# Presentation: 030726

## August 26, 2005University of Iowa

- “The Health of Hispanics in the United States with Special Focus on Older People”
- Kyriakos S. Markides, Ph.D.
- University of Texas Medical Branch
- Galveston, Texas, USA

## U.S. Hispanic Population Growth, 1940...2003

- Millions

- Source: U.S. Bureau of the Census

## Hispanics as % of U.S. Population

- Source: U.S. Bureau of the Census

## FIGURE 1. 

**FIGURE**** ****1****.**

**Hispanics by Origin: 2002**

**(In**** ****percent)**

**Mexican**
**American ** **66.9**

**Central and**

**South American 14.3**

**Puerto Rican 8.6**

**Cuban** **3.7**

**Other Hispanic 6.5**

- Source: U.S. Census Bureau, Annual Demographic Supplement to the March 2002 Current Population Survey.

- (Adapted from U.S. Bureau of the Census, 2003)

## POPULATION PROJECTIONS TO 2050

- Non-Hispanic Whites		210 million
- Hispanics				103 million (25%)
- African Americans (Blacks)	  61 million
- Asian Origin				  33 million

- Source:  U.S. Bureau of the Census (2004)

## An Epidemiologic Paradox

- Hispanics (except Cuban Americans) are socioeconomically disadvantaged, but have favorable overall mortality
- Markides and Coreil (1986)

- Risk factor profiles
- High rates of DIABETES
- High rates of obesity
- Similar rates of hypertension, cholesterol
- High SMOKING rates among men, lower among women (fewer cigarettes). Cuban American males smoke the most
- High ALCOHOL (binge) drinking rates among men, low among women.  Alcohol consumption in women increases with acculturation
- Low rates of physical ACTIVITY
- Strong families
- Migration selection

## Aging, Migration and Mortality: Current Status of Research on the Hispanic Mortality Paradox

- Data based on Vital Statistics show the greatest mortality advantage compared to Non-Hispanic Whites for all Hispanics combined. The advantage is greatest among older people.
- National Community Surveys linked to the National Death Index show a narrowing of the advantage and one study suggests that the Mexican origin mortality advantage (Palloni & Arias, 2004) can be attributed to selective return migration of less healthy immigrants to Mexico.
- The Medicare – NUDIMENT data show a much lower advantage of Hispanic elders than the Vital Statistics Method.
- Markides & Eschbach, J. Geront: Social Sciences (in press)

## A LONGITUDINAL STUDY OF THE HEALTH OF MEXICAN AMERICAN ELDERLY      1992-2008        FUNDED BY NIA(HISPANIC EPESE)

**UTMB,   GALVESTON, TX**
**PI, ***Kyriakos S. Markides,Ph.D.*
**CO-INVESTIGATORS:     **
*James S. Goodwin, MD.*
*Kenneth Ottenbacher, Ph.D.*
*M. Kristen Peek, Ph.D.*
*Glenn V. Ostir, Ph.D.*
*Mukaila Raji, MD.*
*Laura Rudkin, Ph.D.*
*Karl Eschbach, Ph.D.*
*Daniel H. Freeman, Jr., Ph.D -Biostatistician.*
*Laura A. Ray, M.P.A. -Project Director*
*Soham Al Snih, MD., PhD –Research Associate*
*Max Otiniano, MD., MPH –Research Associate*

**NIA STAFF:**
*Sidney Stahl, Ph.D.*
**FIELD STAFF:**
*Harris Interactive, Inc. (formerly Louis Harris and Associates)*
**OUTSIDE CONSULTANTS:**
*Carlos Mendes de Leon, Ph.D.*
*Laurence Branch, Ph.D.*
*Robert Wallace, MD.*
*Dan Blazer, Ph.D.*
*Denis Evans, MD.*
*Sandra A. Black, Ph.D.*
*David Chiriboga, Ph.D.*
*Mary Haan, Dr.PH*

## Investigators - continued

**UNIVERSITY  OF TEXAS HEALTH SCIENCE CENTER,**
**     ****SAN ANTONIO, TX**
**PI,  ***David V. Espino, MD.*
**CO-INVESTIGATORS:**
*Ray Palmer, Ph.D., Biostatistician*
*Donald Royall, MD*
**UNIVERSITY OF TEXAS, **
**     ****AUSTIN, TX**
**PI,  ***Ronald J. Angel, Ph.D*.
**CO-INVESTIGATOR:**
*Jacqueline Angel, Ph.D.*

