Utilization of Community-Based Social and Health Services Among Foreign Born Hispanic American Elderly

ABSTRACT

This study examined factors associated with the utilization of community-based social and health services among foreign born elderly Hispanic Americans. The data came from a nationwide probability sample of Hispanic Americans age 65 and older including 296 Mexico-born Mexican Americans, 571 Cuba-born Cuban Americans, and 247 respondents from other Hispanic countries. Being a Cuba-born Cuban American, living alone, having poorer self-rated health and living below poverty level were positively related with the utilization of community-based social services. Cuban Americans with more limitations in activities of daily living (ADL) used more community-based health services. Among Mexico-born Mexican Americans, those who lived alone used more social as well as health services while those who were married used more social services. Those with greater limitations in ADL used more health services. Among other foreign born Hispanic Americans, going to church, living alone and living below poverty status, were positively correlated with the utilization of social services. Respondents with better English language ability were less likely to use community based health services. Elderly men and people who rated their health as poorer or had more ADL limitations were more likely to use these services. Implications of these findings for health and social services are discussed.     

Using Private Social Care Services in Finland: Free or Forced Choices for Older People?

ABSTRACT

Use of private social care services among older people is increasing in Finland. This study aims to understand why older people choose private care in a comprehensive tax-subsidized social care system and examines whether people choose private service as a free choice or a forced choice as well as what factors contribute toward making these choices. Data for this study (N = 1,436) were gathered in 2010 from people aged 75 and above living independently at home in two Finnish cities: Tampere and Jyväskylä. Data were analyzed with several quantitative tests: chi-squared tests, multinomial regression analysis, and qualitative content analysis (for the open-ended responses from the survey questionnaire). Findings reveal that people chose private services mostly because of the effortlessness involved in its use and of the need for additional services that are unavailable through municipality; for example, cleaning. Majority of the respondents performed a free choice to use private services. People who lived in a city center with a higher level of income and who needed more services were more likely to be constrained toward using private support. Major concern, due to diminishing public service provision, is about service accessibility of economically disadvantaged groups; therefore, more research is required to understand the effects of the growing care market in Finland.     

Age Differences in Stressors,Coping Resources,and General Well-Being Among Korean Immigrants

ABSTRACT

 This study explored 346 Korean immigrants living in California to examine: a) differences in stressors, coping resources, and general well-being (anxiety, depression, positive well-being, self-control, vitality, and general health) between younger (18–64 years old) and older (65–96 years old) Korean immigrants; and b) differences in associations of stressors and coping resources with general well-being in the 2 groups. Results revealed that the older immigrants experienced higher levels of socioeconomic stressors and psychological/physical problems. In addition, English-language problems, low education, and financial difficulties were more consistently associated with lower levels of general well-being in the older immigrants than in the younger immigrants. Social support, religious practice, and spiritual coping were more likely to alleviate the detrimental consequences of stressors on general well-being in the older immigrants than in the younger immigrants. To improve the general well-being of older Korean immigrants, the results suggest: a) emphasis of social and health care services with bilingual capability; b) improved social support systems; and c) utilization of spiritual assessments and interventions. Future research should extend the current study with longitudinal data of a more generalizable sample of Korean immigrants.     

Families on the move in China: challenges,strategies, and implications

We studied 12 migrant families who lived on the outskirts of Beijing, conducting participant observations and in-depth interviews between July 2008 and December 2009. Adopting the family strengths perspective, we identified the strategies employed by the migrant population to manage family life, the reliance on family networks for help and support, and their means of coping with the lack of equal access to state-provided benefits and services. We argue that migrants and their families should not be the target of policy or practice interventions – despite the unequal treatment, they cope with various difficulties, survive the migration process and succeed in adjustment and adaptation to the migrant life – rather, the divisive hukou system and the associated unequal distribution of benefits and services require fundamental reform.     

