title: Opportunity costs associated with caring for older Mexican-Americans.
abstract: Long-term care use among older Mexican-Americans is poorly understood, despite the adverse effects on health and economic disadvantage in this vulnerable population. This study examines gender-based risk of long-term care use in 628 women and 391 men, age 70 and over in the 2000-2001 and 2004-2005 waves of the Hispanic Established Populations for Epidemiologic Studies of the Elderly. Logistic regression models are employed to assess the impact of the opportunity cost implications of family support (kin availability and co-residence) relative to health care needs (quality-adjusted life years (QALY) weighted scores and functional limitations) on women's risk of entry into a nursing home. A small percentage (~5%) of men and women had entered a long-term care facility. Women had lower weights for QALY weights and greater disability than men, but on average were more likely to live with or in closer proximity to an adult child. Higher disability rates (p < 0.01) increased the risk of institutionalization regardless of gender because disability increases time burdens. Families with fewer adult children faced higher time burdens per child in caring for elderly parents; particularly for elderly mothers. Demographic trends suggest that the number of adult children available to share the caregiving load may decrease long-term care use.
authors: University of Texas School of Public Health, Austin Regional Campus, Austin, TX, USA, Henry.S.Brown@uth.tmc.edu.
authors: H Shelton
authors: HS
authors: Brown
authors: Angelica P
authors: AP
authors: Herrera
authors: Jacqueline L
authors: JL
authors: Angel
mesh_terms: D000368:Aged; D040561:Assisted Living Facilities / Q000706:statistics & numerical data*; D017281:Cost of Illness; D005191:Family Characteristics; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008134:Long-Term Care / Q000706:statistics & numerical data*; D008297:Male; D017058:Mexican Americans; D009735:Nursing Homes / Q000706:statistics & numerical data*; D019057:Quality-Adjusted Life Years; D018570:Risk Assessment; D012737:Sex Factors; D015206:Southwestern United States
references: JAMA. 1963 Sep 21;185:914-9
references: 14044222
references: Bull World Health Organ. 1994;72(3):429-45
references: 8062401
references: J Gerontol B Psychol Sci Soc Sci. 2002 May;57(3):S177-86
references: 11983744
references: J Health Soc Behav. 1997 Dec;38(4):345-62
references: 9425779
references: J Community Health. 2009 Aug;34(4):301-10
references: 19333744
references: J Am Geriatr Soc. 1983 Dec;31(12):721-7
references: 6418786
references: Diabetes Educ. 2004 Nov-Dec;30(6):980-93
references: 15641619
references: Health Aff (Millwood). 2009 Jan-Feb;28(1):262-72
references: 19124878
references: Gerontologist. 2005 Feb;45(1):90-106
references: 15695420
references: Healthy People 2000 Stat Notes. 1995 Apr;(7):1-15
references: 11762385
references: Med Care. 2008 Apr;46(4):449-53
references: 18362827
references: Am J Psychiatry. 2004 May;161(5):857-63
references: 15121651
references: BMC Geriatr. 2007 Jun 19;7:13
references: 17578574
references: J Cross Cult Gerontol. 2006 Sep-Dec;21(3-4):139-55
references: 17216577
references: J Diabetes Complications. 2012 May-Jun;26(3):181-6
references: 22520403
references: J Gen Intern Med. 2001 Nov;16(11):770-8
references: 11722692
references: J Aging Health. 2004 Jun;16(3):338-54
references: 15155066
references: J Am Geriatr Soc. 2003 Feb;51(2):178-83
references: 12558713
references: Gerontologist. 1969 Autumn;9(3):179-86
references: 5349366
references: Gerontologist. 1996 Aug;36(4):464-73
references: 8771974
references: J Aging Health. 2007 Apr;19(2):213-28
references: 17413132
references: Am J Public Health. 2006 Aug;96(8):1342-6
references: 16809597
references: Health Aff (Millwood). 2010 Jan-Feb;29(1):65-73
references: 20048362
references: Health Aff (Millwood). 2012 Jul;31(7):1600-12
references: 22692089