BORDERS OF HEALTH
The needs of elderly people living in rural areas will be easier to address thanks to the Texas Tech 5000 survey.
Written by Andrea Watson
The needs of elderly people living in rural areas is now a little easier to address thanks to a survey just completed by the Department of Health Services Research and Management at Texas Tech University Health Sciences Center.
The Texas Tech 5000 survey was one of the largest surveys of health and health care accessibility and quality ever conducted among elderly individuals. The survey is based on a random sample of 65,000 telephone listings in the 108 counties that comprise West Texas. Households were screened to identify age-eligible respondents.
"This survey and its results will help us target the rural population more effectively," said Tyrone F. Borders, Ph.D., assistant professor in the Department of Health Services Research and Management and co-author of the survey.
Respondents were questioned about health services use, satisfaction with accessibility and quality, health insurance coverage, health beliefs, health status, demographics and other health-related factors. A Spanish version was administered upon respondent request.
"We had a wonderful response," said James E. Rohrer, Ph.D., chairperson of the Department of Health Services Research and Management and co-author of the survey. "We were inundated with calls from people who wanted to be involved. People want their voices heard about the problems they face."
The survey was funded by the Administration on Aging/U.S. Department of Health and Human Services.
"There have been surveys of Hispanics that included Mexican-, Cuban- and Puerto Rican-Americans, but there's never been a survey in the Southwestern part of the United States that targeted elderly Mexican-Americans," Rohrer added. "That was a big part of this study."
One of the more startling results of the survey was that one in five respondents had not seen a doctor in the previous six months. Rohrer said the researchers controlled for various health problems to compare sub-groups. However, the statistics were still significant.
"It's not likely that it's due to chance," he said. "The bottom line is we have to ask 'Is this how we want the health system to function?' Do we want this many people to be limited in their access to health care?"
Among the results discovered from the survey were that a higher percentage of elderly Hispanics have no health insurance coverage, and of those with health insurance coverage, Medicaid is more common among Hispanics while private health insurance is more prevalent among non-Hispanic whites.
The study also revealed that a lower percentage of Hispanics were satisfied with their accessibility to specialty physicians and a lower percentage of Hispanics had visited a doctor within the last six months.
Despite their potential inadequate access to health services, more in-depth analyses led by Borders revealed that Hispanic elders in West Texas tend to have better physical health status than their non-Hispanic white counterparts. Hispanic elders were found to be less likely to have most chronic diseases, with the exception of diabetes and they reported having better physical health-related quality of life. Few differences were found between elders residing in metropolitan versus rural areas.
Rohrer said the study revealed many interesting facts, but that this survey should not be considered the last word on the health care needs of the rural elderly.
"There will be more rounds of surveys and more results compiled," he said. In fact, a second round of questions which further expands on pharmacy needs, transportation and other barriers has already been administered and the results are being analyzed, he said. Plans are under way for another possible round of questions that will further inquire into the respondents' health status.
Studies such as these will become even more important as the United States. population continues to age and as age demographics shift throughout rural and urban areas, said Joel Kupersmith, M.D., dean of the School of Medicine and the Graduate School of Biomedical Sciences.
"Many young people are leaving rural areas, so examining the rural elderly is key," Kupersmith said. "Rural health care presents different needs for us to address. This gives us our first good look at this group and tells us a lot about their access to health care and what we can do to meet their needs."
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