, Volume 37, Issue 3, pp 267-283

The racial crossover in comorbidity, disability, and mortality

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This study analyzed one respondent per household who was age 70 or more at the time of the household’s inclusion in Wave 1 (1993–1994) and whose survival status was determinable at Wave 2 (1995–1996) of the Survey on Asset and Health Dynamics Among the Oldest Old (AHEAD Survey). At age 76 at Wave 1, there was a racial crossover in the cumulative number of six potentially fatal diagnoses (chronic lung disease, cancer, heart disease, hypertension, diabetes, and stroke) from a higher cumulative average number for blacks to a higher average number for whites. Also, there was a racial crossover at age 86 in the cumulative average number of disabilities in the Advanced Activities of Daily Living (AADLs), from a higher average for blacks to a higher average for whites. Between Waves 1 and 2, there was a racial crossover in the odds of mortality from higher odds for blacks to higher odds for whites; this occurred at about age 81. The results are consistent with the interpretation that the racial crossover in comorbidity (but not the crossover in AADL disability) propelled the racial crossover in mortality.

This report was funded by National Research Initiatives Competitive Grant 98-35401-6160 from the U.S. Department of Agriculture and by Michigan Agricultural Experiment Station Projects MICL03350, MICL01874, and MICL08206. I thank anonymous reviewers, plus Kenneth Kochanek, Richard Rogers, John Weeks, and especially Charles B. Nam, for constructive suggestions on earlier drafts. I alone am responsible for any errors. The current draft was written while I was on a sabbatical leave of absence to the Department of Sociology, Florida State University. This paper was presented at the 2000 annual meetings of the Population Association of America, held on March 24 in Los Angeles, CA.