Racial and Ethnic Differences in the Health of Older Americans

Racial and Ethnic Differences in the Health of Older Americans

  • Author: Soldo, Beth J.; Martin, Linda G.
  • Publisher: National Academies Press
  • ISBN: 9780309054898
  • eISBN Pdf: 9780309553063
  • eISBN Epub: 9780309175562
  • Place of publication:  United States
  • Year of digital publication: 1997
  • Month: September
  • Pages: 313
  • Language: English

Older Americans, even the oldest, can now expect to live years longer than those who reached the same ages even a few decades ago. Although survival has improved for all racial and ethnic groups, strong differences persist, both in life expectancy and in the causes of disability and death at older ages. This book examines trends in mortality rates and selected causes of disability (cardiovascular disease, dementia) for older people of different racial and ethnic groups.

The determinants of these trends and differences are also investigated, including differences in access to health care and experiences in early life, diet, health behaviors, genetic background, social class, wealth and income. Groups often neglected in analyses of national data, such as the elderly Hispanic and Asian Americans of different origin and immigrant generations, are compared. The volume provides understanding of research bearing on the health status and survival of the fastest-growing segment of the American population.

  • Racial and Ethnic Differences in the Health of Older Americans
  • Copyright
  • Contents
  • Preface
  • 1 Introduction
    • REFERENCES
  • 2 Racial and Ethnic Differences in Mortality at Older Ages
    • INTRODUCTION
    • VITAL STATISTICS AND CENSUS DATA
      • African Americans and Whites
      • Hispanics
      • Asian Americans and Pacific Islanders
    • LINKED STUDIES
      • Social Security and Medicare Data
      • National Longitudinal Mortality Survey
        • African Americans
        • Hispanics
        • Asian Americans and Pacific Islanders
      • Subnational Studies
    • EXTINCT GENERATION ESTIMATES
    • CAUSES OF DEATH
    • CONCLUSIONS
    • REFERENCES
  • 3 Health and Disability Differences Among Racial and Ethnic Groups
    • INTRODUCTION
    • MAJOR MORBIDITY PROCESSES AND THEIR AGE DEPENDENCE ACROSS RACIAL AND ETHNIC GROUPS
      • Osteoporosis and Hip Fracture
      • Heart Diseases and Stroke
        • Atherosclerosis
        • Diabetes Mellitus (Adult Onset)
        • Body Iron Stores
        • Hypertension
      • Cancers
        • Prostate Cancer
        • Breast Cancer
        • Cervical Cancer
        • Multiple Myeloma
      • Disease Interactions
      • Health Care
    • BLACK, HISPANIC, AND WHITE TOTAL AND CAUSE-SPECIFIC MORTALITY DIFFERENCES
    • WHITE-NONWHITE DIFFERENCES IN DISABILITY AND ACTIVE LIFE EXPECTANCY
    • SUMMARY
    • REFERENCES
  • 4 Race, Socioeconomic Status, and Health in Late Life
    • INTRODUCTION
    • THE THEORY OF HEALTH PRODUCTION AND ITS RELEVANCE TO SOCIOECONOMIC STATUS-RACE-HEALTH RESEARCH
      • The Socioeconomic Status-Health Gradient
      • Measurement of Socioeconomic Status
        • Education
        • Financial Resources
        • Occupation
      • The Race Connection
        • The Role of Race
        • Measurement of Race
    • RACE, SOCIOECONOMIC STATUS, AND HEALTH STATUS: EXISTING EMPIRICAL EVIDENCE
      • Mortality
      • General Health Status, Functional Status, and Morbidity
    • RACIAL HEALTH DISPARITIES
    • HEALTH AND WEALTH
    • RISK BEHAVIORS
    • EMPIRICAL MODELS OF SELF-REPORTED HEALTH OUTCOMES
      • Measurement of Household Resources
      • Changes in Health Outcomes
      • Long-Run Measures of Economic Resources
    • CONCLUSIONS
    • ACKNOWLEDGMENT
    • REFERENCES
  • 5 How Health Behaviors and the Social Environment Contribute to Health Differences Between Black and White Older Americans
    • INTRODUCTION
    • THE ROLE OF ATTITUDES AND SOCIAL CONTEXT IN BEHAVIORS THAT DAMAGE OR PROMOTE HEALTH AMONG BLACKS AND WHITES
      • Self-Appraisal of Health and Health Behavior
      • Health Behaviors
        • Diet and Exercise
