Predictors of Use of Body-Based CAM Therapies (acupuncture, chiropractic, herbal medicine, holistic health, massage) Predictors Odds Ratio 95 % CI` Physical Health .98 .966-.993 Status Education/ some 1.39 1.02-1.88 college Education/college 1.88 1.37-2.58 Arthritis 1.44 1.10-1.88 Not significant: age, ethnicity, gender, marital status, mental health status, hypertension, stroke , diabetes, resp. illness, kidney disease, cancer, suppl. health ins., having primary care physician, difficulties with medical care, dissatisfaction with medical care. 31
Predictors of Use of Psychology-Based Cam Therapies (energy healing, guided imagery, relaxation, self-help groups, spiritual healing) Predictors Odds Ratio 95 % CI Gender (female) 1.67 1.26-2.21 Ethnicity (AA) 1.30 1.01-1.70 Education (some 1.54 1.13-2.07 college) Education (college) 1.70 1.11-2.15 Cancer 1.70 1.01-2.75 Dissatisfaction with 1.93 1.09-3.44 medical care 32
Summary • Middle of population shift • Overall, health status of status of population slightly worse than national rates—due to higher proporiton of old-old • Blacks report worse health than whites, feamles wors than males, and black females report the worst health • Healthy behaviors—room for improvement particularly among black males, the old-old and the less educated 33
Who Needs Help Most? • Poor self-assessed health • Poor mental/emotional health • Four or more chronic health conditions • Unable to do heavy housework • No supplemental insurance • Lives alone • Low to moderate social support • Poor or unsafe neighborhood • Income below $15,000 34
Who Uses Senior Services? • 13% had used senior services in past month. • Groups most likely to report service use: – Females (particularly Black females) – Those with more service needs in general – Older – Physical disability – Low income – Low social support / Live alone – Poor mental health • Generally high levels of satisfaction with services • Approximately half reporting service use said it would 35 be difficult remaining independent without them.
Unmet Needs for Services • Approximately 7% reported unmet needs for senior services. • Groups most likely to report unmet needs: – Females (particularly Black females) – Those with more service needs in general – Poor physical health – Physical disability – Living in poor neighborhood / housing – Poor mental health • Most needed services – Household / chore / shopping; medical; transportation; financial / legal 36
Physical Disability, Caregiving, and Service Use
Percent Receiving or Providing Help with Personal and Routine Care 0% 5% 10% 15% 20% 25% Receives help with 3.2% personal care needs Receives help with 20.2% routine needs Provides help with 12.0% personal care needs Provides help with 15.0% routine needs
Who helps? Who do they help? • Receive help from: • Provide help to: 1. Spouse 1. Spouse 2. Daughters/sons 2. Elderly parents 3. Other family 3. Other family 4. Professionals 4. Friends/neighbors
Physical Disability: Receiving Help
Receives Help with Personal Care Needs by Race and Gender 0% 1% 2% 3% 4% 5% 6% 7% 3.2% All Persons 3.6% Black Male 6.0% Black Female 1.8% White Male 3.9% White Female
Receives Help with Personal Care Needs by Age and Living Arrangement 0% 2% 4% 6% 8% 10% 12% 14% 3.2% All Persons 1.0% Age 65 - 74 3.0% Age 75 - 84 12.1% Age 85+ 3.9% Lives with Others 2.0% Lives Alone
Receives Help with Personal Care Needs by Marital Status and Education 0% 1% 2% 3% 4% 5% 6% 7% 3.2% All Persons 2.9% Married 4.1% Widowed 1.2% Divorced / Separated / Single 5.9% Less than High School 2.2% High School Grad 2.3% Some College
Receives Help with Routine Needs by Race and Gender 0% 5% 10% 15% 20% 25% 30% 35% 20.2% All Persons 12.5% Black Male 33.3% Black Female 10.8% White Male 25.0% White Female
