Disability among older American Indians and Alaska Natives: An analysis of the 2000 census public use microdata sample

Purpose: We compared the prevalence of disability among older American Indians and Alaska Natives (AI/ANs) with that among their African American and White peers, then examined sociodemographic characteristics associated with disability among AI/ANs. Design and Methods: We analyzed the 5% 2000 Census Public Use Microdata Sample. We assessed disability by functional limitation, mobility disability, and self-care disability for four age groups (55-64, 65-74, 75-84, and 85 years or older). Results: For all age strata, AI/ANs reported the highest rates of functional limitation and African Americans the highest level of mobility disability. In the 55-to-64 age group, AI/ANs experienced the highest prevalence of self-care disability, and among those aged 65 years or older, African Americans reported the highest prevalence. Compared to Whites, the adjusted odds ratios for functional limitation, mobility disability, and self-care disability were significantly elevated in AI/ANs (1.62, 1.33, and 1.56, respectively) and African Americans (1.27, 1.54, and 1.56, respectively). For AI/ANs, being of increased age, being female, having lower educational attainment and household income, not being married or in the labor force, and residing in a metropolitan area were associated with disabilities. Implications: This study contributes to researchers' limited knowledge regarding disability among older AI/ANs. The lack of available empirical data poses obstacles to understanding the antecedents and consequences of disability for AI/ANs. More information on the nature and extent of disabilities among AI/AN elders would enhance the ability of advocates to document their needs and raise public awareness. Likewise, policy makers could enact prevention strategies and make comprehensive rehabilitative and long-term care services available to this population.