under control. If it is well managed, a diabetic’s risk for serious illness from a coronavirus infection is similar to that of the general population, according to the ADA.
That is why it’s especially important that all people with diabetes — both type 1 and type 2 — keep adequate supplies of insulin and other diabetes medications on hand to limit extra trips to the pharmacy during the spread of the virus. The ADA also recommends keeping simple carbs (regular soda, honey, jam, hard candies, etc.) stocked “to help keep your blood sugar up if you are at risk for lows and too ill to eat.”
“With diabetes, the high blood sugar is damaging to a lot of different systems in the body, including your immune system,” says Pinchas Cohen, dean of the University of Southern California Leonard Davis School of Gerontology and a member of the advisory board for the Milken Institute Center for the Future of Aging. “So by getting your diabetes under control, you’re actually leading to improved immune function. It’s really uncontrolled diabetes that puts you at risk for secondary infections, including coronavirus.”
Heart patients could face complications
Underlying heart conditions can escalate the seriousness of any infection, including COVID-19. That’s because someone who has had a heart attack or has chronic high blood pressure can also have a weak heart muscle, the Mayo Clinic’s Kopecky explains.
And when someone with those conditions gets an infection, it can “do a double whammy,” Kopecky says. In the case of the coronavirus, the infection could affect the heart and the lungs. The heart muscle may have to work harder because the lungs, which are primarily affected by the virus, may not be able to get enough oxygen to the heart.
All of this can lead to added stress on the heart, which then can have a ripple effect on other organs, such as the kidneys, and even cause multi-organ failure.
Diabetes and heart disease are not the only underlying health conditions that can complicate a coronavirus infection. People with compromised immune systems also are more likely to experience severe illness if infected. So are those with kidney disease and lung ailments.
How to reduce your risk
For the high-risk population, the most important thing to do is practice social isolation and to stay away from sick people, Cohen says. Continue to exercise at home, if you can, and take care of your primary medical problems, “particularly diabetes,” he stresses.
Public health experts also recommend every day precautions as a way to lower risk of serious illness from the coronavirus: Wash your hands with soap and water for at least 20 seconds and use alcohol-based hand sanitizer when soap is not an option. Wipe down frequently touched surfaces and avoid touching your face, nose and eyes.
Retirement saving is not just about accumulating assets. It is also about laying the groundwork for retirement spending.
Any retirement strategy has a core goal: the goal of helping an individual or couple pursue their retirement dreams once their careers have concluded. So, from that perspective, the amount that needs to be saved directly relates to the amount a retiree household may need to spend. To live your best retirement, your degree of retirement savings needs to be great enough to try and correspond to that vision.
Often, articles state that pre-retirees will need to live on 70% to 80% of their final working incomes. This is a general guideline, yet it may or may not prove true for a particular household. Some people retire and find they are spending less than they once did. Others spend as much as they did while working, maybe even a bit more, due to traveling, hobbies, and social engagements. What does this imply for retirement saving? While you arguably cannot save too much for the future, you can save too little.1
A practical financial checklist for the future.
When our parents retired, living to 75 amounted to a nice long life, and Social Security was often supplemented by a pension. The Social Security Administration estimates that today’s average 65-year-old woman will live to age 86½. Given these projections, it appears that a retirement of 20 years or longer might be in your future.1,2
Are you prepared for a 20-year retirement? How about a 30-year or even 40-year retirement? Don’t laugh; it could happen. The SSA projects that about 33% of today’s 65-year-olds will live past 90, with approximately 14% living to be older than 95.2
Start with good questions. How can you draw retirement income from what you’ve saved? How might you create other income streams to complement Social Security? And what are some ways you can protect your retirement savings and other financial assets?
Enlist a financial professional. The right person can give you some good ideas, especially one who understands the challenges women face in saving for retirement. These may include income inequality or time out of the workforce due to childcare or eldercare. It could also mean helping you maintain financial equilibrium in the wake of divorce or death of a spouse.
Invest strategically. If you are in your fifties, you have less time to make back any big investment losses than you once did. So, protecting what you have is a priority. At the same time, the possibility of a retirement lasting up to 30 or 40 years will likely require a growing retirement fund.
