Elderly Hispanics Research Articles

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.

Nutrient Intakes and Determine Checklist Scores of Hispanic Elderly in South Texas

LEARNING OUTCOME: To describe how the DETERMINE Checklist scores of Hispanic elderly compare with their intake of 19 nutrients. The purpose of this study is to compare the nutrition-risk status of Hispanic elderly with their nutritional intake. A demographic survey, a 24-hour dietary recall and the DETERMINE Checklist (DC) were administered to 70 randomly selected Hispanic elderly, 60 years and older, who eat at a senior center. Dietary analyses were done using Food Processor software. DETERMINE Checklist Scores (DCS) of 0-2, 3-5, and ≥ 6 respectively establish elderly at no or low risk, moderate risk, or high risk for malnutrition. Of the 70 elderly, 27 ( 38.5%), 18 (25.7%) and 25 (35.7%) were assessed at low, moderate, and high risk. The 70 participants had mean intakes greater than 100% of the Recommended Dietary Allowances (RDA) for vitamin C, vitamin B12, thiamin, riboflavin, niacin, folic acid, iron, phosphorous, selenium and protein. There were no significant differences between the mean intakes of 19 nutrients for the three nutrition-risk groups. Higher percentages of elderly with DCS 0-2 compared to those with DCS ≥6 ate less than 75% of the RDA for Vitamin A (56%, 48%; DCS 0-2, ≥ 6); vitamin D (56%, 36%); thiamin (26%, 16%); riboflavin (15%, 12%); niacin (33%, 20%); iron (33%, 8%); potassium (89%, 80%); calcium (44%, 38%), zinc (82%, 72%), and fiber (82%, 72%). Higher percentages of elderly with DCS ≥ 6 compared to elderly with DCS 0-2 ate less than 75% of the RDA for vitamin C (48%, 26%; DCS≥6, 0-2); vitamin B6 (56%, 48%); vitamin B12 (16%, 11.1%) folate (32%, 26%) and magnesium (76%, 63%). Fourteen elderly (52.8% with DCS 0-2), 11 (61.1%, DCS 3-5), and 8 (32.0%, DCS ≥ 6) ate < 75% of the RDA for 5 or more nutrients. More research may be needed before the DC is widely used to assess nutrition risk of Hispanic elderly at senior centers, particularly if the current DCS are used. Elderly may be assessed at “no or low risk” when they may be at a greater risk for malnutrition than those with DCS ≥ 6.

ECONOMIC WELL‐BEING AMONG OLDER LATINOS

Using data from the 1990 Latino sample of the Panel Study of Income Dynamics and the 1988 National Survey of Elderly Hispanics, this research examines ethnic variation in the economic well‐being of older Latinos. Older Puerto Ricans are less economically secure than Cubans or Mexican Americans, reporting lower median incomes, higher rates of poverty, and disproportionate enrollments in the state health insurance program. We decompose household income into its sources to provide insight in ethnic differences in economic security and highlight how federal cutbacks in social programs for the elderly will uniquely impact each Latino ethnic group. The results show that older Puerto Ricans remain most vulnerable to the negative consequences of changing social policies. Health insurance coverage varies by ethnicity, revealing that access to health care is most limited among older Cubans. Clearly, each Latino ethnic group present a distinctive economic profile for older adults, profiles which call for policies guarding economic security to be tailored to each ethnic group.

Poverty, Chronic Stress, Ethnicity and Psychological Distress Among Elderly Hispanics

This study examined the relationship between chronic stress and psychological distress among poor and nonpoor elderly Hispanics belonging to three major ethnic groups: Cubans, Mexicans, and Puerto Ricans. The study used data from a nationwide probability sample of 1,239 Hispanics age 65 and older. The results show that poverty status and ethnicity influence the relationships between chronic stress and psychological distress. For example, financial stress had a significant relationship with psychological distress for the nonpoor Cubans, but not for the other two ethnic groups. Social stress was associated with psychological distress in all the three ethnic groups, but the association was strongest among poor Puerto Ricans. Family/personal stress was associated with more psychological distress among poor and nonpoor Cuban, poor Mexicans and nonpoor Puerto Ricans. Poverty and ethnicity also influenced the relationships between gender, marital status and health status and psychological distress. Implications of the study findings for future research and social work practice are discussed.

The Hispanic elderly: implications for nursing care.

