Similar to non-Hispanics, a majority of
Hispanics support 4 of the 5 policy proposals that may help Americans prepare
for the costs of long-term care, though the level of support differs between
the two groups.
The survey shows that Americans’ experiences with long-term
care are diverse and span a number of socioeconomic and other demographic
factors. Like non-Hispanic Americans, a majority of Hispanics age 40 or older (60
percent) have experience providing, receiving, or financing long-term care
services. Fifteen percent of Hispanics are currently receiving, or have ever
received, ongoing living assistance.
Similar to other Americans, Hispanics receiving care tend
to be women, but they also tend to be younger and have lower incomes than other
Americans receiving care. Six in 10 Hispanics who have experience receiving
ongoing living assistance are women. Hispanic recipients of care are more
likely than non-Hispanic care recipients to have household incomes of less than
$50,000 (93 percent vs. 64 percent of non-Hispanics). Hispanic care recipients are
also younger on average (58 years old) than non-Hispanic care recipients (65
Providers of care among Hispanics and non-Hispanics are
mostly women, but Hispanics again tend to be younger and have lower incomes
than non-Hispanic caregivers. About half of Hispanics age 40 or older (51
percent) are currently providing, or have ever provided, ongoing living
assistance to a family member or close friend on a regular basis. Seventy-seven
percent of Hispanic caregivers have a household income of less than $50,000,
compared to 54 percent of non-Hispanic caregivers. Hispanic caregivers are an
average age of 56, slightly younger than the average non-Hispanic caregiver (59
years). Non-Hispanic women age 40 or older (57 percent) are more likely than
non-Hispanic men (49 percent) to say they have experience providing care to a
family member or close friend. These gender differences disappear for Hispanics
(52 percent women, 50 percent men). In all, 53 percent of Hispanic caregivers
Americans also experience the long-term care system through
financial means. Twelve percent of Hispanics age 40 or older say they are, or
someone in their family is, currently employing someone to provide in-home,
ongoing living assistance services.
Overall, Americans age 40 or older reflect positively on
their personal experiences providing assistance to loved ones, but it’s nearly
universal among Hispanic caregivers. Fully 94 percent of Hispanic caregivers say
it has been a positive experience in their lives, compared to fewer—82 percent—of
non-Hispanic caregivers. Similar to other Americans, 83 percent of Hispanics
say the experience strengthened their personal relationship with the friend or
family member for whom they cared, and just 9 percent say the experience
weakened their relationship.
The stress levels that result from caregiving differ
sharply among non-Hispanic and Hispanic caregivers, even controlling for other
socioeconomic and demographic factors. While over half of non-Hispanic
caregivers (54 percent) say their experience providing ongoing living
assistance caused stress in their family, far fewer Hispanic caregivers say the
same (36 percent). Hispanic caregivers are also slightly less likely to say the
experience was a burden on their personal finances (21 percent vs. 29 percent).
For non-Hispanic caregivers, the financial burden of
providing care varies significantly by household income. Those with household
incomes of less than $50,000 are more likely than those earning more to say
providing ongoing living assistance is a burden on their personal finances (36
percent vs. 21 percent). However, there is no difference on the question of
financial burden between income groups among Hispanics (21 percent for those
with incomes of less than $50,000, 23 percent for those with incomes of $50,000
The survey shows that while Hispanics age 40 or older are
more likely to need ongoing living assistance, they are less likely than
non-Hispanics to have planned for such assistance. Seven in 10 Hispanics age 40
or older who are not currently receiving ongoing living assistance say it is at
least somewhat likely that they will personally require ongoing living
assistance someday—more than the 6 in 10 non-Hispanics who anticipate needing
care. Fewer than 3 in 10 Hispanics (26 percent) say it is unlikely that they
will require ongoing living assistance in the future.
Despite a solid majority believing that they will
personally require living assistance as they age, few Hispanics have planned
for this kind of care. Ten percent say they have done quite a bit or a great
deal of planning for their ongoing living assistance needs, 16 percent have done
a moderate amount, and an overwhelming majority, 73 percent, have done only a
little or no planning at all.
A closer look at specific actions one might take to plan
for ongoing living assistance reveals more planning, but Hispanics are still less
likely than non-Hispanics to report taking steps to plan for their personal
needs as they age. In the survey, respondents were asked about seven individual
long-term care planning actions; 87 percent of non-Hispanics age 40 or older report
doing at least 1 of the 7 planning actions, compared to 65 percent of
Hispanics. Hispanics are nearly three times as likely as other Americans to say
they completed none of these actions (35 percent vs. 13 percent).
