Exploring Family Caregiver Services: Variations in Utilization Patterns and Barriers to Access among Diverse Ethnic Groups Julian Chow 1, Erica Auh 1, Nancy Giunta 1, and Andrew Scharlach 1 1 Center for the Advanced Study of Aging Services - University of California, Berkeley Annual Meeting of the Society for Social Work and Research Miami, FL, January 14, 2005

Center for the Advanced Study of Aging Services Mission:  Improving services for the elderly through research, collaboration and education Current projects include:  Strategic Plan for an Aging CA (SB910)  Family Caregiver Support Program  LTC Insurance and Quality Assurance  LTC Integration and Case Management  Consortium for Social Work Training in Aging

Overview  Literature Review  Research Questions  Method  Results  Discussion & Implication

Literature Review  Lower level of formal service use among minority CGs compared with White CGs (yet, inconclusive)  Disparities in types of formal service use between minority and White CGs  Comparison between White and non-White CGs in most studies

Research Questions  Do racial/ethnic CGs use services differently from White?  Do racial/ethnic groups rely on different sources of service?  Do they use different types of services?  How do they see barriers to service use?

Method  Random Digit Dialing  Respondent caring for someone over age 50  Surveys conducted in English and Spanish  Interview lasted approx. 30 minutes  N = 1,643

Demographic ANHPIHispanicAfrican AmericanWhite Female73%76%80%74% Gender (n=1,559) Age** (n=1, 529) Under 3518%27%19%8% %41%34%28% %24%39%40% 65 +3%8%21%25% * p<0.05; ** p<0.01

Demographics (cont’d) Marital Status** (n=1,435) ANHPIHispanicAfrican AmericanWhite Married65%58%33%64% Living w/ partner0%4%2% Separated0%3%7%2% Divorced6%12%22%12% Widowed1%3%8%9% Never Married28%22%28%12% Children < 18 Living in Household** (n=1,555) Yes41%47%36%24%

Demographics (cont’d) Education** (n=1,552) ANHPIHispanicAfrican AmericanWhite < High school0%15%1%2% Some high school3%10%9%4% High school graduate16%23% 20% Post high school education19%29%40%36% College graduate43%18%21%25% Post graduate degree19%5%6%14% 2001 Household Income** (n=1,359) < $30,00032%53%52%35% $30, %47%48%65%

Demographics (cont’d) Country of Origin** (n=1,323) ANHPIHispanicAfrican AmericanWhite USA34%67%96% Canada0% 1% Mexico0%25%0% Europe0% 2% South America0%2%0% Middle East0% 1%0% Asia/Pacific Island49%0% Indian Subcontinent14%0% Central America0%6%2%0% Other3%0%

Total Number of Service Use ANHPIHispanicAfrican American WhiteTotal Used no service21%20%13%17%18% Used at least one service 79%80%87%83%82% Mean number of total service use** Range (min:max)8(0:8)9(0:9)8(0:8)10(0:10) * p<0.05; ** p<0.01

Result of Post Hoc Test (Tukey HSD) ANHPIHispanic African American White ANHPI * Hispanic ** ** African American * p<0.05; ** p<0.01

Formal & Informal Service Use ANHPIHispanic African American WhiteTotal Used at least one FORMAL service** 57%65%77%72%70% Used at least one INFORMAL service* 66%59%58%52%55% * p<0.05; ** p<0.01

Ratio of Formal and Informal within One’s Service Use** ANHPIHispanic African American WhiteTotal FORMAL only26%36%34%45%41% INFORMAL only34%22%14%15%18% Both40%42%51%40%41% * p<0.05; ** p<0.01

Service Use by Type ANHPIHispanic African American WhiteTotal Information**28%19%34%29%27% Access17%10%6%11% Education*20%28%42%28%29% Counseling11% 12%14%13% Counseling from clergy4%18%21%18%17% Support group**19%20%18%23%22% * p<0.05; ** p<0.01

Service Use by Type (cont’d) ANHPIHispanic African American WhiteTotal In-home respite*42%39%41%32%35% Day respite7% 16%11%10% Night respite*10%9%15%12%11% Legal information**15%16%29%27%23% Financial information*23%13%20% 18% * p<0.05; ** p<0.01

Service Use by Source ANHPIHispanic African American WhiteTotal In-home respite** formal informal 30% 70% 19% 81% 18% 82% 37% 63% 30% 70% Night respite** formal informal 0% 100% 31% 69% 43% 57% 54% 46% 47% 53% * p<0.05; ** p<0.01

Barriers to Service Use ANHPIHispanic African American WhiteTotal Already have all the help needed** 69%63% 75%70% Help not wanted by CR44%42%37%41% Service not available**26%42%34%28%33% Poor quality**17%37%40%21%27% Language**35%25%11%9%15% No one to stay with CR while CG gets help* 17%30%23%25%26% * p<0.05; ** p<0.01

Barriers to Service Use (cont’d) * p<0.05; ** p<0.01 ANHPIHispanic African American WhiteTotal No time to get help39%23%17%25% Not available the times they need** 22%38%34%20%26% Transportation not available** 30%24%14%23% High cost**30%53%49%46%47% Service not offered by people like them* 17%24%29%19%21%

Discussion  Ethnic differences in total number of service use  Differences in sources  Some groups are more likely to rely on one source

Discussion (cont’d)  Different ethnic groups use different types of services  In-home respite, education, and information are most widely used across group  But sources of help seem to matter  Ethnic groups identify different barriers

Implication  Provide culturally specific services  Outreach to minority, especially immigrant, communities  Provide resources for the informal support network

Thank You! Center for the Advanced Study of Aging Services University of California, Berkeley