Abstract:

Interview data from random samples of elders ages 55+ in 5 states (AR, MD, MT, IL, & SC) are drawn on to determine the appropriateness of utilizing proxy variables, including urban/rural location, as indicators of need & unmet need for health services. Regression models used proxy measures typical to the intrastate allocation formula components for Title III monies from Older Americans Act against 7 measures of need & 2 measures of unmet need. In most cases, it was found that biasing in favor of rural elders is an inappropriate strategy: 3 of the 5 states have rural bias in their allocation formulas. This approach may be particularly inappropriate in IL & MD because their counties with core central cities frequently report greater proportions of needy elders than corresponding rural areas. An expanded definition of need is recommended as a basis for addressing the actual needs of urban & rural elderly residents.