How Will the U.S. Healthcare System Meet the Challenge of the Ethnogeriatric Imperative?

Abstract

Much of the geriatric imperative that is facing providers in the United States is an ethnogeriatric imperative, because one-third of older Americans are projected to be from one of the minority populations by mid-century, and that vastly underrepresents the actual diversity providers will see. Because of the vast heterogeneity of culture, language, health beliefs, risk for disease, and other factors, it is important for policy makers and health providers to be familiar with the diverse characteristics and needs of the various groups that will need geriatric care if they are to receive effective services. Challenges to high-quality ethnogeriatric care include disparities in health status and health care, differences of acculturation level and other characteristics within the populations, language and limited English proficiency, health literacy, culturally defined health beliefs and syndromes, and specific beliefs and preferences about long-term and end-of-life care. Some models of successful ethnogeriatric care have been identified and have in common the involvement of members of the target population in the development and design of the services and the use of cultural liaisons from the ethnic community being served, such as community health workers, or promatores. Thirteen recommendations are suggested for policy and practice changes in multiethnic and ethnic-specific health programs to provide competent ethnogeriatric care in the U.S. healthcare system.

Causal Attributions of Dementia Among Korean American Immigrants

“…education, poverty, English proficiency, acculturation, and health status), Asian Americans are frequently lumped together in research studies (Yeo, 2009). Some of the more recent literature has focused on Chinese and Vietnamese Americans and/or their caregivers (e.g., Braun & Browne, 1998;Elliott et al, 1996;Guo et al, 2000;Hinton et al, 2000;Hinton et al, 2005;Yeo et al, 2001) as subgroups within the Asian American population.…”

Attitudes toward Community Services Use in Dementia Care among Korean Americans

“…Because of the multiplicity and complexity of the historical experiences, and diverse cultural and social characteristics (e.g., education, poverty, English proficiency, acculturation) in the Asian American population (Yeo, 2009), there is a pressing need to build a foundation of knowledge about caregiving unique to its subgroups. Responding to this need, we examined attitudes toward community services use in dementia care among Korean Americans, one of the largest subgroups within the Asian American population (U.S. Census Bureau, 2000b).…”

How to Buy a Medical Home? Policy Options and Practical Questions

“…Other important patient characteristics might merit some adjustment of visit payments as well (e.g., cognitive impairment, health literacy, limited English proficiency) [9][10][11][12] . Further, advances in our understanding of human genetics is beginning to identify patients with additional risks of disease and treatment side effects, adding new patient management complexity not captured in current code definitions for office visits 13 .…”