Disparities in the Prevalence of Unmet Needs and Their Consequences Among Black and White Older Adults

J Aging Health. 2018 Oct;30(9):1427-1449. doi: 10.1177/0898264317721347. Epub 2017 Jul 24.

Abstract

Objective: We document differential prevalence of need for assistance with personal, instrumental, and mobility tasks and adverse consequences of unmet needs, nursing home relocation, and mortality among Black and White older adults.

Method: Data are from the National Health and Aging Trends Study. Using logistic and multinomial logistic regression, we determine whether race is predictive of reporting need or adverse consequence and test the role of race as a moderator of the relationship between baseline need and three 1-year outcomes.

Results: Black older adults are more likely to experience a consequence of unmet need (35.33% vs. 29.97%, p = .028) in unadjusted models. In adjusted models, we find no moderating effect of race on baseline need on nursing home placement (0.00, 95% confidence interval [CI] = [-2.43, 2.42], p = .991), mortality (0.73, 95% = [-1.58, 0.11], p = .089), or a Round 2 consequence of unmet (-0.51, 95% CI = [-1.15, 0.14], p = .121).

Discussion: This work highlights the complex relationship between race, need, unmet need, mortality, and nursing home entry.

Keywords: adverse consequences; long-term care; racial disparities; unmet need.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Activities of Daily Living
  • Age Factors
  • Aged, 80 and over
  • Black or African American*
  • Dementia / epidemiology
  • Disability Evaluation*
  • Educational Status
  • Female
  • Health Services Needs and Demand / statistics & numerical data*
  • Health Surveys
  • Hospitalization
  • Humans
  • Male
  • Medicaid
  • Multiple Chronic Conditions / epidemiology
  • Nursing Homes*
  • Prevalence
  • Sex Factors
  • United States / epidemiology
  • White People*