## SAMPLING PROCEDURES

**Area probability multi-stage sample of Mexican Americans aged 65 and over residing in the five Southwestern states (Texas, New Mexico, Colorado, Arizona, and California) **
**(Non-institutionalized population).**
**Data collected during 1993-1994.**
**N = 3,050**

## Hispanic EPESE Summary: Baseline, Wave 2, Wave 3, Wave 4 and Projected Waves 5 & 6

- 	_**Total**_**	**_**Proxy**_**+**** **_**Deceased**_**    **_**Refused**_**	**_**Not Located**_**	**_**Age**_

- 1993-4	   3050	     177						  65+
- 1995-6	   2438	     143	         236	  105	          270	  67+
- 1998-9	   1980	     145	         424 	  120	          289	  70+
- 2000-1	   1683	     101	         280	  131               297	  72+
- 2004-5*	   1158	      91	         392    	    86	         155	  75+
***Added Sample*****	**** **
- 2005* 758(of 1000)  45	           0		     0	           na	  75+
***Both samples combined***
- 2006        1500	      300	            ?		     ?		?	  77+

- + Included in Total 				*Currently in the field.   Status as 10/06/05

- Cumulative deceased=940 at end of 4th wave

## SELECTED SAMPLE  CHARACTERISTICSN=3,050 (1993-94)

_**AGE**_
-  RANGE 65-99
** **MEAN**  **73.0 yrs.

_**GENDER**_
-  MALE**      **43.3%
** **FEMALE**  **56.7%

_**MARITAL STATUS**_
-  MARRIED **            **55.3%
** **DIV/SEP**                  **7.9%
** **WIDOWED**            **31.6%
** **NEVER MARRIED** **5.3%

**Continued on next slide**

_**YEARS of SCHOOL**_
-  MEAN **   **5.1** ****yrs**.

_**PLACE OF BIRTH**_
-  MEXICO       46.8%
-  U.S.A.           53.2%

_**LIVING ARRANGEMENTS**_
-     ALONE             20.9%
-     2 PERSONS     41.0%
-     3 PERSONS     15.3%
-     4+ PERSONS   22.8%

## SELECTED SAMPLE CHARACTERISTICS 

_**SPEAKS ENGLISH**_
**   **NOT AT ALL**            **30.1%
**   **NOT TOO WELL      27.0%
-    PRETTY WELL        17.0%
-    VERY WELL             24.6%

_**SOURCES OF INCOME**_
-    SOCIAL SECURITY   96.1%
-    PRIVATE PENSION   17.1%
-    SSI                              25.4%
-    CHILDREN                   7.0%
-    RENT/STOCKS/
-       BONDS, ETC.           4.4%

**CONTINUED**

_**HOUSEHOLD INCOME**_
**            **$0- 4,999     13.2%
-     $5,000-  9,999     37.7%
-   $10,000-14,999     25.8%
-   $15,000-19,999     11.7%
-   $20,000-29,999       6.2%
-   $30,000 +                5.4%

_**HEALTH INSURANCE**_
-   MEDICARE      87.4% (92%)
-    MEDICAID       34.1%
-    PRIVATE         23.5%

## PERCENT REPORTING SELECTED CHRONIC CONDITIONS by AGE and GENDER

_**MALES**_

**65-74    ****	****75 +**
**(n= 863)  ****	****(n= 431)**
**34.5    ****	****31.4**
**28.4    ****	****28.2**
**25.0    ****	****17.6**
**19.2   ****	****	****22.9**
**  ****5.9     ****	****  6.7**
**  ****4.4     ****	****  6.7**
**  ****1.6     ****	****  3.5**

**HYPERTENSION**
**ARTHRITIS**
**DIABETES**
**HEART DISEASE**
**STROKE**
**CANCER**
**HIP FRACTURE**

## PERCENT REPORTING SELECTED CHRONIC CONDITIONS by AGE and GENDER 

**65-74   ****	**** 75 +**
**(n=1139)  ****	****(n= 615)**
**45.6    ****	****49.3**
**47.3    ****	****50.5**
**24.6    ****	****19.5**
**21.9    ****	****23.2**
** ****3.5     ****	****  9.8**
** ****4.7    ****	****	****  6.7**
** ****2.4    ****	****	****  7.5**

