ERIC Number: EJ817687
Record Type: Journal
Publication Date: 2008-Oct
Abstractor: As Provided
Reference Count: 0
Racial/Ethnic Differences in the Relationship between the Use of Health Care Services and Functional Disability: The Health and Retirement Study (1992-2004)
Bowen, Mary Elizabeth; Gonzalez, Hector M.
Gerontologist, v48 n5 p659-667 Oct 2008
Purpose: The purpose of this study was to examine racial/ethnic differences in the relationship between functional disability and the use of health care services in a nationally representative sample of older adults by using the Andersen behavioral model of health services utilization. Design and Methods: The study used 12 years of longitudinal data from the Health and Retirement Study (1992-2004), a nationally representative sample of community-dwelling adults older than 50 in 1992 (N = 8,947). Nonlinear multilevel models used self-reported health care service utilization (physician visits and hospital admissions) to predict racial/ethnic differences in disability (activities of daily living and mobility limitations). The models also evaluated the roles of other predisposing (age and gender), health need (medical conditions and self-rated health), and enabling factors (health insurance, education, income, and wealth). Results: Blacks and Latinos utilizing physician visits and hospital admissions were associated with significantly more activity of daily living disability than Whites (p less than 0.001). Blacks utilizing physician visits (p less than 0.001) and hospital admissions (p less than 0.05) and Latinos utilizing hospital admissions (p less than 0.05) were associated with more mobility disability than Whites. Other predisposing, health need, and enabling factors did not account for these racial/ethnic differences. Implications: Nationally, health care use for Blacks and Latinos was associated with more disabilities than for Whites after we accounted for predisposing, health need, and enabling factors. The findings suggest that improving health care quality for all Americans may supersede equal access to health care for reducing ethnic and racial disparities in functional health.
Descriptors: Health Services, Health Needs, Retirement, Physicians, Hospitals, Health Insurance, Access to Health Care, Whites, Longitudinal Studies, African Americans, Hispanic Americans, Geriatrics, Gerontology, Older Adults, Aging (Individuals), Racial Differences, Disabilities, Daily Living Skills, Independent Living, Physical Mobility, Models
Gerontological Society of America. 1030 15th Street NW Suite 250, Washington, DC 20005. Tel: 202-842-1275; Fax: 202-842-1150; e-mail: email@example.com; Web site: http://www.geron.org/journals/gsapub.htm
Publication Type: Journal Articles; Reports - Research
Education Level: N/A
Authoring Institution: N/A