Impact of household living arrangements on preventive care use among community-dwelling elders in the United States

OBJECTIVE: To examine the impact of household living arrangements on the use of preventive care among community-dwelling older adults. METHODS: Using data from the 2002-2005 Medical Expenditure Panel Survey, this cross-sectional study analyzed 13,038 U.S. community-dwelling elders age 65 and older whose living arrangements included 38% living alone; 52% living with spouse only (SP-only); 5% living with spouse and at least one adult offspring age 18+ (SP+AO); and 5% living with at least one adult offspring but no spouse (AO-only). United States Preventive Services Task Force (USPSTF)-recommended preventive care services included influenza vaccination, routine check-up, dental checkup, and screening for hypertension, colon cancer, and cholesterol. RESULTS: Controlling for elder's characteristics (age, sex, race, primary language, education level, household income, health insurance, chronic conditions, self-reported health, and functional status), elders living with SP-only were more likely than elders living alone to obtain all types of preventive care. Elders living with AO-only had similar odds as elders living alone in obtaining all preventive services, except for dental checkup and influenza vaccination, both of which they had lower odds in obtaining. Elders living with SP+AO had similar odds as elders living lone in obtaining all types of preventive care. Similar results were found after controlling for employment status and functional status of the adult offspring. CONCLUSION: Living arrangements are strongly associated with preventive care use among elders. Interventions to improve adherence to preventive care guidelines should target elders living alone, as well as family members, especially adult offspring, who live with elders.