Specifically, on a few of these steps to address future
long-term care needs or end-of-life planning, Hispanics are less likely than
non-Hispanics to plan ahead. For example, Hispanics are less likely than
non-Hispanics to report setting aside money to pay for ongoing living
assistance (15 percent vs. 34 percent), discussing their ongoing living
assistance preferences with a loved one (26 percent vs. 43 percent), creating a
living will or advance directive (30 percent vs. 55 percent), and discussing funeral
arrangement preferences with someone they trust (47 percent vs. 68 percent).
On a number of items, nonetheless, Hispanics and
non-Hispanics report planning at similar rates. Comparable proportions of
Hispanics and non-Hispanics report looking for information about aging,
modifying their home to make it easier to live in as they age, and making plans
to move into a community or facility designed for older adults.
Household income plays a significant role in the level of
preparation for long-term care needs as people age. For example, Hispanics are
less likely than non-Hispanics to set aside money to pay for ongoing living
assistance expenses such as nursing home care, housing in a senior community,
or care from a home health care aide (15 percent vs. 34 percent). Even when
taking household income into account, the differences remain stark.
Non-Hispanics with household incomes of less than $50,000 are nearly four times
as likely as Hispanics in the same income category to set aside money to pay
for ongoing living assistance expenses (22 percent vs. 6 percent). Similarly,
nearly half of lower-income non-Hispanics (48 percent) report creating a living
will or advance treatment directive, while just 21 percent of Hispanics in the
same income category have done so.
Similar to the non-Hispanic U.S. population age 40 or older,
most Hispanics are not very confident that they will have the financial
resources to pay for the ongoing living assistance they may require as they
age. Fifty percent of Hispanics age 40 or older say they are not too or not
confident at all that they will have the financial resources to pay for any
care they may need, 28 percent are somewhat confident, and 21 percent are very
or extremely confident.
Not surprisingly, income is a clear indicator of one’s
level of confidence to pay for future care. Among Hispanics, those who have
annual household incomes of less than $50,000 are more than twice as likely to
express lower levels of confidence in their ability to pay for ongoing living
assistance (61 percent vs. 26 percent).
The survey also looked at Americans’ perceptions about
Medicaid as it relates to long-term care, and specifically whether people age 40
or older think they will have to rely on the program for care as they age. Medicaid
is a government health care coverage program for low-income people and people
with certain disabilities, and it is the single largest payer for long-term
care services in the United States. Hispanics age 40 or older are
more likely than non-Hispanics to say they anticipate needing Medicaid to help
pay for their ongoing living assistance expenses (62 percent vs. 39 percent). Even
among Hispanics with health care coverage, a majority (59 percent) think they
will need Medicaid to pay for their long-term care needs.
The differences between Hispanics and non-Hispanics in the
anticipated need for Medicaid remain robust even when accounting for household
income and other demographic factors. For example, 76 percent of Hispanics with
household incomes of less than $50,000 say they will need Medicaid to help pay
for their long-term care, compared with 58 percent of non-Hispanics in the same
Indeed, when it comes to thinking about aging, Hispanics and
non-Hispanics express similar levels of concern about most aspects of aging
with one significant difference: concern about how to pay for long-term care. Fifty-two
percent of Hispanics say they have quite a bit or a great deal of concern about
being able to pay for any care, while 43 percent of non-Hispanics express the
same concern. This difference is true even controlling for income and other
At similar levels, Hispanics and non-Hispanics are concerned with losing their independence, losing their memory or other mental abilities, being a burden on their family, having to move into a nursing home, not planning enough for the care they might need as they age, leaving debts to their family, or being alone without family or friends around.
The survey gauged opinion on five different policy measures that may help Americans prepare for the costs of ongoing living assistance. Like non-Hispanic Americans, large majorities of Hispanics age 40 or older express support for four of the proposals, though there are some differences in degree of support. Hispanics are less likely than non-Hispanics to favor tax breaks to encourage saving for ongoing living assistance expenses (71 percent vs. 82 percent), the ability for individuals to purchase long-term care insurance through their employer (67 percent vs. 76 percent), and tax breaks for consumers who purchase long-term care insurance (65 percent vs. 78 percent).
