Access to Healthcare Among Working‐Aged Hispanic Adults in the United States*

Objectives. The purpose of this research is to examine differences in access to and sources of healthcare for working‐aged adults among major Hispanic subpopulations of the United States. Nativity, duration in the United States, citizenship, and sociodemographic factors are considered as key predictors of access to and sources of care. Methods. Using pooled National Health Interview Surveys from 1999–2001, logistic and multinomial logistic regression models are estimated that compare Mexican Americans, Puerto Ricans, Cuban Americans, and other Hispanics with non‐Hispanic blacks and non‐Hispanic whites. Results. Mexican Americans, Puerto Ricans, and other Hispanics display significantly less access to care than non‐Hispanics whites, with immigrant status and socioeconomic status variables accounting for some, but not all, of the differences. For sources of care, Mexican‐American, Puerto Rican, and other Hispanic adults were all much more likely than non‐Hispanic whites to report clinics or emergency rooms as their source of regular care. Conclusions. There are wide differences in access to and sources of care across racial and ethnic groups in the United States. Mexican‐American adults, regardless if born in Mexico or the United States, appear to be most in need of access to regular and high‐quality care. Naturalization may be an especially important factor in greater access to regular and high‐quality care for Hispanic immigrants.     

Formal Social Participation and Utilization of Community-based Services among Urban Elderly Chinese Living Alone in Shanghai,China

This research examined formal social participation among elderly Chinese adults living alone and the association between utilization of community-based services and formal social participation, which refers to participation in employment, volunteer jobs, and social groups. Using a secondary analysis on a survey data from a simple random sample of 228 adults aged 60 and older living alone in a Shanghai neighborhood, it was found that only small percentage of older adults living alone were involved in formal social participation. Hierarchical multiple regression analysis showed that use of community-based services is significantly associated with formal social participation among elderly Chinese living alone. Thus, future policies and programs should focus on strengthening community-based services for elderly Chinese, to more effectively promote and facilitate their social participation.     

Older Americans Act Service Consumers

Two consumer groups of the Older Americans Act programs were compared in this research: the homebound and the users of nutrition programs. Comparisons were made on demographic characteristics, health and functional status, personal security, social resources, life perspective, and on knowledge about and access to services. Not unexpectedly, findings from this research revealed that the homebound are older, more socially impoverished, more impaired on health and functional status, have more limited resources, poorer life perspective, and less access to services. These findings clearly indicate that needs of those who benefit from Older Americans Act programs are great and many of them would be unable to continue their community living without these services.     

Religion and Abortion Attitudes Among U.S. Hispanics: Findings from the 1990 Latino National Political Survey*

Objective. The goal of this article is to examine the relationship between religious involvement, gauged mainly in terms of affiliation and frequency of attendance at services, and abortion attitudes among three major Hispanic subgroups: Mexican Americans, Puerto Ricans, and Cuban Americans. Method. The study analyzes data from the Latino National Political Survey, a sample of over 2,700 U.S. Hispanics completed in 1990. Results. Committed (i.e., regularly attending) Hispanic Protestants, most of whom belong to conservative groups, are more strongly pro‐life than any other segment of the Latino population, and are much more likely than others to support a total abortion ban. Committed Catholics also tend to hold pro‐life views, but they are relatively more likely to endorse an abortion ban that includes exceptions for rape, incest, and threats to the mother's life. Less devoted Catholics and Protestants generally do not differ from religiously unaffiliated Hispanics in their abortion views. There are also modest variations in the links between religious involvement and abortion attitudes across the three Latino subgroups. Conclusion. Religious factors are highly important predictors of Hispanics' preferences regarding abortion policies. Contrary to some previous discussions, it is committed Protestants, more so than Catholics, who are the staunchest opponents of abortion in the Latino population.     

Trajectories of Community-Based Service Use: The Importance of Poverty and Living Arrangements

ABSTRACT

This study examined how older adults’ living arrangements and poverty status affected their use of in-home health, functional, and out-of-home services over time. Using eight waves of data from the Korea Welfare Panel Study, we employed a logistic mixed-effect model to analyze how poverty and living arrangements affect community-based service use. Living-alone older adults and elder-only couples were more likely than co-residing households to use services. Elder-only couples, when poor, were more likely to use in-home and out-of-home services over time. Understanding predictors of community-based service use over time enables researchers and policymakers to better understand the process of aging-in-place.     

Community-Based Services and Depression from Person-Environment Fit Perspective: Focusing on Functional Impairments and Living Alone

ABSTRACT

Guided by the Person-Environment Fit perspective, we investigated the extent to which personal and environmental factors influence depression among community-dwelling adults. The data came from the special section about community-based service utilization in the 2012 Health and Retirement Study (N=1,710). Although community-based service was not significantly associated with depression after controlling for covariates, respondents with functional limitations and living alone were less likely to be depressed when using community-based services. This study demonstrates the different associations between community-based services and depression depending on personal needs. It discusses the importance of community-based services for aging-in-place policy, particularly among vulnerable populations.     