Individual- and Contextual-Level Factors Affecting the Use of Social Support Services among Older Adults

ABSTRACT

By 2060, the number of Americans aged 65 and older is expected to more than double, while the number of Americans aged 85 and older is expected to nearly triple. As the nation's aging population grows, older adults will need to rely on social support services, such as transportation and housing services, in order to remain active and lead independent lives. In this study we use data collected from the elderly supplement of the Southeastern Pennsylvania Household Health Survey (SPHHS) (n = 3,042) to explore the relationship between the availability of elderly specific social service providers and utilization of social support services among older adults. We find that while the number of elderly specific social service providers can increase use of social support services among older adults, its impact is relatively minimal. We find that individual factors, instead, are stronger predictors of service use. This is a finding that should be particularly encouraging for elder care providers who may not have the resources needed to undertake large structural changes (like building new facilities). Still, future research should explore how the availability of a broader range of elderly specific social services (than explored in this study) impacts use.     

Coping Strategies and Caregiving Outcomes Among Rural Dementia Caregivers

We studied the coping styles by which family caregivers living in rural areas of Alabama deal with the demands of caring for an older relative with dementia. Data were obtained from a sample of 141 caregivers through the random-digit dialing telephone survey. Two coping styles were identified: deliberate coping and avoidance coping. Deliberate coping was related to higher life satisfaction scores and, avoidance coping was related to lower life satisfaction scores and higher caregiver burden scores. Avoidance coping appeared to moderate the effects of caregiver health on caregiver burden. Social workers should pay greater attention to caregivers with dysfunctional coping styles.     

Impact of the Village Model: Results of a National Survey

ABSTRACT

Villages are a relatively new, consumer-directed model that brings together older adults in a community who have a mutual interest in aging in place. These membership organizations provide social and civic engagement opportunities, volunteer provided support services, and referral to vetted community providers to achieve their primary goals of promoting independence and preventing undesired relocations. This cross sectional survey of 1,753 active Village members from 28 Villages across the US measured members’ perceived impacts in the areas of social connection, civic engagement, service access, health and well-being, and ability to age in place. Results showed that involvement in the Village was a key factor associated with greater perceived impacts. Over half of members perceive that the Village has improved their sense of connection to others and their feeling that they have someone to count on. Though younger members in better health were more likely to perceive impacts in social connections, results suggest older women, living alone with some disability may be the most likely to experience improved health, quality of life, and mobility. The implications for social work practice are discussed.     

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.     

Experiences of Stigma and Spirituality of Older Black Men Living with HIV

Abstract

Previous research on HIV stigma and the use of spirituality by people living with HIV/AIDS is scarce. Moreover, the research with older Black men who have sex with men is scant. This study aimed to investigate experiences of HIV stigma and the use of spirituality among older HIV positive Black men who sleep with men. In-depth interviews were conducted with a sample of ten men. Data were analyzed utilizing to the modified van Kaam data analysis method. Three major themes were identified that explores the participants lived experiences with HIV stigma and use of spirituality: experiences of stigma reinforcing the use of spirituality; defining spirituality as a functional concept; and self-empowerment through the use of spirituality. The findings could guide social workers and other helping professionals in developing informed assessments and interventions regarding HIV stigma and the use of spirituality. Future qualitative and quantitative research is needed to achieve generalizable knowledge about the relationship between stigma on the use of spirituality.     

Service Users' Perspectives on the Benefits System in Israel: A Participatory Action Research

This article presents a position paper on Israel's benefits system. It was produced in the framework of a participatory action research with the collaboration of welfare services users and social welfare policy practitioners, academics, social practitioners, and social activists. Some 78 persons living in poverty, from various population groups, were asked, in group settings, to describe their experiences with the benefit system and services, their coping strategies, their perceptions and attitudes towards these services, and their recommendations for ways to improve them. The position paper which emerged from this process served as the basis for discussions between service users, social welfare policy practitioners, researchers, social activists and social practitioners at an academic conference. Issues such as benefits cuts, eligibility, and definitions of poverty are discussed and recommendations are presented.     