**HYPERTENSION**
**ARTHRITIS**
**DIABETES**
**HEART DISEASE**
**STROKE**
**CANCER**
**HIP FRACTURE**

**PERCENT REPORTING SELECTED CHRONIC CONDITIONS by AGE and GENDER **

**continued**

## Percent of Persons 65 and Over Who Report Difficulty Performing Selected Activities of Daily Living by Ethnicity

**  ****Whites**
**(n=24,753)**

**Non-Whites**
-  **(n=2,784)**

**Mexican Americans**
**       ****(n=3,050)**

- Note:  Data on Whites and Non-Whites are from the 1986 National Health Survey (NCHS, 1993).  Data on Mexican Americans are from the 1993-94 Hispanic EPESE.

## Changes in Blood Pressure and Risk Factors for Cardiovascular Disease among Older Mexican Americans from 1982-1984 to 1993-1994

- Prevalence of obesity and diabetes rose significantly
- Mean diastolic pressure increased significantly

- Stroup-Benham, C.A., Markides, K.S., Espino, D.V. & Goodwin, J. S.

- Journal of the American Geriatric Society, 1999

## Depression Predicts Increased Incidence of Adverse Health Outcomes in Older Mexican Americans with Type 2 DiabetesBlack, S.A., Markides, K.S, Ray, L.A.

-    Depression exacerbates effect of diabetes on complications, disability, mortality over seven years
-                           Diabetes Care, 2003

## Lower Body Functioning as a Predictor of Subsequent Disability among Older Mexican AmericansOstir, G.V., Markides, K.S., Black, S.A. and Goodwin, J.S.

** **Eight foot walk, repeated chair stands, and standing balance are strong predictors of the development of disability among initially non-disabled persons**   **

- J. of Gerontology: Medical Sciences, 1998

## Lower Body Function and Mortality in Mexican American Elderly PeopleMarkides, K.S., Black, S.A., Ostir, G.V., Angel, R.J., Angel, J.A., Guralnik, J.M., and Lichtenstein, M.

- Physical performance tests are strong independent predictors of mortality over a two-year period
-    J. of Gerontology: Medical Sciences, 2001

## Handgrip Strength and Mortality in Older Mexican AmericansAl Snih, S.A., Markides, K.S., Ray, L.A., Ostir, G.V., and Goodwin, J.S.

- Handgrip strength is an independent predictor of mortality over a five year period

- Journal of the American Geriatrics Society, 2002

## Emotional Well-Being Predicts Subsequent Functional Independence and SurvivalOstir, G.V., Markides, K.S., Black, S.A. and Goodwin, J.S.

- Independently of depressive symptoms, positive affect predicts independence and survival over a two-year period

- Journal of the American Geriatrics Society, 2000

## Baseline Prevalence of 6 Medical Conditions, Disability, and 7-Year Mortality by Mexican Americans Population Share in Local Environments (Hispanic EPESE)Eschbach, K., Markides, K.S., Patel, K., Goodwin, J.S.  

- Neighborhood Percentage Mexican American is associated with lower prevalence of stroke, cancer, hip fracture, and seven-year mortality.

**American Journal of Public Health, 2004**

## Neighborhood Composition and the Incidence of Cancer among Hispanics in the United States Eschbach et al. 

- Using SEER and Census data Eschbach et al (2005) found that the incidence of breast, colorectal, and lung carcinoma among Hispanics increased as the percentage of Hispanics in the census tract decreased.
- The lower cancer rates among Hispanics relative to non-Hispanic Whites may dissipate as Hispanics become more assimilated into the mainstream society.

- 								                 Cancer,  2005

## Figure 1. Conceptual Model

**Stressors/Strains**

**Major Life Events**
**Financial Strain**

**Stage I**

**Stage II**

**Stage III**

**Stage IV**

_**Sociodemographic**_

_**Variables**_

**Age, Gender,**

**Social Class,**

**Acculturation,**

**Migration History**

**Social Support**

**Medical Conditions**

**Cognitive**

**Function**

**Function**

**Physical**

**Emotional**

**Mortality**

**Institutionalization/**

**Changes in Living**

**Arrangements**

**Figure 1. Conceptual Model**

**Community**

**Context**

**Impairments/Limitations**

**Sensory, Physical, etc.**

**Health Service Use/**

**Access**

**Function**

## COLLABORATIONS

- Mexican Health and Aging Study (MHAS)
- Puerto Rican Health Conditions Study (PREHCO)
- SABE Studies (Chile, Mexico, Uruguay, Brazil, Cuba, Argentina, Barbados)

