Latino Aging in the Pacific Northwest: Challenges ... Forum The La… · Latino Aging in the...

Latino Aging in the Pacific Northwest: Challenges & Opportunities

College of Public Health and Human Sciences

Carolyn A. Mendez-Luck, PhD, MPH

Rural Aging Forum |Pendleton, Oregon

May 17, 2018

Outline

• Population trends• Challenges for aging Latinos

• Economic indicators• Health indicators • Access to care

• Opportunities for aging Latinos• Affordable Care Act (ACA)• Family ties

• Strategies for improving health among aging Latinos


Racial and Ethnic Minority Populations Are Growing at a Fast Pace …….

Source: https://files.eric.ed.gov/fulltext/ED578934.pdf

Percent of total U.S. population, all ages


7.1%

80.2%

8.0%

3.3% 1.2%

2010

Hispanic NH WhiteNH African American NW AsianOther

19.8%

58.5%

11.2%

8.4%

2.1%

2050

Hispanic NW WhiteNW African American NW AsianOther

…… And in the 65+ Population as Well

Source: U.S. Census for Population 65+


Elders are a Larger Proportion of Oregon’s Population Than in U.S. Overall


The Latino Population Has Grown Rapidly in Oregon

84%77%

8%12%

2000 2016

OREGON

All Latinos

All Non-Hispanic WhitesNHW 65+, 91.%

Latino 65+, 3%

69%62%

13%17%

2000 2016

UNITED STATES

Source: https://www.oregoncf.org/Templates/media/files/reports/latinos_in_oregon_report_2016.pdf

All Latinos

All Non-Hispanic Whites

NHW 65+, 78%

Latino 65+, 8%


Life Expectancy is High for U.S. Latino Men and Women

6

18.1

77.1

7.1

20.7

81.7

7.1

19.5

78.9

8

22.1

83.7

0 20 40 60 80 100

Age 85

Age 65

Age 0

2012

Hispanic Females Hispanic MalesNHW & Asian Females NHW & Asian Males

7

20.6

82.2

8.5

23.5

86.2

7

20.6

82.2

8.5

23.5

86.2

0 20 40 60 80 100

Age 85

Age 65

Age 0

2050

Hispanic Females Hispanic MalesNHW & Asian Females NHW & Asian Males

Source: https://www.census.gov/prod/2014pubs/p25-1140.pdfCollege of Public Health and Human Sciences

Challenges: Selected Social Determinants of Health for Aging Latinos

Latino Elder

Economic Stability

Health

Health Care Use

Access to Care


Latino Oregonians Are More Insecure Economically Than Non-Latino White Oregonians


Latinos Age 25+ Have Lower Educational Attainment Than Non-Latino Whites

25.523.8

10.5

1.8 2.1

27.9

12.2

3.9

0.5 0.70

5

10

15

20

25

30

High School Bachelor's degree Master's degree Professional degree Doctorate degree

NHW Latino


Source: U.S. Census Bureau, Current Population Survey, 2017 Annual Social and Economic Supplement

Percent of Deaths for 75-79 Year-olds in U.S., 2016


Source: https://www.cdc.gov/nchs/data/dvs/lcwk/lcwk1_hr_2016.pdf

Cause of Death Total Ranking Hispanic Females

Ranking Hispanic Males

1. Cancer 27.3 1 25.5 1 26.82. Diseases of the

heart22.2 2 21.1 2 24.3

3. Chronic lower respiratory diseases

8.3 6 3.5 5 4.4

4. Stroke 5.4 3 6.9 3 6.15. Alzheimer's

disease3.5 5 4.4 6 2.8

6. Diabetes 3.3 4 6.4 4 5.9

https://www.cdc.gov/nchs/data/dvs/lcwk/lcwk1_hr_2016.pdf

Prevalence of Chronic Health Conditions, Adults 65+

27.6%

21.6%

4.2%6.6%

2.9%5.6%

3.0%0%

5%

10%

15%

20%

25%

30%

35%

40%

Heart Diseases Cancer Chronic LowerRespiratory

Disease

Stroke Alzheimer'sDisease

Diabetes Influenza &Pneumonia

All races/ethnicities NH- White NH- Black Hispanic


Source: https://www.cdc.gov/features/agingandhealth/state_of_aging_and_health_in_america_2013.pdf

Functional Limitations by Nativity, Adults 65+

37%33%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

U.S.-Born Foreign-Born

NLW Black Latino Asian


Source: Dallo et al., 2015

Preventive Services Use among Adults 65+

38%

51%

16%

47%

28%

10%

45%

0%

10%

20%

30%

40%

50%

60%

70%

No FluVaccination

NoPneumococcal

Vaccine

No mammogram65-74

No ColorectalScreening (2008)

