Jacqueline L. Angel

Age at migration, social connections, and well-being among elderly Hispanics.

This study employs data from the 1988 National Survey of Hispanic Elderly People to examine the impact of age at migration and social contacts on the self-assessed health, functional disability, and life satisfaction of elderly Cuban Americans, Mexican Americans, and Puerto Ricans in the United States. The results indicate that the difficulties associated with immigration late in life undermine an older persons morale and interfere with the ability to perform basic activities of daily living. Although children are important sources of social support for all Hispanic groups, our findings also reveal important group differences in the use of other community social resources and their impact on health. Older Cuban Americans, in particular, appear to benefit from residence in ethnic enclaves in which they have largely duplicated their culture of origin.

Financial strain and health among elderly Mexican-origin individuals.

In this paper we examine the associations among perceived financial strain and various health measures--including self-rated health, self-reported functional capacity, performance-based mobility, and mortality--in a sample of older Mexican-origin individuals. We employ the Hispanic Established Population for Epidemiological Studies of the Elderly, an eight-year longitudinal survey of over 3,000 Mexican-origin individuals in five southwestern states who were initially interviewed in 1993 and 1994. Although financial strain is associated with actual income and poverty, it is also associated with cognitive capacity, depression, and self-esteem, and while it is strongly associated with subjective measures, it has a weaker association with more objective measures, such as performance-based mobility and mortality. Financial strain appears to be part of a package of cognitions and emotions indicative of low morale or demoralization that has adverse effects on subjective health.

The demography of minority aging populations.

ABSTRACT: Studies of aging and the life course have often documented great diversity in family structure and living arrangements among the elderly. This article examines historical and demographic trends in the ethnic and racial composition of older cohorts in the United States and their impact on family structure; identifies the demographic causes of these changes and projects future trends in the relative size and proportion of different racial and ethnic populations; and discusses the important policy implications of such compositional shifts for social policy and for the welfare of the minority elderly in the next century.

Stability and Change in Health Insurance Among Older Mexican Americans: Longitudinal Evidence From the Hispanic Established Populations for Epidemiologic Study of the Elderly

OBJECTIVES This study examined the association between health insurance coverage, medical care use, limitations in activities of daily living, and mortality among older Mexican-origin individuals. METHODS We analyzed longitudinal data from the Hispanic Established Populations for Epidemiologic Study of the Elderly (H-EPESE). RESULTS The uninsured tend to be younger, female, poor, and foreign born. They report fewer health care visits, are less likely to have a usual source of care, and more often receive care in Mexico. Conversely, those with private health insurance are economically better off and use more health care services. Over time, the data reveal substantial changes in type of insurance coverage. CONCLUSIONS The data reveal serious vulnerabilities among older Mexican Americans that result from a lack of private Medigap supplemental coverage.

Minority Group Status and Healthful Aging: Social Structure Still Matters

During the last 4 decades, a rapid increase has occurred in the number of survey-based and epidemiological studies of the health profiles of adults in general and of the causes of disparities between majority and minority Americans in particular. According to these studies, healthful aging consists of the absence of disease, or at least of the most serious preventable diseases and their consequences, and findings consistently reveal serious African American and Hispanic disadvantages in terms of healthful aging. We (1) briefly review conceptual and operational definitions of race and Hispanic ethnicity, (2) summarize how ethnicity-based differentials in health are related to social structures, and (3) emphasize the importance of attention to the economic, political, and institutional factors that perpetuate poverty and undermine healthful aging among certain groups.

Minority Group Status, Health Transitions, and Community Living Arrangements among the Elderly

This study examines patterns of change in functional capacity among Black and non-Latino White older persons over a 4-year period using the 1988 Longitudinal Study of Aging. The results reveal that among all three groups, improvements in functional capacity often follow declines, but they also show that Blacks are more likely than non-Latino Whites to suffer protracted declines in functional capacity, ultimately resulting in more serious incapacity. The central objective of the article is the development of a conceptual model to identify those factors that account for racial and ethnic group differences in health and functional capacity as well as the documented greater propensity of Black and Latino elderly to rely on informal sources of support in the community rather than on formal long-term care.

Can the family still cope? Social support and health as determinants of nursing home use in the older Mexican-origin population.

Objectives: This article examines the impact of disability, cognitive status, and social support on nursing home use in a sample of older Mexican Americans. Method: We used four waves of the Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE), a longitudinal study of 3,050 older Mexican Americans living in the Southwest initially contacted in 1993 to 1994. Results: The findings reveal that advanced age, being a man, activities of daily living disability, and cognitive impairment are strong predictors of institutionalization and death. Living with family, arriving in the United States in late life, and access to social support independently decreased the probability of dying in a nursing home. Discussion: Although it is clear that adequate social support can make it possible for an impaired older person to remain in the community serious impairment can eventually overwhelm even a supportive network and result in the institutionalization of an impaired older person.

Shorter Stay, Longer Life: Age at Migration and Mortality Among the Older Mexican-Origin Population

Objectives: In this article, we investigate the association between age at migration and mortality during a 13-year period in a sample of Mexican American immigrants 65 and older at baseline. Method: We employ the Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-PESE) to control for mortality-related health and social factors. Results: Our analyses show that the immigrant generation does not represent a homogeneous mortality risk category. Individuals who migrated to the United States in mature adulthood have a considerably lower risk of death than individuals who migrated in childhood or midlife. Chronic conditions or functional capacity do not account for these differences. Conclusion: Our findings suggest that standard risk pools may differ significantly on the basis of genetic and unmeasured life-course factors. A better understanding of the late-life immigrant mortality advantage has important implications for more effective and targeted social and medical interventions.

Nativity and self-assessed health among pre-retirement age hispanics and non-hispanic whites

Economic, social and familial resources are known to influence subjective health assessments. We examine the salience of nativity in determining how these resources influence self-assessed health using a large, nationwide sample of Hispanic and non-Hispanic white adults. The results indicate that while education, accumulated assets and marital status benefit the physical and emotional health of the native and foreign-born, family resources and income are significant only for the native-born. English language proficiency is a significant protective factor for both groups and is especially protective for immigrants. These surprising findings call into question previous studies stressing the positive role of the family in maintaining immigrant health.

A Comparison of the Health of Older Hispanics in the United States and Mexico Methodological Challenges

Objectives: This study compares various dimensions of physical and emotional health between older Mexican-origin individuals in the United States and in Mexico. Method: The samples are drawn from the Mexican Health and Aging Study (MHAS) and the Hispanic Established Epidemiologic Study of the Elderly (H-EPESE) and include 3,875 Mexican residents with no history of residence in the United States and 2,734 Mexican-origin individuals 65 and older who live in the southwestern United States. Results: Both immigrant and native-born Mexican-origin elders in the United States report more chronic conditions than elderly Mexicans, but they report fewer symptoms of psychological distress. Longer residence in the United States is associated with higher body mass index scores. Discussion: The discussion addresses the possibility that access to care influences reports of diagnosed conditions and touches on issues of comparability in cross-cultural research and the difficulty in clearly distinguishing cultural and system-level factors in the production and measurement of health.