Geographic distribution of availability of adult day services in Missouri

Abstract Adult day service (ADS) is an important component of long-term supportive services. Geographic availability of ADS is an essential factor for aging in place especially for people with assistance needs. This study aims to examine the geographic distribution of availability of ADS and its relationship with the disadvantaged characteristics of neighborhoods. Data from the Missouri Department of Health and Senior Services and the American Community Survey were utilized. Geographic availability of ADS was measured as capacity (number of clients served) of ADS centers per week divided by the number of people who were 65 or older and under poverty at the census tract level. To examine neighborhood disadvantaged characteristics, principal component analysis was applied to construct a socioeconomic deprivation index (SDI). Using geographic information systems, we mapped ADS centers, geographic availability of ADS, and SDI scores. Pearson correlation coefficient was calculated between geographic availability of ADS and SDI scores. In 92.3% of the census tracts in Missouri, ADS centers are not available. Further, ADS centers are less likely to locate in rural areas or census tracts with higher numbers of residents 65 or older and poor. Also, lower availability of ADS was associated with higher levels of neighborhood disadvantage at a marginal level (r = - 0.163). Our findings suggested that strategies should be identified to provide ADS in rural areas, especially in the areas with higher levels of neighborhood disadvantage. Further investigation on the geographic distribution of ADS accessibility and its association with neighborhood characteristics is warranted.


GEOGRAPHIC DISTRIBUTION OF AVAILABILITY OF ADULT DAY SERVICES IN MISSOURI
Takashi Amano, 1 Yung Chun, 2 Sojung Park, 3 and Yi Wang, 4 1.Rutgers University-Newark, Newark, New Jersey, United States,2. Washington University in St. Louis,St. Louis,Missouri,United States,3. Washington university,St.Louis,Missouri,United States,4.University of Iowa, Iowa City, Iowa, United States Adult day service (ADS) is an important component of long-term supportive services.Geographic availability of ADS is an essential factor for aging in place especially for people with assistance needs.This study aims to examine the geographic distribution of availability of ADS and its relationship with the disadvantaged characteristics of neighborhoods.Data from the Missouri Department of Health and Senior Services and the American Community Survey were utilized.Geographic availability of ADS was measured as capacity (number of clients served) of ADS centers per week divided by the number of people who were 65 or older and under poverty at the census tract level.To examine neighborhood disadvantaged characteristics, principal component analysis was applied to construct a socioeconomic deprivation index (SDI).Using geographic information systems, we mapped ADS centers, geographic availability of ADS, and SDI scores.Pearson correlation coefficient was calculated between geographic availability of ADS and SDI scores.In 92.3% of the census tracts in Missouri, ADS centers are not available.Further, ADS centers are less likely to locate in rural areas or census tracts with higher numbers of residents 65 or older and poor.Also, lower availability of ADS was associated with higher levels of neighborhood disadvantage at a marginal level (r = -0.163).Our findings suggested that strategies should be identified to provide ADS in rural areas, especially in the areas with higher levels of neighborhood disadvantage.Further investigation on the geographic distribution of ADS accessibility and its association with neighborhood characteristics is warranted.

HOUSING, NEIGHBORHOOD FACTORS, AND COGNITIVE STATUS OF OLDER ADULTS LIVING IN HOUSES VERSUS APARTMENTS
Ethan Siu Leung Cheung, 1 and Ada Mui, 2 1.Columbia University, New York, New York, United States,

Columbia University, COLUMBIA UNIVERSITY, New York, United States
This study examines associations between housing, neighborhood factors and cognitive status among communitydwelling older adults, and how the associations differ between older adults who live in houses and in apartment buildings.Specifically, using the neighborhood stressor theory, three research questions are examined: 1) What individual-level factors predict late-life cognitive status? 2) After controlling for individual-level factors, what housing and neighborhood factors are significant in predicting older adults' cognitive status? 3) How do individual, housing, neighborhood predictors of cognitive status differ between house and apartment residents?Using data from the Wave 3 NSHAP, multilevel linear regression analyses are conducted with the total sample.Results suggest that individual-level factors including young-age, female, white, and having a bachelor's degree are associated with better cognitive status.After controlling for individual-level factors, housing and neighborhood factors including quality maintenance and high level of community safety are associated with higher cognitive scores.In addition to the additive model, we also test the interactive effect between housing type and three level of factors -individual level, housing, and neighborhood factors.Findings suggest that the joint effect of depression and housing type on cognitive status is significant.To explore the last research question, we conduct parallel regression analyses by housing type.Findings suggest that quality maintenance and high level of community safety are associated with higher cognitive scores among house residents only.Findings highlight the predictors of cognitive health vary between older adults living in different residential environments.

MOTIVATIONS TO JOIN AND STAY A MEMBER OF A VILLAGE FOR OLDER ADULTS
Joonyoung Cho, Ruth Dunkle, and Garrett Pace,

University of Michigan, Ann Arbor, Michigan, United States
People join a customer-driven organization with motivations that may not be static over time, an important issue for long-term organizational viability.In this study, we examined motivations among members of ShareCare, the first Village for older adults in the U.S. Using qualitative data from a random sample of 91 members, we compared motivations for becoming a member and for continuing membership.Motivations to join and continue membership are not necessarily the same.Motivations were categorized as: instrumental, social, and altruistic motivation.We categorized length of membership as short-term: 8-years or less (51.63%) and long-term: 9-years and more (49.37%).While 36% of members joined only for instrumental motivation, 59% continued membership only for instrumental motivation.While about 52% joined with multiple motivations, only 35% of members mentioned multiple motivations when continuing their membership.Finally, 18% of short-term members mentioned altruistic motivation when continuing their membership, while 28% of long-term members mentioned altruistic motivation when continuing their membership.While people's motivation might change over time, altruistic motivation may be the greatest motivating factor for long-term memberships.Long-term members may identify themselves as supporters rather than users of the