        • Cigarette Smoking
        • Alcohol Use
      • Health Practices of Elderly Diabetics and Hypertensives
      • Social Networks and Social Support
    • RACIAL AND SOCIOECONOMIC DIFFERENCES IN HEALTH AND SOCIAL BEHAVIORS: FINDINGS FROM THE NEW HAVEN EPESE
    • CONCLUSIONS
    • REFERENCES
  • 6 Black-White Differences in the Use of Medical Care by the Elderly: A Contemporary Analysis
    • INTRODUCTION
    • DATA AND METHODS
      • Data and Study Sample
      • Variables
        • Utilization of Medical Care
        • Demographic and Socioeconomic Characteristics
        • Health Status
        • Attitudes and Beliefs
      • Statistical Analysis
    • RESULTS
      • Bivariate Analyses
      • Multivariate Analyses
    • DISCUSSION
    • REFERENCES
  • 7 Are Genetic Factors Involved in Racial and Ethnic Differences in Late-Life Health?
    • INTRODUCTION
    • TWO SIMPLE MONOGENIC DISORDERS DIFFERING IN FREQUENCY IN BLACKS AND WHITES
    • DIFFERENCES IN ALLELE FREQUENCY FOR GENETIC POLYMORPHISMS IN BLACKS AND WHITES
    • SOME GENETICALLY COMPLEX, ENVIRONMENTALLY INFLUENCED DISORDERS DIFFERING IN FREQUENCY IN BLACKS AND WHITES
    • PROSPECTS FOR A BETTER UNDERSTANDING OF THE BASIS FOR DIFFERENCES IN LATE-LIFE DISEASES
    • REFERENCES
  • 8 Differences in Rates of Dementia Between Ethno-Racial Groups
    • EPIDEMIOLOGICAL BACKGROUND
      • Dementia Rates and Subtypes
      • Estimating Rates of Dementia
      • Ethno-Racial Differences in Rates of Dementia
      • Putative effects of Education
    • METHODOLOGICAL ISSUES
      • The North Manhattan Aging Project and the Active Life Expectancy Study
      • Our Methods for Minimizing Biases in Ethno-Racial Comparisons of Dementia
        • Case Findings
        • Screening and Field Classification Techniques
        • Criterion Diagnosis
        • Biological Indicators
        • Longitudinal and Outcome Information
        • Dementia and Quality of Life
        • Dementia and Service Utilization
        • Convergence of Conclusions
        • Border-Zone Dementias and Nondementias
        • Designation of Ethno-Racial Membership
        • Other Socioeconomic Information
    • RESULTS
      • General Results
        • Yields from the Survey Component
        • Overrepresentation
        • Differences in Prevalence Rates of Dementia
        • Mislabeling
        • Prevalence and Other Indices of Rates
        • Effect of the Breadth of the Concept of Dementia
        • Risk Factors
        • Educational Associations
        • Subtypes of Dementia Among Ethno-Racial Groups
        • Other Risk Factors: Income and Immigration
      • Quality-of-Life Impairments
        • Memory Complaints
        • Tasks of Daily Living
        • Affective Suffering
      • Service Utilization
        • Nursing Homes
        • Home Care
        • Emergency Clinics
        • Hospitalization
    • DISCUSSION
      • Limitations of the Findings and Potential of the Methods
      • Ethno-Racial Variation in Prevalence Rates
      • Ethno-Racial Consistency in the Associations of Dementia
      • Working Hypotheses for the Effects of Education
      • Ethno-Racial Differences in Service Utilization
    • CONCLUSION
    • ACKNOWLEDGMENT
    • REFERENCES
  • 9 Cardiovascular Disease Among Elderly Asian Americans
    • INTRODUCTION
    • METHODS
      • Study Population
      • Baseline Examination
      • Measures of Acculturation for the Hawaii Cohort
      • Follow-up Examinations and Surveillance
      • Definition of Cases
      • Age Categories
    • RESULTS
      • Ni-Hon-San Comparisons
      • Cultural Pathways to Coronary Heart Disease in the Elderly
    • DISCUSSION
    • FUTURE RESEARCH
    • REFERENCES
  • 10 Health Status of Hispanic Elderly
    • INTRODUCTION
    • MORTALITY AND LIFE EXPECTANCY
    • EXPLAINING THE HISPANIC ADVANTAGE IN HEART DISEASE AND CANCER MORTALITY
    • OTHER DISEASES
    • FUNCTIONAL LIMITATIONS
    • SELF-ASSESSED HEALTH
    • MENTAL HEALTH
    • ISSUES IN MEDICAL CARE
    • CONCLUSION
    • REFERENCES

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