Access to long-term services and support (LTSS) is a public policy concern fueled by the aging of the population, the rising cost of formal care, and a declining pool of informal caregivers. In the United States, Medicaid is the largest payer of LTSS. Those not eligible for Medicaid and without financial resources to cover the out-of-pocket expenses rely on informal care networks or go without adequate care. This dissertation includes three manuscripts exploring the association between socioeconomic status and the interrelated topics of informal versus formal care use, unmet care needs, and concordance between preferred care and actual care used. Each study involved a cross-sectional analysis using National Health and Aging Trends Study (NHATS) data. Guided by Andersen and Newman’s behavioral model of health, each study examined the relationship between socioeconomic status and the outcome of interest, controlling for predisposing, enabling, and need factors associated with LTSS utilization. Descriptive analysis was used to characterize the sample; bivariate analysis examined the relationship between SES and the outcome of interest and associations between the control variables. Logistic regression models with backward stepwise elimination iteratively removed all control variables with a p-value greater than 0.10. The results of each study were interpreted using adjusted odds ratios (AOR) and their corresponding 95% confidence intervals (CI). The first study found that middle and upper-SES groups had decreased odds of using informal care. Other factors associated with decreased odds of informal care included being single, having higher levels of education, having insurance coverage, having a greater number of chronic illnesses, and having a greater number of needs related to activities of daily living (ADL) and instrumental activities of daily living (IADL) deficits. Conversely, women and those with children had increased odds of using informal care. Compared to the low-SES group, those in the middle-SES group had decreased odds of informal care but increased odds compared to the upper-SES group. The second study found that those in the middle-SES group had greater odds of unmet care needs (UCN). Other factors associated with increased odds of UCN included IADL and ADL dependencies, being single, and having children, while increased age and having only one or two chronic illnesses were inversely associated with UCN. The third study found that those in the middle and upper-SES groups had decreased odds of concordance between preferred care and care used compared to the low-SES group. Other factors significantly associated with decreased odds of concordance were age (75-84 years), education (high school or 2-4 years of college), and having insurance to assist with long-term care. No factors were associated with increased concordance. Compared to the low-SES group, those in the middle-SES group had decreased odds of concordance but increased odds compared to the upper-SES group. When individually comparing the middle-SES group to the low-SES and upper-SES groups, distinctly different patterns of association emerged. Collectively, these three studies contribute to a gap in the existing U.S.-based research by examining the relationship between SES and various aspects of LTSS utilization, with a particular focus on the middle-class demographic. The variability of associations from one study to the next reflects the complexity of the LTSS decision-making processes, which challenges providers and policymakers to consider the intricate interplay of variables that influence LTSS decisions and outcomes. My findings establish an exploratory foundation for further research on a segment of older adults currently under-represented in long-term care research.