Skip to main content

Advertisement

SpringerLink
Log in

Advances in Understanding the Causes and Consequences of Health Disparities in Aging Minorities

  • Epidemiology of Aging (K Lapane, Section Editor)
  • Published:
Current Epidemiology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The purpose was to discuss appropriate methods for advancing our understanding of health disparities or minority aging including life-course perspectives, biological measures, pain measurement, and generational approaches.

Recent Findings

Life course perspectives provide an orientation for studying older minorities that concomitantly captures exposures and stressors that may lead to earlier onset of disease and premature mortality. The use of biological markers to study health disparities in older minorities is necessary in order to identify pathways between psychosocial factors and health outcomes. Work focusing on pain disparities should include explorations of relationships between psychosocial factors and subjective and objective measures of pain. Studying families can provide insight into genetic associations and coping styles in older minorities.

Summary

Methodological approaches that take life course, biology, and social factors into account may help identify causal pathways between social determinants of health and health outcomes among older minorities. Once these causal pathways have been identified, more strategies and interventions that strive toward health equity across older adults of all race/ethnic groups can be developed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Poon LW. Differences in human memory with aging: nature, causes, and clinical implications. 1985.

    Google Scholar 

  2. Miller D, O’callaghan J. Aging, stress and the hippocampus. Ageing Res Rev. 2005;4(2):123–40.

    Article  CAS  PubMed  Google Scholar 

  3. • Thorpe RJ Jr, Whitfield KE. Advancing minority aging research. Res Aging. 2017;39(4):471–5. https://doi.org/10.1177/0164027516672779Review explaining the importance of the racial/ethnic population shift and how it requires researchers and policy-makers to shift their thinking.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Bauer UE, Briss PA, Goodman RA, Bowman BA. Prevention of chronic disease in the 21st century: elimination of the leading preventable causes of premature death and disability in the USA. Lancet. 2014;384(9937):45–52.

    Article  PubMed  Google Scholar 

  5. Healthy People 2020. Healthy People 2020: Social Determinants of Health U.S Department of Health and Human Services, Office of Diease Prevention and Health Promotion 2019. https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health. Accessed 11 Apr 2019.

  6. •• Ferraro KF, Kemp BR, Williams MM. Diverse aging and health inequality by race and ethnicity. Innov Aging. 2017;1(1):igx002. https://doi.org/10.1093/geroni/igx002Review explaining why an understanding of cumulative biological, social, and environmental risks and exposures is needed to understand health disparities.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Thorpe Jr RJ, Kelley-Moore JA. Life course theories of race disparities. Race, ethnicity, and health: a public health reader 2013;355.

  8. Hill CV, Pérez-Stable EJ, Anderson NA, Bernard MA. The National Institute on Aging health disparities research framework. Ethn Dis. 2015;25(3):245–54.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Whitfield KE, Allaire JC, Belue R, Edwards CL. Are comparisons the answer to understanding behavioral aspects of aging in racial and ethnic groups? J Gerontol Ser B Psychol Sci Soc Sci. 2008;63(5):P301–P8.

    Article  Google Scholar 

  10. Whitfield KE, Baker-Thomas T. Individual differences in aging minorities. Int J Aging Hum Dev. 1999;48(1):73–9.

    Article  CAS  PubMed  Google Scholar 

  11. Beard JR, Officer AM, Cassels AK. The world report on ageing and health. Cary: Oxford University Press; 2016.

    Book  Google Scholar 

  12. Adler NE, Stewart J. Health disparities across the lifespan: meaning, methods, and mechanisms. Ann N Y Acad Sci. 2010;1186(1):5–23.

    Article  PubMed  Google Scholar 

  13. Jackson JS, Knight KM, Rafferty JA. Race and unhealthy behaviors: chronic stress, the HPA axis, and physical and mental health disparities over the life course. Am J Public Health. 2010;100(5):933–9.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Jackson JS, Govia IO, Sellers SL. Racial and ethnic influences over the life course. In: Handbook of aging and the social sciences. Amsterdam: Elsevier; 2011. p. 91–103.

    Chapter  Google Scholar 

  15. Huntley J, Ostfeld AM, Taylor JO, Wallace RB, Blazer D, Berkman LF, et al. Established populations for epidemiologic studies of the elderly: study design and methodology. Aging Clin Exp Res. 1993;5(1):27–37.

    Article  Google Scholar 

  16. Rooks RN, Simonsick EM, Miles T, Newman A, Kritchevsky SB, Schulz R, et al. The association of race and socioeconomic status with cardiovascular disease indicators among older adults in the health, aging, and body composition study. J Gerontol B Psychol Sci Soc Sci. 2002;57(4):S247–56. https://doi.org/10.1093/geronb/57.4.s247.