The elderly Hispanic population is growing and with them will also grow their demand for nursing care. The purpose of this article was to establish some general guidelines that might help the nurse have a better understanding of who the Hispanic elder client is. As alluded to earlier, if there is one word to describe the Hispanic elder client it would be "diverse." As such, the reader is reminded that the discussion of the factors and interventions in care outlined here will not apply to all Hispanic clients all of the time. The Hispanic elder client will act differently depending on their Hispanic subgroup heritage and on their special personal history. In fact, most of the literature is based on research with Mexican-Americans who comprise the largest group of Hispanics in the United States. As such, there may be some bias in an attempt to generalize the findings discussed here across all Hispanics. The nurse is encouraged to acknowledge the specific sociocultural background of each individual and to plan and execute sensitive, tactful interventions that help to maximize the individual's health while valuing their uniqueness. Finally, being in touch with one's own values and beliefs will help to ensure that holistic nursing be implemented as a tool that is both comprehensive and sensitive to the various factors surrounding the Hispanic elder.

Cross-cultural neuropsychological assessment: A comparison of randomly selected, demographically matched cohorts of English-and Spanish-speaking older adults

As the US population of elderly Hispanics continues to grow, there is an increasingly greater need for neuropsychological measures that are appropriate for assessing Spanish-speaking elders. The current study compared the performance of randomly selected, community-based samples of English-and Spanish-speaking elders on a brief neuropsychological test battery. Subject groups were matched for age and education. Multivariate analysis indicated significant group differences on the test battery. English and Spanish speakers scored comparably on many language-based tasks, but Spanish speakers scored significantly lower on almost all of the nonverbal measures. Significant group differences were observed on multiple-choice matching and recognition memory for stimuli from the Benton Visual Retention Test, as well as on Identities and Oddities from the Mattis Dementia Rating Scale, category fluency, and Complex Ideational Material from the Boston Diagnostic Aphasia Examination (BDAE). Results suggest that caution is warranted when using nonverbal as well as verbal measures to assess non-English-speaking individuals.

Ethnicity, gender and social stress among three groups of elderly Hispanics.

This study examines ethnic and gender differences in social stress among three groups of elderly Hispanics: Mexican Americans (n = 773), Cuban Americans (n = 714), and Puerto Ricans (n = 368). Findings from the crosstabulation analysis between stress and ethnic groups reveal that the elderly Cuban Americans appear to experience less caregiving, family, anxiety, and social dependence stress than their Mexican Americans and Puerto Rican American counterparts. Findings from the crosstabulation analysis between stress and gender reveal that elderly Hispanic women were more likely to experience family, anxiety, social isolation, and social dependence stress. The logistic regression analyses reveal that ethnic differences in family stress, and anxiety and gender differences in caregiving stress and social isolation stress were confounded by differences in sociodemographic and health variables. Further sub-group analyses of ethnic and gender differences provide a more in-depth understanding of social dependency stress and anxiety. Implications for human services and research are discussed.

Residential preferences and eldercare views of Hispanic elders.

A cross-sectional, qualitative study was undertaken with a group (n = 10) of elderly Mexican-American men and women in an inner city congregate meal site of a large Midwestern city. The purpose of the study was to explicate: the older adults' residential preferences should they become unable to live in their own homes, and their beliefs about eldercare. Themes arising from the semi-structured interviews include: nursing homes as places of last resort, the desire not to be a burden to children, intergenerational differences in lifestyle, and extended family involvement in eldercare. Implications of the findings for helping professionals are discussed as are areas needing further investigation.

Acculturation, health, stress, and psychological distress among elderly Hispanics

A structural equations model is proposed to identify direct, indirect, and total effects of selected predictors of psychological distress in a national-area probability sample of Mexican American, Puerto Rican and Cuban elderly. Multivariate regression procedures vis-\,a-vis LISREL-7 techniques are used. The findings indicate that the modified path model explains 29% of the variance in psychological distress. Measures of acculturation have significant indirect effects on psychological distress via other intervening variables in the model. All selected measures of health and stress included in the model have significant direct effect on psychological distress. Implications of the findings for future research and public policy are discussed. jg]Key words gw]Acculturation gw]Health gw]Psychological distress gw]Stress gw]Elderly Hispanics gw]USA.

Correlates of psychological distress among Mexican, Cuban, and Puerto Rican elders living in the USA

Little is known about the impact of coping resources and health-related and family stresses on the well-being of Hispanic elders, or the extent to which these factors operate differentially for various Hispanic nationality groups. The present study examined the correlates of psychological distress of three groups of Hispanic elders. The researcher analyzed the Mexican American (n = 773) Cuban American (n = 714), and Puerto Rican (n = 368) elderly individuals drawn from the 1988 National Survey of Hispanic Elderly People in the USA. Multivariate analyses results indicated that activities of daily living impairments, poor perceived health, and unmet needs in formal social service were common predictors of psychological distress for all three groups. Older Mexican American women and Puerto Rican women reported higher levels of psychological distress than their male counterparts, other things being equal. For Cuban American elders, fear of depending too much on others, conflicts in the family, and living alone were unique predictors of their psychological distress. jg]Key words gw]Stress gw]Coping gw]Psychological well-being gw]Mexican Americans gw]Cuban Americans gw]Puerto Rican Americans gw]USA.

