Comorbid Conditions and Driving Status Among Older Low-Income African Americans
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.
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.
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.
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.
KeywordsUtilization of healthcare Older drivers Chronic disease burden Transportation Underserved
We acknowledge Elizabeth N. Head, MPH, at the Georgia Department of Public Health for the input on study design. We also acknowledge Camille P. Vaughan, MD, MS, Associate Professor, Section Chief of Geriatric Medicine and Gerontology, Emory University School of Medicine, for the input on study design and editing support.
Compliance with Ethical Standards
Conflict of Interest
Dr. Quratulain Syed is a member of the Driver’s License Advisory Board at the Georgia Department of Driver Services. Dr. Okosun and Ms. Dubbaka declare no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was not required as this research is a retrospective chart review, and the manuscript does not contain any protected health information.
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