application): This research will utilize sociological theories of family and intergenerational exchange behaviors to examine the variation among racial/ethnic elderly groups in use of community-based long-term care services. The effects of family structure and intergenerational exchange behavioral patterns across racial groups on use of care had not been empirically examined until very recently. However, the findings are not consistent. Furthermore, a hierarchy of service preferences (e.g., kin care followed by non-kin care and finally formal care) has never been statistically tested due to methodological limitations. This study will: (1) expand the Andersen behavioral model which incorporates information on family/kinship structure and intergenerational transfer patterns to examine the impacts of race/ethnicity on the hierarchy of service preference; (2) apply a new analytical model with random effect and non-proportional odds for explanatory variables to examine the research questions. The Assets and Health Dynamics Among the Oldest Old (AHEAD) longitudinal surveys will be used and an outcome variable will be constructed with seven categories according to the hierarchy of long-term care service preference. The specific research questions are: (1) Are long-term care utilization patterns different for minority elderly groups compare to those of Caucasians? Is the pattern of change the same for minority groups as for Caucasians? (2) Are kinship structures and intergenerational transfer patterns different across racial/ethnic groups? Do these differences, if any, have the same or different impact on the transitional utilization patterns across the six types of long-term care services? (3) How much of the variation in service utilization can be explained by kinship structure and intergenerational exchange behaviors among the racial/ethnic elderly groups while controlling for socio-economic factors and brain health? (4) What changes occurred over time? The findings will contribute needed information regarding the extent to which minorities have access blocked to formal long-term care services. Furthermore, the results will contribute knowledge and insight into public policy-making, regarding the longstanding public debate about whether the family or the society should take major responsibility for provision of care to the elderly.
