Health Care for Hispanic Elders

• Nationally, Hispanics are expected to grow from the current 5.6% (two million people) to 16.4% of the over 65 year old population by 2050 – the largest group after Whites.

  In Kansas, Hispanics will also become the second largest group of elders. Most will live in the cities and larger towns, but all counties are expected to have Hispanic residents with significant concentrations in Ford, Finney and Seward counties. Approximately 80% of Hispanics in Kansas are of Mexican ancestry, 18% from Central or South America and the remainder from Puerto Rico or Cuba.

  The degree of acculturation or comfort with US systems is not necessarily linked to the duration of residence in US – the elderly may have lived within the Hispanic community with relatively little external contact for decades. Hispanics have lived in Kansas since the earliest settlements. During most of the last century, immigration from Mexico was encouraged to meet agricultural and industrial labor shortages (the Bracero program). Illegal immigration accelerated when this program was discontinued in the 1960s. Wichita has both long-established Hispanic families and new immigrants. Tensions exist within the community between the new arrivals and the more-highly accultured groups and between Hispanics from different countries or regions. In south-western Kansas, the Hispanic immigration began about a decade ago and is dominated by meat-packing workers from Mexico and Central America. Elderly Hispanic patients range from those who have lived in Kansas for decades to recent arrivals.

  As a group, Hispanic elders have the lowest average years of formal education with only 30% graduating from high school but this varies widely. They also have high rates of poverty, particularly for women. At least one in five elderly Hispanics are below poverty levels. A particular feature of Hispanic elderly income is that many have no retirement or Social Security incomes due to immigration status and/or their occupational experiences. Many continue to work well into old age. Elderly Hispanics are more likely than any other group to live with family members and least likely to live in nursing homes. At least one in three elderly Hispanics speaks little or no English.

  Although some generalizations apply, even within the major groups of Hispanics (Mexican, Cuban, Puerto Rican, Central America, South America, other and mixed) individuals have a wide range of socioeconomic factors, life experiences and health concerns .

• Overall (all-cause) death rates for elderly Hispanics are about one third of non-Hispanic Whites (NHW) of the same age for both men and women.

  This has been attributed to the "health survivor" effect i.e. the elderly are those who were sufficiently healthy, resourceful, or lucky to avoid dying from anything at a younger age. Lifestyle, diet, family support, and enhanced role of the elderly in the community have also been suggested as contributing to reduced mortality rates in all Hispanic age groups after 65 years.

Overall mortality rates in elderly Hispanics are one third those of Non-Hispanic Whites