Health and nutritional status of old-old African Americans

Nutrition Risk and Associated Factors in Congregate Meal Participants in Northern Florida

Nutrition is a key for extending quality of life of the elderly. Factors associated with nutritional risk in elders were identified with a modified nutrition screen initiative checklist. High, moderate and low nutritional risk was seen in 31, 46 and 23%, respectively, of 324 elders in six congregate meal sites in northern Florida. High nutritional risk was associated with urban residency, females, being African American, self-reported poor health and irregular visits to medical/health professionals. African American females living in urban areas with limited access to health care are most vulnerable.

Geriatric gynecologic care of minorities

African-American and Hispanic-American women, as well as women of other minorities are susceptible to the same gynecologic diseases as white women. Elderly minority patients need gynecologic care; they reluctantly seek care because they harbor both fear and distrust. Gynecologists who care for the elderly are expected to provide the same quality of care to whites and minorities. However, ethnicity, cultural differences, and socio-economic status can impact negatively on outcomes. This racial/ethnic disparity is most clearly demonstrated in the poor prognosis, increased mortality, and decreased 5-year survival rates for several gynecologic cancers in African-Americans compared with whites. Poverty, ignorance, and a history of limited access to and limited availability of quality health care are all contributing factors to the late detection of most cancers in African-Americans. Distrust of the medical establishment and fatalism prevent many members of minority groups, particularly the elderly members, from fully using screening procedures. Gynecologists who are providing care to geriatric minority patients must be aware of, and sensitive to the ethnic and cultural differences that may contribute to either noncompliance or poor compliance with medical management. Also, an awareness of the problems that are endemic within minority communities, such as domestic violence, drug abuse, and HIV/AIDS, will assist the gynecologist or other providers of gynecologic care in identifying elderly patients who may be at high risk. Education is a critical component in the practice of caring for elderly minorities. It is only through education about the benefits of screening, early diagnosis and treatment, and the need for routine gynecologic examinations (even if hysterectomized), that any significant improvement will be made in the dismal cancer-related mortality and survival rate statistics for minorities, both young and old.

The nutrition screening initiative: a 5-year perspective

A history of the goals, activities, and accomplishments of the Nutrition Screening Initiative (NSI) is provided. A commentary on the development and intended use of the NSI's self-assessment and screening tools is given to facilitate selection of feeding devices for older Americans who need nutrition care. Additional questionnaires and interventions designed to address the needs identified through the NSI's standardized, interdisciplinary approach to the assessment of nutritional risk are described and their use encouraged. Legislative and public policy advocacy is summarized. A systemic approach to the assessment and maintenance of optimal nutritional health in the older population will have a profound effect on health care delivery systems.