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Disparities/Minority Health

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Ethnicity, age, and living arrangements affect the use of assistive devices by people with impaired mobility

Blacks and older people suffer from more impaired mobility than others. Blacks with mobility problems are more likely than whites and Hispanics to use assistive devices such as canes, walkers, or wheelchairs. However, this is not true of the oldest group of blacks, according to a study of ethnic- and age-related differences in assistive device use among people who have trouble walking. Assistive devices help prevent injury and promote independence, but are too often underused, note the Brown University researchers who conducted the study.

In a study supported in part by the Agency for Healthcare Research and Quality (T32 HS00011), researchers identified 7,148 mobility-impaired adults from the National Health Interview Survey on Disability. They used models to estimate the influence of age, race/ethnicity, and living arrangements on device use. Blacks were 20 percent more likely and Hispanics were 22 percent less likely than whites to use devices. However, these differences were increased with age. There was a 40 percent increased likelihood of use attributable to being black and aged 45 to 75, a 30 percent increased likelihood attributable to being Hispanic and aged 65 to 75, and a 130 percent increased likelihood attributable to being Hispanic and older than 75.

More use of assistive devices by younger blacks may be due to a greater prevalence of disabling conditions, including amputations due to uncontrolled diabetes, that afflict blacks at younger ages. Lower device use among the oldest blacks may be due to lower prevalence of uncontrolled diabetes and disabling chronic disease among blacks who survive this long. Hispanic culture encourages informal caregiving by family, neighbors, and friends, which may substitute for device use by Hispanics with mobility impairments at younger ages. However, the care needs of elderly Hispanics may begin to overwhelm family and friends, at which time use of a mobility device may become more culturally acceptable and hence more prevalent. Finally, the researchers note that those who lived alone were 40 percent more likely to use mobility devices, indicating that assistive devices can substitute or supplement human assistance.

See "Racial and ethnic differences in use of assistive devices for mobility," by Linda Resnik, Ph.D., P.T., O.C.S., and Susan Allen, Ph.D., in the February 2006 Journal of Aging and Health 18(1), pp. 106-124.

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