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Survey: Nearly one-third of elderly in state, bay area in poor or fair shape


Mercury News
October 28, 2003

The first wide-ranging survey of the health of California 's 3.6 million seniors finds serious maladies marring the golden years of many in the state, most notably Latinos and people who speak little English.

Nearly 30 percent of seniors in the Bay Area and around the state report being in poor or only fair health, compared with 26 percent of seniors nationwide, according to the study conducted by researchers at the University of California-Los Angeles. About 46 percent of seniors who speak little English and 45 percent of Latinos reported similarly diminished health -- in part because they report lower rates of preventive care such as flu shots, dental work and colon cancer screenings.

The study, which involved detailed interviews of about 10,000 people over age 65, provides a rare health snapshot that is likely to spur statewide debate about how best to improve care for the state's seniors.

``It's tremendous data,'' said Dr. Sandra Moody-Ayers, a geriatric-medicine specialist at the University of California-San Francisco and director of palliative care at the San Francisco Veterans Affairs Medical Center. ``Now we need to focus on what's driving these differences in order for us to understand what interventions we need.''

Among the study's findings:

• About 45 percent of older Latinos do not receive flu shots, compared with a third of all California seniors. Flu vaccination can help prevent hospitalizations and deaths from this serious respiratory disease.

• About 45 percent of seniors who are poor, speak limited English or are African-American report receiving no dental care in the past year, compared with a third of all California seniors.

• About two in five California seniors report never having a colonoscopy, a standard screening procedure for colon cancer. That lack of preventive care was even higher among Latinos (49 percent), Asian-Americans (48 percent) and those who speak limited English of all backgrounds (50 percent).

• While 78 percent of white seniors reported having supplemental health insurance, only 37 percent of those speaking limited English had such insurance. While seniors over 65 receive Medicare, supplemental insurance can help pay for prescription drugs and other items that Medicare does not cover.

Researchers also noted that seniors in rural counties, particularly Tulare and Kings counties, reported the worst health in the state. Better health was to be found in Marin County , with its relatively affluent population, as well as other Bay Area counties, including Santa Clara County .

The findings on seniors were drawn from the 2001 California Health Interview Survey, a UCLA project.

That survey, the largest ever conducted in any state, covers a wide array of public health topics. Researchers contacted 55,248 randomly selected households and conducted health interviews in six languages from November 2000 to September 2001. The 10,000 seniors in the group were asked about heart disease, diabetes, asthma, smoking and drinking, cancer screening, high blood pressure, and their use of prescription drugs among other topics.

``While California seniors are working hard to remain healthy, large numbers aren't getting the preventive services they need to stay that way,'' said Dr. Steven Wallace, the lead author of the study and associate director of the UCLA Center for Health Policy Research.

Jessie Swain, a 92-year-old great-grandmother from Mexico who resides in the Mission de la Casa nursing home in San Jose , said she tries to stay healthy by exercising and not overeating. A diabetic since 1969, Swain receives insulin injections four times daily to control her blood sugar.

``I take care of myself,'' she said, demonstrating the sit-ups and arm exercises she does in bed to improve her circulation. ``I feel strong, like I can do a lot of things. I don't feel sick.''

Not all seniors are as fortunate.

Dr. Marty Fenstersheib, public health officer for Santa Clara County , said the UCLA study's findings square with his experience with the county's seniors. Sometimes it doesn't matter whether elderly people have insurance such as Medicare -- if they speak little English, it can be difficult to figure out where to find a doctor or get a flu shot, he said.

Some seniors lack family or community support that compromises their health care, Fenstersheib said. ``We don't value elders as we should,'' Fenstersheib said. ``That can lead to isolation.''

Lead author Wallace said he hopes the study will help health officials target resources to where they're most needed.

``We're facing a disastrous state budget situation,'' Wallace said. ``We need to prioritize our dollars even more than in the past.''


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