Fabius Chanee D, Parker Lauren J, Thorpe Roland J
Johns Hopkins Bloomberg University School of Public Health, Baltimore, Maryland, USA.
Innov Aging. 2021 Dec 30;6(2):igab060. doi: 10.1093/geroni/igab060. eCollection 2022.
Nearly 8.2 million community-dwelling, older Medicare beneficiaries receive support from long-term services and supports (LTSS) with routine daily activities. Prior work demonstrates disability-related disparities; however, it is unclear whether these patterns persist among LTSS recipients and across specific sets of activities. We examine race and gender differences in receiving help with self-care (e.g., eating), mobility (e.g., getting around the house), and household (e.g., shopping) activities in a nationally representative sample of community-dwelling Medicare beneficiaries receiving LTSS.
Cross-sectional analysis of 1,808 White and Black older adults receiving assistance with routine daily activities in the 2015 National Health and Aging Trends Study. Bivariate statistics were used to describe the sample and provide comparisons of characteristics by race and gender. Logistic regression models examined race and gender differences in receiving assistance with self-care, mobility, and household activities after adjusting for sociodemographic and health characteristics.
Race and gender differences were observed across all sociodemographic and health characteristics, as well as for all forms of assistance. Relative to White men, Black men had lower odds of receiving help with self-care activities. White and black women had higher odds and Black men had lower odds of getting help with mobility activities than White men. Black men and White and Black women all had higher odds of receiving assistance with household tasks compared to White men.
Our findings indicate that, despite prior evidence of disability-related disparities, the receipt of help with self-care, mobility, and household activities varies by race and gender. Findings reveal several target areas for future research. Future work should examine the role of cultural and social preferences for care, as well as the appropriateness of help, as evidenced by health service use and changes in quality of life.
近820万居住在社区的老年医疗保险受益人接受长期服务与支持（LTSS）以开展日常活动。先前的研究表明存在与残疾相关的差异；然而，尚不清楚这些模式在LTSS接受者中以及在特定活动类型中是否持续存在。我们在一个具有全国代表性的接受LTSS的社区居住医疗保险受益人的样本中，研究在自我护理（如进食）、行动能力（如在家中走动）和家务（如购物）活动方面接受帮助时的种族和性别差异。
对2015年国家健康与老龄化趋势研究中1808名接受日常活动协助的白人和黑人老年人进行横断面分析。采用双变量统计来描述样本并按种族和性别进行特征比较。逻辑回归模型在调整社会人口统计学和健康特征后，研究在自我护理、行动能力和家务活动方面接受帮助时的种族和性别差异。
在所有社会人口统计学和健康特征以及所有形式的帮助方面均观察到种族和性别差异。相对于白人男性，黑人男性在自我护理活动方面获得帮助的几率较低。与白人男性相比，白人和黑人女性在行动能力活动方面获得帮助的几率较高，而黑人男性获得帮助的几率较低。与白人男性相比，黑人男性以及白人和黑人女性在做家务方面获得帮助的几率均较高。
我们的研究结果表明，尽管先前有与残疾相关差异的证据，但在自我护理、行动能力和家务活动方面获得帮助的情况因种族和性别而异。研究结果揭示了几个未来研究的目标领域。未来的工作应研究文化和社会对护理的偏好的作用，以及帮助的适当性，这可通过医疗服务利用和生活质量变化来证明。
