Mental and Physical Health Correlates of Financial Difficulties Among African-American Older Adults in Low-Income Areas of Los Angeles

Background. Several publications highlight data concerning multiple chronic conditions and the medication regimen complexity (MRC) used in managing these conditions as well as MRCs’ association with polypharmacy and medication non-adherence. However, there is a paucity of literature that specifically details the correlates of MRC with multimorbidity, socioeconomic, physical and mental health factors in disadvantaged (medically underserved, low income) African American (AA) seniors. Aims. In a local sample in South Los Angeles, we investigated correlates of MRC in African American older adults with chronic disease(s). Methods. This was a community-based survey in South Los Angeles with 709 African American senior participants (55 years and older). Age, gender, continuity of care, educational attainment, multimorbidity, financial constraints, marital status, and MRC (outcome) were measured. Data were analyzed using linear regression. Results. Higher MRC correlated with female gender, a higher number of healthcare providers, hospitalization events and multimorbidity. However, there were no associations between MRC and age, level of education, financial constraint, living arrangements or health maintenance organization (HMO) membership. Conclusions. Disadvantaged African Americans, particularly female older adults with multimorbidity, who also have multiple healthcare providers and medications, use the most complex medication regimens. It is imperative that MRC is reduced particularly in African American older adults with multimorbidity.

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Substance Use among Economically Disadvantaged African American Older Adults; Objective and Subjective Socioeconomic Status

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16101826 ◽

2019 ◽

Vol 16 (10) ◽

pp. 1826 ◽

Cited By ~ 16

Author(s):

Shervin Assari ◽

James Smith ◽

Ritesh Mistry ◽

Mehdi Farokhnia ◽

Mohsen Bazargan

Keyword(s):

Older Adults ◽

African American ◽

Cigarette Smoking ◽

Educational Attainment ◽

Alcohol Drinking ◽

Economically Disadvantaged ◽

Health Risk Behaviors ◽

Subjective Socioeconomic Status ◽

Financial Difficulties ◽

African American Older Adults

Purpose. This study investigated the effects of objective and subjective socioeconomic status (SES) indicators on two health behaviors, cigarette smoking and alcohol drinking, among African American older adults. Methods. This community-based study recruited 619 economically disadvantaged African American older adults (age ≥ 65 years) residing in South Los Angeles. Structured face-to-face interviews were conducted to collect data. Data on demographic factors (age and gender), subjective SES (financial difficulties), objective SES (educational attainment), living arrangement, marital status, healthcare access (insurance), and health (number of chronic medical conditions, self-rated health, sick days, depression, and chronic pain) and health behaviors (cigarette smoking and alcohol drinking) were collected from participants. Logistic regressions were used to analyze the data. Results. High financial difficulties were associated with higher odds of smoking cigarettes and drinking alcohol, independent of covariates. Educational attainment did not correlate with our outcomes. Similar patterns emerged for cigarette smoking and alcohol drinking. Conclusion. Subjective SES indicators such as financial difficulties may be more relevant than objective SES indicators such as educational attainment to health risk behaviors such as cigarette smoking and alcohol drinking among African American older adults in economically constrain urban environments. Smoking and drinking may serve as coping mechanisms with financial difficulty, especially among African American older adults. In line with the minorities’ diminished returns (MDR) theory, and probably due to discrimination against racial minorities, educational attainment has a smaller protective effect among economically disadvantaged African American individuals against health risk behaviors.

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Binge Drinking among Economically Disadvantaged African American Older Adults with Diabetes

Behavioral Sciences ◽

10.3390/bs9090097 ◽

2019 ◽

Vol 9 (9) ◽

pp. 97 ◽

Cited By ~ 3

Author(s):

Shervin Assari ◽

James L. Smith ◽

Mohammed Saqib ◽

Mohsen Bazargan

Keyword(s):

