The State of Older Undocumented Immigrants and Their Health View Digital Media
Presentation in a Themed Panel Arturo Vargas-Bustamante
Accessing high-quality healthcare can be difficult for immigrants living in the United States, however, for older undocumented immigrants this difficulty is compounded by a combination of legal, cultural, language and systemic barriers that have widened the existing disparities of healthcare access for this population. Approximately 10 percent of the undocumented population is older than age 55 now. This population, however, is rapidly aging. As the number of older undocumented immigrants in the United States continues to grow, new challenges are emerging, and the expansion of healthcare coverage across the country has not included undocumented immigrants. Across the board undocumented immigrants have disproportionately higher health risks. Our study found that twice as many undocumented immigrants ages 65 and older reported being in “fair or poor” health than U.S.-born citizens, and only 29.3 percent said they were in “very good” or “excellent” health, compared to 54.2 percent of citizens. In 2021, California created the first ever expansion of Medi-Cal, the state's Medicaid program, to undocumented Californian’s ages 50 and older, with plans of expanding to all undocumented immigrants in California by 2024. This expansion is seen by many as a necessary step for a state that is home to more than a quarter of all undocumented immigrants. Expanding Medicare coverage for all older adults at the federal level could solve many of the difficulties that immigrants face in finding healthcare coverage. Similarly, immigration reforms to naturalize undocumented immigrants could have positive spillover effect providing eligibility to Medicare and Medicaid to most immigrants.
Alzheimer’s Disease Among Communities of Color: The Role of Place for Brain Health Equity View Digital Media
Presentation in a Themed Panel Stipica Mudrazjia
Alzheimer’s disease and related dementias (ADRD) is the sixth leading cause of death for all Americans and the fourth and third leading cause of death for older Black and Latino Americans, respectively. The effects of where people live, and the social determinants of health are under-recognized and under-appreciated in our national response to effectively treat and prevent ADRD. This study compares counties with the highest prevalence of ADRD among Blacks, Latinos, and non-Latino Whites against counties with the lowest prevalence among these populations to identify trends related to the social determinants of health and risk factors for ADRD. The analysis finds deep social inequities in counties highlight impacted by ADRD among Latinos and Blacks. For example, counties with the highest prevalence of ADRD among Blacks and Latinos are more likely to have higher levels of poverty, less household income, less access to exercise opportunities, and less educational attainment compared to counties with the lowest prevalence among Blacks and Latinos. We observed less drastic differences in social determinants in counties with the highest prevalence of ADRD among non-Latino Whites when compared to counties with the lowest prevalence of ADRD. Understanding the geographic impacts of ADRD is critical given the growing burden the disease is placing on families, our healthcare system, and our economy, and can help public health departments, policymakers and community researchers better address barriers to healthcare access, research participation, and prevention in communities at the greatest risk for ADRD.
How Does Caregiving Influence the Social Networks of Latino Older Adults Over Time? : Results from the National Social Life, Health and Aging Project (NSHAP) View Digital Media
Presentation in a Themed Panel Lissette Piedra, Linda Waite, James Iveniuk
Latinos tend to outlive the general population, but their longevity is overshadowed by serious functional limitations and a heightened need for caregiving resources as they age. Although much care occurs within informal networks, we know little about how becoming a caregiver influences the social networks of community-dwelling Latino older adults. Given the link between health and social networks, understanding these nuances could provide useful insights. Latent Class Analysis was used to group the social-relational characteristics of 6,489 respondents across three rounds of NSHAP data. We generated a three-class solution: A ‘family-centric’ class with overall low social connectivity, an ‘enriched’ class with strong connections, and a ‘diverse’ class showing the greatest network range. Although most (70%) belong to either an enriched or diverse network, Latino respondents did not. In the first round, nearly half (49%) were in the ‘family-centric’ class, compared to non-Latino Blacks (37%) and Whites (24%). By the third round, Latino respondents in the ‘family-centric’ class dropped but rose for all other groups. When caregiving and network type were considered, being someone's caregiver significantly increases one’s probability of belonging to an ‘enriched’ network, regardless of ethnic/racial group. However, Latino caregivers had a decreased likelihood of belonging to a 'diverse' social network. Latinos’ reliance on informal care could explain the change from ‘family-centric’ to ‘enriched’ network, a constructive transfer that coincides with better health outcomes. However, this shift suggests a capacity for positive network movement, making it worrisome that Latino caregivers are less likely to be in a ‘diverse’ network.
Pathways of Dementia Care: The Experience and Costs of Caring for Family Members Living with Dementia in Mexico View Digital Media
Presentation in a Themed Panel Mariana Lopez-Ortega
Mexico’s formal health care system is unequipped to respond to significant dementia prevalence, estimated to be between 3.3 and 7.9%. Care for people living with dementia is primarily, if not exclusively, provided by family members. While the economic, social and health consequences of providing this care underpin the sustainability and equity of Mexico’s dementia care reality, very little is known about the experiences of those called upon to provide it. Based on almost 2 years of highly inductive fieldwork, carried out before and during the ongoing COVID-19 pandemic, and including 49 in-depth interviews with 23 unpaid family caregivers, this paper presents families’ health and social dementia care seeking trajectories and the structural factors that shape them. At the health and social care system level, we explore the impact that timely access to comprehensive social security institutions, high quality private care facilities and home-based services, and information about dementia, and healthcare practitioners’ communication around diagnosis and symptoms, have on when, where and if families obtain appropriate health and/or social care, and the consequences of this for them. At the social and economic level, we explore the high opportunity costs borne by family members who change, reduce or stop paid work to provide care, the impact of caregiving responsibilities on their social life and mental wellbeing, as well as strategies that are, or are not, employed by family members to alleviate the negative consequences of caring for those with dementia.
