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Backgrounds/Objectives: The prevalence of dementia in the elderly Latino population is expected to significantly increase from around 200,000 cases in 2000 to as many as 1.3 million cases in 2050. This demographic trend has important consequences for options in care and living arrangements. Very little is known about how of cognitive impairment trajectories co-vary with support available to Mexican Americans. We examine the relationship between living arrangements and the social support of individuals with dementia. Methods: Using data from nine waves from the 23 years of the Hispanic EPESE (n=3,952), we examine trajectories of cognitive functioning and family and social support. We first describe the change in Mini Mental Status Examination (MMSE) scores for survivors from Wave 1 (1993/1994) to Wave 9 (2015/2016), n=255. Growth Mixture Modeling (GMM) is then used to assess how changes in MMSE scores are distributed among living arrangements for individuals living independently compared to household extension (living with others) using the full sample. Results: Analyses reveal different trajectories in MMSE score. 12% (n=27) of the sample had no decrease, while the remaining (88%) were split between moderate decline (60% n=136, 1-10 point decline in MMSE) and severe decline (28% n=62 >10 point decline In MMSE). Changes in living arrangement over the same period show that 89% of individuals who move from independent living into extended household experienced cognitive decline. Conclusions: This study provides new information on how cognitive trajectories are associated with living arrangements. We discuss implications for improving community-based interventions for Latino family caregivers. Translational Significance: Where you live in late life matters. Health affects where you live but this research suggests that cognitive health is affected by where you live. There may be protective effects of living independently. [ABSTRACT FROM AUTHOR]

Objective: This study examines nativity differentials in healthy and unhealthy life expectancy among Mexican American men and women ages 65 and older residing in the southwestern United States. Specifically, we assess whether the healthy immigrant effect in mortality extends to disability within a single ethnic group and in a border region. Method: We employ 17 years of data from the Hispanic Established Population for the Epidemiologic Study of the Elderly (HEPESE) to calculate multistate life tables of life expectancy with and without disabilities and provide detailed comparisons in the length of life and disabled life specific to nativity and gender. Results: Overall life expectancy for the foreign-born is modestly higher than the nativeborn. Native-born males and foreign-born females spend a larger fraction of their elderly years with Activities of Daily Living disability in comparison to foreign-born males and native-born females. Conversely, both foreign-born males and females spend a larger fraction of their remaining years with Instrumental Activities of Daily Living disability than their native-born peers. Discussion: The healthy immigrant effect does not apply to disability within this sample. While foreign-born Mexican elders live slightly longer lives, on average they do so with more years spent in a disabled state. Given the rapid aging of the Latino population, the prevention and treatment of disabilities, particularly among the foreign-born should be a major public health priority. [ABSTRACT FROM AUTHOR]

Our reliance on an employment based health insurance system in the United States means that those individuals who are disadvantaged in the labor market are also disadvantaged in terms of health insurance coverage. Hispanics in the United States, and especially those of Mexican origin, have historically been disadvantaged in both domains. Throughout the life course, Americans of Mexican origin have lower rates of health insurance coverage than other groups, including African Americans and other Hispanics. Although employment in jobs that do not offer benefits is the major barrier to health care coverage for this population, other factors, including immigration history, citizenship status, and language proficiency play a role. In this paper we examine health insurance coverage among Mexican American pre-retirement age adults and the elderly and compare it to that of blacks and other Hispanic groups. We use data from the 2001 Current Population Survey (CPS) to identify the major sources of health care coverage for young and older adults from the three major Hispanic groups, Mexican Americans, Cuban Americans, and Puerto Ricans and to compare their coverage to that of non-Hispanic blacks and whites. The results clearly reveal that health coverage disadvantages among Hispanic elders represent the continuation of life-long disadvantages that begin in the earliest years of the life course. A very important motivation for such a comparison arises from the fact that given a finite economic pie different age groups necessarily compete for resources. The fact that Mexican Americans, in particular, are at elevated risk of inadequate health care coverage at all ages adds an ethnic dimension to age differences in health care financing. We end with a discussion of policy options for overcoming some of the major barriers to adequate health care coverage for this group and other poor Americans. ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]

In this study, we document the ways in which the Social Security system creates major disparities within ethnic minority groups. Immigrants and individuals who never participated in the Social Security program or those who immigrated to the United States in middle or late adulthood face particularly serious problems. Our purpose is to focus closely on the interplay of marital history, immigration, and retirement income supports. We address the following questions: (1) Does race/ethnicity and nativity affect changes in the sources of income for elderly women in the years prior to retirement and in the years after retirement? (2) What are the impacts of nativity and immigration on the economic security of pre-retirement age Latinos, in particular? (3) Do sociocultural factors such as age at migration and family structure make a significant difference in predicting Hispanics? economic well-being defined in terms of personal income and assets, in late life? These analyses extend previous research on Latino economic security by employing several waves of the Health and Retirement Survey (HRS). The HRS was initiated in 1992, and is an excellent data set to examine these research questions since it includes in-depth economic, social, and program participation information on a nationally representative sample of individuals between ages 50 and 61. The large cohort, in addition to purposive over sampling of Latinos, provides ample opportunity to consider the importance of nativity, generally, and the specific effect of age at migration on Latino economic profiles and their implications for social security reform. [ABSTRACT FROM AUTHOR]