Older Adults ◽

African American ◽

African Americans ◽

Los Angeles ◽

Binge Drinking ◽

Economically Disadvantaged ◽

Living Arrangement ◽

Urban Environments ◽

Health Determinants ◽

African American Older Adults

Purpose. This study investigated the effect of demographic, socioeconomic, and psychological factors as well as the role of health determinants on alcohol consumption and binge drinking among economically disadvantaged African American older adults with type 2 diabetes mellites (T2DM). Methods. This survey recruited 231 African Americans who were older adults (age 65+ years) and had T2DM. Participants were selected from economically disadvantaged areas of South Los Angeles. A structured face-to-face interview was conducted to collect data on demographic factors, objective and subjective socioeconomic status (SES) including education and financial difficulty, living arrangement, marital status, health, and drinking behaviors (drinking and binge drinking). Results. Age, gender, living alone, pain, comorbid conditions, and smoking were associated with drinking/binge drinking. Male gender, pain, and being a smoker were associated with higher odds of drinking/binge drinking, while individuals with more comorbid medical conditions had lower odds of binge drinking. Conclusion. In economically constrained urban environments, gender, pain, and smoking but not age, SES, depression, and health may predict binge drinking for African American older adults with T2DM. African Americans older adult men with T2DM with comorbid pain should be screened for binge drinking.

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Evaluation of the Chronic Disease Self-Management Program With Low-Income, Urban, African American Older Adults

Journal of Community Health Nursing ◽

10.1080/07370010802421178 ◽

2008 ◽

Vol 25 (4) ◽

pp. 193-202 ◽

Cited By ~ 12

Author(s):

Molly A. Rose ◽

Christine Arenson ◽

Pamela Harrod ◽

Robyn Salkey ◽

Abbie Santana ◽

...

Keyword(s):

Older Adults ◽

African American ◽

Chronic Disease ◽

Low Income ◽

Management Program ◽

Self Management ◽

African American Older Adults

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Evaluation of a Mindfulness-Based Intervention Program to Decrease Blood Pressure in Low-Income African-American Older Adults

Journal of Urban Health ◽

10.1007/s11524-011-9654-6 ◽

2012 ◽

Vol 89 (2) ◽

pp. 308-316 ◽

Cited By ~ 59

Author(s):

Priya Palta ◽

G. Page ◽

R. L. Piferi ◽

J. M. Gill ◽

M. J. Hayat ◽

...

Keyword(s):

Blood Pressure ◽

Older Adults ◽

African American ◽

Low Income ◽

Intervention Program ◽

Decrease Blood Pressure ◽

African American Older Adults

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Insomnia Symptoms among African-American Older Adults in Economically Disadvantaged Areas of South Los Angeles

Brain Sciences ◽

10.3390/brainsci9110306 ◽

2019 ◽

Vol 9 (11) ◽

pp. 306 ◽

Cited By ~ 2

Author(s):

Mohsen Bazargan ◽

Nadia Mian ◽

Sharon Cobb ◽

Roberto Vargas ◽

Shervin Assari

Keyword(s):

Older Adults ◽

African American ◽

Los Angeles ◽

Linear Regression ◽

Pain Intensity ◽

Economically Disadvantaged ◽

Financial Difficulty ◽

South Los Angeles ◽

Insomnia Symptoms ◽

African American Older Adults

Background. Although psychosocial and health factors impact insomnia symptoms, less is known about these effects in economically disadvantaged African-American older adults. Aims. This study investigated social and health determinants of insomnia symptoms among economically disadvantaged African-American older adults. Methods. This survey enrolled 398 African-American older adults (age ≥ 65 years) from economically disadvantaged areas of South Los Angeles. Gender, age, educational attainment, financial difficulty, number of chronic diseases, self-rated health, pain intensity, and depression were covariates. Total insomnia, insomnia symptoms, and insomnia impact were our outcomes. Linear regression was applied for data analysis. Results. Based on linear regression, higher financial difficulty (B = 0.48, 95% CI = 0.35–0.61), smoking status (B = 1.64, 95% CI = 0.13–3.16), higher pain intensity (B = 0.39, 95% CI = 0.11–0.67), higher number of chronic diseases (B = 0.34, 95% CI = 0.05–0.64), and more depressive symptoms (B = 0.35, 95% CI = 0.12–0.57) were associated with a higher frequency of insomnia symptoms. Based on a logistic regression model, lower age (B = 0.91, 95% CI = 0.91–1.00) and high financial difficulty (OR = 1.15, 95% CI = 1.08–1.24), pain (OR = 2.08, 95% CI = 1.14–3.80), chronic disease (OR = 1.27, 95% CI = 1.07–1.51) and depression (OR = 2.38, 95% CI = 1.22–4.65) were associated with higher odds of possible clinical insomnia. We also found specific predictors for insomnia symptoms and insomnia impact. Conclusions. Among African-American older adults in economically disadvantaged areas of South Los Angeles, insomnia symptoms co-occur with other economic, physical, and mental health challenges such as financial difficulty, smoking, multimorbidity, pain, and depression. There is a need to address sleep as a component of care of economically disadvantaged African-American older adults who have multiple social and health challenges.

