Comparative analysis of dementia and ethnicity in the New South Wales Aged Care Assessment Program: 1996 and 2001

Abstract

Objective:To compare assessment and dementia rates for different client countries of birth in the New South Wales Aged Care Assessment Program (NSW ACAP). Methods: The NSW ACAP Minimum Data Set and Australian Bureau of Statistics census data were used to calculate age-standardised assessment and dementia rates for different client groups based on country of birth. Characteristics of people with dementia were examined to explore reasons for variation by ethnicity. Results: ACAP assessment and dementia rates for people from several overseas-born groups in this study were significantly lower than those for Australian-born clients (P < 0.05). Statistical differences were maintained for 1996 and 2001. Characteristics of those with dementia and born overseas were significantly different from Australian-born clients. Conclusions: Australian-born ACAP clients have higher assessment and dementia rates than many overseas-born groups. Further examination of reasons for these differences is required to ensure equity of access to services for all aged people.

Do Depression and Educational Attainment Mediate the Association between Ethnicity and Dementia?

“…It was hypothesized that depression and education explain ethnic disparities in the prevalence of dementia. As expected, in line with previous studies showing statistically significant ethnic differences in prevalence of dementia [8,12,13,19], the findings from our study showed a significant association between ethnicity and dementia, wherein elderly Malays reported higher prevalence rate of dementia (15%) compared to elderly Chinese (6%). The main aim of the current study is to test potential mediating effects of depression and education on the association between ethnicity and dementia…”

“…In other words, ethnicity is significantly associated with dementia [8,9,10,11]. For instance, the findings from a study in Australia revealed that the prevalence of dementia among people from several overseas-born groups was significantly lower than those for Australian-born clients [12]. Similarly, a few studies in the United States have shown that African-Americans and Hispanics have higher prevalence rates of dementia than non-Hispanic whites [8].…”

Ethnic aged discrimination and disparities in health and social care: A question of social justice

“…In Australia, public policies, programs and practices integral to the delivery of health and social care are at least implicated in, if not the cause of ethnic aged disparities in health and social care, and accordingly demand our moral attention and action (see [3,13]). The 'moral drivers' in this instance can be found on at least three fronts.…”

“…Despite the ethnic aged in Australia being identified as a 'special needs' group, and despite over 30 years of multicultural policies and programs, emerging research is showing that older Australians of non-Englishspeaking backgrounds are generally underserved by local health and social care services, experience unequal burdens of disease and encounter cultural and language barriers to accessing appropriate health care as they get older compared to the average Australian-born proficient English-speaking population [1][2][3][4][5][6][7][8].…”

“…Nonetheless, researchers have tended to emphasise as causal explanations: cultural and language barriers, a lack of consumer health literacy and knowledge about health and social support services, the impact of geographical location and circumstances of migration on migrants financial circumstances, service provider cultural insensitivity and lack of cultural competency, a lack of agreed standards guiding the delivery of culturally and linguistically appropriate services and a lack of understanding among community and government stakeholders of the importance of evidence-based policy and practice [1][2][3][4]9].…”