Reassessing the Needs of Black Elders ANN W. NGUYEN, PH.D., M.S.W. - - PowerPoint PPT Presentation
Reassessing the Needs of Black Elders ANN W. NGUYEN, PH.D., M.S.W. MANDEL SCHOOL OF APPLIED SOCIAL SCIENCES CASE WESTERN RESERVE UNIVERSITY ANNA V. BROWN COMMUNITY FORUM & CONFERENCE Overview of Black Elderly 2 Health Service Use
ANN W. NGUYEN, PH.D., M.S.W.
MANDEL SCHOOL OF APPLIED SOCIAL SCIENCES CASE WESTERN RESERVE UNIVERSITY ANNA V. BROWN COMMUNITY FORUM & CONFERENCE
Overview of Black Elderly Health Service Use Social Isolation Social Support Caregiving Concluding Remarks
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U.S. Census Bureau
U.S. Census Bureau
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U.S. Census Bureau
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77 59 9 12 4 9 8 20 2 3 10 20 30 40 50 60 70 80 90 2016 2050 % of Population
U.S. Population Projections for Persons 65+
White Black Asian Hispanic Other
U.S. Census Bureau
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72.9 23.9 1.9 0.5 0.8 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 White Black Asian Native Hawaiian/PI/AIAN Other %
Race of Adults 60+ in Cuyahoga County
ACS 2011-2015
75 18 44 7 10 20 30 40 50 60 70 80 High school/GED Bachelor's or higher %
Educational Attainment among African Americans Age 65+ in the U.S.
2017 1998
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U.S. Census Bureau
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9.3 18.7 5 10 15 20 All Americans African Americans %
Poverty Rate
58559 31618 18380 43554 22177 15696 20000 40000 60000 80000 Total population Men Women
Median Household Income
African Americans All Americans
U.S. Census Bureau
Married 36% Widowed 27% Divorced 19% Separated 5% Never married 13%
Marital Status of African Americans Age 65+ in the U.S.
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U.S. Census Bureau
50 14 6 30 24 30 2 43 10 20 30 40 50 60 Live w/spouse Live w/other relatives Live w/non- relatives Live alone %
Living Arrangements among African Americans Age 65+ in the U.S.
Men Women
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U.S. Census Bureau
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Improvement in the life expectancy gap has
been gradual
Highest gains in life expectancy among African
American men—from 74.7 years in 1999 to 78.4 years in 2013 16
Why is the life expectancy gap decreasing?
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Professional & Informal 51% Professional Only 4% Informal Only 31% None 14%
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Woodward, Chatters, Taylor, Neighbors, & Jackson, 2010
Older African Americans less likely to seek
professional help than younger African Americans and older Whites
More likely to seek care for mental health problems
from primary care physician than mental health specialist
More likely to seek care at emergency rooms than
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Cost Insurance Transportation Knowledge of services and access Perception of problem Perception of service/service provider Communication style Discrimination
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10 20 30 40 50 60 70 80 90 100 African Americans Whites African Americans Whites African Americans Whites African Americans Whites Psychiatrist Other Mental Health Professional Family Doctor Clergy
Race of Service Providers
White Provider Black Provider
Nguyen, Taylor, Chatters, Taylor, & Woodward, 2019
Implicit bias Barrier to effective communication Affects client’s reactions to and trust in provider
recommendations 23
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Holt-Lundstad, Smith, Baker, Harris, & Stephenson, 2015
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with other people
and members of their social network 27
Not Isolated from Both 79% Isolated from Family 6% Isolated from Friends 11% Isolated from Both 4%
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Not Isolated from Both 89% Isolated from Family 2% Isolated from Friends 7% Isolated from Both 2%
Objective Isolation Subjective Isolation
Hamler, Taylor, & Nguyen, 2019
0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 Not Subjectively Isolated from Either Group Subjectively Isolated from Family and Friends High Blood Pressure Men Women
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Hamler, Taylor, & Nguyen, 2019
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53 28 10 5 3 2 10 20 30 40 50 60 Nearly every day At least once a week A few times a month At least once a month A few times a year Hardly ever
Frequency of Contact with Extended Family
National Survey of American Life: Coping with Stress in the 21st Century
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84 12 3 1 10 20 30 40 50 60 70 80 90 Very close Fairly close Not too close Not close at all
Emotional Closeness to Extended Family
National Survey of American Life: Coping with Stress in the 21st Century
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18 25 23 34 5 10 15 20 25 30 35 40 Never Not too often Fairly often Very often %
Social Support from Extended Family
National Survey of American Life: Coping with Stress in the 21st Century
Older African Americans are well integrated into
family support networks
Family members are viable sources of support Providers should consider how family members
can be incorporated into the care of older African Americans 34
Historically played a major role in African American
communities
Social, civic, political, educational, and economic
institution
Offer wide range of community programs and
services 35
89 7 2 1 90 6 2 2 20 40 60 80 100 Very important Fairly important Not too important Not important at all %
How important is religion/spirituality in your life?
Religion Spirituality
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National Survey of American Life: Coping with Stress in the 21st Century
3.4 9 12 23 45 8 5 10 15 20 25 30 35 40 45 50 Never Less than
A few times a year A few times a month At least
week Nearly everyday %
Religious Service Attendance among Older African Americans 37
National Survey of American Life: Coping with Stress in the 21st Century
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53 28 10 5 3 2 20 40 60 Nearly every day At least once a week A few times a month At least once a month A few times a year Hardly ever
Contact
84 12 3 1 50 100 Very close Fairly close Not too close Not close at all
Emotional Closeness
Relationships with Church Members
National Survey of American Life: Coping with Stress in the 21st Century
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19 34 24 23 5 10 15 20 25 30 35 40 Never Not too often Fairly often Very often %
Social Support from Church Members
National Survey of American Life: Coping with Stress in the 21st Century
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National Survey of American Life: Coping with Stress in the 21st Century
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0.05 0.1 0.15 0.2 0.25 5 10 15 20 25 30 35 40 45 50 Generalized Anxiety Disorder Discrimination
Discrimination, Contact & Generalized Anxiety Disorder
Low frequency of contact with church members High frequency of contact with church members
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0.02 0.04 0.06 0.08 0.1 0.12 5 10 15 20 25 30 35 40 45 50 Generalized Anxiety Disorder Discrimination
Discrimination, Emotional Closeness & Generalized Anxiety Disorder
Low emotional closeness to church members High emotional closeness to church members
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Older African Americans less likely to be
institutionalized
Caregiver-recipient relationship diverse Caregivers have higher need for formal support
services but lower utilization rates 45
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Older adult population is becoming increasingly
diverse
Social support is critical for well-being Providers should take into account resources clients
have available/lack
Assessments of social isolation should consider both
Services must be culturally relevant
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