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Understanding Alzheimer’s Disease Knowledge in Low-Income, Racially Diverse Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.918 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 286-287

Author(s):

Faika Zanjani ◽

Taylor Wilkerson ◽

Annie Rhodes ◽

Jennifer Inker ◽

Joann Richardson

Keyword(s):

Alzheimer’S Disease ◽

Older Adults ◽

Alzheimer's Disease ◽

African American ◽

Low Income ◽

Community Dwelling ◽

Racial Groups ◽

Or Education ◽

Disease Knowledge ◽

African American Older Adults

Abstract Individuals demonstrate varying levels of Alzheimer’s disease (AD) knowledge, as well as commonly held misconceptions about the risk factors and nature of the disease. Older adults often demonstrate low scores on AD knowledge scales and African Americans are often specifically not aware of their higher AD risk status compared to other racial groups. We measured the Alzheimer’s knowledge in 60+ community-dwelling adults, as part of a larger study on AD health coaching. Participants (n=20) were recruited from low-income communities within the Richmond, Virginia area. The study sample was 85% African American (n=17) and 55% male (n=11). Participants completed a behavioral psychosocial test battery, including the Alzheimer’s Disease Knowledge Scale. Similar to previous research, this sample of older adults held common misconceptions about AD, including the ideas that mental exercise can prevent AD (80% answered incorrectly) and individuals with AD are incapable of making decisions about their care (70% answered incorrectly). In this sample, the majority of African American older adults were aware of the fact that they have the highest risk for developing AD (20% answered incorrectly) compared to other racial groups. Analyses found no significant relationship between AD knowledge and health outcomes, alcohol consumption, or education. In conclusion to reduce AD risk, addressing AD knowledge in minority low-income population is important and needed. This is especially relevant since African American older adults are more likely to live in communities rather than nursing or assisted living facilities, receiving less access to interventions and research innovation.

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Practical Solutions to Address COVID-19-Related Mental and Physical Health Challenges Among Low-Income Older Adults

Frontiers in Public Health ◽

10.3389/fpubh.2021.674847 ◽

2021 ◽

Vol 9 ◽

Author(s):

Caroline D. Bergeron ◽

Ali Boolani ◽

Erica C. Jansen ◽

Matthew Lee Smith

Keyword(s):

Physical Activity ◽

Older Adults ◽

Older People ◽

Physical Health ◽

Low Income ◽

Health Consequences ◽

Healthy Living ◽

Mental And Physical Health

Low-income older adults are disproportionately impacted by the COVID-19 pandemic. In this perspective article, we review the context in which low-income older people experience the pandemic and the mental and physical health consequences they have faced to date. Then, we offer practical solutions to help improve low-income older adults' sleep, physical activity, nutrition, and stress that require no or low financial commitment. We argue that governments, communities, and organizations should make greater efforts to promote healthy living for low-income older adults in times of health emergencies to ensure their ability to be universally adopted, regardless of income and resources.

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Memory Problems During COVID in Low-income Older Adults

Innovation in Aging ◽

10.1093/geroni/igab046.2734 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 741-741

Author(s):

Faika Zanjani ◽

Annie Rhodes

Keyword(s):

