Racial Differences in Mortality in Older Adults: Factors Beyond Socioeconomic Status
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Little is known about the simultaneous effect of socioeconomic status (SES), psychosocial, and health-related factors on race differences in mortality in older adults.
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.
Data consisted of 2,938 adults participating in the Health, Aging and Body Composition study. Mortality was assessed over 8 years.
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.
Race-related risk factors for mortality may differ by the underlying cause of mortality.
KeywordsRace SES Behavior Psychosocial Mortality Older adults Aging
- 2.Davey Smith G, Neaton JD, Wentworth D, Stamler R, Stamler J. Mortality differences between black and white men in the USA: Contribution of income and other risk factors among men screened for the MRFIT. MRFIT Research Group. Multiple Risk Factor Intervention Trial. Lancet. 1998; 351(9107): 934-939.PubMedGoogle Scholar
- 5.Hummer R, Benjamins M, Rogers R. Racial and ethnic disparities in health and mortality among the U.S. elderly popuation. In: Anderson N, Bulatao R, Cohen B, eds. Critical perspectives on racial and ethnic differences in health in late life. Washington D.C.: National Academy Press; 2004: 69-110.Google Scholar
- 11.National Center for Health Statistics. Health United States, 2009: With Special Feature on Medical Technology. Hyattsville, MD; 2010.Google Scholar
- 18.Winkleby MA, Cubbin C. Chapter 12: Racial/ethnic disparities in health behaviors: A challenge to current assumption. In: Critical Perspectives on Racial and Ethnic Differences in Health in Late Life. Anderson NB, Bulatao RA, Cohen B, eds. Washington DC: National Academies Press; 2004.Google Scholar
- 24.Thorpe RJ, Jr, Brandon DT, LaVeist TA. Social context as an explanation for race disparities in hypertension: Findings from the exploring health disparities in integrated communities (EHDIC) study. Soc Sci Med. 2008; 67(10): 1604-1611. doi:10.1016/j.socscimed.2008.07.002 PubMedCrossRefGoogle Scholar
- 28.National Center for Health Statistics. Health United States,2001, with urban and rural health chartbook. DHDD Publication No. (PHS) 01-1232. Hyattsville, MD; 2001.Google Scholar
- 29.Rogers RG, Hummer RA, Nam CB. Living and Dying in the USA. New York: Academic Press; 2000.Google Scholar
- 34.U.S. Department of Health and Human Services. Healthy people 2000: National health promotion and disease prevention objectives. (Report No. PHS 91-50213). Washington, DC: Public Health Service; 1991.Google Scholar
- 35.U.S. Department of Health and Human Services. Tracking Healthy People 2010. Washington, DC: U.S. Government Printing Office; 2000.Google Scholar
- 40.Manly JJ. Deconstructing race and ethnicity: Implications for measurement of health outcomes. Med Care. 2006; 44(11(Suppl 3)): S10-S10-S16.Google Scholar
- 48.Andersen E, Malmgren J, Carter WB, Patrick DL. Screening for depression in well older adults: Evaluation of a short form of the CES-D. AM J Prev Med. 1994; 10: 77-84.Google Scholar
- 50.Preston SH, Taubman P. Socioeconomic differences in adult mortality and health status. In: Martin LG, Preston SH, eds. Demography of Aging. Washington, DC: National Academy Press; 1994: 279-318.Google Scholar
- 59.Guralnik JM, Butterworth S, Wadsworth, ME, Kuh, D. Childhood socioeconomic status predicts physical functioning a half century later. J Gerontol B Psychol Sci Soc Sci. 2006; 61(7): 694-701.Google Scholar
- 62.LaVeist TA. Beyond dummy variables and sample selection: What health services researchers ought to know about race as a variable. In: LaVeist TA, ed. Race, ethnicity, and health: A public health reader. 1st ed. San Francisco: Jossey-Bass; 2002.Google Scholar