This proposal seeks to understand the relationship between disease occurrence, and psychosocial socioeconomic, nutritional and other risk factors on the development of functional impairment: disability, health care use, and mortality in a unique cohort of rural elderly Hispanic and non-Hispanic white (NHW) subjects in southern Colorado. We propose to expand a previously identified representative cohort of elderly Hispanic and NHW persons who live in two rural counties, and to determine the prevalence and subsequent incidence of physical and mental disability and those disease and psychosocial characteristics that may predict them. We will test several descriptive hypotheses: 1) -older Hispanics will have a greater prevalence of all measures of functional limitation and cognitive impairment than NHWs; 2) poorer overall nutrition will lead to greater disability; 3) health care utilization will be lower among Hispanics than NHWs at each age; 4) the incidence of functional limitation, disability, and institutionalization will be higher among Hispanics than NHWs. We will also test several analytic hypotheses that examine the role of specific mediating factors such as acculturation, social networks and social support, and nutrition. These data will help alleviate the paucity of descriptive and analytic information on elderly Hispanics in the southwestern U.S. This regional Hispanic population is heterogeneous, and there are virtually no data on those Hispanics who self-identify as """"""""other Hispanic"""""""", rather than the more urban and border-related 'Mexican-American"""""""" subgroup. This proposal will provide data for health policy and services planning, and improve the understanding of disease and disability relationships in the rural Hispanic elderly.
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