Older Adults ◽

African American ◽

Physical Health ◽

Low Income ◽

Large Scale ◽

Poor Mental Health ◽

Health Coaching ◽

Memory Problems ◽

American Black ◽

Lifestyle Risk

Abstract Prevention, with widespread lifestyle risk reduction at the community-level, is currently considered an effective method to decrease Alzheimer’s disease (AD). As part of the Virginia Commonwealth University iCubed Health and Wellness in Aging Core, diverse older adults (60+) living in Richmond, VA, with incomes below $12,000/year and managing either diabetes/cardiovascular symptoms, were offered weekly lifestyle telephone-health coaching for 12-weeks, providing education, motivations, self-efficacy, and referral services for AD lifestyle risk. The study sample (n=40, mean age 68 years (range: 60-77 years) was 88% African American/Black (n=35), 100% Non-Hispanic, and 45% males (n=18)). Thirty-nine (95%) of subjects successfully participated in coaching sessions; on average 91.9% (11) sessions/subject were completed. Participants provided positive anecdotal feedback and the need for continued health coaching during COVID. N=30 (75%) of the original sample consented for continued health coaching during the Covid pandemic, 63% female, 88% African American/Black, 60-77 age range (mean age 69 years), and 47% reporting memory problems. Baseline Covid interviews indicated poorer health status associated with reporting memory problems for poor physical health days (F=7.03;p=.01); poor mental health days (F=6.88;p=.01); total mental/physical health poor days (F=2.76;p=.11); sad days (F=15.52;p=.001); worried days (F=6.27;p=.02); tired days (F=9.77;p=.004); feelings of emptiness (F=10.09;p=.004); feelings of rejection (F=3.382;p=.08); feelings of failure (F=7.58;p=.01); little interest/pleasure (F=7.84;p=.009); and feeling down (F=6.75;p=.02). In conclusion, this preliminary work creates the impetus for future large-scale AD prevention investigations to improve the lives of AD-risk, low-income, diverse older adults reporting memory problems. This research indicates the subjective reporting of memory problems requires health intervention.

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Chronic Respiratory Disease and Health-Related Quality of Life of African American Older Adults in an Economically Disadvantaged Area of Los Angeles

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16101756 ◽

2019 ◽

Vol 16 (10) ◽

pp. 1756 ◽

Cited By ~ 4

Author(s):

Mohsen Bazargan ◽

James L. Smith ◽

Paul Robinson ◽

John Uyanne ◽

Ruqayyah Abdulrahoof ◽

...

Keyword(s):

Older Adults ◽

African American ◽

Los Angeles ◽

Urban Areas ◽

Economically Disadvantaged ◽

Disadvantaged Area ◽

Related Quality ◽

Health Related ◽

African American Older Adults

Background. Most of the attention of policy makers, program planners, clinicians, and researchers in the area of physical health disparities among African American older adults has been traditionally focused on cardiometabolic disease and cancer. Among a long list of chronic medical conditions, chronic respiratory conditions (CRCs), such as asthma, chronic bronchitis, and emphysema, have received less attention. Purpose. This study investigated whether CRCs contribute to physical and mental health-related quality of life (HRQoL) of African American older adults who live in economically disadvantaged urban areas, and whether these effects are due to demographic factors, socioeconomic status (SES), health behaviors, and comorbid medical and mental conditions. Methods. This community-based study recruited 617 African American older adults (age ≥ 65 years) from Service Planning Areas (SPA) 6, an economically disadvantaged area in South Los Angeles. Structured face-to-face interviews were used to collect data on demographic factors (age and gender), SES (educational attainment and financial difficulty), living arrangements, marital status, health behaviors (cigarette smoking and alcohol drinking), health (CRC, number of comorbid medical conditions, depressive symptoms, and pain intensity), and physical and mental HRQoL (Physical and Mental Component Summary Scores; PCS and MCS; SF-12). Linear regressions were used to analyze the data. Results. The presence of CRCs was associated with lower PCS and MCS in bivariate analysis. The association between CRCs and PCS remained significant above and beyond all confounders. However, the association between CRCs and MCS disappeared after controlling for confounders. Conclusion. For African American older adults living in economically disadvantaged urban areas, CRCs contribute to poor physical HRQoL. Evaluation and treatment of CRCs in African American older adults may be a strategy for reduction of disparities in HRQoL in this population. As smoking is the major modifiable risk factor for CRCs, there is a need to increase accessibility of smoking cessation programs in economically disadvantaged urban areas. More research is needed on the types, management, and prognosis of CRCs such as asthma, chronic bronchitis, and emphysema in African American older adults who reside in low-income and resource limited urban areas.

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