In-home and community-based service utilization by three groups of elderly Hispanics: A national perspective

In-home and community-based service utilization by three groups of elderly Hispanics: A national perspective

Telephone Interview Timing and Measurement Properties of Well-Being in a Sample of Elderly Hispanics

The influences of interview timing on the measurement properties of Bradburn's (1969) positive and negative affect scales were examined in a nationwide telephone survey of 2299 elderly Hispanics aged 65 and older. Analyses were performed on different sample sizes to avoid possible statistical biases caused by sample size discrepancies. The findings revealed that the factor structures of the positive affect scale were not equivalent between morning and afternoon interviews. Items in the positive affect scale had more favorable measurement properties in morning interviews than in afternoon interviews. Although the negative affect scale had statistically similar measurement properties between morning and afternoon interviews, morning interviews tended to have slightly better measurement properties than afternoon interviews. Implications for social work research are discussed.

Perceptions of Job Discrimination Among Lower-Income, Elderly Part-Timers

Findings from a study of 164 part-time employed older adults (mean age = 67.1 years) placed by four senior employ- ment programs in the greater Philadelphia metropolitan area docu- ment an important aspect of the quality of the work experience of lower-income, white and minority (Hispanic and African American) elders. Analysis of quantitative index data suggest that discrimina- tion was not perceived to be a major impediment in the work lives of these individuals. Age discrimination, and to a lesser degree, racial and gender discrimination are experienced, but only by a small ro- portion of older workers in part-time jobs. When it does s&e. older workers verceive it to be reflected in reduced salaries, fewer promotions, arid inadequacies in fringe benefit packages. Given a series of qualitative responses offered by study subjects, the possibil- ity that i~tances of dikrimination, especially ageism, may 6e down- played by some elder part-time employees because of fear of job loss is not ruled out.

Religiosity and Religious Participation Among Hispanic Elderly

ABSTRACT Religious faith and practices in old age have received increased attention as important in understanding more fully the well-being of older persons as well as their coping resources. This article explores the roles that religious faith and religious practices play in the lives of the Hispanic elderly. More specifically, it investigates public and private practices of religious faith and their perceived usefulness to this ethnic minority population. A survey of 178 older Hispanics suggests that indeed this population is quite religious in its self-perceptions and its reported beliefs and behaviors.

Health Status Of Hispanic Elders

Hispanic elders living in the United States compose a rapidly increasing population. They are underinsured and more likely to be living in poverty. Health care is hindered in this population by lower access to health services and less use of preventive services. Barriers to access are primarily socioeconomic. Acculturation exerts an effect, primarily through its association with language skills, employment, and education. Cardiovascular disease is the leading cause of mortality for Hispanics, who have a higher prevalence of risk factors for cardiovascular disease, such as diabetes mellitus, obesity, and hyperlipidemia. Although neoplasia is the second most frequent cause of death among Hispanics, as it is in whites who are not Hispanic, Hispanics have an overall lower cancer rate. Cancer rates are increasing, however. Non-insulin-dependent diabetes mellitus is a significant cause of morbidity and mortality in the Hispanic population, affecting nearly a quarter of adult Puerto Ricans and Mexican Americans. Although higher prevalence of obesity in the Hispanic population accounts for some of this difference, some data suggest the possibility of a genetic component as well. Assessment of psychological health in Hispanic elders is impeded by the lack of instruments designed for this population. Distress is often expressed as somatic symptoms. Values traditional to Hispanic culture, such as respeto, allocentrism, and familialism, are important to US Hispanic elders, many of whom were born in rural Mexico. Our knowledge of determinants of healthy aging in this population is still preliminary, but rapidly expanding, in part, because of increased attention to ethnicity in health reporting.

Culture-Relevant Functional Performance Assessment of the Hispanic Elderly

Because the Hispanic population is growing, there is a need for a reliable and valid functional assessment that is not culturally biased for white North Americans and that incorporates culture-relevant tasks for this large minority group. The Assessment for Motor and Process Skills (AMPS) (Fisher, 1993) is a unique evaluation tool that appears to meet that need. The AMPS consists of two scales (motor and process) that are assumed to be universal taxonomies that are free from cultural bias. This study was designed to investigate whether four Hispanic-culture-relevant tasks could be added to the AMPS as task choices and whether the AMPS could be used as a sensitive cross-cultural assessment for Hispanic elderly. Hispanic older adults performed two Hispanic-culture-relevant tasks and two culture-free tasks. Both goodness-of-fit among tasks and the performance of Hispanic subjects compared with North American subjects who had performed the same culture-free tasks were evaluated. The results indicated that (a) the Hispanic subjects' response patterns were consistent with response patterns of the North American subjects, and (b) the four Hispanic-culture-relevant tasks showed the same psychometric characteristics as previously established AMPS tasks. These findings support the potential to further develop the AMPS as a sensitive cross-cultural assessment for the Hispanic elderly.