## Census Disability Rates among Older People by Race/Ethnicity and Type of Hispanic Origin

- Kyriakos S. Markides
- Karl Eschbach
- Laura A. Ray
- M. Kristen Peek

## Hypotheses

- Older Hispanics as a group will have greater disability rates than older Non-Hispanic Whites, rates that are only slightly lower than those for African Americans.
- Older Asian and Pacific Islanders will have disability rates that are somewhat lower than those of older Non-Hispanic Whites.
- Older Native Americans (American Indians and Alaska Natives) will have high disability rates possibly higher than any other population.

## Hypotheses (continued)

- Among the Hispanic populations, older Puerto Ricans will have the highest disability rates with older Cubans having the lowest and Mexican Americans having intermediate rates.
- It is not clear what rates for older Central Americans and older South Americans would be like given absence of guidance from existing literature. We might hypothesize that since these groups are overwhelmingly immigrants, that their rates might be somewhat lower than rates for Mexican Americans if indeed they are selected through migration. Given that men are more likely to be selected than women, men will have lower disability rates.

## Hypotheses (continued)

- It is also not clear what the rates for Other Hispanics might be like. Other Hispanics are a heterogeneous mix of Spaniards, Dominicans, perhaps some Filipinos, as well as more than a few Mexican Americans, Puerto Ricans, and Cubans and persons of mixed ancestry who fail to identify with a specific Hispanic origin in their responses to the Census. Given this mix, we might expect them to exhibit average disability rates perhaps similar to those for Mexican Americans.
- Among older persons of Mexican origin the foreign-born will have lower disability rates than the native-born. This is more likely to be the case for men than for women.

## Note:  Directly standardized to age 65+ population, U.S. all racial/ethnic groups in 2000, for ages 65-69, 70-74, 75-79, 80-84, 85-89, 90+.

## Table 1 Age-standardized census disability rates (percent) by race/ethnicity

| Race/Ethnicity | Sensory | Physical | Mental | Self-Care | Go Outside | Any Disability |
| --- | --- | --- | --- | --- | --- | --- |
| MALES
Non-Hispanic White | 
17.2 | 
27.8 | 
11.3 | 
9.5 | 
18.5 | 
42.4 |
| Hispanic | 18.2 | 30.1 | 16.4 | 12.5 | 27.1 | 49.3 |
| Black | 17.4 | 35.8 | 18.1 | 16.3 | 28.7 | 53.1 |
| Asian American | 15.7 | 24.6 | 15.0 | 10.3 | 24.8 | 43.4 |
| Native American | 30.3 | 41.8 | 19.2 | 15.4 | 25.6 | 59.7 |
| Other | 16.2 | 26.0 | 11.8 | 9.9 | 22.7 | 43.5 |
| FEMALES
Non-Hispanic White | 
13.2 | 
31.0 | 
12.0 | 
12.6 | 
23.5 | 
42.4 |
| Hispanic | 16.5 | 36.8 | 19.4 | 16.4 | 32.2 | 53.5 |
| Black | 15.1 | 42.7 | 19.6 | 20.2 | 34.1 | 57.4 |
| Asian American | 14.3 | 29.9 | 18.3 | 13.4 | 29.1 | 45.9 |
| Native American | 23.4 | 48.2 | 19.9 | 18.8 | 31.6 | 61.0 |
| Other | 16.4 | 33.6 | 15.8 | 15.7 | 27.0 | 46.8 |

**Table 1 Age-standardized census disability rates (percent) by race/ethnicity**
**                       ****for persons 65 over: United States Census, 2000**

- Note:  Directly standardized to age 65+ population, U.S. all racial/ethnic groups in 2000, for ages 65-69, 70-74, 75-79, 80-84, 85-89, 90+.

## Note: Directly standardized to age 65+ population, U.S. all racial/ethnic groups in 2000, for ages 65-69, 70-74, 75-79, 80-84, 85-89, 90+. 

