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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
College of Public Health and Human Sciences
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
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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+
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Elders are a Larger Proportion of Oregon’s Population Than in U.S. Overall
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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%
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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
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Latino Oregonians Are More Insecure Economically Than Non-Latino White Oregonians
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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
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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
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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
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
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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
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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
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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
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Poor health in old age
Multiple disparities
over a long
lifetime
Economic Insecurity
Chronic Conditions & Impairment
Access to healthcare
Poor Aging Outlook for Latinos
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Opportunities
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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
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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.
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The Family is a Strength for Latino Elders
• Multi-generational household
• Extended-family orientation• La familia• Compadrazgo system
• Familism – commitment to family
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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
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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
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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
College of Public Health and Human Sciences
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
College of Public Health and Human Sciences
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
College of Public Health and Human Sciences