Receives Help with Routine Needs by Age and Living Arrangement 0% 10% 20% 30% 40% 50% 60% 20.2% All Persons 12.8% Age 65 - 74 17.2% Age 75 - 84 53.6% Age 85+ 17.5% Lives with Others 25.3% Lives Alone
Receives help with Routine Needs by Marital Status and Education 0% 10% 20% 30% 40% 20.2% All Persons 10.6% Married 34.3% Widowed 14.5% Divorced / Separated / Single 32.4% Less than High School 16.6% High School Grad 14.2% Some College
Receipt of Personal or Routine Care – Other Factors • Poor self-rated health • Multiple chronic conditions • Low income • Low social support • Poor mental health • Living in poor / unsafe neighborhood or unsatisfactory housing
Adequacy of Care Received 100% 84.0% 80% 60.4% 60% 40% 23.6% 16.0% 20% 13.6% 2.3% 0% Usually adequate Sometimes adequate Rarely adequate Personal Care Routine Needs
Physical Disability: Summary • Low overall levels of personal care needs (3%). • One in five report needing help with routine needs. • Groups most at risk for disability: – African American females – Oldest old – Widowed – Less educated / Low income – Poor physical health – Low social support – Poor mental health – Poor neighborhood / housing • Help received generally adequate (less for personal care)
Caregiving: Providing Help
Provides Personal Care Help by Race and Gender 0% 2% 4% 6% 8% 10% 12% 14% 16% 12.0% All Persons 10.7% Black Male 9.5% Black Female 13.7% White Male 11.4% White Female
Provides Personal Care Help by Age and Living Arrangements 0% 2% 4% 6% 8% 10% 12% 14% 16% 12.0% All Persons 13.9% Age 65 - 74 11.8% Age 75 - 84 5.9% Age 85+ 13.2% Lives with Others 10.0% Lives Alone
Provides Personal Care Help by Marital Status 0% 2% 4% 6% 8% 10% 12% 14% 16% 12.0% All Persons 15.1% Married 9.5% Widowed Divorced / 5.5% Separated / Single
Provides Routine Help by Race and Gender 0% 5% 10% 15% 20% 25% 15.0% All Persons 18.2% Black Male 11.9% Black Female 20.8% White Male 11.8% White Female
Provides Routine Help by Age and Living Arrangements 0% 5% 10% 15% 20% 15.0% All Persons 18.4% Age 65 - 74 14.1% Age 75 - 84 5.8% Age 85+ 18.2% Lives with Others 9.3% Lives Alone
Provides Routine Help by Marital Status 0% 5% 10% 15% 20% 25% 15.0% All Persons 20.2% Married 9.2% Widowed Divorced / 10.9% Separated / Single
Caregiving: Summary • Providing personal care help was four times as prevalent (12%) as receiving personal care help (3%). • Providing routine care (15%) was slightly less prevalent than receiving routine help (20%). • Groups most likely to be providing care: – Males – Younger – Lives with others – Married • Care provision generally unrelated to other health indicators.
Knowledge and Use of Area Agency on Aging Senior Services
Knowledge and Use of Area Agency on Aging, Allegheny County 80 68.9% 70 60 50 Percent 40 29.1% 30 20 13.0.% 10 6.6% 0 Heard of AAA Aware of Services AAA Have Used Senior Not Receiving Needed provides Services in Last Month Senior Services
Awareness of AAA and Services
Heard of Area Agency on Aging by Race and Gender 0% 10% 20% 30% 40% 50% 60% 70% 80% 68.9% All Persons 58.2% Black Male 75.9% Black Female 61.0% White Male 73.6% White Female
Heard of Area Agency on Aging by Number of “Service Needs” 58% 60% 62% 64% 66% 68% 70% 72% 74% 68.9% All Persons 70.6% None 71.7% One or Two 63.3% Three or Four 65.0% Five or more
Heard of AAA? - Other Factors • More educated • Have additional medical insurance • High social support • Live alone
Aware of Services Agency Provides by Race and Gender 0% 10% 20% 30% 40% 50% 29.1% All Persons 27.2% Black Male 39.2% Black Female 18.9% White Male 34.4% White Female
Aware of Services Agency Provides by Number of “Service Needs” 0% 5% 10% 15% 20% 25% 30% 35% 40% 29.1% All Persons 28.2% None 30.6% One or Two 25.1% Three or Four 36.7% Five or more
Aware of AAA Services? - Other Factors • More educated • Younger • Fewer chronic conditions • Live with others
