Variation in Older Americans Act Caregiver Service Use, Unmet Hours of Care, and Independence Among Hispanics, African Americans, and Whites

Abstract

Home- and community-based services (HCBS) are underused by minority seniors and their caregivers, despite greater rates of disability. We examined racial/ethnic variation among 1,749 Hispanics, African Americans, and Whites receiving Older Americans Act Title III caregiver services in 2009. In addition, we identified the volume of services used by caregivers, their unmet hours of respite care, and the relationship between service use and seniors' ability to live independently. Minority caregivers cared for seniors in urban areas who had higher rates of disability, poverty, and Medicaid coverage. Hispanics had the highest rate of unmet hours of care, while caregiver services were less likely to help African Americans remain at home. Minorities sought services through community agencies and were more educated than demographically similar national cohorts. Greater efforts to reach minority caregivers of less educated, disabled seniors in urban areas and through community agencies may reduce unmet needs and support independent living.

Keywords:

• African Americans
• caregiver support services
• Mexican Americans
• Older Americans Act

Acknowledgments

Support for this study was provided by a grant from the National Institute on Minority Health and Health Disparities (NCMHD), Grant No. R01MD005894 for Angelica P. Herrera and Jacqueline L. Angel; and the Health and Aging Policy Fellows Program, Atlantic Philanthropies, for Angelica P. Herrera. The authors also wish to thank the analytical support of doctoral students Carlos Diaz and Stipica Mudrazija.