Trends in Assistance with Daily Activities: Racial/Ethnic and Socioeconomic Disparities Persist in the U.S. Older Population

Assistive technology has become increasingly important in facilitating independence among older Americans. It remains unclear, however, whether this trend has been experienced broadly. Using the 1992 to 2001 Medicare Current Beneficiary Survey, we provide evidence that among older people who have difficulty with daily activities, there were substantial increases in the independent use of assistive technology (without help from another person). Controlling for shifts in the composition of the older population reporting difficulty with daily activities, the independent use of assistive technology increased on average 4% to 5% per year, amounting to a 6 percentage point increase over the entire period. These increases were accompanied by declines in the use of any help and in unassisted difficulty, with larger declines in the latter. Substantial differentials in assistance—which favor the more highly educated in the case of technology and favor minorities in the case of help—persisted over this period. All else equal, 5-percentage point gaps were evident between more and less advantaged education groups with respect to the independent use of assistive technology for walking. Gaps in the independent use of assistive technology to bathe were even larger, amounting to 7 to 8 percentage points in 2001 by education and race. We discuss the implications of findings for the study of late-life disability trends and disparities therein.