Awareness of AAA Services: Summary • Almost 70% had heard of AAA. • Less than 30% were aware of the services AAA provides. • Groups more aware of AAA: – Females – More educated
Use of Senior Services
Used Senior Services in Last Month by Race and Gender 0% 5% 10% 15% 20% 25% 30% 13.0% All Persons 12.5% Black Male 25.0% Black Female 6.0% White Male 16.3% White Female
Used Senior Services in Last Month by Number of “Service Needs” 0% 5% 10% 15% 20% 25% 30% 35% 13.0% All Persons 4.0% None 11.4% One or Two 19.5% Three or Four 32.2% Five or more
Used Senior Services in Past Month - Other Factors • Older • Unable to do housework • Low income • Low social support • Live alone • Poor mental health • Routine care needs
Overall Satisfaction with Services 100% 77.9% 80% 60% 40% 19.0% 20% 3.1% 0% Very Satisfied Somewhat Satisfied Not at All Satisfied
Difficulty Remaining Independent If Services Unavailable 60% 54.0% 40% 23.2% 22.8% 20% 0% Very Difficult Somewhat Difficult Not at All Difficult
Use of Senior Services: Summary • 13% had used senior services in past month. • Groups most likely to report service use: – Females (particularly Black females) – Those with more service needs in general – Older – Physical disability – Low income – Low social support / Live alone – Poor mental health • Generally high levels of satisfaction with services • Approximately half reporting service use said it would be difficult remaining independent without them.
Unmet Needs for Senior Services
Not Receiving Needed Services by Race and Gender 0% 2% 4% 6% 8% 10% 12% 14% 16% 6.6% All Persons 9.3% Black Male 15.0% Black Female 3.6% White Male 7.5% White Female
Not Receiving Needed Services by Number of “Service Needs” 0% 5% 10% 15% 20% 25% 6.6% All Persons 1.0% None 3.1% One or Two 13.9% Three or Four 23.3% Five or more
Unmet Needs for Services – Other Factors • Poor self-rated health • Four or more reported chronic conditions • Low social support • Living in a poor / unsafe neighborhood or unsatisfactory housing • Poor mental health • Personal care needs • Routine care needs
Service Needs Among Those Reporting Service Needs (5.6%) Other/Misc. Social Activities/ 3% Companionship 6% Food/Meals on Wheels 6% Homemaker/Chore Shopping Services 34% Financial/Legal Insurance Services 15% Transportation/ACCESS 18% Medical or Personal Services 18%
Unmet Needs for Services: Summary • Approximately 7% reported unmet needs for senior services. • Groups most likely to report unmet needs: – Females (particularly Black females) – Those with more service needs in general – Poor physical health – Physical disability – Living in poor neighborhood / housing – Poor mental health • Most needed services – Household / chore / shopping; medical; transportation; financial / legal
Allegheny County Survey Results • General Health Status • Health Insurance Coverage and Health Care • Healthy and Unhealthy Behaviors • Need for Senior Services
General Health Status
Self-Assessed Health Status by Race and Gender Allegheny County Aged 65 & over Percent 50 40 30 20 10 0 10 20 30 40 50 All Persons - US All Persons - Allegheny County White male White female Black male Black female Fair/Poor/Very Poor Excellent/Very Good
Self-Assessed Health by Age and Living Arrangements Allegheny County Aged 65 & over Percent 50 40 30 20 10 0 10 20 30 40 50 All Persons - US All Persons - Allegheny County Ages 65-74 Ages 75-84 Ages 85+ Lives With Others Lives Alone Fair/Poor/Very Poor Excellent/Very Good
Self-Assessed Health By Education Allegheny County Aged 65 & over Percent 50 40 30 20 10 0 10 20 30 40 50 60 All Persons - US All Persons - Allegheny County Less than High School High School Graduate Some College College Graduate Fair/Poor/Very Poor Excellent/Very Good
SF-8 Summary Physical Health Scores by Race and Gender Allegheny County Aged 65 & over 50 49 White male 48 Black All Persons - Allegheny White male County female 47 Mean Score 46 45 Black female 44 43 42 41 Physical Health Scale
