title: Variation in the Presence of Simple Home Modifications of Older Americans: Findings from the National Health and Aging Trends Study.
abstract: To investigate the association between sociodemographic and economic factors and the presence of simple home modifications (HMs) among older adults in the United States.
  
  
  
  Cross-sectional.
  
  
  
  National Health and Aging Trends Study (2011, Round 1).
  
  
  
  Community-dwelling Medicare enrollees aged 65 and older (N = 6,628).
  
  
  
  The primary dependent variable was the reported presence or absence of simple HMs (grab bars in the shower or near the toilet, shower seats, raised toilet seats).
  
  
  
  Of the individuals sampled, 60.7% reported having at least one HM of interest. Black (odds ratio (OR) = 0.79, 95% confidence interval (CI) = 0.68-0.91) and Hispanic (OR = 0.60, 95% CI = 0.45-0.78) respondents were less likely than white, non-Hispanic respondents to have HMs. Those with more education (high school graduate: OR = 1.20, 95% CI = 1.01-1.42; >high school: OR = 1.36, 95% CI = 1.14-1.62) and larger social networks (≥4 people; OR = 1.46, 95% CI = 1.12-1.89) were more likely to have at least one HM, whereas being divorced (OR = 0.57, 95% CI = 0.43-0.74) was associated with lower likelihood. Income (OR = 1.01, 95% CI = 0.97-1.05), Medicaid enrollment (OR = 0.98, 95% CI = 0.77-1.25), and living alone (OR = 1.02, 95% CI = 0.85-1.23) were not significantly associated with the presence of HMs.
  
  
  
  Minorities, individuals with less education, and those with less social support are less likely to have HMs. Awareness of these disparities and the shortcomings of the HM delivery system is important to clinicians and policy-makers who seek to prevent falls and facilitate aging in place for all older Americans.
authors.affiliation: Department of Health Services Policy and Practice, School of Public Health, Brown University, Providence, Rhode Island. Marissa_Meucci@brown.edu.
authors.forename: Marissa R
authors.initials: MR
authors.lastname: Meucci
authors.affiliation: Department of Health Services Policy and Practice, School of Public Health, Brown University, Providence, Rhode Island.
authors.forename: Pedro
authors.initials: P
authors.lastname: Gozalo
authors.affiliation: Department of Health Services Policy and Practice, School of Public Health, Brown University, Providence, Rhode Island.|Department of Medicine, Warren Albert Medical School, Brown University, Providence, Rhode Island.|Providence Veterans Administration Medical Center, Health Services Research Program, Providence, Rhode Island.
authors.forename: David
authors.initials: D
authors.lastname: Dosa
authors.affiliation: Department of Health Services Policy and Practice, School of Public Health, Brown University, Providence, Rhode Island.|Providence Veterans Administration Medical Center, Health Services Research Program, Providence, Rhode Island.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Allen
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000061:Accidents, Home / Q000517:prevention & control*; D000368:Aged; D001107:Architectural Accessibility; D003430:Cross-Sectional Studies; D003710:Demography; D004777:Environment; D005006:Ethnicity; D005260:Female; D006801:Humans; D057187:Independent Living / Q000592:standards* / Q000706:statistics & numerical data; D008297:Male; D008484:Medicaid; D012944:Social Support; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology
keywords: disparities; falls; home modifications; prevention