Great Lakes American Indian Elders and Service Utilization: Does Residence Matter?

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Abstract
Discussions about service usage by older individuals often center around the relative importance of need and knowledge variables. The impact of these variables among minority elderly remains a matter of debate. This article examines service usage among a sample of urban, rural, and reservation-based eastern Great Lakes American Indian elders. Issues of availability, awareness, acceptability, accessibility, and need are examined through both a survey of 309 respondents and a small sample of service providers. Regression results show predictors of use vary by type of service. Reservation residence and need characteristics predict in-home and preventive health service use. Being female, older, having knowledge of services, and problems with Instrumental Activities of Daily Living (IADL) predicts in-home service use. Service providers'perceptions suggest issues of trust, past experiences, and cultural acceptability need to be explored more intensely in efforts to explain service usage among American Indians and other ethnic and racial groups.

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