SF-8 Physical Health Scores by Age and Living Arrangement Allegheny County Aged 65 & over 49 Ages 65-74 48 Lives With Others All Persons - Allegheny County 47 Lives Alone Ages 75-84 Mean Score 46 45 Ages 85+ 44 43 Physical Health Scale
SF-8 Summary Mental Health Scores by Race and Gender Allegheny County Aged 65 & over 55 54 White male 53 All Persons - Allegheny Black 52 County male Mean Score White female 51 Black female 50 49 48 47 Mental Health Scale
SF-8 Mental Health Scores by Age and Living Arrangement Allegheny County Aged 65 & over 52.5 Ages 65-74 52 All Persons - Allegheny Lives With Others County 51.5 Ages 75-84 Mean Score Lives Alone 51 Ages 85+ 50.5 50 49.5 Mental Health Scale
Number of Chronic Health Conditions by Race and Gender, and Living Arrangements All Persons White male White female Black male Black female Lives With Others Lives Alone 0 10 20 30 40 50 60 70 80 90 Percent 4 or more Conditions 2 or 3 Conditions
Number of Chronic Health Conditions by Age and Education All Persons Age 65-74 Age 75-84 Age 85+ < High Schl High Schl Some College or more 0 10 20 30 40 50 60 70 80 90 Percent 4 or more Conditions 2 or 3 Conditions
Unable to Do Heavy Housework by Race and Gender, and Living Arrangements All Persons White male White female Black male Black female Lives With Others Lives Alone 0 5 10 15 20 25 30 35 40 Percent
Unable to Do Heavy Housework by Age and Education All Persons Age 65-74 Age 75-84 Age 85+ < High Schl High Schl Some College or more 0 5 10 15 20 25 30 35 40 45 50 Percent Unable to do heavy housework
General Health Status: Summary • Self-assessed health of elderly in Allegheny County is slightly worse than for persons age 65 and over nationally primarily due to the greater percentage of oldest old (85+) in the County. • Blacks reported worse self-assessed health than whites, and females reported worse health than males, with black females reporting the worst health. • Poor self-assessed health was also related to: – Older age – Lower levels of education – Living alone • Similar patterns were seen for the SF-8 summary scales, for the number of chronic health conditions reported, and for the inability to regularly do heavy housework. • In general, the health status of the elderly in Allegheny County is comparable to national figures.
Health Insurance Coverage and Health Care
Health Insurance, Prescription Medications, Persons in Allegheny County Aged 65 & over 100 94.5% 88.1% 90 85.7% 80 72.4% 70 60 Percent 50 40 30 20 10 0 Has Health Insurance in Has Prescription Takes Prescription No Difficulty Getting Addition to Medicare Medication Insurance Medications Prescription Medications
Health & Prescription Medication Insurance Allegheny County Aged 65 & over 100 White White female male 90 White Black White 80 female Black female male male 70 Black Black female male 60 Percent 50 40 30 20 10 0 Has Health Insurance in Addition to Medicare Has Prescription Medication Insurance
Has Health Insurance in Addition to Medicare by Age and Living Arrangements 92 Ages 65-74 90 Lives With Others All Persons - Allegheny County Ages 75-84 88 Lives Alone 86 Percent 84 Ages 85+ 82 80 78 Health Insurance in Addition to Medicare
Prescription Medication Use and Availability Allegheny County Aged 65 & over 98 White male White 96 female 94 Black 92 male 90 Black Black Percent female female 88 White female 86 White Black male male 84 82 80 78 Takes Prescription Medications No Difficulty Getting Prescription Medications
Medical Care, Access and Physician Visits, Allegheny County 98 96.1% 96 95.1% 94.2% 94 93.4% 92 Percent 90 89.6% 88 86 84 Has Seen Any MD in Has Personal MD Routine Checkup in No Difficulty Getting Satisfied with last year Last Year Medical Care Medical Care
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