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2010 ICAA Poster Winners

The 2010 international Conference on Aging in the Americas (ICAA) organized a poster session for the emerging scholar mentorship program. The poster session was designed to attract students and post-doctoral trainees to the meeting. The event showcased poster presentations by emerging scholars whose abstracts were reviewed and selected for display at the conference. Four outstanding poster submissions were selected by Drs. Mary Haan and Eileen Crimmins for oral presentation during the regular conference proceedings. For a complete list of abstracts and poster presenters see http://www.utexas.edu/lbj/caa/2010/caa_program-2010.pdf.

Organized by Dr. Terrence Hill the poster session served as a medium for conveying information to emerging, mid-career, and senior Hispanic health and aging scholars as well as policy makers. The procedure of selection and appropriate content of the posters was determined by a panel of peer-reviewers which consisted of one CAA Advisory Group member and two scholars with expertise on the topic. The criteria used to accept abstracts included empirical research projects that reported actual, not promised, results about aspects of healthful aging among people of Mexican origin or Hispanic background in the United States and Latin America. To promote and ensure continuity across conferences, each poster session included the following themes:

  1. Aging and Health in Mexico and the United States;
  2. Aging policies and Hispanic Health and Long-term Care, and
  3. Biobehavioral factors and Hispanic health.

The poster session also provided individuals an opportunity to present a poster on applied research they have conducted on new or different methodological techniques used to improve understanding and knowledge that may inform effective behavioral interventions, preventive health practices, and geriatric care arrangements. To facilitate one-on-one interaction and networking, the poster presentation was held just outside the Lecture Hall where all participants were located to assure maximum interaction. Participants attended a mentoring dinner cruise and special program led by Dr. Keith Whitfield (Duke University) to foster further work.

Sixteen emerging scholars from the United States and Mexico presented peer-reviewed research on Hispanic health and aging in a poster format. The top three posters were selected by Drs. Terrence Hill, Kristen Peek, and Nestor Rodriguez to receive prizes. The judges evaluated the work based on the following set of criteria: background, methods, results, and presentation.

The following winners placed in the top three award categories:

FIRST PRIZE

Zhanlian Feng
Center for Gerontology and Healthcare Research
Department of Community Health
The Warren Alpert Medical School
Brown University

Geographic Concentration and Correlates of Nursing Home Closures: 1999-2008

Zhanlian FengWhile demographic shifts project an increased need for long-term care for an aging population, hundreds of nursing home facilities close each year. It remains unknown as to whether nursing home closures disproportionately affect certain communities and population subgroups more than others. To examine whether nursing home closures were geographically concentrated and related to local community characteristics such as the racial/ethnic population mix and poverty. The study included all Medicare/Medicaid certified nursing homes from the Online Survey Certification and Reporting database, 1999-2008 (N=18,192 unique facilities). Nursing home closure was defined as termination from the Medicare/Medicaid programs. Census 2000 zip-code level data on the proportion of minorities and poverty rate were matched to study facilities, to examine the likelihood of closure associated with each zip-code characteristic. The Gini coefficient was used to measure geographic concentration of closures. Spatial clustering patterns of closures were illustrated using GIS maps. Between 1999 and 2008, there were 2,894 closures or nearly 16% of all facilities. The relative risk of closure among facilities in the top quartile of zip codes by percent black was 1.64 (95% confidence interval [CI], 1.47-1.83) times greater than those in the bottom quartile. Similar results were observed by percent Hispanics in a zip-code (relative risk=1.52; 95% CI, 1.37-1.68) and poverty (relative risk=1.95; 95% CI, 1.76-2.16). The Gini coefficient for closures was 0.65 across all Metropolitan Statistical Areas and 0.79 across all zip codes. Closures tended to be spatially clustered in minority-concentrated zip codes around the urban core, often in pockets of concentrated poverty. Nursing home closures are geographically concentrated in minority and poor communities. Since minority elderly now use nursing homes more than whites, these findings suggest future access barriers.

SECOND PRIZE

Kate Chambers
Department of Sociology
The Population Research Center
University of Texas at Austin

Pre-Retirement Age Women and the New Health Care Law: How will Minority Women Fare?

Kate ChambersIn 2008, close to 18 million women lacked health insurance coverage in the United States. Often this lack of coverage comes later in life when serious health problems become common. As written, the passage of the Patient Protection and Affordable Care Act promises to improve the situation for many of these minority women who will now be able to purchase subsidized coverage though the new health insurance exchanges, and the poorest will qualify for Medicaid, which in 2014 will be extended to all adults in households with incomes below 133% of poverty. We employ the 2008 American Community Survey to estimate the number of uninsured women aged 55-64 years by race and Mexican-origin ethnicity and marital status. The ultimate goal is to determine the extent to which Medicaid expansion and the new insurance exchanges will increase coverage and reduce the total number of uninsured women in this age bracket. Preliminary results reveal that a disproportionate fraction of uninsured women are minorities. In 2008, 33.2% of Mexican-origin women aged 55-64 years old were uninsured, compared to 8.7% of non-Hispanic white women and 15.3% of African-American women in this age bracket. In addition, 50% of all Mexican-origin women aged 55-64 years old who were uninsured lived below 133% of the poverty line, a much higher rate than their non-Hispanic white and African-American counterparts (26.4% and 26.6%, respectively). Pre-retirement Mexican-origin women living above 133% of the poverty line are four times more likely than their non-Hispanic white counterparts to be uninsured. The research has important implications of how numerous provisions enacted in the PPACA law will reduce the number of particularly vulnerable uninsured women. These findings also make it is clear that Medicaid expansion and insurance exchanges will vary across states, and consequently has potential benefits for low-income minority group women on the verge of becoming Medicare eligible.

THIRD PRIZE

E. Carolina Apesoa-Varano
Department of Sociology
University of California-Davis

‘Me Siento Inutil’: Masculinity and Depression among Older Mexican Men

E. Carolina Apesoa-VaranoSummary: Background and Significance: Clinical depression in older men is associated with physical and psychological disability, increased health care costs, poor co-morbid management, and significantly higher rates of suicide. Older men of Mexican origin remain under-diagnosed and under-treated for depression in primary care settings, where they are likely to receive on-going care. Studies show that inadequate access is partly related to such disparity in diagnosis and treatment, while stereotypical conceptions of masculinity may also play a role. We know little about older Mexican men’s experience and expression of depression. Having a better understanding of older Mexican men’s explanatory model of depression and what idioms of distress they use may help reduce barriers to depression care. Methods: Findings come from in-depth interviews with 25 Mexican men over 60 (both English and Spanish speakers) with clinical depression, treated and untreated (MeHASR01 MH080067-03). Interviews were transcribed verbatim and translated into English. Thematic coding was done by independent coders using NVivo based on on-going analyses by the team, where emerging topics were identified and discussed in view of the study’s conceptual framework. Discussion: We found that Mexican older men experience depression as a loss of productivity and self-worth, typically triggered by physical disability due to catastrophic events, chronic illness, or aging. They perceive lost productivity as a threat to their masculinity given strongly held ideas of men as providers of the family. Further, older Mexican men do not express their depression in typical idioms of distress such as feeling down or sad. Instead, they speak about feeling “inutil”—feeling useless—in the context of physical decline and chronic socio-economic hardships. Thus health practitioners must elicit life and family changes, engage older Mexican men in discussions about their experiences, and expand their repertoire of “red flags” for depression for diagnosis and treatment.

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