Prevalence of Psychiatric Illnesses in Older Ethnic Minority Adults

OBJECTIVES: To compare lifetime and 12‐month prevalence of psychiatric disorders in a nationally representative sample of older Latino, Asian, African‐American, and Afro‐Caribbean adults with that of older non‐Latino white adults. DESIGN: Cross‐sectional study conducted in 2001 through 2004. SETTING: Urban and rural households in the contiguous United States. PARTICIPANTS: Two thousand three hundred seventy‐five community‐dwelling residents aged 60 and older living in noninstitutional settings. Data are from the National Institutes of Mental Health Collaborative Psychiatric Epidemiological Studies. METHODS: The World Mental Health Composite International Diagnostic Interview assessed lifetime and 12‐month psychiatric disorders. Bayesian estimates compared psychiatric disorder prevalence rates of ethnic and racial groups. RESULTS: Older non‐Latino whites exhibited a greater prevalence on several lifetime diagnoses than older Asian, African‐American, and Afro‐Caribbean respondents. Older Latinos did not differ from older non‐Latino whites on any lifetime diagnosis and had higher 12‐month rates of any depressive disorder. No differences were observed in the 12‐month diagnoses between older non‐Latino whites and the other racial and ethnic minority groups. Older immigrant Latinos had higher lifetime rates of dysthymia and generalized anxiety disorder (GAD) than U.S.‐born Latinos. Older immigrant Asians had higher lifetime rates of GAD than U.S.‐born Asians. Older immigrant Latinos had higher 12‐month rates of dysthymia than older U.S.‐born Latinos. CONCLUSION: Caution should be taken when generalizing the protective effects of ethnicity into old age. Older Asians and African‐Americans exhibited lower prevalence rates of some psychiatric disorders, whereas older Latinos exhibited rates equal to those of older non‐Latino whites. Also, the protective effect of nativity seems to vary according to age, psychiatric disorder, and ethnicity.     

Cultural Identity and Patient Trust Among Older American Indians

BACKGROUND

Patients’ trust in healthcare providers and institutions has been identified as a likely contributor to racial-ethnic health disparities. The likely influence of patients’ cultural characteristics on trust is widely acknowledged but inadequately explored.

OBJECTIVE

To compare levels of patients’ trust in primary care provider (interpersonal trust) with trust in healthcare organizations (institutional trust) among older American Indians (AIs), and determine associations with cultural identity.

DESIGN

Patient survey administered following primary care visits.

PARTICIPANTS

Two-hundred and nineteen American Indian patients ≥ 50 years receiving care for a non-acute condition at two clinics operated by the Cherokee Nation in northeastern Oklahoma.

MAIN MEASURES

Self-reported sociodemographic and cultural characteristics. Trust was measured using three questions about interpersonal trust and one measure of institutional trust; responses ranged from strongly agree to strongly disagree. Finding substantial variation only in institutional trust, we used logistic generalized estimating equations to examine relationships of patient cultural identity with institutional trust.

KEY RESULTS

Ninety-five percent of patients reported trusting their individual provider, while only 46 % reported trusting their healthcare institution. Patients who strongly self-identified with an AI cultural identity had significantly lower institutional trust compared to those self-identifying less strongly (OR: 0.6, 95 % CI: 0.4, 0.9).

CONCLUSIONS

Interpersonal and institutional trust represent distinct dimensions of patients’ experience of care that may show important relationships to patients’ cultural characteristics. Strategies for addressing low institutional trust may have special relevance for patients who identify strongly with AI culture.     

Ethnic and Class Variations in Promoting Social Activities Among Older Adults

Engagement in social activities impacts the health outcomes of older adults, especially as regards mortality and physical and cognitive disability. Participation and its benefits vary by socioeconomic gradient and ethnicity. This research aims to identify activities of interest to diverse older adults and factors that influence participation (barriers, motives, perceived benefits, and role expectations). We conducted five focus groups throughout Baltimore City with nonactive elders stratified by class, gender, and ethnicity. Activities, motives, and barriers varied across groups. Differences may exist in the challenges and facilitators for maintaining socially active lifestyles among different groups of older adults. Common barriers were found across the groups, in particular the absence of adequate transportation and financial resources, as well as health in the form of mobility difficulties. Nuanced differences among the groups described may help target interventions to particular groups as needed and create opportunities for engagement where extrinsic barriers might exist. Findings were disseminated to community partners to improve awareness of social factors in developing health-promoting strategies for active and meaningful roles for older adults.     

Depressive Symptoms,Self-Reported Physical Functioning,and Identity in Community-Dwelling Older Adults

In this study, we examined the relationship between self-reported physical functioning and depressive symptoms by testing the mediation of identity processes in linking this relationship. Sixty-eight older adults (mean age = 74.4) participated in this cross-sectional study. Participants completed measures of physical functioning (Physical Symptoms Checklist), depressive symptoms (CESD-20) and identity processes (IES-G). The relationship between physical functioning and depressive symptoms was partially mediated by sensitivity of older adults to feedback from experiences, the process known as identity accommodation (Whitbourne et al. 2002). Not only are physical changes relevant to negative psychological outcomes in later adulthood, but it is the interpretation of these changes that seems to have particular relevance for aging individuals. Though preliminary based on cross-sectional data, the findings suggest that examining individual differences in sensitivity to aging stereotypes may help identify factors related to depressive symptoms in later adulthood. Future research is needed to disentangle these interrelated concepts.     