No Diabetesscreening

No BloodCholesterolScreening

No OsteoporosisScreening (2006)

White Black Hispanic Asian/PI AI/AN Other


Source: https://www.cdc.gov/aging/pdf/Clinical_Preventive_Services_Closing_the_Gap_Report.pdf

Barriers to Care among Latino Adults 65+

• Lack of transportation • Lack of health insurance | eligibility for services |

immigration status• Healthcare system complexity • Financial costs• Cultural beliefs• Poor patient –provider communication• Limited English proficiency • Availability of services | residential location• Stigma and marginalization

Source: Horton & Johnson 2010


Poor health in old age

Multiple disparities

over a long

lifetime

Economic Insecurity

Chronic Conditions & Impairment

Access to healthcare

Poor Aging Outlook for Latinos


Opportunities


Affordable Care Act

• 4+ million nonelderly Latino adults have gained health insurance coverage since 2012

• Included health promotion and wellness

• Increased funding to federally qualified health centers


1621

36

24

47

913

29

14

43

0

10

20

30

40

50

White Black Latino (total) Latino (U.S.-born) Latino (foreign-born)

July–Sept. 2013 Feb.-April 2016

Percent adults ages 19–64 uninsured

Uninsured Rates Have Dropped More Slowly for Latinos Than for Other Groups

Source: The Commonwealth Fund Affordable Care Act Tracking Surveys, July–September 2013 and February–April 2016.


The Family is a Strength for Latino Elders

• Multi-generational household

• Extended-family orientation• La familia• Compadrazgo system

• Familism – commitment to family


http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=y4xtQzNameMNdM&tbnid=wJl3P2qRRX2ZSM:&ved=0CAUQjRw&url=http://blog.latinovations.com/2011/04/07/new-poll-reveals-latinos-optimistic-about-achieving-american-dream-but-concerned-with-housing-market/&ei=2fh2UbeVI-33igLOqICwDg&bvm=bv.45580626,d.cGE&psig=AFQjCNGA3RQOC7gnkYwhRvcqNz59YPLW9g&ust=1366837838699624

Elders Are an Important Member of the Latino Family

• Elders are at center of social network

• Elders are esteemed for their wisdom and knowledge

• Elders fulfill important social role


Latino Caregiving Families Have a Greater Burden of Care ….

24.6%33.9%

44.3%

0%

10%

20%

30%

40%

50%

Percent of Elders Receiving Care from Family

NHWAfrican AmericanLatino

30%39% 40%

20%

0%

10%

20%

30%

40%

Caregivers in High Burden Situations

NLW African American Latino AsianSources: National Alliance for Caregiving and AARP, 2009; Weiss et al. 2005)College of Public Health and Human Sciences

7.5 6.3

11

0

2

4

6

8

10

12

Hours of Weekly Care

…. at a Greater Financial Cost

$6,964 $6,616

$10,704

$6,233

$2,935

$0

$2,000

$4,000

$6,000

$8,000

$10,000

$12,000

Annual Average Spending

White African AmericanLatino Female Latino MaleAsian

14%

34%

47%

39%

9%

0%

10%

20%

30%

40%

50%

Sum of Expenses as a Percentage of Annual

Income

Source: AARP, 2016


Strategies for Improving Health for Aging Latinos

• Continue efforts to increase health insurance coverage through ACA expansion

• Strengthen financial programs for caregivers and families

• Design Long-Term Services and Supports that • Are culturally acceptable for Latino families | eliminate stigma• Use a multigenerational approach• Build communities’ capacity to support caregivers

• Deliver clinical services that• Are family- and patient-centered • Include caregivers


New state law, effective 1/1/2016

Source: https://www.aarp.org/content/dam/aarp/caregiving/2017/11/or-ich-care-act-flyer-aarp.pdf


https://www.aarp.org/content/dam/aarp/caregiving/2017/11/or-ich-care-act-flyer-aarp.pdf

Thank you for Listening! Questions??

Carolyn A. Mendez-Luck, PhD, MPHAssociate Professor, Health Management & Policy | Human

Development & Family SciencesEmail: [email protected]

Phone: (541) 737-4503


mailto:[email protected]

Latino Aging in the Pacific Northwest: Challenges ... Forum The La… · Latino Aging in the...

Documents

Transcript of Latino Aging in the Pacific Northwest: Challenges ... Forum The La… · Latino Aging in the...