Original Article

Annals of Behavioral Medicine

, Volume 43, Issue 1, pp 29-38

Racial Differences in Mortality in Older Adults: Factors Beyond Socioeconomic Status

  • Roland J. ThorpeJrAffiliated withHopkins Center for Health Disparities Solutions, Department of Health Policy and Management, The Johns Hopkins Bloomberg School of Public Health Email author 
  • , Annemarie KosterAffiliated withFaculty of Health, Medicine and Life Sciences, Universiteit MaastrichtLaboratory of Epidemiology, Demography, and Biometry, National Institute on Aging
  • , Hans BosmaAffiliated withFaculty of Health, Medicine and Life Sciences, Universiteit Maastricht
  • , Tamara B. HarrisAffiliated withLaboratory of Epidemiology, Demography, and Biometry, National Institute on Aging
  • , Eleanor M. SimonsickAffiliated withDivision of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins School of MedicineClinical Research Branch, National Institute on Aging
  • , Jacques Th. M. van EijkAffiliated withFaculty of Health, Medicine and Life Sciences, Universiteit Maastricht
  • , Gertrudis I. J. M. KempenAffiliated withFaculty of Health, Medicine and Life Sciences, Universiteit Maastricht
  • , Anne B. NewmanAffiliated withDepartment of Epidemiology, Graduate School of Public Health, University of Pittsburgh
  • , Suzanne SatterfieldAffiliated withDepartment of Preventive Medicine, University of Tennessee College of Medicine
    • , Susan M. RubinAffiliated withDepartment of Epidemiology and Biostatistics, University of California
    • , Stephen B. KritchevskyAffiliated withSticht Center on Aging, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine
    • , for the Health ABC Study

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Abstract

Background

Little is known about the simultaneous effect of socioeconomic status (SES), psychosocial, and health-related factors on race differences in mortality in older adults.

Purpose

This study examined the association between race and mortality and the role of SES, health insurance, psychosocial factors, behavioral factors, and health-related factors in explaining these differences.

Methods

Data consisted of 2,938 adults participating in the Health, Aging and Body Composition study. Mortality was assessed over 8 years.

Results

SES differences accounted for 60% of the racial differences in all-cause mortality; behavioral factors and self-rated health further reduced the disparity. The racial differences in coronary heart disease mortality were completely explained by SES. Health insurance and behavioral factors accounted for some, but not all, of the race differences in cancer mortality.

Conclusions

Race-related risk factors for mortality may differ by the underlying cause of mortality.

Keywords

Race SES Behavior Psychosocial Mortality Older adults Aging