PHONE: (313) 593-5518
DATE: May 18, 2004
Changing family structures affect health care among elderly Arabs and Arab Americans in Detroit area, according to UM-Dearborn study
DEARBORN---In addition to the many cultural and language issues faced
by elderly Arab Americans in the Detroit area, changes in family dynamics
have resulted in increased challenges in providing health care and other
social services to that group.
That was one of the findings of a survey and set of interviews conducted
by researchers from the University of Michigan-Dearborn in 2002-03.
Paul Wong, former dean at UM-Dearborn who is now a dean at San Diego
State University, conducted the study with a grant from the federal Administration
on Aging, administered by Wayne County Senior Citizens' Services.
The project was completed in conjunction with The
Senior Alliance-Area Agency on Aging 1-C, which serves the elderly
in western and southern Wayne County, and ACCESS, the Arab
Community Center for Economic and Social Services.
"All of the respondents had quite a bit to say about changing roles
and customs within the Arab American family of today," Wong said.
"The biggest change, all agreed, was in the lesser amount of care
and time devoted to the elderly due to economic and societal pressures,
particularly the employment of women and other family members."
Wong and colleagues surveyed a random sample of 200 seniors from the
Muslim and Christian Arab communities in 2003. They also conducted interviews
with 16 professionals, including physicians, nurses, psychologists and
social workers who serve those communities.
Topping the list of problems faced by Arab and Chaldean elderly in the
survey was the problem of language, followed closely by issues connected
to cultural differences. Language barriers can result in social isolation
and contribute to depression in some cases. Some of the recent immigrants
also suffer from depression or post-traumatic stress due to experiences
in their countries of origin.
In addition to the cultural and language issues faced by many Arab elderly,
changes in family dynamics have also had an impact. "A great concern
of the interview participants was that Arab American women are often employed
outside the home and can no longer care for the elderly as in the past,"
More of the elderly in the survey indicated a need for transportation
(46.5 percent) than any other item in the needs-assessment section. Prescription
assistance received the second highest rating of need, at 38.5 percent
of the survey sample. The lack of adequate transportation prevents many
of them from receiving services they need in the community.
"Transportation services and prescription assistance have been identified
as the two most important unmet needs of older adults in western and southern
Wayne County by our key informant survey the past two years," according
to Mike Simowski, executive director of The Senior Alliance. "It
is not surprising that Arab American elders are experiencing many of the
same challenges faced by other older adults in the region."
In the random sample, 197 of those interviewed were immigrants, with
the largest group, 70.5 percent, from Lebanon, and the second largest,
11.5 percent, from Yemen. Two-thirds were Muslim and one-third were Christian.
Of the 200 surveyed, 16 percent were able to speak both Arabic and English
and 82 percent were able to speak Arabic only. Some of the less-educated
elderly surveyed were unable to read any language, thus compounding the
Both the survey and qualitative interview questions focused on the quality
of life and psychosocial as well as practical needs of elderly Arab Americans,
including life satisfaction, social support, housing, health-care needs
and needs for services such as transportation and assistance with meals
and other household tasks.
"A new influx of Arab immigrants who have entered the country in
the last two decades is of particular concern," Wong said. "Many
of these immigrants brought their elderly with them or are now in their
senior years themselves."
In general, the survey found that those elderly with more education and
who are bilingual have distinct advantages over those who speak Arabic
only or have little education.
"Due most probably to their language ability and educational advantages,
the bilingual educated elderly perceive themselves as having a higher
sense of well-being or life satisfaction, and a lower need for assistance
with health care needs, transportation, personal emergencies, tax filing
or other needs," Wong said.
Sixteen percent of the elderly surveyed did not have a health plan, and
of those who did not, most were Arabic-speaking only, Wong said. While
the figure is lower than the 25 percent of all immigrant elderly who do
not receive Medicare, "it still represents a significant proportion
of uninsured seniors," Wong said.
The UM-Dearborn study was developed in response to the changing senior
citizen demographics in Wayne County, according to Wong. Wayne County
gained nearly 3,000 older adults in the 1990s and many of them immigrated
to this area from the Middle East.