Race Disparities Identified in Rehab Use
Older white Americans are more likely to receive rehabilitation services than their black American counterparts, according to a study co-authored by a School of Public Health researcher.
The study, published in the Journal of the American Geriatrics Society, revealed racial differences in the overall use of rehabilitation services among Americans aged 65 years or older.
About half of Americans in that age bracket suffer from disability. Racial differences in disability rates are well-documented, with black Americans having consistently higher rates of disability. While rehabilitation services can improve function and quality of life, previous studies have found that the use of rehabilitation centers declines with age.
The researchers conducted a secondary analysis of the 2016 National Health and Aging Trends Study, analyzing data from 1276 Medicare enrollees who utilized rehabilitation services during the previous 12 months. Data collected included self-reported measures of: utilization of rehabilitation services, setting, reasons for use, and perceptions of improvement while receiving rehabilitation services.
Among participants, 16.3 percent of black Americans reported using rehabilitation services, compared to 21.5 percent of white Americans. In both home-based services and inpatient services, black Americans were more likely to be low-functioning; the study found no significant racial differences in the overall improvement in function among those who use the services. The researchers identified a number of drivers that affect utilization of rehabilitation services, including access to transportation and payment mechanisms.
The researchers suggested that greater utilization of rehabilitation services by older black Americans could lead to improved late-life functioning.
“Further study is needed to develop strategies aimed at identifying possible barriers to use of rehabilitation services for vulnerable groups of aging individuals, particularly those who are black, dually eligible, and of the oldest age groups and lowest functioning,” the authors wrote.
Howard Cabral, professor of biostatistics, and Alan Jette, professor of health law, policy & management, were co-authors on the study, which was led by Tamra Keeney, PhD candidate at MGH Institute of Health Professions. The other author was Vicki Freedman, research professor at the University of Michigan.