Informal Caregiving Disparities in Transportation Support for Minoritized Older Adults

Context: Older adults who give up driving often face adverse health outcomes. Nevertheless, primary care clinicians will continue to counsel patients with functional and cognitive decline to stop driving due to safety concerns. Getting rides from others may be an important coping factor for older adults navigating driving cessation. However, preliminary evidence suggests that there are racial/ethnic disparities in getting rides.

Objective: We characterize the association between race/ethnicity and the odds of getting a ride among older adults, and test potential moderating effects of one’s social network characteristics on this association.

Study Design and Analysis: Cross-sectional analysis of survey data using descriptive statistics and weighted logistic regression models.

Setting or Dataset: National Health and Aging Trends Study.

Population Studied: Community-dwelling Medicare enrollees ages 65+ in 2015.

Outcome Measures: Whether someone got a ride from a family member, friend, or someone paid to help, in the last month, adjusted for driving status, social network characteristics, and sociodemographic characteristics.

Results: Hispanic older adults were less likely to get rides compared to White non-Hispanic older adults (adjusted Odds Ratio [aOR] = 0.47, 95% Confidence Interval [CI]: 0.34-0.66). When testing the interaction between race/ethnicity and social network size, we see that among older adults with no one to talk to, there was no difference in the odds of getting a ride between Hispanic and White non-Hispanic older adults (aOR = 0.53, 95% CI: 0.26-1.11). However, for older adults with one person to talk to, Hispanic older adults were less likely to get rides vs White non-Hispanic older adults (aOR = 0.54, 95% CI: 0.3-30.90). We also found this association for Hispanic vs White non-Hispanic older adults who had two or more people to talk to (aOR = 0.36, 95% CI: 0.22-0.60). There was no difference in the odds of getting a ride between Black non-Hispanic vs White non-Hispanic older adults, and no interaction with social network size.

Conclusions: Hispanic older adults may be less likely to get rides from their social networks regardless of the size of their social network, compared to White non-Hispanic older adults. Future research should examine additional barriers to getting rides for Hispanic older adults, such as neighborhood disadvantage, walkability, or rurality/urbanicity.