Living Arrangements,Depression, and Health Status Among Elderly Russian-Speaking Immigrants

Abstract

This study examines the relationship between living arrangements, depression, and health status in a community-based sample of 300 elderly Russian-speaking immigrants. Data were collected via a self-administered questionnaire survey method. The questionnaire was designed to investigate various aspects of health, mental health, health services utilization, and health behaviors. A team of bilingual professionals was involved in the construction and translation of the survey instrument. The sample consists of 150 females and 150 males. The respondents' average age was 73.2 years. The regression analysis reveals that elderly Russian-speaking immigrants who live alone are more likely to experience a higher level of depression than those living with others. This relationship remains statistically significant after controlling for age, education, income, ability to speak English, years residing in the United States, gender, and health status. Since health status appears to influence depression, we performed further regression analyses and found that living arrangements had no statistically significant relationship with health status. Health status serves as an intermediate variable between the block of demographic variables and depression. Implications for future research are discussed.     

Ageing-in-place in studio apartments in Singapore: maintaining independence in community living

Abstract

Living alone in later life is increasingly a common style of living in Singapore. We investigated the extent of maintaining independent living in a studio apartment using a survey of older residents (n = 925), focusing on three aspects of coping strategies: self-care management, social support, and use of social services. As compared to older adults who lived with others, those who lived alone had better self-care management, tended to rely more on friends and neighbours, and indicated higher use of social services. Those living alone also showed higher awareness in managing their health. This study provides valuable insights to understand the issues on coping strategies involved with living alone in later life.     

Barriers to the Use of Mental Health Services by African-American and Hispanic Elderly Persons

Abstract

This study discusses barriers to the utilization of community-based mental health services by African-American and Hispanic elderly persons. The study sample consists of “key Informants,” chosen because they were knowledgeable about the mental health needs and use of mental health services by African-American or Hispanic elderly persons. Principal component analysis using orthogonal rotation was conducted on the 23 item barrier scale and identified three levels of service barriers for the entire sample and for each subsample of African-American and Hispanic informants. Based upon the study findings, a number of strategies are offered to improve Utilization and overcome service delivery barriers.     

Poverty, welfare problems and social exclusion

This article investigates whether, and to what degree, poverty is linked to other types of welfare problems and, in larger perspective, whether the situation can be understood in terms of social exclusion. Two different measures of poverty – income poverty and deprivation poverty – and 17 indicators of welfare problems were used in the analysis. It was shown that income poverty was rather weakly related to other types of welfare problems, i.e. the most commonly used measure of poverty seems to discriminate a section of the population that does not suffer from the kinds of problems we usually assume that poverty causes. Deprivation poverty, identifying those who most often had to forgo consumption of goods and services, did correlate strongly with other types of welfare problems. Hence, people living under poor conditions do suffer from welfare problems even though this section of the population is not always captured by income poverty measures. The final analysis showed that the types of welfare problems that were most likely to cluster were deprivation poverty, economic precariousness, unemployment, psychological strain and health problems. Whether these types of accumulated welfare problems, from a theoretical perspective, can be seen as indicators of social exclusion is more doubtful.     

Hispanic and Anglo gang membership in two southwestern cities

Delinquent gangs have attracted the attention of social scientists for most of the twentieth century. The current study presents a systematic comparison of the gang-related attitudes and behavior of youths living in cities of dramatically differing size but subjected to similar cultural forces. Specifically, we explored the attitudes and orientations of gang and nongang eighth grade students living in two southwestern cities with large pluralities of Mexican Americans: Phoenix, Arizona, and Las Cruces, New Mexico. While statistical comparisons supported the position that the Phoenix children expressed higher levels of pro-gang attitudes, there did not appear to be significant differences in self-reported gang membership. Hispanic youths in both cities were not only more pro-gang in their attitudes and orientations, but they reported higher levels of gang membership. However, multivariate analyses reveal that a far more complex set of forces is at work.     

Understanding Mexican‐American Marriage Patterns Using a Life‐Course Approach*

Objective. Guided by a life‐course framework that incorporates the interconnection between marriage, migration, and other transitions, we critically examine the familism explanation for the earlier age at marriage among Mexican Americans. Methods. We compare the marriage patterns of Mexican immigrants derived from the National Survey of Family Growth (NSFG) to those of women living in Mexico derived from the Mexican Census. We then use data from the NSFG to estimate proportional hazard models of marriage using fixed variables such as parent's education and time‐varying variables such as school enrollment. Results. Analyses show that the Mexican immigrant population marries earlier than Mexicans who do not migrate to the United States. In addition, the U.S.‐born Mexican population has lower marriage rates than whites once family background characteristics associated with early marriage are controlled and Anglos are no less likely than Mexican Americans to marry in response to a pregnancy. Conclusion. We find reason to doubt that ethnic differentials are driven by a strong attachment to marriage, female chastity, and the “traditional” family. Although cultural factors may play an important role, researchers need to more carefully specify the aspects of Mexican culture that might encourage marriage and how these factors interrelate with economic and demographic constraints.     

