Emergency Department Utilization among Underserved African American Older Adults in South Los Angeles

Bazargan, Mohsen; Smith, James; Cobb, Sharon; Barkley, Lisa; Wisseh, Cheryl; Ngula, Emma; Thomas, Ricky J.; Assari, Shervin

doi:10.3390/ijerph16071175

Cited by 14 publications

(20 citation statements)

References 73 publications

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“…This community-based cross-sectional study surveyed a convenience sample (n = 740) of older African Americans residing in South Los Angeles [3,4,6,[28][29][30][31]. Also referred to as "South Los Angeles" Service Planning Area 6 of Los Angeles County, which serves the communities of Athens, Compton, Crenshaw, Florence, Hyde Park, Lynwood, Paramount, and Watts.…”

Section: Methodsmentioning

confidence: 99%

“…This subset of older adults is faced with numerous health disparities, including lower rates of preventative health services and a greater delay in care. Individuals enrolled in any type of nursing facility, enrolled in any other research study, and who have observable intellectual impairments, were excluded from this study [3,4,6,[28][29][30][31].…”

Section: Methodsmentioning

confidence: 99%

“…Potential participants were recruited through various methods, including flyers in community areas and healthcare clinics. In addition, potential participants were referred by healthcare providers and already-enrolled participants [3,4,6,[28][29][30][31].…”

Section: Methodsmentioning

confidence: 99%

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Smoking Status and Well-Being of Underserved African American Older Adults

Bazargan

Cobb

Sandoval

et al. 2020

Behavioral Sciences

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Purpose: This study investigated the association between current and past cigarette smoking, with four domains of well-being, namely, physical quality of life, mental quality of life, depressive symptoms, and self-rated health status (SRH), among older African American adults who lived in economically impoverished areas of South Los Angles. Methods: This community-based cross-sectional study included a convenience sample of economically-disadvantaged African Americans adults (n = 740) who were 55 years old and older residing in South Los Angeles. We conducted in-depth face-to-face interviews to collect data on the socioeconomic status (level of education and fiscal pressures), demographic factors (age and gender), physical health (number of chronic medical conditions), smoking (never smokers (reference group), past smokers, and current smokers), and well-being (quality of life, depressive symptoms, and self-rated health). Linear regressions were used to analyze the data. Results: Over 21% reported that they are current smokers, compared with 31% who identified as former smokers. Almost 40% perceived the quality of their health status to be fair or poor. Compared with non-smokers, current cigarette smokers reported a worse physical quality of life, depressive symptoms, and self-rated health. Current smokers also reported a marginally worse mental quality of life.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Smoking Status and Well-Being of Underserved African American Older Adults

Bazargan

Cobb

Sandoval

et al. 2020

Behavioral Sciences

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“…Given the nature of the data collection, we defined our medication data collection as comprehensive. Data were gathered between 2015 and 2018 [10,[38][39][40][41][42][43].…”

Section: Comprehensive Evaluation Of Medicationsmentioning

confidence: 99%

Polypharmacy Is Associated with Lower Memory Function in African American Older Adults

et al. 2020

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Although previous research has linked polypharmacy to lower cognitive function in the general population, we know little about this association among economically challenged African American (AA) older adults. This study explored the link between polypharmacy and memory function among AA older adults. This community-based study recruited 399 AA older adults who were 65+ years old and living in economically disadvantaged areas of South Los Angeles. Polypharmacy (taking 5+ medications) was the independent variable, memory function was the outcome variable (continuous variable), and gender, age, living arrangement, socioeconomic status (educational attainment and financial strain), health behaviors (current smoking and any binge drinking), and multimorbidity (number of chronic diseases) were the covariates. Linear regression was used for data analyses. Polypharmacy was associated with lower scores on memory function, above and beyond covariates. Among AA older adults, polypharmacy may be linked to worse cognitive function. Future research should test the mechanisms by which polypharmacy is associated with lower levels of cognitive decline. There is a need for screening for memory problems in AA older adults who are exposed to polypharmacy.

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“…Andersen's health care services utilization framework [25][26][27] is a useful and widely used framework for investigating health care service utilization by middle-aged and older adults [28][29][30].…”

Section: Theoretical Frameworkmentioning

confidence: 99%

Eye Examination Recency among African American Older Adults with Chronic Medical Conditions

et al. 2020

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Background: Pervasive racial and economic inequalities have a disproportionate impact on health care utilization among African Americans. One area where we see such disparities is in the recency of eye examinations among the economically disadvantaged. However, our current understanding of the barriers and facilitators of eye examinations in underserved African-American older adults is limited. Aims: Building on Andersen’s model of health service use and using an exploratory approach; we tested various demographic, social, and health factors that were associated with eye examination among underserved middle-aged and older adults in South Los Angeles. We examined predisposing characteristics, enabling factors, and need-for-care characteristics. Methods: With a cross-sectional design, we conducted this survey on a convenience sample of (n = 740) non-institutionalized African-American older adults who were 55+ years old and residing in South Los Angeles, CA, USA. Data were collected on demographic factors, continuity of care, access to care, self-rated health, chronic medical conditions, and depressive symptoms. The outcome was recency of eye examination. Multivariate regression was used for data analysis. Results: 59% of the participants had received at least one eye examination during the last 12 months. A total of 17% had an eye examination within the last two years. Notably, 26% of diabetic participants did not have an eye examination within the last two years. One out of four participants indicated that, within the last two years, no provider ever recommended that they receive an eye examination. Age, education, continuity of medical care, accessibility of medical care, satisfaction with medical care, providers’ recommendation for eye examination, self-rated health, and a diagnosis of hypertension and diabetes mellitus were predictors of eye examination recency. Overall, our analysis indicates that these enabling factors accounted for most of the variance in the recency of eye examinations. Conclusion: A large proportion of underserved African-American middle-aged and older adults in South Los Angeles do not comply with the recommended annual eye examination. This is, in part, because about one-third of them have not received an eye exam recommendation from their health care providers. However, a wide range of factors such as age, education, continuity of care, satisfaction with access, self-rated health, and a diagnosis of hypertension and diabetes mellitus, also influence whether or not African-American middle-aged and older adults receive an eye examination. Programs should address a wide range of multi-level factors to tackle this health inequality.

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Emergency Department Utilization among Underserved African American Older Adults in South Los Angeles

Cited by 14 publications

References 73 publications

Smoking Status and Well-Being of Underserved African American Older Adults

Smoking Status and Well-Being of Underserved African American Older Adults

Polypharmacy Is Associated with Lower Memory Function in African American Older Adults

Eye Examination Recency among African American Older Adults with Chronic Medical Conditions

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