Availability of geriatric care facilities in the community: Variation by the proportion of foreign-born population

Objective. Expanding the previous immigrant health service literature, which has focused heavily on individual-level characteristics, this study examined whether the supply of geriatric care facilities in the community differ by the proportion of foreign-born population at the county level. Contextual factors, such as community-level socioeconomic compositional and resource characteristics, play a significant role in shaping individuals' health service utilization. Methods: This study analyzed the 2009 Area Recourse File and the 2005-2009 American Community Survey (ACS) at the county level (N=3,114). The five-year aggregated ACS sample is designed to facilitate meaningful analyses of smaller areas. The number of stand-alone geriatric care facilities (skilled nursing facilities (SNF), home healthcare agencies (HHA), and hospice) per 100,000 older adults (ages 65+) in each county was calculated to reflect the level of availability of such services. The percentage of foreign-born population was an independent variable. County-level compositional and socioeconomic characteristics were controlled for in the multivariate models.

Results: The percentage of foreign-born to the total population ranged from 0% to 63%. The results indicate that as the proportion of foreign-born population in the county increased, the availability of geriatric care facilities decreased (SNF (b=-0.04, p < .0001) and HHA (b=-0.09, p< .0001)). Conclusion: These discrepancies in the availability of geriatric care facilities in the counties with high proportions of foreign-born individuals will, in turn, affect individual level service utilization among older foreign-born individuals who live in the areas with limited resources.