Hispanics age 40 or older are most divided on a requirement that individuals purchase private long-term care insurance, with 49 percent saying they strongly or somewhat favor the proposal, 26 percent saying they strongly or somewhat oppose it, and 19 percent saying they neither favor nor oppose it. Yet, Hispanics age 40 or older are more likely than non-Hispanics (32 percent) to say they favor the proposal. Hispanics are also more likely than non-Hispanics to support a policy proposal for a government administered long-term care insurance program similar to Medicare (68 percent) than non-Hispanics (57 percent).
The national study showed that Americans generally lack information about long-term care, mostly get it from their friends or family, and tend to trust information from their own social network or their own doctor. On the issue of receiving little information on long-term care, results for Hispanics are consistent with the national findings. Further, 43 percent of Hispanics age 40 or older have received information about ongoing living assistance in the last 12 months from at least 1 of the 9 sources tested in the survey, similar to the proportion of non-Hispanics (46 percent).
However, Hispanics and non-Hispanics who have received information about ongoing living assistance in the last 12 months differ in terms of the types of sources they consult. Among non-Hispanics who received information, friends, family, or co-workers are the most prevalent sources; 48 percent of them say they have received long-term care information from this source, compared to 28 percent of Hispanics who received information. For Hispanics, Medicare is the most common information source; 44 percent of Hispanics who received information say they have received such information from Medicare, compared to 28 percent of non-Hispanics. Among those who have received information, Hispanics are more likely than other Americans to say they have received information in the past year from their family physician (38 percent vs. 19 percent) and Medicaid (37 percent vs. 16 percent).
Despite some differences in terms of how each of these
groups obtains long-term care information, they hold similar levels of trust in
This survey, funded by The SCAN Foundation, was
conducted by the Associated Press-NORC Center for Public Affairs Research
between the dates of March 13 through April 23, 2014. Staff from NORC at the
University of Chicago, the Associated Press, and The SCAN Foundation
collaborated on all aspects of the study.
This random-digit-dial (RDD) survey of the 50 states and
the District of Columbia was conducted via telephone with 1,745 adults age 40
or older. In households with more than one adult age 40 or older, we used a
process that randomly selected which eligible adult would be interviewed. The
sample included 1,340 respondents on landlines and 405 respondents on cell
phones. The sample also included oversamples of Californians and Hispanics
nationwide age 40 or older. The sample includes 458 Hispanics and 1,287
non-Hispanics from the 50 states and the District of Columbia age 40 or older.
Cell phone respondents were offered a small monetary incentive for
participating, as compensation for telephone usage charges. Interviews were
conducted in both English and Spanish, depending on respondent preference. All
interviews were completed by professional interviewers who were carefully
trained on the specific survey for this study.
The RDD sample was provided by a third-party vendor,
Marketing Systems Group. The final response rate was 22 percent, based on the
American Association of Public Opinion Research Response Rate 3 method. The sample design aimed to
ensure the sample representativeness of the population in a time- and
cost-efficient manner. The sampling frame utilizes the standard dual telephone
frames (landline and cell), with a supplemental sample of landline numbers
targeting households with Hispanic adults. The targeted sample was also provided
by Marketing Systems Group and was pulled from a number of different commercial
consumer databases and demographic data at the telephone exchange level. Sampling
weights were appropriately adjusted to account for potential bias introduced by
using the targeted sample.
Sampling weights were calculated to adjust for sample
design aspects (such as unequal probabilities of selection) and for nonresponse
bias arising from differential response rates across various demographic
groups. Poststratification variables included age, sex, race, region,
education, and landline/cell phone use. The weighted data, which thus reflect
the U.S. population, were used for all analyses. The overall margin of error
for the national sample is +/- 3.6 percentage points, including the design
effect resulting from the complex sample design. The overall margin of error
for the Hispanic sample is +/-6.8 percentage points.
All analyses were conducted using STATA (version 13), which
allows for adjustment of standard errors for complex sample designs. All
differences reported between subgroups of the U.S. population are at the 95
percent level of statistical significance, meaning that there is only a 5
percent (or less) probability that the observed differences could be attributed
to chance variation in sampling. Additionally, bivariate differences between
subgroups are only reported when they also remain robust in a multivariate
model controlling for other demographic, political, and socioeconomic
covariates. A comprehensive listing of all study questions, complete with
tabulations of top-level results for each question, is available on the AP-NORC
Center’s long-term care website: www.apnorc.org/longtermcare.