Longitudinal Trends in Healthcare Use Among Racial and Ethnic Minority Older Adults, 1996-2016.

BACKGROUND AND OBJECTIVES: Racial and ethnic disparities in healthcare use among older adults persist in the U.S. and remain a pressing equity issue. While prior studies have documented these disparities, few have examined how they change over time across different care domains. This study aims to fill this gap by investigating how disparities in preventive, treatment, and long-term care use have changed over the past two decades.

RESEARCH DESIGN AND METHODS: Using 11 waves (1996-2016) of the Health and Retirement Study (HRS), a nationally representative longitudinal survey of U.S. older adults (N = 23,724), this study examines trends in healthcare use by race/ethnicity. Healthcare use was categorized as preventive care (physician visits and dental care), treatment care (hospital stays and outpatient surgeries), and long-term care (home health care and nursing home care). Mixed-effects logistic regression models assessed racial/ethnic differences over time.

RESULTS: Non-Hispanic Black and Hispanic older adults were less likely to use preventive and treatment care than their non-Hispanic White counterparts, with disparities widening notably after 2008. In contrast, long-term care use increased among Non-Hispanic Black older adults but declined among Hispanic older adults over time. Significant interaction terms confirmed that disparities shifted over time and differed by care type.

DISCUSSION AND IMPLICATIONS: Findings indicate that national healthcare reforms have not equally benefited all racial and ethnic groups. Persistent and growing disparities highlight the need for targeted, culturally responsive policies and equity-focused monitoring systems to ensure fair access to healthcare for an increasingly diverse aging population.