Nativity, Family, Disability: Results from the Hispanic Established Populations for the Epidemiologic Study of the Elderly

Abstract

Objectives: Nativity and family support may influence attitudes and behaviors that delay or accelerate the disability process in older adults. The objectives of this study were twofold: 1) to evaluate nativity and migration cohort differences in trajecto­ries of disability (assessed by activities of daily living [ADL]) among older Mexican Americans; and 2) to determine the role of objectively measured family support in the association between nativity, migration cohort, and disability changes over time.Methods: This is a longitudinal study with up to 18 years follow-up (1993-2011) using data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly (N=2,785, mean age =72.4 years). Disability was assessed using self-reported limitations in activities of daily living (ADL). Nativity and migration cohort were self-reported. Family support was as­sessed by marital status and the number of their children participants saw each month. Linear growth curve models evaluated the trajectory of ADL disability over 18 years and assessed variations by nativity status, migration cohort and family support.Results: Foreign-born respondents who migrated before age 20 had more starting ADL limitations (β= .36, P<.001) and ac­cumulated disability faster (β=.04, P<.01) compared with their US-born counterparts. In contrast, foreign-born respondents who migrated at later ages showed disability trajectories similar to US-born respondents. Married respondents had a lower level of disability (β= -.14, P<.01) and a lower rate of accumulation over time (β= -.02, P=.001) compared with participants who were not married.Discussion: Mexican Americans who migrate at younger ages may experience greater disability over time; however, family support may help mitigate the accumula­tion of disability among older Mexican Americans.Ethn Dis. 2021;31(2):253-262; doi:10.18865/ed.31.2.253