GREAT-LAKES AMERICAN-INDIAN ELDERS AND SERVICE UTILIZATION - DOES RESIDENCE MATTER

Discussions about service usage by older individuals often center arou nd the relative importance of need and knowledge variables. The impact of these variables among minority elderly remains a matter of debate. This article examines service usage among a sample of urban, rural, a nd reservation-based eastern Great Lakes American Indian elders. Issue s of availability, awareness, acceptability, accessibility, and need a re examined through both a survey of 309 respondents and a small sampl e of service providers. Regression results show predictors of use vary by type of service. Reservation residence and need characteristics pr edict in-home and preventive health service use. Being female, older h aving knowledge of services, and problems with Instrumental Activities of Daily Living (IADL) predicts in-home service use. Service provider s' perceptions suggest issues of trust, past experiences, and cultural acceptability need to be explored more intensely in efforts to explai n service usage among American Indians and other ethnic and racial gro ups.