Unmet needs for formal home and community services among African American and White older adults: The Forsyth County Aging Study

Using the Andersen-Newman model of health services utilization,factors associated with unmet needs for formal home and community services were evaluated cross-sectionally in a sample of community-dwelling African American and White older adults. Unmet needs for services were associated with inadequate transportation, use of mobility aids (e.g., canes, walkers, wheelchairs), and activities of daily living (ADL) limitations among both African Americans and Whites. Older Whites with unmet needs also reported low instrumental support (ie., availability of daily help with bathing, dressing, etc.) and were less likely to have a daily caregiver The predictive ability of the Andersen-Newman model varied slightly by race. Although comparable in terms of specificity (i.e., identifying those without unmet needs), the model was more sensitive to older African Americans than Whites with unmet needs. Findings provide evidence and a rationale for a more extensive assessment of unmet needs for services than is provided by consideration of functional limitations alone.