Disparities in Mobility Device Use in Late-life

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DESCRIPTION (provided by applicant): Technology is playing an increasingly important role in facilitating independence among older Americans. Despite evidence that minorities experience more disability throughout late life, the continuing debate on racial disparities in health care has not explicitly recognized technology as a type of care with which to be concerned. Research on the use of mobility devices among older adults has also not focused explicitly on racial disparities. The proposed research is a sociobehavioral analysis of secondary data that attempts to disentangle the effects of race/ethnicity, socioeconomic status, health, and functioning on the use of mobility devices by older Americans. We propose expanding upon the Andersen behavioral framework (Andersen & Newman 1973), which has been widely used in the study of acute and long-term care utilization, to guide our investigation of two specific aims: 1) whether there are racial and ethnic differences in the use, adoption and abandonment of mobility devices and 2) the extent to which racial and ethnic differences in need (e.g., health, functioning and environmental barriers) and enabling factors (e.g., income, assets, insurance, and use of other health services) account for the these differences. Analyses will be based primarily on data from the NIA-funded Health and Retirement Study (MRS) which contains rich data on disability, device use, health, socioeconomic status, the use of personal care and environmental barriers. A series of regression models will examine the relationship between race and the use, adoption and abandonment of mobility devices and the effects that controlling for need and enabling factors have on the race-device use relationship. Based on these models, we apply a direct standardization technique to quantify the percentage of the observed racial gap in device use explained by racial differences in health and economic access factors. The proposed research will lay the groundwork for future work on interventions related to enhancing independence for minorities experiencing functional decline in late-life. By examining both the adoption and abandonment of devices, this research will also provide insight into where in the disablement process interventions and policies might be most effective.