Longitudinal trends in healthcare use among racial and ethnic minority older adults, 1996–2016

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BACKGROUND AND OBJECTIVES: Racial and ethnic disparities in healthcare use among older adults persist in the United States and remain a pressing equity issue. While prior studies have documented these disparities, a few have examined how they change over time across different care domains. This article 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, 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.

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