Race, Gender, And Lifestyle Discussions in Geriatric Primary Care Medical Visits‪.‬

1. INTRODUCTION The primary causes of mortality in the United States and other industrialized nations have shifted from acute illnesses to chronic conditions. The three leading causes of mortality in the United States in 2006 were heart disease, cancer, and stroke [1]. These deaths are attributed to tobacco use, poor diet, and physical inactivity [2]. Health care delivery continues to change as a result of these trends in mortality, and other factors like the aging U.S. population [3]. Increasingly, health care providers spend more time and effort aimed at prevention and lifestyle modification [4]. Many argue that health care providers are in a unique position to provide information and advice for effective lifestyle and behavior change [5,6]. Recent research suggests that physicians and other health care providers are important and effective facilitators for change of health-related behaviors [7,8]. Relatively little research, however, has been directed toward understanding the role of interpersonal provider and patient characteristics, such as race and gender, on discussions of lifestyle choices about specific public health issues. This study aims to answer two questions. First, what is the prevalence of discussions about nutrition, physical activity, and smoking in geriatric primary care medical visits? Second, does the prevalence of lifestyle discussions about nutrition, exercise, and smoking vary by patient and/or physician race and gender? We focus on geriatric patients because they represent an important and growing segment of American society [3]. They are also less likely than other groups to engage in regular physical activity, and more vulnerable to the consequences of unhealthy behaviors and poor nutrition [9].