**Note: Directly standardized to age 65+ population, U.S. all racial/ethnic groups in 2000, for ages 65-69, 70-74, 75-79, 80-84, 85-89, 90+. **
**Note: Hispanic origin persons are recorded based on ancestry or country of birth, if they report general Hispanic. “All Other” includes U.S. born Hispanics, who report non-specific identity, and who live in a Southwestern state.**

## Table 2.  Age-standardized census disability rates (percent) for persons 65 and over by type of  

| Type of Hispanic Origin | Sensory | Physical | Mental | Self-Care | Go Outside | Any Disability |
| --- | --- | --- | --- | --- | --- | --- |
| MALES
Non-Hispanic White | 
17.2 | 
27.8 | 
11.3 | 
9.5 | 
18.5 | 
42.4 |
| All Hispanic | 18.2 | 30.1 | 16.4 | 12.5 | 27.1 | 49.3 |
| Mexican | 20.1 | 31.4 | 16.8 | 12.9 | 26.7 | 50.6 |
| Puerto-Rican | 19.9 | 36.2 | 20.3 | 16.0 | 31.1 | 54.8 |
| Cuban | 11.8 | 22.9 | 13.9 | 10.2 | 26.9 | 43.8 |
| Central American | 13.6 | 25.2 | 12.5 | 9.6 | 24.6 | 42.4 |
| South American | 12.3 | 22.3 | 12.4 | 8.0 | 24.6 | 41.8 |
| Dominican | 18.0 | 30.7 | 17.4 | 14.0 | 30.8 | 50.2 |
| Spaniard | 14.2 | 25.2 | 11.4 | 9.3 | 21.9 | 40.1 |
| All Other Hispanic | 21.4 | 34.4 | 18.0 | 14.0 | 28.1 | 52.8 |
| FEMALES
Non-Hispanic White | 
13.2 | 
31.0 | 
12.0 | 
12.6 | 
23.5 | 
42.4 |
| All Hispanic | 16.5 | 36.8 | 19.4 | 16.4 | 32.2 | 53.5 |
| Mexican | 17.8 | 37.8 | 19.1 | 17.0 | 32.1 | 53.9 |
| Puerto-Rican | 19.3 | 44.4 | 22.9 | 20.0 | 36.8 | 61.5 |
| Cuban | 12.0 | 31.7 | 18.9 | 14.7 | 31.8 | 49.9 |
| Central American | 14.3 | 34.3 | 19.5 | 12.9 | 31.3 | 51.7 |
| Dominican | 13.4 | 29.3 | 18.0 | 12.2 | 28.6 | 46.7 |
| Spaniard | 16.4 | 36.8 | 23.0 | 16.6 | 32.5 | 56.0 |
| South American | 13.8 | 27.2 | 14.0 | 12.3 | 27.0 | 44.5 |
| Other Hispanic | 16.7 | 38.1 | 17.4 | 16.7 | 30.7 | 53.5 |

**Table 2.  Age-standardized census disability rates (percent) for persons 65 and over by type of  **
**               ****Hispanic origin: United States Census, 2000 **

## Note:  Directly standardized to age 65+ population, U.S. all racial/ethnic groups in 2000, for ages 65-69, 70-74, 75-79, 80-84, 85-89, 90+.

##  Table 3. Age-standardized census disability rates (percent) for U.S. born and 

| Race/Ethnicity | Sensory | Physical | Mental | Self-Care | Go Outside | Any Disability |
| --- | --- | --- | --- | --- | --- | --- |
| U.S.-Born
Non-Hispanic White | 
17.4 | 
28.1 | 
11.3 | 
9.5 | 
18.4 | 
42.6 |
| Hispanic | 21.4 | 33.0 | 17.2 | 13.9 | 26.7 | 51.6 |
| Black | 17.6 | 36.4 | 18.4 | 16.5 | 28.7 | 53.5 |
| Asian American | 16.4 | 23.5 | 11.9 | 9.5 | 21.9 | 41.8 |
| Native American |  |  |  |  |  |  |
| Other | 18.7 | 27.9 | 11.6 | 9.7 | 20.1 | 46.4 |
| Foreign-Born
Non-Hispanic White | 
13.1 | 
22.6 | 
12.1 | 
9.4 | 
21.2 | 
39.4 |
| Hispanic | 15.9 | 28.1 | 15.8 | 11.6 | 27.5 | 47.7 |
| Black | 13.6 | 25.7 | 13.7 | 12.8 | 28.3 | 45.4 |
| Asian American | 15.4 | 25.2 | 16.2 | 10.6 | 25.8 | 44.1 |
| Native American |  |  |  |  |  |  |
| Other | 13.3 | 23.1 | 12.0 | 10.1 | 26.2 | 40.0 |

-  **Table 3. Age-standardized census disability rates (percent) for U.S. born and **
**           ****foreign born men 65 and over by race/ethnicity: United States Census, 2000**

- Note:  Directly standardized to age 65+ population, U.S. all racial/ethnic groups in 2000, for ages 65-69, 70-74, 75-79, 80-84, 85-89, 90+.

