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Similar procedures were used to minimize item nonresponse.Imputed values provided on the public use files were used for cases of missing income and wealth data.The term economic access is used to refer to Andersen 1995).

These socioeconomic differences translate into reduced access to health services, which can impact utilization (Freeman and Corey 1993; Newhouse and the Insurance Experiment Group 1993).

Thus, we investigate the indirect effect of economic access (i.e., education, income, wealth, health insurance) on gender and ethnicity/race utilization differences, controlling for other predisposing factors and health needs.

Functional limitations were evaluated by task limitations in basic activities of daily living (ADLs) and in higher level function related to instrumental ADLs (IADLs) and lower and upper extremity use.

Baseline basic functioning was evaluated using six ADL tasks: walking across a room, dressing, bathing, eating, using the toilet, and transferring from a bed.

Baseline information was obtained on eight categories of chronic conditions: arthritis, diabetes, cancer, hypertension, heart disease, lung disease, stroke, and psychiatric problems.

Arthritis was based on an affirmative response given to seeing a doctor within 12 months for arthritis or rheumatism or the report of a joint replacement that was not associated with a hip fracture.

AHEAD also provided information on age, gender, and marital status.

Health needs are represented by chronic conditions and functional health reported at the baseline (1993) interview.

Higher level function is evaluated using five IADL tasks (preparing hot meals, shopping for groceries, making telephone calls, taking medications, and managing money); four tasks involving lower extremity use (walking several blocks, climbing one flight of stairs without resting, pulling or pushing large objects, lifting or carrying weights over 10 pounds); and one upper extremity task (picking up a dime from a table).

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