Bilingualism and Subjective Well-Being in a Sample of Elderly Hispanics

This study aims to examine Ihe relationship between bilingualism and subjective well-being among elderly Hispanics. Bilingualism is viewed as the abilily to communicate in both English and Spanish. Subiective well-being includes positive affect and lack of negative affect. The study uses data from the 1988 national survey on elderly Hispanics. A sample of 632 elderly bilinguals whose first language was Spanish was selected for the analyses. LISREL 7 was used to test the correlations among two dimensions of bilingualism and two dimensions of subjective well-being. Both first-order confirmatory factor analysis and second-order confirmatory factor analysis reveal that languages and psychological well being correlated in expected directions. More importanlly, the study found that elderly Hispanics who had a stronger bilingual ability had a better psychological status. It is suggested that the social work profession can play an important role in helping recently arrived immigrants and refugees to learn English...

Ethnic and Sociodemographic Correlates of the Use of Proxy Respondents

The goal of this research is to examine the ethnic and sociodemographic correlates of older Latino adults who report for themselves in survey research, and those who use a spouse, child, or other adult as a proxy respondent. Multivariate analysis of the National Survey of Hispanic Elderly People identifies specific ethnic and sociodemographic factors that are significant correlates to sources of information. Researchers collecting data on an older, immigrant population might consider use of a proxy respondent to reduce nonresponse rates.

Book Reviews : Spero M. Manson. Applied Research on Health and Ethnicity: American Indian and Alaska Native Elderly. Washington, DC: American Association of Retired Persons, 1993. Paperback. Elena Bastida. Applied Research on Health and Ethnicity: Hispanic Elderly. Washington, DC: American Association of Retired Persons, 1993. Paperback. Harry H. L. Kitano. Applied Research on Health and Ethnicity: Asian and Asian-American Elderly.

Book Reviews : Spero M. Manson. Applied Research on Health and Ethnicity: American Indian and Alaska Native Elderly. Washington, DC: American Association of Retired Persons, 1993. Paperback. Elena Bastida. Applied Research on Health and Ethnicity: Hispanic Elderly. Washington, DC: American Association of Retired Persons, 1993. Paperback. Harry H. L. Kitano. Applied Research on Health and Ethnicity: Asian and Asian-American Elderly.

Effect of language of interview on the validity and reliability of psychological well-being scales.

Thanh V Tran , PhD, is associate professor ; and Leon F. Williams , PhD, is associate professor ; Graduate School of Social Work , Boston College, 216 McGuinn Hall, Chestnut Hill, MA 02161. The data used in this publication were made available by the Interuniversity Consortium for Political and Social Research. The data for the National Survey of Hispanic Elderly People were originally collected by Karen Davis and the Commonwealth Fund. The authors bear all responsibility for the analysis and interpretations presented here and thank the anonymous reviewers for their comments. Social people long titioners ferently scientists recognized across (Palmore, have conversely doing cultures the 1983). cross-cultural need behave been Human to understand cognizant similarly services research or of prachave how difthe long recognized the need to understand how people across cultures behave similarly or differently (Palmore, 1983). Human services practit on h v conve sely een co zant f t e need to provide different treatments or services to meet the needs of clients across ethnic populations (Henderson, 1989; Lum, 1992). In this article, we focus on an important methodological issue of cross-cultural research: the effect of the language of interview on psychometric properties of critical research measures. Several studies of Hispanic populations have been concerned with the uniformity of data (Trevino, 1988), the comparative translation of research instruments (Berkanovic, 1980), and the effect of the language used in an interview on outcome variables (Kirkman-Liff & Mondragon, 1991). However, no previous study has examined whether language of interview affects the psychometric properties of outcome variables such as psychological well-being. Traditionally, investigators have used translation as a method to achieve comparability in cross-cultural research. In addition, non-English-speaking respondents have often been given the choice of being interviewed in English or in their native language. Investigators tend to assume that good translation guarantees cross-cultural comparability of research methods across ethnic groups. This belief may mask true substantive similarities or differences between ethnic groups. An examination of the effect of language of interview on the measurement properties of psychological variables should indicate not only whether the translation truly achieves cross-cultural comparability but also whether it, in fact, confounds the comparability of research instruments. This research assumes that the language of the interview, whether conducted directly or indirectly, has an influence on the reliability and validity of research instruments.