## Note:  Directly standardized to age 65+ population, U.S. all racial/ethnic groups in 2000, for ages 65-69, 70-74, 75-79, 80-84, 85-89, 90+.

## Note:  Directly standardized to age 65+ population, U.S. all racial/ethnic groups in 2000, for ages 65-69, 70-74, 75-79, 80-84, 85-89, 90+.

| Race/Ethnicity | Sensory | Physical | Mental | Self-Care | Go Outside | Any Disability |
| --- | --- | --- | --- | --- | --- | --- |
| U.S.-Born
Non-Hispanic White | 
13.3 | 
31.3 | 
12.0 | 
12.6 | 
23.3 | 
42.4 |
| Hispanic | 17.4 | 37.9 | 18.1 | 17.2 | 30.9 | 53.3 |
| Black | 15.2 | 43.2 | 19.8 | 20.5 | 34.3 | 57.8 |
| Asian American | 12.1 | 25.9 | 13.4 | 12.3 | 23.9 | 39.4 |
| Native American |  |  |  |  |  |  |
| Other | 16.7 | 36.1 | 15.8 | 16.8 | 25.7 | 47.1 |
| Foreign-Born
Non-Hispanic White | 
11.8 | 
27.4 | 
13.2 | 
12.2 | 
25.1 | 
41.5 |
| Hispanic | 15.9 | 28.1 | 15.8 | 11.6 | 27.5 | 47.7 |
| Black | 14.3 | 33.5 | 17.5 | 15.6 | 30.3 | 50.3 |
| Asian American | 15.2 | 31.4 | 20.1 | 13.8 | 30.8 | 48.1 |
| Native American |  |  |  |  |  |  |
| Other | 16.2 | 30.7 | 16.0 | 14.4 | 28.2 | 46.2 |

**Table 4.  Age-standardized census disability rates (percent) for U.S. born and ****	****foreign-****	****born females 65 and over by race/ethnicity: United States ****	****Census, 2000 **

## Note: Hispanic origin persons are recoded to a specific group based on ancestry or country of birth,  if they report general Hispanic.    

**Note: Hispanic origin persons are recoded to a specific group based on ancestry or country of birth,  if they report general Hispanic.    **
**Note: Directly standardized to age 65+ population, U.S. all racial/ethnic groups in 2000, for ages 65-69, 70-74, 75-79, 80-84, 85-89, 90+.**

## Table 5.  Age-standardized census disability rates (percent) for U.S. born 

| Race/Ethnicity | Sensory | Physical | Mental | Self-Care | Go Outside | Any Disability |
| --- | --- | --- | --- | --- | --- | --- |
| U.S.-Born

Non-Hispanic White | 

17.4 | 

28.1 | 

11.3 | 

9.5 | 

18.4 | 

42.6 |
| All Hispanic | 21.4 | 33.0 | 17.2 | 13.9 | 26.7 | 51.6 |
| Mexican  | 21.8 | 32.5 | 17.1 | 13.6 | 26.2 | 51.4 |
| Other Hispanic | 21.7 | 34.9 | 18.0 | 14.2 | 28.3 | 53.1 |
|  |  |  |  |  |  |  |
| Foreign-Born

Non-Hispanic White | 

13.1 | 

22.6 | 

12.1 | 

9.4 | 

21.2 | 

39.4 |
| All Hispanic | 15.9 | 28.1 | 15.8 | 11.6 | 27.5 | 47.7 |
| Mexican  | 18.0 | 30.1 | 16.4 | 12.1 | 27.4 | 49.4 |

- Note: Hispanic origin persons are recoded to a specific group based on ancestry or country of birth,  if they report general Hispanic.
- Note: Directly standardized to age 65+ population, U.S. all racial/ethnic groups in 2000, for ages 65-69, 70-74, 75-79, 80-84, 85-89, 90+.