Poverty Among Korean Immigrant Older Adults: Examining the Effects of Social Exclusion

ABSTRACT

Previous studies have shown that elderly Asian immigrants face greater risks for living in poverty compared with their native contemporaries. Particularly, Korean immigrant older adults are reported to be most likely to experience poverty among many Asian immigrant groups. The purpose of this study is to examine the extent to which demographic, human capital, and social exclusion factors contribute to such economic vulnerability among Korean immigrant older adults. Adding to previous research, this study broadly conceptualizes social exclusion and tests for its additive effects on poverty using nationally representative public data of Korean immigrant older adults. From the 2008–2010 Public Use Microdata Sample of the American Community Survey, this study extracts a sample that consists of individuals aged 65 years and older whose national origin is Korean, who were not born in the United States, and thereafter immigrated to the United States (N = 3,820). The findings indicate that 3 dimensions of social exclusion—exclusion from social and civic life, exclusion from asset building, and exclusion from the labor market—contribute significantly to Korean immigrant older adults’ odds of living in poverty. The study concludes with practice implications for socially inclusive workforce development as a way to ameliorate economic afflictions among Korean immigrant older adults.     

Home and Community-based Services and Life Satisfaction among Homebound and Poor Older Adults

ABSTRACT

Little evidence exists regarding the role of Home and Community-Based Services (HCBS) utilization on life satisfaction among older people who are both homebound and low-income. Guided by the personal-environment (P-E) fit perspective, this study aims to: (1) describe characteristics of older people with homebound and low-income status; (2) investigate how the combination of homebound and low-income status is associated with life satisfaction; and (3) examine whether HCBS utilization moderates the association between homebound and low-income status and life satisfaction. Data were drawn from the 2012 Health and Retirement Study, and the sample included respondents who were 51+ years who completed a questionnaire for HCBS utilization (n= 1,662). Results describe sociodemographic, health-related, and environmental characteristics of older adults. Combined homebound and low-income status was a significant predictor of lower life satisfaction (β = ?0.15, p< .05), but better life satisfaction when they used HCBS (β = 0.33, p <.10). These findings suggest that promoting HCBS utilization is a promising strategy to enhance well-being among those homebound and poor. Further studies are needed to test the effectiveness of HCBS with longitudinal data and to investigate the details of effective HCBS utilization such as frequency of use and types of services.     

Psychological Vulnerability and Gambling in Later Life

ABSTRACT

Objectives: Because behavioral problems often emerge from maladaptive coping methods, we investigated whether unmet basic psychological needs evolve toward a level of psychological vulnerability that puts older adults who gamble at risk for becoming problem gamblers. Methods: Data from a community sample of 379 adults ages 60 and above were analyzed using structural equation modeling. Participants responded to items regarding their demographics, gambling frequency, engagement in at-risk gambling behaviors, and the extent to which their basic psychological needs were met. Results: Satisfaction of basic psychological needs among older adults who gamble was negatively associated with their being at risk for developing a gambling problem. Satisfaction of basic psychological needs also mediated the negative effect of socioeconomic status on at-risk gambling behavior. Conclusion: Social workers should become mindful of how older adults, who are confronting psychological vulnerabilities in later life, might well turn to gambling as a maladaptive coping mechanism.As per journal style, abstract must not exceed100 words. Please amend accordingly.     

Community Service Use by Older Adults: The Roles of Sociocultural Factors in Rural–Urban Differences

ABSTRACT

This study examined the influence of sociocultural factors in explaining the rural–urban differences in home and community-based service (HCBS) use among older adults. Survey data of 228 older adults living in Alabama were analyzed. Sociocultural factors included participants’ perceptions of service availability, attitudes toward seeking formal help, informal support, and religious behaviors. Rural older adults were less likely to use HCBS than their urban counterparts (p < .05). An interaction effect between perceived service availability and church attendance was found. These findings suggest a need for collaborations between community aging services with religious organizations to ensure existing programs are accessible to older adults living in rural areas. Future research based upon large probability samples is needed to shed more light on the relation between church attendance and service use.     

Migration, ageing and mental health: an ethnographic study on perceptions of life satisfaction, anxiety and depression in older Somali men in east London

