TY - JOUR
T1 - Aging versus disease
T2 - The opinions of older black, hispanic, and non- hispanic white Americans about the causes and treatment of common medical conditions
AU - Goodwin, James S.
AU - Black, Sandra A.
AU - Satish, Shiva
PY - 1999/8
Y1 - 1999/8
N2 - BACKGROUND: Little is known about how older people interpret disease and how those interpretations might relate to use of medical services. OBJECTIVE: To assess opinions of older subjects about the cause and treatment of common diseases and how they are related to health behaviors. DESIGN: In-home interview of a population-based sample (n = 601) of noninstitutionalized black, Hispanic, and non-Hispanic white American men and women aged 75 and older in Galveston County, Texas. RESULTS: Substantial proportions of the subjects considered heart disease, arthritis, or difficulty sleeping to be a normal part of aging. In multivariate analyses including age, gender, education, marital status, living arrangement, global self-rating of health, and comorbidity, older black subjects were less likely to view heart disease (OR = 0.41; 95% CI, 0.26-0.64), arthritis (OR = 0.48; 95% CI, 0.31-0.73), or sleep problems (OR = 0.50; 95% CI, 0.32-0.77) as a normal part of aging than were non-Hispanic whites. Blacks were more than three times as likely to attribute heart disease to overwork or stress than were non-Hispanic whites. In multivariate analyses, subjects who considered all three of the medical conditions to be a normal part of aging ('fatalistic') were less likely to have received preventive medical services in the previous year (OR = 0.13; 95% CI, 0.02-0.96), and subjects who felt that nothing could be done to treat any of the conditions ('nihilistic') were less likely to have a regular physician (OR = 0.24; 95% CI, 0.08-0.74). CONCLUSIONS: Substantial numbers of older subjects are fatalistic about the cause of disease and/or nihilistic about its treatment. These attitudes are associated with decreased utilization of health services. Attempts to improve the health of underserved groups should employ interventions that are sensitive to the health beliefs of the targeted group.
AB - BACKGROUND: Little is known about how older people interpret disease and how those interpretations might relate to use of medical services. OBJECTIVE: To assess opinions of older subjects about the cause and treatment of common diseases and how they are related to health behaviors. DESIGN: In-home interview of a population-based sample (n = 601) of noninstitutionalized black, Hispanic, and non-Hispanic white American men and women aged 75 and older in Galveston County, Texas. RESULTS: Substantial proportions of the subjects considered heart disease, arthritis, or difficulty sleeping to be a normal part of aging. In multivariate analyses including age, gender, education, marital status, living arrangement, global self-rating of health, and comorbidity, older black subjects were less likely to view heart disease (OR = 0.41; 95% CI, 0.26-0.64), arthritis (OR = 0.48; 95% CI, 0.31-0.73), or sleep problems (OR = 0.50; 95% CI, 0.32-0.77) as a normal part of aging than were non-Hispanic whites. Blacks were more than three times as likely to attribute heart disease to overwork or stress than were non-Hispanic whites. In multivariate analyses, subjects who considered all three of the medical conditions to be a normal part of aging ('fatalistic') were less likely to have received preventive medical services in the previous year (OR = 0.13; 95% CI, 0.02-0.96), and subjects who felt that nothing could be done to treat any of the conditions ('nihilistic') were less likely to have a regular physician (OR = 0.24; 95% CI, 0.08-0.74). CONCLUSIONS: Substantial numbers of older subjects are fatalistic about the cause of disease and/or nihilistic about its treatment. These attitudes are associated with decreased utilization of health services. Attempts to improve the health of underserved groups should employ interventions that are sensitive to the health beliefs of the targeted group.
KW - Aging
KW - Barriers to treatment
KW - Ethnicity
KW - Health promotion
KW - Population-based
KW - Understanding illness
UR - http://www.scopus.com/inward/record.url?scp=0032812022&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0032812022&partnerID=8YFLogxK
U2 - 10.1111/j.1532-5415.1999.tb01293.x
DO - 10.1111/j.1532-5415.1999.tb01293.x
M3 - Article
C2 - 10443859
AN - SCOPUS:0032812022
SN - 0002-8614
VL - 47
SP - 973
EP - 979
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 8
ER -