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Regional Disparities in ADL Limitations Among Older Latinos, Blacks, and Whites in the United States

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Contextualizing Health and Aging in the Americas

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Abstract

This chapter presents original research on within and across regional disparities in the prevalence and onset of ADL limitations among Latino, Black, and White older adults in the United States. We also present a summary analysis and discussion about how social determinants, such as income, are structuring associations between aging and declining functional status in the United States. This analysis is relevant at a historical crossroads in U.S. public health when spatial units have taken on greater significance as habitats and units of analysis for investigating disease risk and fundamental causes of health and disease. Using data from the Health and Retirement Study, we find major differences across regions in ADL-limitation risk, also large differences within and across regions in ADL-limitation risk by racial/ethnic group, and accounting for socioeconomic status greatly reduces, but does not eliminate, differences among racial/ethnic groups in their risk of developing an ADL limitation within and across regions. We also find a nearly 17-year difference in a 50% risk probability level for first onset of ADL limitations on average between individuals of any race or ethnic group in the lowest and highest income quartiles.

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Notes

  1. 1.

    Methodologies that employ linear, logistic, or logit regression analysis on individual-level cross-sectional or pooled data.

  2. 2.

    Averaging across waves as well as fitting survival models with time being age both mask possible cohort effects. We tried limiting the waves in our analysis sample to the most recent cohorts, but it did not give a large enough sample to look at effects by ethnicity. We recognize that the possibility of cohort effects and not being able to assess them is a limitation of our analysis.

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Acknowledgements

This research was sponsored by the Edward R. Royal Institute on Aging at the University of Southern California.

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Authors and Affiliations

  1. Academic Health Center, Florida International University, Miami, FL, USA

    William A. Vega

  2. USC Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, CA, USA

    William A. Vega

  3. Third Way Statistics, College Station, TX, USA

    William M. Sribney

  4. Independent Researcher, Washington, DC, USA

    Sofia G. Ayala

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  1. William A. Vega
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Correspondence to William A. Vega .

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Editors and Affiliations

  1. University of Southern California, Los Angeles, CA, USA

    William A. Vega

  2. LBJ School of Public Affairs, The University of Texas at Austin, Austin, TX, USA

    Jacqueline L. Angel

  3. Instituto Nacional de Geriatría, Mexico City, Mexico

    Luis Miguel F. Gutiérrez Robledo

  4. Department of Preventive Medicine and Community Health, The University of Texas Medical Branch, Galveston, TX, USA

    Kyriakos S. Markides

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Vega, W.A., Sribney, W.M., Ayala, S.G. (2019). Regional Disparities in ADL Limitations Among Older Latinos, Blacks, and Whites in the United States. In: Vega, W., Angel, J., Gutiérrez Robledo, L., Markides, K. (eds) Contextualizing Health and Aging in the Americas. Springer, Cham. https://doi.org/10.1007/978-3-030-00584-9_2

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  • DOI: https://doi.org/10.1007/978-3-030-00584-9_2

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