Lightning Presentations
Selected Presentations in honor of Prof. Steve Wallace
These poster presentations have been selected in honor of Professor Steve Wallace. The session has been organized by Terrence Hill, Adriana Reyes, and Emma Aguila. The session discussant is Marc Garcia.
Urban-Rural Healthcare Cost Differences among Latinxs with and without Dementia in the United States: Implications for Resilience
Lightning Talk Angela Gutierrez
Background: Research comparing healthcare costs by geographic context has primarily been conducted outside the U.S. and has overlooked Latinxs and comparisons by dementia status. Given that Latinxs have a greater risk and earlier onset of dementia relative to Whites, assessing rural-urban-dementia disparities in healthcare costs is critical to address burden of disease and to inform tailored points of intervention. We compared healthcare costs across rural and non-rural contexts among Latinxs and examined whether differences vary by dementia status. Methods: Data are from a nationally representative sample of Latinx adults ages 51+ (n = 15,567) in the Health and Retirement Study (2006-2018 waves). Healthcare costs were inflated using the 2021 consumer price index. Geographic context and dementia status were the main exposure variables. The Langa-Weir algorithm determined dementia status. We applied multivariate two-part generalized linear models and adjusted for sociodemographic and health characteristics. Results: Higher total healthcare costs were found in rural areas regardless of dementia status. The total cost of care was estimated to be $752 greater in rural ($2,580) compared to non-rural ($1,828) areas (95% CI: 10.43-1,463). Larger hospitalization and office visit costs drove the higher costs in rural areas. Likewise, the out-of-pocket costs of care were $771 (2,613 vs. 1,842; 95% CI: 49.16-1492.17) higher in rural areas. Dementia status did not significantly moderate the geographic context-healthcare costs relationship. Discussion: Findings identify disproportionately higher healthcare costs among Latinxs living in rural areas, relative to their non-rural counterparts. As Latinxs are the largest ethnic minoritized population in the U.S. and Latinx communities are growing in rural America, addressing the burden of dementia and healthcare costs among Latinxs in rural areas is a public health priority. Mobilizing providers, promotoras, and resources to address these disparities is critical to promote healthy aging and resilience among this population.
Impact of Ethnic Enclaves on Life-space Mobility for Older Mexican Americans View Digital Media
Lightning Talk Felipe L. Antequera
Objective: Life-space assessment (LSA) is an important tool used to assess mobility in older adults. High concentration of poverty is negatively associated with life-space mobility, but little is known about the role of ethnic enclaves as a potential moderator of this relationship. This study examines the role of ethnic enclaves in life-space mobility measured using the LSA score. Method: The data come from the Hispanic Established Populations for the Epidemiologic Study of the Elderly (HEPESE) survey, Wave 7, 2010-2011 (n=1,078), linked to census tract characteristics. Life-space mobility is measured using the LSA score and ethnic enclaves are determined using the tract percentage of Mexican American. We also examine socio-demographic characteristics and self-reported physician-diagnosed medical conditions. We use multiple regression analysis on the LSA score, controlling for tract poverty, tract percentage Mexican American, sociodemographic and health characteristics. Results: The profile of those with mean age of participants was 85.9 years (SD, 4.0), sixty-five percent were female, and the mean score of LSA was 37.21 (SD, 23.3). Poverty was negatively associated with LSA and this relationship maintained statistical significance when controlling for tract percentage Mexican American, sociodemographic and health characteristics. However, tract percentage Mexican American reduced the level of association between poverty and LSA. Conclusion: Preliminary results show that higher poverty levels are associated with lower LSA scores, however, when adding the tract percentage of Hispanic population to the model, we observed that the relationship between LSA and percentage of poor is moderated by the presence of ethnic enclaves. Future research should examine environmental and financial influences on LSM that may improve resilience with reference to physical decline and social isolation
Dementia Trends and Healthcare Access Among Older Latinx Adults During the COVID-19 Pandemic View Digital Media
Lightning Talk Josefina Flores Morales, Jennifer Archuleta
The Latinx older adult population is one of the fastest growing groups in the United States. Between 2019 to 2040, the population of Latinx 65 years and older is expected to increase by 161% (ACL 2021). Latinxs have a higher prevalence of dementia and a greater risk for early dementia compared to non-Latinx White persons (Rote and Moon 2022). Relatively little is known about the healthcare experiences among Latinx persons with dementia during the COVID-19 pandemic. This study has two aims. First, we describe dementia trends in 2019 among Latinx respondents. Second, we describe differences in access to healthcare services before and during the coronavirus pandemic. Specifically, we focus on long-term care visits, hospital visits, receiving help to access a provider, and hospital stays (in the past year) of respondents with probable or possible dementia, with a focus on Latinx older adults. Data come from the National Health and Aging Trend Study (NHATS), (2019, 2020), an annual survey of health, social, and demographic characteristics from a nationally representative sample of Medicare beneficiaries aged 65 years and older. Our sample size for the 2019 NHATS is n=35,610. The sample size for the COVID-19 supplemental survey varies by the healthcare outcome measure and consists of over 4,000 respondents. We find that Latinx respondents have the highest proportion of persons with possible or probable dementia, followed by Non-Latinx (NL) Black and NL white persons. Latinxs with probable or possible dementia are also more likely to have had a hospital visit in the past 12 months, more likely to have received help accessing a healthcare provider, and more likely to have missed a hospital visit than NL white persons of any dementia status. There were no statistically significant differences in missing long-term care visits. This study improves our understanding older Latinx persons’ healthcare needs.
