The purpose of the proposed project is to conduct a comprehensive, comparative analysis of the use of health services by elderly Anglo, Black, Cuban, Puerto Rican, and Mexican Americans. The conceptual framework involves a modification of the behavioral model of health services utilization.
The specific aims are to address the following research questions: (1) are the determinants of health services utilization the same or different (including the magnitude of their effects) for the five ethnic groups (i.e., Anglo, Black, Cuban, Puerto Rican, and Mexican Americans); (2) do the determinants of health services utilization differentially vary among 5 age groups (i.e., 45-54, 55-64, 65-74, 75-84, 85+) within each of the five ethnic groups; (3) does the effect of ethnicity depend on the degree of institutional completeness of the ethnic group in the health care institutions in the community; and, (4) are there universal chronological age markers for categorizing the health services utilization of the elderly, or do these markers need to be ethnicity-specific? The major source of data will be the 1976 through 1984 Health Interview Surveys. Pooling these surveys provides data on approximately 111,500 individuals aged 45 years or more and living in the 31 largest self-representing SMSA's, including about 95,000 Anglo, 12,000 Black, 1,500 Cuban, 1,100 Puerto Rican, and 1,900 Mexican Americans. Supplementary contextual information on the characteristics of the health care available, the communities, and their ethnic diversity will be merged from existing archives, including the 1980 Area Resources File, and the 1980 Census of the United States. Multiple regression and related analytic techniques will be used.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Research Project (R01)
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Study Section
Human Development and Aging Subcommittee 1 (HUD)
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Texas A&M University
Schools of Arts and Sciences
College Station
United States
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Keith, V M; Jones, W (1990) Determinants of health services utilization among the black and white elderly. J Health Soc Policy 1:73-88
Wolinsky, F D; Johnson, R J (1990) Insights, clarification, and missing the mark: a response to Mechanic, Mortimer, and Hafferty. J Health Soc Behav 31:307-12
Wolinsky, F D; Coe, R M; McIntosh, W A et al. (1990) Progress in the development of a nutritional risk index. J Nutr 120 Suppl 11:1549-53
Wolinsky, F D; Arnold, C L (1989) A birth cohort analysis of dental contact among elderly Americans. Am J Public Health 79:47-51
Wolinsky, F D; Aguirre, B E; Fann, L J et al. (1989) Ethnic differences in the demand for physician and hospital utilization among older adults in major American cities: conspicuous evidence of considerable inequalities. Milbank Q 67:412-49
Aguirre, B E; Wolinsky, F D; Niederauer, J et al. (1989) Occupational prestige in the health care delivery system. J Health Soc Behav 30:315-29
Wolinsky, F D; Arnold, C L; Nallapati, I V (1988) Explaining the declining rate of physician utilization among the oldest-old. Med Care 26:544-53
Wolinsky, F D (1988) The professional dominance perspective, revisited. Milbank Q 66 Suppl 2:33-47
Wolinsky, F D; Arnold, C L (1988) A different perspective on health and health services utilization. Annu Rev Gerontol Geriatr 8:71-101
Wolinsky, F D; Coe, R M; Mosely 2nd, R R et al. (1987) Some clarification about health planning in the VA. Med Care 25:1105-10