Dissertations, Theses, and Capstone Projects

Date of Degree


Document Type


Degree Name





Juan Battle

Committee Members

Barbara Katz Rothman

Marianne Fahs

Subject Categories



This dissertation examines the effects of health values on the decisions made by elderly Black women to use self-care methods and homecare services. The research is grounded in the healthicization or wellness promotion paradigm, which prescribes behavioral or lifestyle changes for previously biomedically defined events.

The dissertation consists of both quantitative and qualitative research. The quantitative component focuses on a sample of Black women over 70 years old (N= 642) from the 2000 NHI Second Longitudinal Study on Aging dataset. The qualitative component analyzes ten in-depth interviews with respondents from Southern Maryland used to supplement the quantitative findings.

Although the quantitative and qualitative analyses resulted in complementary findings, there were some important differences. First, the results from the Multiple Regression demonstrate that, for elderly Black women, health values explained a fair amount of the variance in equipment self-care (R2 of .199); equipment self-care also contributes more to the independence of elderly Black women than behavioral and environmental self-care (which accounted for 8.4 and 1.0 percent of the variance respectively).

Secondly, structural equation modeling (SEM) was used to establish causality among the three major constructs of the research in order to make inferences about the sample population. For example, the SEM findings revealed that elderly Black women with positive self-values are less likely to practice traditional self-care, while those who practiced self-care were more dependent on homecare services.

Finally, the interviews helped to illustrate the findings from the quantitative analysis. Specifically, elderly Black women choose to practice self-care to maintain their independence, and believe they are personally responsible for maintaining a healthy lifestyle.

Two major policy implications were derived from this study. First, while the personal responsibility crusade in healthcare is important, clients from marginalized populations should not be deprived of public healthcare programs if they choose not to participate in this trend. Second, greater flexibility should be allowed the elderly client in deciding how to spend homecare subsidies from local Respite programs.


Digital reproduction from the UMI microform.

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