Date of Degree

2-2015

Document Type

Dissertation

Degree Name

D.P.H.

Program

Public Health

Advisor

William T. Gallo

Advisor

Marianne C. Fahs

Subject Categories

Family, Life Course, and Society | Public Health Education and Promotion

Abstract

There is substantial variability across different geographic regions and demographic groups in health outcomes and health resource availability. This dissertation examines the relationship between self-reported ocular disease and depression, functional status, and falls in a diverse sample of senior center attendees in New York City. Further, these analyses explored whether the availability of health care resources at the area level affects the observed relationship between ocular disease and these other adverse outcomes.

This dissertation project addresses two main gaps in the current research, specifically, the need to better understand elders' experiences with these conditions in different geographic regions and demographic groups (the study sample is a low-income sample in New York City, and is racially/ethnically/linguistically diverse), and to explore whether these relationships are modified by the availability of primary care resources.

Data for this dissertation come from a subsample of n=1,393 participants in the Senior Center Health Status Survey (SCHSS), conducted by the Brookdale Center for Healthy Aging & Longevity of Hunter College in 2008. This data was linked to data provided by the Primary Care Service Area (PCSA) Project of the Dartmouth Institute for Health Policy and Clinical Practice to allow for an examination of provider density.

Results indicate that this population experiences high rates of depression, functional status limitations and falls. Although provider density and ocular disease were not significantly associated with these outcomes as hypothesized, the analyses nevertheless reveal factors associated with increased risk of these adverse health outcomes. Targeting individuals with these risk factors and addressing certain modifiable risk factors remain important strategies to prevent and treat these outcomes.

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