Consider extended care coverage. Women have longer average life expectancies than men and can require significant periods of eldercare. Medicare is no substitute for extended care insurance; it only covers a few weeks of nursing home care, and that may only apply under special circumstances. Extended care coverage can provide a huge financial relief if the need arises.1,3
Claim Social Security benefits carefully. If your career and health permit, delaying Social Security is a wise move. If you wait until full retirement age to claim your benefits, you could receive larger Social Security payments as a result. For every year you wait to claim Social Security, your monthly payments get about 8% larger.4
Retire with a strategy. As you face retirement, a financial professional who understands your unique goals can help you design a wealth management approach that can serve you well for years to come.
1 – cdc.gov/nchs/products/databriefs/db355.htm [1/20]
2 – ssa.gov/planners/lifeexpectancy.htm [2/25/20]
3 – medicare.gov/coverage/skilled-nursing-facility-care.html [2/25/20]
4 – investopedia.com/retirement/when-take-social-security-complete-guide/ [11/24/19]
This guide was developed as an educational tool to help individuals and families understand the basics of required minimum distributions (RMDs), and to support further discussions with a qualified financial professional on the complexities of RMDs and how they may affect individuals differently.
What is covered:
Contact your advisor today to get your complimentary RMD eGuide.
Are you aware of these potential tax breaks and tax-saving opportunities?
The federal government offers some major tax breaks for older Americans. Some of these perks deserve more publicity than they receive.
At age 65, the Internal Revenue Service gives you a larger standard deduction. For 2020, standard deductions look like this for taxpayers 65 and older: single filer or married filing separately, $14,050; head of household, $20,300; married filing jointly or qualifying widow(er), $26,100 (when one spouse is 65 or older) or $27,400 (when both spouses are 65 or older). The standard deductions for younger taxpayers range from $1,650-$2,600 less.1
There are two situations where your standard deduction may be limited at age 65 or older, or disappear entirely. One is when another taxpayer claims you as a dependent. The other is when you are married and filing separately, and your spouse itemizes deductions.1
You may be able to write off some medical costs. The I.R.S. will let you deduct qualifying medical expenses once they exceed 10% of your adjusted gross income (AGI). The list of eligible expenses is long. Beyond out-of-pocket costs paid to doctors and other health care professionals, it also includes things like insurance premiums for extended care coverage, travel costs linked to medical appointments, and payments for durable medical equipment, such as dentures and hearing aids.2
Are you thinking about selling your home? Many retirees consider this. If you have lived in your current residence for at least two of the five years preceding a sale, you can exclude as much as $250,000 in gains from federal taxation (a married couple can shield up to $500,000). These limits, established in 1997, have never been indexed to inflation. This exclusion is only allowed once every two years.3
Low-income seniors may qualify for the Credit for the Elderly or Disabled. This incentive, intended for people 65 and older, can be as large as $7,500 based on your filing status. You must have very low AGI and nontaxable income to claim it, though. It is basically designed for those living wholly or mostly on Social Security benefits.4
Affluent IRA owners may want to make a charitable IRA gift. Generally, once you reach age 70½, you must begin taking required minimum distributions (RMDs) from a traditional IRA. You may not be looking forward to these annual withdrawals, especially if you are well off. You have another option: you can make a Qualified Charitable Distribution (QCD) using those traditional IRA assets.5
You can donate up to $100,000 of traditional IRA assets to a qualified charity in a single year this way, and the amount donated counts toward your required withdrawal. The amount of the QCD is excluded from your gross income for the year of the donation. Eligibility to make a QCD still begins at 70½, even though the Setting Every Community Up for Retirement Enhancement (SECURE) Act raised the starting age for annual traditional IRA distributions from 70½ to 72.5
It must be mentioned that withdrawals from traditional IRAs are taxed as ordinary income (and, if taken before age 59½, may be subject to a 10% federal income tax penalty).
