Self-Perceptions of Aging and Perceived Barriers to Care: Reasons for Health Care Delay

Background and Objectives: Self-perceptions of aging (SPA), or attitudes toward one's aging experience, have been linked to health through multiple pathways. Few studies, however, have investigated how older adults' views on aging influence their care-seeking behaviors. Research Design and Methods: Using two independent subsamples from the Health and Retirement Study (2011 Health Care Mail Survey: N = 2,866; 2013 Health Care and Nutrition Study: N = 2,474), logistic regression and negative binomial regression were used to examine the association between SPA and health care delay over the next 12 months. Subsequently, we used latent class analysis to identify subgroups reporting different reasons for delay. With multinomial logistic regression, we then examined if, compared with the no delay group, SPA differentiated membership in the delay subgroups. Results: In both samples, more negative aging self-perceptions were associated with a higher likelihood of health care delay and more perceived barriers to care, after adjusting for predisposing, enabling, and need factors. Latent class analysis revealed three subgroups characterized by different reasons for delay: (a) limited health care access, (b) too busy to go to the doctor, and (c) dislike of going to the doctor. In fully adjusted models, individuals with more negative SPA were more likely to belong to "limited-access" and "dislike" subgroups compared with the no delay group. Discussion and Implications: SPA may affect decision-making processes regarding whether to seek care for worrisome symptoms. Efforts to promote more positive SPA may encourage older adults to be more proactive in addressing their health care needs.