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Disability Burdens among Rural and Urban Older Americans
The number of older Americans is projected to grow dramatically over the next several decades, and will include more minorities. Costs of providing formal long-term health care are also growing rapidly, exceeding $100 billion. There is evidence that disability trends vary substantially among groups of older Americans. Compared with men, women live longer, and live a greater percentage of their lives with severe disability. Compared with whites, African Americans live shorter, more disabled lives. Less is known about disability patterns over the later life course by area of residence. Some research suggests that people living in rural areas have lower levels of disability and mortality than those in urban areas. This is paradoxical in that people living in rural areas generally are less likely to have health insurance, have lower incomes, have less access to health services, and have greater travel time to obtain health care.
This project will use the 1994-2000 Second Longitudinal Study of Aging, a nationally representative sample of community-dwelling adults age 70 and over, to develop detailed estimates of healthy, disabled, and total life expectancy among rural and urban populations. To address anticipated differences among populations, we will develop and compare the estimates between women and men, by race/ethnicity, and across differing levels of education. A greater understanding of differences in the burden of disability among groups defined by these characteristics would help national and local policymakers anticipate needs for services of various types.
Findings from this study will be presented at national meetings addressing rural health policy issues in addition to papers submitted to peer-reviewed journals.
Publications
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Disability Burdens among Older Americans Associated with Gender and Race/Ethnicity in Rural and Urban Areas
Author(s): James N. Laditka, Sarah B. Laditka, Bankole Olatosi, Keith T. Elder
Date: 09 / 2005
No prior research has investigated differences in disability-free and disabled life
expectancy associated with rural or urban residence. This report addresses this gap, and identifies differences in healthy life expectancy that may signal important policy needs. The authors examined total life expectancy, disability-free life expectancy, and disabled life expectancy, comparing people in rural and urban areas. These expectancy measures for subgroups of rural and urban areas were compared, distinguished by sex, race (white and African American) and educational attainment. The authors found that among a cohort of Americans aged 65 to 69 in 1982, in seven of the eight subgroups, individuals in rural areas lived longer lives than those in urban areas. Rural as compared to urban people lived (a) more disability-free years, (b) more disabled years, and (c) a notably greater percentage of their lives with a disability. There were striking differences among the high and low education groups, with individuals with more education living substantially longer, less disabled lives. Women lived longer, more disabled lives than men. For most subgroups, African Americans lived shorter, more disabled lives than whites. Executive summary available online.
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