Assessing the functional impact of self-reported secondary health conditions in older community-dwelling African American women using the International Classification of Functioning, Disability and Health Framework

Adults aging into disability are at an increased risk of developing secondary health conditions, defined as “preventable physical, mental, and social disorders resulting directly or indirectly from an initial disabling condition…” according to a recent report from the White House Conference on Aging. Secondary conditions can limit the ability to engage in socially, psychologically, and physically constructive behaviors such as physical activity participation. Although the natural aging process is partly responsible for reductions in physiological and psychological functioning, secondary conditions are overlaid upon the natural aging process as factors that can compound, and in some cases accelerate, alterations in health and function. Sixty-nine older community-dwelling African American women in one large urban area were interviewed in six focus groups to determine their self-reported secondary health conditions and the functional impact of these conditions. Focus group questions were structured according to domains from the International Classification of Functioning, Disability, and Health (ICF), using personal, environmental, and social categories to determine the influence on acquired secondary conditions. Results indicated pain, fatigue, sleep problems, and weakness were the most commonly reported secondary health conditions, and nearly half the sample reported having five or more secondary health conditions. Among the highest reports of functional problems resulting from these health conditions were difficulty accessing proper medical care and transportation to achieve daily tasks necessary for independent living such as grocery shopping. By identifying and exploring the severity and impact of certain secondary health conditions, interventions can be tailored to mitigate their adverse effects.