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Are Frail Older People from Racial/Ethnic Minorities at Double Jeopardy of Putting off Healthcare during the Pandemic?

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  • Dongjuan Xu

    (School of Nursing, Purdue University, West Lafayette, IN 47907, USA)

  • Greg Arling

    (School of Nursing, Purdue University, West Lafayette, IN 47907, USA)

Abstract

Given the differential impacts of COVID-19 on racial and ethnic groups, it is unclear how racial/ethnic status and frailty combine to influence pandemic-related healthcare disruptions. This study aimed to test the double jeopardy hypothesis: racial/ethnic minority older adults suffer a double disadvantage in access to health care during the pandemic due to the interactive effects of frailty and race. This study uses the linked National Health and Aging Trends Study (NHATS) and COVID-19 public use data files. A multivariate logistic regression model was performed. Overall, approximately two out of five (41%) older adults reported postponing care due to the pandemic. The likelihood of putting off care increased slightly by frailty status. We found no significant difference between Whites and non-Whites in putting off care. However, the simple comparison masked significant variation across frailty status. Robust non-White older people were less likely to put off care than robust Whites (robust non-Whites: 29% vs. robust Whites: 39%); in contrast, frail non-White older people were more likely to put off care (frail non-Whites: 55% vs. frail Whites: 42%). Being frail and non-White creates double jeopardy, which has a negative impact on access to healthcare. Timely access to care is essential for frail older people, particularly non-Whites, because of their complex health conditions accentuated by health and social disparities.

Suggested Citation

  • Dongjuan Xu & Greg Arling, 2023. "Are Frail Older People from Racial/Ethnic Minorities at Double Jeopardy of Putting off Healthcare during the Pandemic?," IJERPH, MDPI, vol. 20(2), pages 1-12, January.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:2:p:1034-:d:1027012
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    1. Catherine Garcia & Marc A. Garcia & Jennifer Ailshire, 2018. "Sociocultural variability in the Latino population: Age patterns and differences in morbidity among older US adults," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 38(52), pages 1605-1618.
    2. Fitzpatrick, A.L. & Powe, N.R. & Cooper, L.S. & Ives, D.G. & Robbins, J.A. & Enright, E., 2004. "Barriers to health care access among the elderly and who perceives them," American Journal of Public Health, American Public Health Association, vol. 94(10), pages 1788-1794.
    3. Marc A Garcia & Patricia A Homan & Catherine García & Tyson H Brown & Deborah S Carr, 2021. "The Color of COVID-19: Structural Racism and the Disproportionate Impact of the Pandemic on Older Black and Latinx Adults [Racial disparities in mortality in the adult Hispanic population]," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 76(3), pages 75-80.
    4. Hall, W.J. & Chapman, M.V. & Lee, K.M. & Merino, Y.M. & Thomas, T.W. & Payne, B.K. & Eng, E. & Day, S.H. & Coyne-Beasley, T., 2015. "Implicit racial/ethnic bias among health care professionals and its influence on health care outcomes: A systematic review," American Journal of Public Health, American Public Health Association, vol. 105(12), pages 60-76.
    5. Y. J. Decady & D. R. Thomas, 2000. "A Simple Test of Association for Contingency Tables with Multiple Column Responses," Biometrics, The International Biometric Society, vol. 56(3), pages 893-896, September.
    6. Hopman, Petra & de Bruin, Simone R. & Forjaz, Maria João & Rodriguez-Blazquez, Carmen & Tonnara, Giuseppe & Lemmens, Lidwien C. & Onder, Graziano & Baan, Caroline A. & Rijken, Mieke, 2016. "Effectiveness of comprehensive care programs for patients with multiple chronic conditions or frailty: A systematic literature review," Health Policy, Elsevier, vol. 120(7), pages 818-832.
    7. Kirstin Grosse Frie & Terje Eikemo & Olaf von dem Knesebeck, 2010. "Education and self-reported health care seeking behaviour in European welfare regimes: results from the European Social Survey," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 55(3), pages 217-220, June.
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