**Table 5.  Age-standardized census disability rates (percent) for U.S. born **
**               ****and foreign-born males 65 and over by type of Hispanic origin: **
**               ****United States Census, 2000.**

## Note: Hispanic origin persons are recoded to a specific group based on ancestry or country of birth,  if they report general Hispanic.       

- Note: Hispanic origin persons are recoded to a specific group based on ancestry or country of birth,  if they report general Hispanic.
- Note: Directly standardized to age 65+ population, U.S. all racial/ethnic groups in 2000, for ages 65-69, 70-74, 75-79, 80-84, 85-89, 90+.

## Table 6.  Age-standardized census disability rates (percent) for U.S. born 

| Race/Ethnicity | Sensory | Physical | Mental | Self-Care | Go Outside | Any Disability |
| --- | --- | --- | --- | --- | --- | --- |
| U.S.-Born

Non-Hispanic White | 

13.3 | 

31.3 | 

12.0 | 

12.6 | 

23.3 | 

42.4 |
| All Hispanic | 17.4 | 37.9 | 18.1 | 17.2 | 30.9 | 53.3 |
| Mexican  | 17.8 | 38.1 | 18.5 | 17.1 | 31.1 | 53.4 |
| Other Hispanic | 16.8 | 38.0 | 17.3 | 16.9 | 30.6 | 53.5 |
|  |  |  |  |  |  |  |
| Foreign-Born

Non-Hispanic White | 

11.8 | 

27.4 | 

13.2 | 

12.2 | 

25.1 | 

41.5 |
| All Hispanic | 15.9 | 36.0 | 20.2 | 15.9 | 33.0 | 53.7 |
| Mexican  | 18.0 | 37.4 | 20.1 | 16.8 | 33.4 | 54.4 |

- Note: Hispanic origin persons are recoded to a specific group based on ancestry or country of birth,  if they report general Hispanic.
- Note: Directly standardized to age 65+ population, U.S. all racial/ethnic groups in 2000, for ages 65-69, 70-74, 75-79, 80-84, 85-89, 90+.

**Table 6.  Age-standardized census disability rates (percent) for U.S. born **
**               ****and foreign-born females 65 and over by type of Hispanic origin: **
**               ****United States Census, 2000.**

## * For Puerto Ricans, “immigrant” refers to persons born in Puerto Rico or abroad. 

|  | Men |  |  | Women |  |  |
| --- | --- | --- | --- | --- | --- | --- |
|  | US-Born | Immigrant | Total | US-Born | Immigrant | Total |
|  |  |  |  |  |  |  |
| Hispanic | 15,816 | 20,571 | 36,387 | 20,742 | 29,328 | 50,070 |
|  |  |  |  |  |  |  |
| Mexican | 11,216 | 8,530 | 19,746 | 14,291 | 10,731 | 25,022 |
| Puerto Rican* | 555 | 3,131 | 3,686 | 685 | 4,640 | 5,325 |
| Cuban | 221 | 4,756 | 4,977 | 326 | 6,543 | 6,869 |
| Central American | 62 | 1,188 | 1,250 | 89 | 2,564 | 2,653 |
| South American | 69 | 1,848 | 1,917 | 114 | 3,022 | 3,136 |
| Dominican | 45 | 707 | 752 | 48 | 1,268 | 1,316 |
| Spaniard | 212 | 295 | 507 | 266 | 404 | 670 |
| Other | 3,436 | 116 | 3,552 | 4,923 | 156 | 5,079 |
|  |  |  |  |  |  |  |
| Non Hispanic |  |  |  |  |  |  |
| White | 620,357 | 31,669 | 652,026 | 864,085 | 50,624 | 914,709 |
| Black | 50,672 | 2,709 | 53,381 | 83,383 | 4,304 | 87,687 |
| Asian | 4,919 | 12,771 | 17,690 | 5,980 | 17,858 | 23,838 |
| AIAN | 5,550 | 85 | 5,635 | 7,363 | 109 | 7,472 |
| Other | 489 | 360 | 849 | 636 | 491 | 1,127 |

**Appendix Table. Unweighted frequency counts for race and Hispanic origin subjects 65 years-old or older in the Census 2000 5 percent public-use micro data file, by gender and immigrant status**

*** For Puerto Ricans, “immigrant” refers to persons born in Puerto Rico or abroad.**