Community and Individual Race/Ethnicity and Home Health Care Use among Elderly Persons in the United States

Objective To investigate whether the interaction between individual race/ethnicity and community racial/ethnic composition is associated with health-related home care use among elderly persons in the United States. Data Sources A nationally representative sample of community-dwelling elders aged 65+ from the 2000 to 2006 Medical Expenditure Panel Survey (N=23,792) linked to block group-level racial/ethnic information from the 2000 Decennial Census. Design We estimated the likelihood of informal and formal home health care use for four racial/ethnic elderly groups (non-Hispanic [NH] whites, NH-blacks, NH-Asians, and Hispanics) living in communities with different racial/ethnic compositions. Principal Findings NH-Asian and Hispanic elders living in block groups with >= 25 percent of residents being NH-Asian or Hispanic, respectively, were more likely to use informal home health care than their counterparts in other block groups. No such effect was apparent for formal home health care. Conclusions NH-Asian and Hispanic elders are more likely to use informal home care if they live in communities with a higher proportion of residents who share their race/ethnicity. A better understanding of how informal care is provided in different communities may inform policy makers concerned with promoting informal home care, supporting informal caregivers, or providing formal home care as a substitute or supplement to informal care.