This ethnographic study was carried out in the aftermath of an epidemiological investigation, the first of its kind, on the health and social status of Somalis aged 60 years and over living in Tower Hamlets, east London. The main aims of the study are to explore views on mental health and well-being and identify sources of stress and support so as to gain greater understanding of background factors of life satisfaction and depression in 'first-generation' older Somali migrants in Tower Hamlets (males). Face-to-face interviews were conducted among 28 males in Somali with the help of a bilingual interpreter from the same age, sex and cultural background of participants. Several factors were perceived to decrease life satisfaction and increase vulnerability to depression in male Somalis, in particular low family support in the face of increasing physical disability, loneliness, inadequate access to community services and inability to return home. Social isolation, low level of control over one's life, helplessness and social degradation – ageism, perceived racial/religious discrimination and, to a lesser extent, racial harassment – were common themes identified in people who said to be depressed. Family support was the main buffer against depression; other coping resources were represented by religious practices and reliance on Somali peers. Avoidance coping seemed to encompass denial of depression in participants who had low mood. The study revealed multiple reasons for ill-being, in particular in people who had high expectations about medical and social care. Low levels of distress were found in Somalis who felt supported by their families. There is a need for social workers and other health professionals to advance discussions of mental-health issues in the community and for service providers to promote greater access to culturally relevant medical and social services for Somali elders in Tower Hamlets and strengthen their informal support networks.     

Pathways to age-friendly communities in diverse urban neighborhoods: Do social capital and social cohesion matter?

ABSTRACT

Using a social capital and social cohesion lens, we reposition the concept of civic engagement among older adults to examine pathways for building age-friendly communities. We analyzed data drawn from a Community-Based Participatory Research study in the Southern U.S. that explored lived experiences of older adults, age 55 and above, who participated in individual interviews (n = 15) and six focus group discussions (n = 45) to examine their perceptions of social identity, social connectedness, and civic engagement geared toward an age-friendly city. Findings indicated that several older adults had access to social networks and socially invested resources, thereby having opportunities for civic engagement and building age-friendly neighborhoods. However, social, cultural, linguistic, and structural barriers were more evident among certain diverse ethnic populations. Marginalized low-income minorities and immigrants, such as Hispanic participants, felt the lack of social cohesion among the larger society limited their ability to give back, thus decreasing their civic engagement activities. In contrast, Caucasian and African-American older adults were able to contribute to the political process through more civic participation activities. We provide implications for examining the role of social capital and social engagement to bolster civic engagement among older adults in building age-friendly communities.     

Women Coping With Chronic Disease: The Psychosocial Impact of Lupus

ABSTRACT

The purpose of this cross-sectional study (n = 92) was the further identification of the unique psychosocial challenges facing those living with lupus. Specifically, the study aim was to clarify which particular lupus symptomatology may result in which emotional states. The authors review relevant literature, discuss findings, and provide evidence-based recommendations for social workers providing services to patients with lupus. Key findings include the following: Frequent flare-ups resulted in the highest need for assistance with feelings of depression, anxiety, and socioeconomic challenges. Hair loss had the most significant impact on depression, anxiety, and socioeconomic coping. Being hospitalized in the past year for lupus also significantly impacted depression, anxiety, and socioeconomic coping. And, finally, the participants reported that having friends to rely on reduced their reported depression and anxiety. Fatigue from lupus was seen as the highest correlate of anxiety.     

Coping and Post-traumatic Stress after Hurricanes Katrina and Rita: Racial Disparities in Social Work Student-Practitioners

ABSTRACT

Recent hurricanes have focused on lives and properties lost, however, additional mental health concerns may emerge in these post-disaster settings. Post-traumatic stress symptoms (PTSS) are particularly problematic for minorities due to pre-disaster disparities. Scholars must thus examine the antecedents of PTSS to support these and other vulnerable individuals and communities. This study examined racial disparities regarding active and avoidant coping, prayer, and subsequent relative contribution of each to PTSS following Hurricanes Katrina and Rita among social work student-practitioners. Using secondary data, results revealed that minority students (n = 233) used coping via prayer more often than their non-minority peers (n = 124; t = 7.18, p < .000; d = 0.76). Moderate, positive relationships emerged between avoidant coping and PTSS for both groups (r = .58–.63, p<.01), though prayer did not emerge as inversely related to PTSS as anticipated. Avoidant coping accounted for the largest variation in PTSS for both groups (β = .35–.51, p<.001). Sampling, survey methods, and PTSS measures limit generalizability and temper findings. Directions for future research include use of PTSS measures that account for severity and cultural context and examination of coping measure psychometrics. Practice implications include enhanced publicity regarding social services available to student-practitioners on college campuses and within the community.