In Home Social Work With Abused or Neglected Elderly:

This article proposes a practical guide to both assessment and treatment of abused andlor neglected elderly receiving home health care services. Indicators of mistreatment, intervention strategies, and limitations to in-home social work are discussed. This experiential article limits its focus to those elderly recipients of home health care who are living with family.     

Older Americans Act Related Homebound Aged: What Difference Does Racial Baclkground Make?

This research examined racial differences in wellbeing among 440 older persons receiving home based services connected with Older Americans Act funded nutrition sites. These data clearly indicate that compared with white homebound aged, black aged receiving homebased services have more limited economic resources and live in more impoverished neighborhoods, are more irnpaired in their health and functional status, have more limited social resources and have more limited knowledge and access to services. Service utilization appears similar for both groups and the life perspective of blacks is somewhat higher than that of white homebound aged.     

Older Americans Act Related Homebound Aged: What Difference Does Racial Baclkground Make?

This research examined racial differences in wellbeing among 440 older persons receiving home based services connected with Older Americans Act funded nutrition sites. These data clearly indicate that compared with white homebound aged, black aged receiving homebased services have more limited economic resources and live in more impoverished neighborhoods, are more irnpaired in their health and functional status, have more limited social resources and have more limited knowledge and access to services. Service utilization appears similar for both groups and the life perspective of blacks is somewhat higher than that of white homebound aged.     

Who Attends Senior Centers?

Abstract

Logistic regression analysis was used to compare users and non-users of senior centers. Variables assessing linkage to the service system were more significant predictors of senior center utilization than predisposing, enabling, or need variables. More specifically, users of senior centers were older and more likely to live in rural areas. They also had more social contacts, better mental health, and fewer ADL problems. Senior center users were also more aware of specific service agencies, more likely to consult formal resources in making service decisions, and more likely to have used other services.     

The Older Woman:

Interviews were conducted with 302 elderly persons residing in two ethnic urban communities to determine their problems as well as their needs for diverse community services. Sex and living arrangements were found to be critical mediators of the demand for and use of various services. A greater proportion of women than men (particularly women living alone) reported needs for household, self-maintenance, and community services. Older women living alone were also more likely to report that they had experienced neighborhood problems. Implications for designing community-based services to better meet the needs of older persons in diverse living situations are discussed.     

Latino Phenotypic Discrimination Revisited: The Impact of Skin Color on Occupational Status

Objective . We reexamine the issue of phenotypic discrimination against Mexicans in the U.S. labor market, originally studied by Telles and Murguia (1990) and later by Bohara and Davila (1992). We also seek to explain this topic with respect to the Puerto Rican and Cuban populations in the United States. Methods . Instead of using household income as a dependent variable, we use occupational ranking scores computed by Hauser and Warren (1996) in combination with data from the 1990 Latino National Political Survey (LNPS). The occupational rankings more accurately reflect the level of labor market discrimination faced by individuals. Furthermore, the use of the more recent LNPS allows us to update the work of previous scholars and extend the analysis to two previously unexamined Latino groups—Puerto Ricans and Cubans. Results . Our findings indicate that darker-skinned Mexicans and Cubans face significantly lower occupational prestige scores than their lighter-skinned counterparts even when controlling for factors that influence performance in the labor market. However, we find no conclusive evidence that skin-color differences impact occupational prestige scores for Puerto Ricans. Conclusions . Using earlier data, some scholars found evidence for difference in labor market performance among Mexican Americans as a function of phenotypic variations among Mexican Americans. Today, dark-skinned Mexican Americans and Cuban Americans continue to face higher levels of discrimination in the labor market, whereas dark-skinned Puerto Ricans do not, which may indicate regional differences across the three groups that need to be controlled for.     

Retirement and health benefits for Mexican migrant workers returning from the United States

In the absence of a bilateral agreement for the portability and totalization of social security contributions between the United States and Mexico, this article examines the access to pension and health insurance benefits and employment status of older Mexican return migrants. We find that return migrants who have spent less than a year in the United States have a similar level of access to social security benefits as non‐migrants. Return migrants who have spent at least a year in the United States are less likely to have public health insurance or social security benefits, and could be more vulnerable to poverty in old age. These results inform the debate on a bilateral social security agreement between the United States and Mexico to improve return migrants' social security.