The Relationship Between Living Arrangement and Preventive Care Use Among Community-Dwelling Elderly Persons

Objectives. We sought to examine the relationship between living arrangements and obtaining preventive care among the elderly population. Methods. We obtained data on 13038 community-dwelling elderly persons from the 2002 to 2005 Medical Expenditure Panel Survey and used multivariate logistic regression models to estimate the likelihood of preventive care use among elderly persons in 4 living arrangements: living alone (38%), living with one's spouse only (52%), living with one's spouse and with one's adult off spring (5%), and living with one's adult offspring only (5%). Preventive care services included influenza vaccination, physical and dental checkup, and screenings for hypertension, cholesterol, and colorectal cancer. Results. After we controlled for age, gender, race, education, income, health insurance, comorbidities, self-reported health, physical function status, and residence location, we found that elderly persons living with a spouse only were more likely than were those living alone to obtain all preventive care services, except for hypertension screening. However, those living with their adult offspring were not more likely to obtain recommended preventive care compared with those living alone. These results did not change when the employment status and functional status of adult offspring were considered. Conclusions. Interventions to improve preventive care use should target not only those elderly persons who live alone but also those living with adult offspring. (Am J Public Health. 2009;99:1315-1321. doi:10.2105/AJPH.2008.151142)