The Undocumented Elderly: Coverage Gaps and Low Health Care Use

Balakrishnan, Aparna; Jordan, Neil

doi:10.1353/hpu.2019.0062

Cited by 8 publications

(3 citation statements)

References 12 publications

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“…Research done in primary care elucidates intervention trends and targets for anxiety, depression, and suicidal behaviors among older adults (Kroenke et al, 2007; Luoma et al, 2002; Park & Unützer, 2011). However, many racial/ethnic minority older adults may not seek services due to lack of trust and prior negative experiences, as well as linguistic barriers (Balakrishnan & Jordan, 2019; Glover et al, 2017; Hansen et al, 2016; Musa et al, 2009). Community-based organizations (CBOs), where these adults congregate, offer a unique opportunity to identify those with unmet need and serve them.…”

Section: Social Determinants Of Health Frameworkmentioning

confidence: 99%

Late life anxiety and depression symptoms, and suicidal behaviors in racial/ethnic minority older adults in community-based organizations and community clinics in the U.S.

Jiménez¹,

Cruz-Gonzalez²,

Calhoun³

et al. 2024

Cultural Diversity & Ethnic Minority Psychology

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Objective: Late life anxiety and depression represent a significant source of disability, with racial/ethnic minority older adults in the U.S. showing marked disparities in healthy aging. Community-based organizations (CBOs) and community clinics serve these populations for preventive care, yet few identify their mental health service needs. We examine the association between race/ethnicity and risk of mild-tosevere symptoms of anxiety and depression, and suicidal behaviors in minority older adults. Method: Data come from the multisite randomized controlled trial Building Community Capacity for Disability Prevention for Minority Elders, which screened 1,057 adults (45.5% Asian, 26.8% Latinx, 15.0% non-Latinx Black, 8.5% non-Latinx White, and 4.2% American Indian) aged 60+ years at CBOs and clinics in Massachusetts, New York, Florida, and Puerto Rico. Screened participants completed the Generalized Anxiety Disorder-7 (GAD-7) for anxiety symptoms, the Geriatric Depression Scale-15 (GDS-15) for depression symptoms, and the Paykel Suicide Risk Questionnaire for suicidal behaviors. Results: 28.1% of older adults reported mildto-severe anxiety symptoms, 30.1% reported mild-to-severe depression symptoms, and 4.3% reported at least one suicidal behavior. Compared to non-Latinx Whites, Latinxs had higher odds of mild-to-severe anxiety and depression symptoms and one or more suicidal behaviors, and Asians had higher odds of mildto-severe depression symptoms only. Conclusions: There is an urgent need to improve outreach for screening and preventive mental health care for minority older adults. Expanding outreach and communitybased capacity to identify and treat minority older adults with mental health conditions represents an opportunity to prevent disability. Public Significance StatementOur results underscore the importance of outreaching minority older adults participating in communitybased organizations (CBOs) and clinics for mental health screening given the high prevalence of anxiety and depressive symptoms, and suicidal behaviors. CBOs and clinics may offer opportunities for early identification of their mental health problems and provide mental health literacy and connection to secondary prevention programs to mitigate their higher risk of disability.

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Section: Social Determinants Of Health Frameworkmentioning

confidence: 99%

Late life anxiety and depression symptoms, and suicidal behaviors in racial/ethnic minority older adults in community-based organizations and community clinics in the U.S.

Jiménez¹,

Cruz-Gonzalez²,

Calhoun³

et al. 2024

Cultural Diversity & Ethnic Minority Psychology

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“…Undocumented immigrants are ineligible for the Affordable Care Act and for Medicare, the social insurance program for adults 65 and over or adults with a disability (Balakrishnan & Jordan, 2019). Ayón et al.…”

Section: General Health Outcomesmentioning

confidence: 99%

Aging and undocumented: The sociology of aging meets immigration status

Morales

2021

Sociology Compass

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Being undocumented is strongly correlated with low wages, employment in high risk occupations, and poor healthcare access. We know surprisingly little about the social lives of older undocumented adults despite the vast literature about youth and young undocumented migrants. Literature about the immigrant health paradox casts doubts on the argument that unequal social conditions translate to poorer self‐reported health and mortality, but few of these studies consider immigration status as the dynamic variable that it is. Reviewing research about older migrants and minorities, I point to the emergence of undocumented older persons as a demographic group that merits attention from researchers and policymakers. This nexus offers important lessons for understanding stratification and inequality. This review offers new research directions that take into account multilevel consequences of growing old undocumented. Rather than arguing that older‐aged undocumented migrants are aging into exclusion, I argue that we need careful empirical research to examine how the continuity of exclusion via policies can magnify inequalities on the basis of immigration status and racialization in older age.

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“…In addition, these barriers often have an especially high impact on elderly UIs' access to health care, who are already at greater medical risk in regard to most chronic conditions. 7 All of these factors, and the frequent local administration of accessible health care, make the collection of personalized data for population-based monitoring and control of both acute and chronic diseases in UI populations extremely difficult.…”

Section: Introductionmentioning

confidence: 99%

A Novel Application of Non-Negative Matrix Factorization to the Prediction of the Health Status of Undocumented Immigrants

Wells

Yang

et al. 2021

Health Equity

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Introduction: Undocumented immigrants (UIs) in the United States are less likely to be able to afford health insurance. As a result, UIs often lack family doctors and are rarely involved in annual screening programs, which makes estimating their health status remarkably challenging. This is especially true if the laboratory results from limited screening programs fail to provide sufficient clinical information. Methods: To address this issue, we have developed a machine learning model based on the non-negative matrix factorization technique. The data set we used for model training and testing was obtained from the 2004 cost-free hepatitis B screening program at the Omni Health Center located in Plano, Texas. Total 300 people were involved, with 199 identified as UIs. Results: People in the UIs group have higher cholesterol (219.6 mg/dL, p =0.038) and triglycerides (173.2 mg/dL, p =0.03) level. They also have a lower hepatitis B vaccination rate (38%, p =0.0247). No significant difference in hepatitis B (+) was found ( p =0.8823). Using 16 individual clinical measurements as training features, our newly developed model has a 67.56% accuracy in predicting the ratio of cholesterol to high-density lipoprotein; in addition, this newly developed model performs 9.1% better than a comparable multiclass logistic regression model. Conclusions: Elderly UIs have poorer health status compared with permanent residents and citizens in the United States. Our newly developed machine learning model demonstrates a powerful support tool for designing health intervention programs that target UIs in the United States.

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The Undocumented Elderly: Coverage Gaps and Low Health Care Use

Cited by 8 publications

References 12 publications

Late life anxiety and depression symptoms, and suicidal behaviors in racial/ethnic minority older adults in community-based organizations and community clinics in the U.S.

Late life anxiety and depression symptoms, and suicidal behaviors in racial/ethnic minority older adults in community-based organizations and community clinics in the U.S.

Aging and undocumented: The sociology of aging meets immigration status

A Novel Application of Non-Negative Matrix Factorization to the Prediction of the Health Status of Undocumented Immigrants

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