Racial/Ethnic Disparities in Exercise and Dietary Behaviors of Middle-Aged and Older Adults

BACKGROUND  

Differences in health behaviors may be important contributors to racial/ethnic disparities in the health status of adults. Studies to date have not compared whether there are health behavior differences in exercise and dietary behaviors among middle-age and older adults in the four largest racial/ethnic categories.     

Canada’s labor market: Older workers need not apply

Barries to finding employment after 45 coupled with strong incentives for early retirement make it tough for Canadians to grow old on the job.     

Social Capital in Ethnic Communities and Mental Health: A Study of Older Korean Immigrants

Journal of Cross-Cultural Gerontology - This study examined how social capital in ethnic communities (e.g., social cohesion, community support, community participation, and negative interaction)...     

Life Satisfaction of Older Chinese Adults Living in Rural Communities

Guided by the socio-environmental theoretical framework, this study examined factors associated with life satisfaction experienced by older Chinese adults living in rural communities. The data used in this study were extracted from the Sample Survey on Aged Population in Urban/Rural China conducted by the China Research Center on Aging in 2000. This study included 10,084 rural older adults in mainland China. In this study 60.2 % of rural older adults were satisfied with their lives. Results from a multinomial logistic regression analysis showed that life satisfaction reported by rural older Chinese adults was significantly related to education, financial resources, self-rated health, financial support from children, satisfaction with children’s support, house sitting for their children, visiting neighbors, and being invited to dinner by neighbors. Research and policy implications of these findings are also discussed.     

Individualism, Collectivism and Ethnic Identity: Cultural Assumptions in Accounting for Caregiving Behaviour in Britain

Britain is experiencing the ageing of a large number of minority ethnic groups for the first time in its history, due to the post-war migration of people from the Caribbean and the Indian subcontinent. Stereotypes about a high level of provision of informal caregiving among minority ethnic groups are common in Britain, as in the US, despite quantitative studies refuting this assumption. This paper reports on a qualitative analysis of in-depth interviews with older people from five different ethnic groups about their conceptualisation of their ethnic identity, and their attributions of motivations of caregiving within their own ethnic group and in other groups. It is argued that ethnic identity becomes salient after migration and becoming a part of an ethnic minority group in the new country. Therefore, White British people who have never migrated do not have a great sense of ethnic identity. Further, a strong sense of ethnic identity is linked with identifying with the collective rather than the individual, which explains why the White British participants gave an individualist account of their motivations for informal care, whereas the minority ethnic participants gave a collectivist account of their motivations of care. Crucially, members of all ethnic groups were providing or receiving informal care, so it was the attribution and not the behaviour which differed.     

Racial and Ethnic Differences in the Mental Health Needs and Access to Care of Older Adults in California

Little is known about the unmet mental health needs of minority older adults. Racial and ethnic differences in the prevalence rates of psychological distress and reported need and use of mental health services were examined in a population‐based sample of older adults using the 2005 California Health Interview Survey. The sample comprised 16,974 people aged 55 and older, with 13,974 non‐Hispanic whites, 719 African Americans, 1,215 Asians, and 1,066 Latinos. Respondents were compared in terms of prevalence of symptoms of mental distress and serious mental illness, reported need for help, and access to mental health services. African Americans, Asians, and Latinos were more likely to have mental distress than whites (21.2–24.2% vs 14.4%, P<.001) and a higher prevalence of serious mental illness (4.1–7.7% vs 2.5%, P<.001). After adjustment for age, sex, birthplace, marital status, education, limited English proficiency, chronic health conditions, and insurance status, older African‐American (adjusted odds ratio (aOR)=1.37, 95% confidence interval (CI)=1.04–1.81) and Asian (aOR=1.50, CI=1.13–2.00) adults still had greater odds of mental distress than whites. Furthermore, all three groups had worse access to mental health services than whites (African American aOR=0.64, 95% CI=0.43–0.96; Asian aOR=0.32, CI=0.16–0.63; Latino aOR=0.35, CI=0.17–0.70). Clinicians caring for older individuals should be aware of their high risk for mental health needs. Given that minorities' access to mental health services is worse than whites', even after adjusting for health insurance status, providing insurance alone will not eliminate this disparity. Innovative clinical and systemic strategies are needed to better identify individuals at risk and to provide needed services.     

国人听觉系统老化的研究

年龄因素可影响听力。增龄对纯音听力影响的报导很多,对语言听力的影响则研究较少。近年来,国外也刚开始有些资料。但尚未见到用汉语语言测听法研究我国老年人的听力,特别是听力老化的报导。本文就此进行探讨。