Of course, some states also give seniors tax breaks. For example, the following 11 states do not tax federal, state, or local pension income: Alabama, Hawaii, Illinois, Kansas, Louisiana, Massachusetts, Michigan, Mississippi, Missouri, New York, and Pennsylvania. Twenty-eight states (and the District of Columbia) refrain from taxing Social Security income.6
Unfortunately, your Social Security benefits could be partly or fully taxable. They could be taxed at both the federal and state level, depending on how much you earn and where you happen to live. Whether you feel this is reasonable or not, you may have the potential to claim some of the tax breaks mentioned above as you pursue the goal of tax efficiency.7
1 – efile.com/tax-deduction/federal-standard-deduction/ [1/20/20]
2 – thebalance.com/deducting-medical-expenses-retirement-2894613 [11/4/19]
3 – investopedia.com/ask/answers/06/capitalgainhomesale.asp [2/16/20]
4 – thebalance.com/tax-breaks-for-seniors-and-retirees-4148392 [1/14/20]
5 – giving.princeton.edu/giftplanning/current-ira-gifts [2/18/20]
6 – thebalance.com/state-income-taxes-in-retirement-3193297 [7/15/19]
7 – smartasset.com/retirement/is-social-security-income-taxable [1/16/20]
How do you know you are psychologically ready to retire? See if you are prepared to begin your retirement by answering four key questions.
1.) Is your work meaningful? If it is emotionally and psychologically fulfilling, if it gives you a strong sense of purpose and identity, there may be a voice inside your head telling you not to retire yet. You may want to listen to it.
It can be tempting to see retirement as a “finish line”: no more long workdays, long commutes, or stressful deadlines. But it is really a starting line: the start of a new phase of life. Ideally, you cross the “finish line” knowing what comes next, what will be important to you in the future.
2.) Do you value work or leisure more at this point in your life? If the answer is leisure, score one for retirement. If the answer is work, maybe you need a new job or a new way of working rather than an exit from your company or your profession.
An old saying says that retirement feels like “six Saturdays and a Sunday.” Fantastic, right? It is, as long you don’t miss Monday through Friday. Some people really enjoy their careers; you may be one of them.
3.) Where do your friends come from? If very little of your social life involves the people you work with, then score another point for retirement. If your friends are mainly your coworkers, those friendships may be tested if you retire (and you may want to try to broaden your social circle for the future).
At a glance, it might seem that an enjoyable retirement requires just two things: sufficient income and sufficient return on your investments. These factors certainly promote a nice retirement, but there are also other important factors: your physical health, your mental health, your relationships with family and friends, your travels and adventures, and your outlets to express your creativity. Building a life away from work is a plus.
4.) What do you think your retirement will be like? If you think it will be spectacularly different from your current life, ask yourself if your expectations are realistic. If after further consideration they seem unrealistic, you may want to keep working for a while until you are in a better financial position to try and realize them or until your expectations shift.
Ideally, you retire when you are financially, emotionally, and psychologically ready. The era of the “organization man” retiring with a gold watch and a party at 65 is gone; the cultural forces that encouraged people to stop working at a certain age aren’t as strong as they once were.
Why you are retiring is as important as when you choose to retire. When you are motivated to retire, you see retirement as a beginning rather than an end.
A fair number of employers are offering phased retirements. According to the Transamerica Center for Retirement Studies, 30% of U.S. companies permit their workers to move from full-time hours to part-time hours as part of a retirement transition, and 21% allow employees to move into less-stressful roles prior to retiring.
According to Willis Towers Watson research, total retirement plan assets in the U.S. grew by 18.2% last year to $29.2 trillion. America held 62.5% of the world total of these assets by the end of 2019.
Investment Advisory Services offered through BCJ Capital Management LLC., a (SEC) Registered Investment Adviser. Information presented is for educational purposes only. It should not be considered specific investment advice, does not take into consideration your specific situation, and does not intend to make an offer or solicitation for the sale or purchase of any securities or investment strategies. Investments involve risk and are not guaranteed, and past performance is no guarantee of future results. For specific tax advice on any strategy, consult with a qualified tax professional before implementing any strategy discussed herein.
This material was prepared by MarketingPro, Inc., and does not necessarily represent the views of the presenting party, nor their affiliates. This information has been derived from sources believed to be accurate. The publisher is not engaged in rendering legal, accounting or other professional services. If assistance is needed, the reader is advised to engage the services of a competent professional. This information should not be construed as investment, tax or legal advice and may not be relied on for the purpose of avoiding any Federal tax penalty. BCJ FG 20-28