Long Term Care (LTC) use for aged Afro-Americans is less than for whites in contrast to hospital use. Differences in formal LTC service use including nursing homes are narrowing over time and are highly correlated with personal, health status and residential characteristics which differ by race among the aged. This project will describe and then analyze Long Term Care (LTC) service use over time by race. Descriptors will be health status indicators of physical, cognitive function and disease, personal, social, economic and residential characteristics and area characteristics such as medicare and community service use, and nursing home beds using the 1984-1990 Longitudinal Survey on Aging (LSOA) tapes embellished by additional hospital and LTC use and area resource data. We will first do a pooled time series cross sectional analysis of the relationships among those variables and hospital and formal long term care service use to determine the predictors of LTC use. Changes in impairment from chronic disease and associated residential transitions occur over time and effect the need for LTC. We will analyze transitions from the least to the most restrictive (nursing home) residential environments within two year periods using a separate pooled cross sectional sample based on matching two consecutive LSOA interviews. We will test the hypothesis that LTC use and residential transitions differences among racial groups are largely accounted for by health, personal, and area characteristics. The LSOA was first fielded in 1984 as the SOA and interviewed a national sample of those 55+ including 7,541 respondents who were 70+. Subsequent interviews were conducted in 1986, 1988 and 1990. Respondent Data were merged with their Medicare records and for those dying, National Death Index, to provide diagnostic, health care use, and cause, and site of death data. Proxy respondents were sought for those dead. The Analysis will concentrate on the subset of 5,151 respondents 70+ eligible for re-interview in 1986 who were potentially eligible for interview in all four periods. The 1986 subset retained half those 70+ and all the very old (80+), and minorities including 560 Afro-Americans.
