title: Inner-city older blacks have high levels of functional disability.
abstract: OBJECTIVE
  To describe the frequency and severity of functional problems in two groups of noninstitutionalized inner-city blacks aged 70 years and older contrasted with results from appropriate groups of white and black older adults and with the goals of the Healthy People 2000 program.
  
  
  METHODS
  Cross-sectional descriptive study.
  
  
  METHODS
  Community-based samples.
  
  
  METHODS
  A population-based sample of 416 older adults living in a 3.5-square mile catchment area in north St. Louis (NSL), Missouri, and a sample of 197 older residents living in public housing in East St. Louis (ESL), Illinois.
  
  
  METHODS
  Health status, preventive health activities, health services utilization, and risks for progressive frailty were assessed by self report and observation using well validated, standardized instruments. Whenever possible, comparison data were derived from national datasets, original samples used to validate the measures, and other useful comparison groups.
  
  
  RESULTS
  The NSL sample had somewhat better health status and risk for progressive disability than the ESL sample. However, compared with national or regional reference groups using age-gender adjustments, both study groups demonstrated increased levels of dependence in intermediate activities of daily living, restricted activity days, inability to walk one-half mile without assistance, reported poor vision, living alone, and limited income compared with both older whites and blacks, and increased levels of worsening health, inability to perform heavy work around the house, never walking a mile or more, and currently unmarried versus whites with variable decrements versus blacks. Contrasted with other comparison groups, the two samples had increased body fat; consistent decrements in gait speed, timed chair stands, timed one-leg balance, and frequency of preventive exercise; and lower levels of dental care; results relative to physician visits and hospital days were mixed. They also had high levels of measured visual and hearing impairments, unmet needs for home delivered meals, and problems with false teeth. Deficiencies compared with the goals of Healthy People 2000 were large.
  
  
  CONCLUSIONS
  The special attributes of inner-city blacks, including poverty and access to and acceptance of remedial programs, will have to be considered if the goals of Healthy People 2000 are to be met in this important and growing segment of older Americans. 44:0000-0000, 1996.
authors.affiliation: Division of Geriatric Medicine, St. Louis University Health Sciences Center, MO, USA.
authors.forename: D K
authors.initials: DK
authors.lastname: Miller
authors.forename: M E
authors.initials: ME
authors.lastname: Carter
authors.forename: J P
authors.initials: JP
authors.lastname: Miller
authors.forename: J E
authors.initials: JE
authors.lastname: Fornoff
authors.forename: J A
authors.initials: JA
authors.lastname: Bentley
authors.forename: S D
authors.initials: SD
authors.lastname: Boyd
authors.forename: J H
authors.initials: JH
authors.lastname: Rogers
authors.forename: M N
authors.initials: MN
authors.lastname: Cox
authors.forename: J E
authors.initials: JE
authors.lastname: Morley
authors.forename: L Y
authors.initials: LY
authors.lastname: Lui
authors.forename: R M
authors.initials: RM
authors.lastname: Coe
mesh_terms: D000203:Activities of Daily Living; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D002391:Catchment Area, Health; D003430:Cross-Sectional Studies; D005260:Female; D006299:Health Services for the Aged / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D007087:Illinois; D008297:Male; D008923:Missouri; D011204:Poverty Areas; D014505:Urban Population; D044465:White People