PREHCO Project

Project Description and Objectives

Sponsoring agency: National Institute on Aging

Principal Investigator: Alberto Palloni, University of Wisconsin-Madison

The "Puerto Rican Elderly: Health Conditions (PREHCO)" project aims at providing quality data for researchers and policy makers about issues affecting the elderly population in Puerto Rico: health status, housing arrangements, functional status, transfers, work status, migration, income, childhood characteristics, health insurance, use of health services, marital history, labor history, mistreat, sexuality, etc. The PREHCO Project investigates the characteristics of older adults (aged 60+) in Puerto Rico through an island-wide, cross-sectional sample survey of target individuals and their surviving spouses.

The project has been funded by the National Institute on Aging and it is developed through a collaboration agreement between the Center for Demography and Ecology of the University of Wisconsin-Madison and the Graduate School of Public Health of the Medical Sciences Campus of the University of Puerto Rico.

The project addresses the following goals:

To describe health conditions of adults 60+ in general, and of those 80+ in particular, with regard to self-reported health conditions, physical and mental impairment, and functional disability.
To develop and validate a minimental test to evaluate the cognitive impairment of older Puerto Ricans.
To evaluate socioeconomic differentials in health status, physical and mental impairment, functional disability, rates of institutionalization and mortality risks.
To assess relations between self-reported chronic conditions, functional status, mortality and institutionalization, and background conditions, including migration experience.
To estimate relations between individuals' history of illness, behavioral risks, and shared environments, on the one hand, and chronic diseases, disability, mortality and institutionalization, on the other.
To identify risk profiles based on functional limitations, self-reported conditions and risky behavior and use them as inputs for short-term forecasting of age-patterns of morbidity, disability, and mortality.
To evaluate elderly's access to and use of health care services, including those supplied beyond the boundaries of the formal medical establishment.
To assess the relative contribution of private resources, family and public assistance toward the satisfaction of health-related needs of the elderly, including the activity of kin networks as a function of elderly' health status; and, more generally, investigate sources, magnitude and direction of intergenerational support.
To combine data sources from the US and Latin America and compare results from our survey to shed light on the seemingly favorable health conditions of Hispanics living in the US (NRC1997).

The PREHCO Project involves a number of important innovations:

The design and test of a new tool for assessing cognition among elderly of low levels of education who are also Spanish speaking.
In the area of self reporting, we designed an instrument to identify symptoms which will be useful to assess the validity of selected self reported conditions.
In the area of personal control and stress we implemented a simple protocol (a modification of the Cantrill's `Ladder Scale') that will make responses comparable to a number of other surveys.
The study includes protocols for physical measurements to assess not only current conditions, but also those to which individuals were exposed in the past.
The coupled use of GIS and GPS devices to identify eligible households and to track interviewers' activities. A protocol that greatly reduced the costs of supervision and field operations in general. The identification with GPS will also enable us to perform other activities such as matching our data with a number of geocoded administrative data sources.