julian chow 1 , erica auh 1 , nancy giunta 1 , and andrew scharlach 1

Exploring Family Caregiver Services: Variations in Utilization Patterns and

Barriers to Access among Diverse Ethnic Groups

Julian Chow1, Erica Auh1, Nancy Giunta1, and Andrew Scharlach1

1 Center for the Advanced Study of Aging Services - University of California, Berkeley

Annual Meeting of the

Society for Social Work and Research

Miami, FL, January 14, 2005

Center for the Advanced Study of Aging Services

Mission: Improving services for the elderly through

research, collaboration and education

Current projects include: Strategic Plan for an Aging CA (SB910) Family Caregiver Support Program LTC Insurance and Quality Assurance LTC Integration and Case Management Consortium for Social Work Training in Aging

Overview

Literature Review

Research Questions

Method

Results

Discussion & Implication

Literature Review

Lower level of formal service use among minority CGs compared with White CGs (yet, inconclusive)

Disparities in types of formal service use between minority and White CGs

Comparison between White and non-White CGs in most studies

Research Questions

Do racial/ethnic CGs use services differently from White?

Do racial/ethnic groups rely on different sources of service?

Do they use different types of services? How do they see barriers to service use?

Method

Random Digit Dialing

Respondent caring for someone over age 50

Surveys conducted in English and Spanish

Interview lasted approx. 30 minutes

N = 1,643

Demographic

ANHPI Hispanic African American White

Female 73% 76% 80% 74%

Gender (n=1,559)

Age** (n=1, 529)

Under 35 18% 27% 19% 8%

35 - 49 46% 41% 34% 28%

50 - 64 34% 24% 39% 40%

65 + 3% 8% 21% 25%

* p<0.05; ** p<0.01

Demographics (cont’d)Marital Status** (n=1,435)

ANHPI Hispanic African American White

Married 65% 58% 33% 64%

Living w/ partner 0% 4% 2% 2%

Separated 0% 3% 7% 2%

Divorced 6% 12% 22% 12%

Widowed 1% 3% 8% 9%

Never Married 28% 22% 28% 12%

Children < 18 Living in Household** (n=1,555)

Yes 41% 47% 36% 24%

Demographics (cont’d)Education** (n=1,552)

ANHPI Hispanic African American White

< High school 0% 15% 1% 2%

Some high school 3% 10% 9% 4%

High school graduate 16% 23% 23% 20%

Post high school education 19% 29% 40% 36%

College graduate 43% 18% 21% 25%

Post graduate degree 19% 5% 6% 14%

2001 Household Income** (n=1,359)< $30,000 32% 53% 52% 35%

$30,000 + 68% 47% 48% 65%

Demographics (cont’d)Country of Origin** (n=1,323)

ANHPI Hispanic African American White

USA 34% 67% 96% 96%

Canada 0% 0% 0% 1%

Mexico 0% 25% 0% 0%

Europe 0% 0% 0% 2%

South America 0% 2% 0% 0%

Middle East 0% 0% 1% 0%

Asia/Pacific Island 49% 0% 0% 0%

Indian Subcontinent 14% 0% 0% 0%

Central America 0% 6% 2% 0%

Other 3% 0% 0% 0%

Total Number of Service Use

ANHPI Hispanic African American

White Total

Used no service 21% 20% 13% 17% 18%

Used at least one service 79% 80% 87% 83% 82%

Mean number of total service use**

2.0933 2.0927 2.8969 2.5137 2.4096

Range (min:max) 8(0:8) 9(0:9) 8(0:8) 10(0:10) 10(0:10)

* p<0.05; ** p<0.01

Result of Post Hoc Test (Tukey HSD)

ANHPI Hispanic

African American White

ANHPI -0.8036*

Hispanic -0.8042** -0.4209**

African American

* p<0.05; ** p<0.01

Formal & Informal Service Use

ANHPI Hispanic

African American White Total

Used at least one FORMAL service** 57% 65% 77% 72% 70%

Used at least one INFORMAL service* 66% 59% 58% 52% 55%

* p<0.05; ** p<0.01

Ratio of Formal and Informal within One’s Service Use**

ANHPI Hispanic

African American White Total

FORMAL only 26% 36% 34% 45% 41%

INFORMAL only 34% 22% 14% 15% 18%

Both 40% 42% 51% 40% 41%

* p<0.05; ** p<0.01

Service Use by Type

ANHPI Hispanic

African American White Total

Information** 28% 19% 34% 29% 27%

Access 17% 10% 6% 11% 11%

Education* 20% 28% 42% 28% 29%

Counseling 11% 11% 12% 14% 13%

Counseling from clergy 4% 18% 21% 18% 17%

Support group** 19% 20% 18% 23% 22%

* p<0.05; ** p<0.01

Service Use by Type (cont’d)

ANHPI Hispanic

African American White Total

In-home respite* 42% 39% 41% 32% 35%

Day respite 7% 7% 16% 11% 10%

Night respite* 10% 9% 15% 12% 11%

Legal information** 15% 16% 29% 27% 23%

Financial information* 23% 13% 20% 20% 18%

* p<0.05; ** p<0.01

Service Use by Source

ANHPI Hispanic

African American White Total

In-home respite**

formal

informal

30%

70%

19%

81%

18%

82%

37%

63%

30%

70%

Night respite**

formal

informal

0%

100%

31%

69%

43%

57%

54%

46%

47%

53%

* p<0.05; ** p<0.01

Barriers to Service Use

ANHPI Hispanic

African American White Total

Already have all the help needed**

69% 63% 63% 75% 70%

Help not wanted by CR 44% 42% 37% 41% 41%

Service not available** 26% 42% 34% 28% 33%

Poor quality** 17% 37% 40% 21% 27%

Language** 35% 25% 11% 9% 15%

No one to stay with CR while CG gets help*

17% 30% 23% 25% 26%

* p<0.05; ** p<0.01

Barriers to Service Use (cont’d)

* p<0.05; ** p<0.01

ANHPI Hispanic

African American White Total

No time to get help 39% 23% 17% 25% 25%

Not available the times they need**

22% 38% 34% 20% 26%

Transportation not available**

30% 24% 14% 23% 23%

High cost** 30% 53% 49% 46% 47%

Service not offered by people like them*

17% 24% 29% 19% 21%

Discussion

Ethnic differences in total number of service use

Differences in sources

Some groups are more likely to rely on one source

Discussion (cont’d)

Different ethnic groups use different types of services

In-home respite, education, and information are most widely used across group

But sources of help seem to matter

Ethnic groups identify different barriers

Implication

Provide culturally specific services

Outreach to minority, especially immigrant, communities

Provide resources for the informal support network

Thank You!

Center for the Advanced Study of Aging Services

University of California, Berkeley

http://cssr.berkeley.edu/aging