Diverse groups of individuals differ in their caring styles for older adults depending on their ethnicity and socioeconomic status (SES). Foreign-born individuals in the United States seem to enjoy a mortality advantage over their native-born counterparts. African Americans and Mexican Americans have a rich history of caring for their older family members. Likewise, for Native Americans, taking care of an older adult is a continuation of an ancient custom of the extended family. While there is diversity within the Asian-American community, a dilemma exists between the pull of tradition and that of rapid change in American society, especially with Chinese Americans and Japanese Americans.

As a pecking order is found among chickens, so does a demarcation of strata exist among humans. SES is a key factor in determining the quality of life of older Americans. SES indicators are associated with almost every measure of health and healthcare, and the poverty rate is an important measurement for inequality. Societies that spend little toward preventive care tend to create illness for its older citizens.