Racial-Ethnic Differences in Care Networks of Older Adults: Empirical Exploration of Possible Explanations.

Abstract

Objectives: Previous research on eldercare among minority populations often highlights the role of values, beliefs, and social expectations, placing greater emphasis on ideational factors than on sociostructural and health factors in explaining racial-ethnic differences in care arrangements. This study aims to describe the extent to which care received by older adults varies by race-ethnicity and to explore possible explanations for these variations using the behavioral model of health care use.

Methods: Data were sourced from the 2018 National Health and Aging Trends Study (NHATS), a nationally representative survey of Medicare beneficiaries aged 68 and older. Latent class analyses were used to develop a care network typology with combinations of care from different sources. Multinomial regression models assessed various predisposing, enabling, and need factors associated with racial-ethnic differences in the distribution of constructed care network types. Formal mediation analysis tested potential mediators of these differences.

Results: Black and Hispanic older adults tended to receive care from children and extended kin caregivers, while White older adults were more likely to receive care from their spouses and perform self-care with assistive technologies. Mediation analyses revealed that racial-ethnic differences in care networks were primarily attributable to enabling factors, including family configurations, social networks, and socioeconomic status. Limited evidence was found for the roles of predisposing factors, measured by care preferences, and need factors, measured by health conditions, in explaining these differences.

Discussion: The findings highlight the need for more research and policy interventions to address the diverse challenges faced by socially disadvantaged older adults.