HEALTH AND LIVING ARRANGEMENTS OF MINORITY ELDERS

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In this project, we will analyze the health and living arrangements among minority elders in the U.S. to (1) measure the extent to which frail and well elders in different minority populations coreside with kin, (2) evaluate how observed differences in living arrangements are related to demographic and socioeconomic factors, health conditions, access to and use of health and aging services, and cultural preferences for reliance on kin, and (3) assess the implications of these patterns, and of projected increases in minority elders, on institutional and home care from 1990-2030. Data for the study are drawn from the Public Use MicroSample of Older Persons for the 1990 U.S. Census which provides large enough samples of minority elders to permit the examination of living arrangements (living alone, living with spouse, living with other kin, living with nonkin, and institutional residence) among African American, Asian, Pacific Islander, Hispanic, and Native American elders. The study will use multinomial logistic regression models to examine the association with living arrangements of national origin, nativity status, English language proficiency, gender, age, educational level, marital status (and, for women, number of children ever born), self-reported health status, urban/rural residence, and geographic access to health care services. To explore the role in living arrangements of objective health risks and service utilization data from the National Health and Nutrition Examination Surveys will be used to describe the prevalence of illnesses, and the use of formal health and social services among African-Americans and Hispanics. The detailed information in these studies will permit the estimation of multinomial logistic regression models that assess the mediating effects of these factors on minority group differences in coresidence with kin. Preferences for reliance on kin in old age will be examined using data from previously conducted surveys of Asian populations and of African American and Hispanic groups in the U.S. Using 1990 population counts of persons by age and sex in each minority group, and specially-derived age- and sex- specific mortality, marriage, marital dissolution, and fertility schedules, the number of persons in each minority group by age and family status, and health status will be projected. Current rates of reliance on family coresidence and institutional living arrangements for persons in each category will be applied to obtain overall projections of the number of elders in each minority group who will rely on family and institutionalized care for the period 1990 to 2030.