OLDER LATINO IMMIGRANTS,
THEIR HEALTH STATUS AND
HEALTH CARE
Gwen Yeo, PhD
Stanford Geriatric Education Center
Partially supported by a grant from the Bureau of Health Professions,
Health Resources and Services Administration for
Geriatric Education Centers
The Ethnogeriatric Imperative
Projections of Percent of Ethnic Elders in U.S.
18
16
14
12
African Am.
Asian/PI
Hispanic
AI/AN
10
8
6
4
2
0
2000
2030
2050
Latino Elders
in US, 2000
Latino/Hispanic 1,733,591
Mexican
809,842
Cuban
228,677
Puerto Rican
191,295
Dominican
6,648
Central American 54,151
South American 76,791
Please review the handout on
demographic characteristics of older
Latinos in the U.S.
What patterns do you see? Which
populations are most disadvantaged?
Cohort Analysis
Working with elders, it is important to know
what historical experiences are likely to have
affected their lives.
Examples?
Cuban American elders’ escape from Castro
Mexican American elders: cycles of anti-immigrant
discrimination and deportation
Puerto Rican elders migration back and forth to PR
Please review the chart on
disparities of health conditions.
What patterns do you see?
Mortality Crossovers
and Comparisons
1.6
1.4
1.2
NH White
NH Black
API
Latino
AI/AN
1
0.8
0.6
0.4
0.2
0
Age 65
Age 75
Age 85
Adapted from Hummer et al., 2004
Diabetes in Older Women of Color
35
30
25
Percent
20
15
10
5
0
African Am.
Am.Indian
Mexican Am.
Source: NIH, Women of Color Health Data Book, 1998
NH White
Prevalence of Dementia
North Manhattan Study (N=1449)
Gurland et al., Nat. Research Council, 1997
Effects of Education on
Prevalence of Dementia
Multivariate regression analysis included age,
education, income, gender, and ethno-racial
membership
 Increased age (OR=6.1) and lower education
(OR=4.3) have strongest association with risk
of dementia
 “With age and education controlled, ethnoracial membership loses its association with
rates of dementia.”

Gurland et al., National Research Council, 1997
Reasons for Effect of Education
on Dementia: Hypotheses?
Gurland et al. Hypotheses
 Reduced cognitive ability in early life
 Correlates of low education: e.g.,
malnutrition, poor health care, substance
abuse
 Education builds robust brain structures that
can compensate for deterioration
Other? Less effective assessment techniques
for low literacy, low education elders
SALSA Study
Sacramento Area Latino Study on Aging





N= 1778 aged 60+
45% born in Mexico, 49% in US
Mean years of education: 4.7 for Spanish
speakers, 10.7 for English
Overall dementia prevalence: 4.8%
Risk 8x higher for those with diabetes and
stroke
Haan et al., 2003
Dementia Prevalence 85+
Other Important Findings:





SALSA Study:
Higher risk of dementia with diabetes and/or stroke
Higher risk of dementia with lower folate levels
Higher risk of dementia with abdominal fat;
Lower risk with overall obesity
More sleep problems, wandering, hallucinations, &
combativeness
Earlier age at onset of dementia
Some evidence of longer survival
Dementia frequently seen as normal aging; sometimes as
punishment from God or result of nervios
Latino Caregivers








More likely to be depressed
More depressed when care recipient exhibits
neuropsychiatric symptoms
Less likely to express burden
Frequent feelings of cultural obligation for family
caregiving
Less and later use of nursing homes
Organizational religiosity related to less burden;
non-organizational related to poorer mental health
Less help seeking even with larger social networks
Frequent primary caregiver with minimal help from
family members
Relationship of Caregiver
Percentage of Ethnic Patients
50
40
30
20
10
0
Spouse
White
Son
Daughter
Black
Other Rel.
Hispanic
Friend
Asian/PI
Yeo et al, 1996 Ethnicity & Dementias
End of Life Issues

Less use of hospice

More likely to believe death depends on
God’s timing

More likely to want to maintain the possibility
of a miracle, so prefer aggressive treatment
RESOURCES

Yeo & Gallagher-Thompson (Eds.)
Ethnicity and the Dementias, 2nd Ed.
New York: Routledge/Taylor & Francis. 2006


Stanford Geriatric Education Center 20092010 Webinar Series: Ethnicity and the
Dementias. Replays available on SGEC
website:http://sgec.stanford.edu
Email Gwen Yeo at <gwenyeo@stanford.edu >
Important Research Topics

Latino Elders


To what extent do older immigrants from
Mexico return to Mexico when they
become seriously ill?
Not all older Latinos have family
caregivers; what do they do when they
need assistance?