Higher Instrumental Activities of Daily Living Disability in Hispanics Compared with Non-Hispanic Whites in Rural Colorado: The San Luis Valley Health and Aging Study (original) (raw)
Related papers
2009
Assistive technology has become increasingly important in facilitating independence among older Americans. It remains unclear, however, whether this trend has been experienced broadly. Using the 1992 to 2001 Medicare Current Beneficiary Survey, we provide evidence that among older people who have difficulty with daily activities, there were substantial increases in the independent use of assistive technology (without help from another person). Controlling for shifts in the composition of the older population reporting difficulty with daily activities, the independent use of assistive technology increased on average 4% to 5% per year, amounting to a 6 percentage point increase over the entire period. These increases were accompanied by declines in the use of any help and in unassisted difficulty, with larger declines in the latter. Substantial differentials in assistance-which favor the more highly educated in the case of technology and favor minorities in the case of help-persisted over this period. All else equal, 5-percentage point gaps were evident between more and less advantaged education groups with respect to the independent use of assistive technology for walking. Gaps in the independent use of assistive technology to bathe were even larger, amounting to 7 to 8 percentage points in 2001 by education and race. We discuss the implications of findings for the study of latelife disability trends and disparities therein. Hartke, R.J., T.R. Prohaska, and S.E. Furner. 1998. Older adults and assistive devices: Use, multiple-device use and need. Journal of Aging and Health 10(1): 99-116. Kemper, P. 1992. The use of formal and informal care by the disabled elder. Health Services Research 27(4):421-451. Kington R.S. and J.P. Smith. 1997. Socioeconomic status and racial and ethnic differences in functional status associated with chronic diseases. American Journal of Public Health. 87(5):805-10.
Hospital Topics, 2009
The purpose of this study was to compare disability and functional limitation among elder Hispanic subgroups using data from the 2001-2003 NHIS. Results revealed a 21.4% disability of any type in Hispanics. Puerto Ricans reported the highest rates of ADL, IADL disability compared with other Hispanic subgroups (Mexicans, Cubans, Central and South Americans) and higher than blacks. Cubans showed the lowest rate in IADL and any disability within Hispanics and even lower than whites. The findings highlights the high rates of inter group variability among the US Hispanic population. Among seniors, ADLs and IADLs are significant predictors of admission to nursing homes, use of paid home care, use of physician services, and palliative care.
American Journal of Public Health, 1995
The purpose of this study was to compare the national prevalences and predictors of paid in-home functional assistance among disabled Latino and non-Latino elderly people who receive such assistance. Data were derived from the 1988 wave of the National Center for Health Statistics Longitudinal Study on Aging and the 1988 Commonwealth Fund Commission Survey of Elderly Hispanics. Logistic regression was used to model paid care use and to calculate estimated probabilities of such use. Among Latino and non-Latino Whites 74 years of age and older who received functional assistance, similar proportions used paid assistance. Predictors of paid care coincided with established models for non-Latino Whites only. Disabled Latinos had a lower estimated probability of using paid assistance when they were highly disabled and socially isolated but had a higher estimated probability when their children lived nearby. The effects of disability and social support differ among non-Latino White and Latino elderly people. Latino elderly people with high anticipated needs obtain less paid assistance than similar non-Latino Whites. In addition to a reduction in financial barriers, improving access to long-term care services requires addressing this diversity in service use patterns.
The effect of medical conditions on the functional limitations of Mexican-American elderly
Annals of …, 1996
We examined the relationship of self-reported functional status to common medical conditions using a probability sampk of 3050 noninstitutionaLred Mexican-American men and women aged 65 or older and residing in the Southwestern United States (Arizona, California, Colorado, New Mexico, and Texas). All subjects were interviewed in person (n = 2,873) or by proxy (n = 177) in their homes during ktte 1993 and early 1994. The questionnaire obtained information on self-reported functional statm and prevalence of arthritis, cancer, diabetes, stroke, heart attack, and hip fracture. The prevalence of medical conditions ranged from 4.1% for hip fracture to 40.8% for arthritis. Prevaknce of impairments in seven activities of daily living ranged from 5.4% for eating to I 1.7% for bathing, while 25. J % could not walk up and down stairs, and 28.9% could not walk a half mile without help. In multipk logistic regression analyses, previous diagnoses ofstroke and hip fracture were most predictive of functional limitations, though all conditions examined (arthritis, cancer, diabetes, stroke, heart attack, and hip fracture) were independently associated with increased odds of impairment in some activities of daily liuing. In general, the odds for functional impaiment associated with specific medical conditions were higher than those previously published for non-Hispanic white populations. The fact that Mexican-American eId&y who live in the community and who have medical conditions, espe&y stroke and hip fracture, are at high risk for functional impairment probably reflects the low rate of institutionalization in this population and has implications fur the provision of community-based long-term care suwices for Mexican-American elderly. 0 1996 by
Disability, health and generation status: How Hispanics in the US fare in late life
Journal of Immigrant and Minority Health, 2012
Using prospective data from a cohort of elderly Hispanics, this study explores how first-, second- and 1.5-generation Latinos differ in their levels and trajectories of disability. The results indicate that compared to second-generation elderly Hispanics, first- and 1.5-generation Hispanics had higher levels of disability. In addition, 1.5-generation elderly Hispanics had higher average ADL and IADL limitations than second-generation Hispanics at the beginning, and over time, this difference increasingly diverged. Currently married individuals had lower levels of disability than formerly married Hispanics. Also, marriage at any point in time significantly limits variability in disability in the sample, indicating that readily available spousal support is significant in diminishing generation differences in disability. Implications from these findings for future research are discussed.
Examining the disablement process among older Mexican American adults
Social science & medicine (1982), 2003
The Disablement Process model (Verbrugge and Jette, Social Science & Medicine 38 (1994) 1) describes a pathway leading from pathology to impairment to functional limitations, and, ultimately to disability. Components of this model have been examined among older White adults; however, very little research has examined the disablement process among older adults of other ethnic groups. Our goal in this research is to evaluate the Disablement Process model using Activities of Daily Living (ADL) disability as the outcome among a representative group of older Mexican American adults in the Southwestern United States. Respondents are from two waves of the Hispanic Established Populations Epidemiologic Study of the Elderly (EPESE) (n=2439). Structural equation models (LISREL 8.30) are utilized to examine the Disablement Process model. We also investigate aspects of the original model that have potentially important effects on the process of becoming disabled, such as cognitive impairment an...
Journal of Hospital Marketing & Public Relations, 2009
A drastically increasing elderly population and disparity among disability poses a concern for the US health care industry. This retrospective cross-sectional study analyzed whether ADL and IADL disabilities were different among non-Hispanic white (NHW) and non-Hispanic black (NHB) populations age 65 and over. Data was retrieved from the 2001-2003 National Health Interview Survey (NHIS) for comparing NHBs and NHWs using chi-square analysis for bivariate comparisons. For both elderly NHBs and elderly NHWs, increased rates of disability were reported for being over 75, female, single, and having lower education. NHBs reported statistically higher disability rates for ADL, IADL, and for any disability, with 10.0%, 18.0%, and 19.3%, respectively, compared to NHWs. There is a need to increase the access for NHBs to nursing home, hospice, and assisted-living facilities. Of further concern is the finding of lower institutionalization rates in the NHB population despite the significant presence of increased disability. The growing NHB elderly population needs an urgent societal intervention to address the persistent disparity, which has been neglected for so many years.