Revista Horizontes: primavera/otoño 2011 | Año LIV Núms. 104-105

36 disability as a complex relationship between the external social factors and the personal conditions, where the principal role for the level of independence of the individuals have the social factors and conditions (World Heath Organization, 2000). Chappel and Cooke (2011) discuss the disablement process from a gerontological perspective involved in a dynamic interaction tied to cultural norms, socioeconomic status attitudes, stigma and accessibility to health, and social services. Those socially created boundaries arise as constrains in their everyday life. Factors such as work and occupation, time, financial independence, health, family, environment, and lack of skills are significant for older adults’ activity (Alexandris, Barkoukis, & Tsormpatzoudi , 2007; Lian, Gan, Pin, Wee & Ye, 1999). To understand the level of performance of each constrain type, Jackson (2005), states that replicable set of constrains such as costs of participation and time commitments, availability and quality of facilities, social and geographical isolation, and personal skills and abilities, are the dimensions that mostly affect and determine the level of the presented constrain. Sub categorization When discussing disability issues in older adults we must take into consideration two subgroups within this population: those who are aging-in-place with a previously identified developmental disability and those who acquired impairment later in life. Research has strongly focused on the latter, while those who are aging with a disability are being increasingly studied as their life expectancy is growing due to technological and medical advances. This includes individuals with chronic conditions or those who were diagnosed with multiple sclerosis, spinal cord injury, and polio. Individuals with mental illness and/or intellectual disabilities also fall under this category and so does individuals with visual and auditory impairments who were diagnosed early in life. It is important to make a distinction between the previous groups because individuals who acquired an impairment later in life need specialized services aimed at restoring, re-teaching or substituting previous skills, while those with developmental disabilities need specialized services to acquire skills such as self-care, socialization, and fine motor development (Ansello & Rose, 1989). Furthermore, in Puerto Rico individuals who are aging with pre-existing conditions are cared-for primarily by their parents, usually the mother, while older adults who acquired the impairment later in life are cared- for by their spouses or children. The Puerto Rican Context Individuals who identify themselves as members of a racial or ethnic minority who are also old and disabled are prone to greater difficulties and isolation since their support net, social security benefits, family income, and net worth is lower (Leonesio, Vaughan & Wixon, 2000). According to Ozawa and Hun Yeo (2008), there are “three categories of variables that affect the odds of becoming disabled: (a) socioeconomic variables, (b) race/ethnicity variables, and (c) other demographic variables” (p. 339). Historically, Puerto Ricans have been classified as a group with lower socioeconomic status when compared to North American White people. Although Puerto Rican “baby-boomers” may have higher levels of education and better jobs than their previous generation, more than often these individuals hold blue-collar, physically demanding jobs, increasing the odds of becoming disabled later in life. Ozawa and Hun Yeo (2008) stated that if “Hispanic elderly persons had the same socioeconomic backgrounds (education, income, and net worth) as those of White elderly persons, their odds of being disabled would have been smaller”(p. 340). The previous statement highlights the correlation between low socioeconomic backgrounds and higher disability rates. A review of studies and statistical trends on disability and aging among Puerto Rican communities suggest in particular how the relationship between them is given, their common issues and constrains. Monteverde et al. (2009), in their cross-national comparative study of disability, aging and long term care between Mexico, Argentina, and Puerto Rico, classify three major group factors for accessing aging for dependent elderly people in Latin America and the Caribbean: population growth of elderly, long-term care burdens and technological enhancements of health, and the social policy concerns for building safety nets. Considering the world tendencies of fast growing older adult population, it is important to note that by 2025, 840,000,000 older adults will represent 70% of all the population (WHO, 2002). The US Census Bureau estimates that for Puerto Rico, this number will be 1,441,808 people, around 39% of the total population (3,696,940). The Bureau estimates a double increase of the older adult population, which for 2010 remained at 20.1% (US Census Bureau, 2009). Those trends are characterized with technological and medical improvements in people´s health, providing additional years in life, but most of the time accompanied with a disability condition (Cutler, 2001). As disability rates grow with age, the likelihood of older adults living with any disability type increases (Smith, Raye, & Smith, 2008). The latter goes along with the fact that in Puerto Rico the health status of older adults is most commonly described as with high prevalence of chronic diseases that lead afterwards to decreased abilities for independent living and full social participation. The annual report of older adults profile characteristics in Puerto Rico for 2009 shows that major diseases are hypertension (44.1%), arthritis (26.9%), and diabetes (23%). The need for long-term care as a logical consequence of a chronic disease is supported by the fact that highest percentages of older adults are living with physical disabilities (39.3%) and difficulties for self care (34.6%) (Puerto Rican Community Survey, 2008). These facts have important implications for different aspects of the social policy (health, housing, social security, accessibility) and require the attention