Differential Health Screening of the Well Elderly by Gender and Age: Appropriate Care or Bias?

We use data from a random sample of 5,454 elderly participants in the California Preventive Health Care for the Aging Program to identify gender and age differences in health screening practices. We present a framework to facilitate an evaluation of current targeting of services by gender and age. This framework clarifies where targeting based on age and gender is appropriate or inappropriate and where more or less targeting might be needed. With use of this framework, some inappropriate age bias is indicated. The oldest-old often receive less health screening than their younger counterparts. Gender-based targeting is less frequent and is usually appropriate when it occurs. We discuss implications for practice and future program evaluations.