Comorbid Conditions and Driving Status Among Older Low-Income African Americans

Abstract

Introduction: While driving is an important instrumental activity of daily living (ADL), older adults belonging to low-income racial minorities make up a large proportion of never-drivers who utilize alternative modes of transportation (Babulal et al., Geriatrics 3, 2018; Choi and Mezuk, J Appl Gerontol 32:902-912, 2013). Our study is a comparative analysis of comorbid health conditions among older drivers and nondrivers receiving care at a safety net hospital in Atlanta in order to assess utilization of healthcare resources and chronic disease burden among the two groups.

Methods: This is a retrospective cohort study of 690 patients age 65 or older who received care at the Emma Darnell Geriatric Center at Grady Hospital during 2/1/2016-2/1/2017. Self-reported driving status was analyzed and compared for all variables including demographics, insurance information, ADL scores, use of assistive device, sensory impairment, number of Geriatric Clinic visits in a year, and associated visit diagnoses.

Results: Twenty-three percent of total 690 patients reported being drivers. Over 94% patients were African Americans and over 67% were women in both groups. Drivers were more functionally independent and were less likely to have cognitive impairment compared with nondrivers. Mean number of visits to Geriatric Primary Care Clinic in a year was low in both groups, and enrollment in a Medicare advantage plan did not affect the association.

Conclusion: Approximately 77% of older adults getting care at a safety net hospital in Atlanta reported not driving a motor vehicle. Utilization of primary healthcare resources was low in both groups and was not affected by enrollment in a Medicare advantage plan.

Keywords: Chronic disease burden; Older drivers; Transportation; Underserved; Utilization of healthcare.