    Article  PubMed  Google Scholar 

  17. Kasper JD, Shapiro S, Guralnik JM, Bandeen-Roche KJ, Fried LP. Designing a community study of moderately to severely disabled older women: the Women’s Health and Aging Study. Ann Epidemiol. 1999;9(8):498–507. https://doi.org/10.1016/s1047-2797(99)00026-5.

    Article  CAS  PubMed  Google Scholar 

  18. Nuru-Jeter AM, Thorpe RJ Jr, Fuller-Thomson E. Black-white differences in self-reported disability outcomes in the US: early childhood to older adulthood. Public Health Rep. 2011;126(6):834–43.

    Article  PubMed  PubMed Central  Google Scholar 

  19. LaVeist TA, Bowie JV, Cooley-Quille M. Minority health status in adulthood: the middle years. Health Care Financ Rev. 2000;21(4):1–13.

    PubMed  PubMed Central  Google Scholar 

  20. Thorpe RJ, Fesahazion RG, Parker L, Wilder T, Rooks RN, Bowie JV, et al. Accelerated health declines among African Americans in the USA. J Urban Health. 2016;93(5):808–19.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Szanton SL, Thorpe RJ, Whitfield K. Life-course financial strain and health in African–Americans. Soc Sci Med. 2010;71(2):259–65.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Zhang Z, Hayward MD, Yu Y-L. Life course pathways to racial disparities in cognitive impairment among older Americans. J Health Soc Behav. 2016;57(2):184–99.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Whitfield KE, Forrester S, Thorpe RJ Jr. A comparison of variances in age cohorts to understand longevity in African Americans. J Gerontol Ser A. 2019;74(Supplement_1):S27–31.

    Article  Google Scholar 

  24. Thorpe RJ Jr, Duru OK, Hill CV. Advancing racial/ethnic minority men’s health using a life course approach. Ethn Dis. 2015;25(3):241–4.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Thorpe RJ Jr, Kelley E, Bowie JV, Griffith DM, Bruce M, LaVeist T. Explaining racial disparities in obesity among men: does place matter? Am J Mens Health. 2015;9(6):464–72.

    Article  PubMed  Google Scholar 

  26. Glymour MM, Ertel KA, Berkman LF. What can life-course epidemiology tell us about health inequalities in old age. Annu Rev Gerontol Geriatr. 2009;29:27–56.

    Article  Google Scholar 

  27. Shuey KM, Willson AE. Cumulative disadvantage and black-white disparities in life-course health trajectories. Res Aging. 2008;30(2):200–25.

    Article  Google Scholar 

  28. Dupre ME. Educational differences in age-related patterns of disease: reconsidering the cumulative disadvantage and age-as-leveler hypotheses. J Health Soc Behav. 2007;48(1):1–15.

    Article  PubMed  Google Scholar 

  29. Kelley-Moore JA, Lin J. Widening the view: Capturing “unobserved” heterogeneity in studies of age and the life course. In: Handbook of sociology of aging. Berlin: Springer; 2011. p. 51–68.

    Chapter  Google Scholar 

  30. Lynch SM. Race, socioeconomic status, and health in life-course perspective: introduction to the special issue. Research on Aging. 2008;30(2):127–36.

    Article  Google Scholar 

  31. Whitfield KE. Studying biobehavioral aspects of health disparities among older adult minorities. J Urban Health. 2005;82(3):iii103–i10.

    PubMed  PubMed Central  Google Scholar 

  32. Whitfield KE, Edwards CL, Nelson TL. Methodological considerations for the examination of complex systems in aging. Annual Review of Gerontology and Geriatrics, Volume 30, 2010: Focus on Biobehavioral Perspectives on Health in Late Life. 2010;30:35.

  33. Whitfield K, Bromell L, Bennett G, Edwards C. Biobehavioral perspectives on health morbidities in late life. In: Health Inequalities: life course perspectives on late life outcomes Annual Review of Geriatrics and Gerontology. New York: Springer Publishing; 2010. p. 57–76.

    Google Scholar 

  34. Geronimus AT, Hicken M, Keene D, Bound J. “Weathering” and age patterns of allostatic load scores among blacks and whites in the United States. Am J Public Health. 2006;96(5):826–33.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Belsky DW, Moffitt TE, Cohen AA, Corcoran DL, Levine ME, Prinz JA, et al. Eleven telomere, epigenetic clock, and biomarker-composite quantifications of biological aging: do they measure the same thing? Am J Epidemiol. 2017;187(6):1220–30.

    PubMed Central  Google Scholar 

  36. Horvath S. DNA methylation age of human tissues and cell types. Genome Biol. 2013;14(10):R115. https://doi.org/10.1186/gb-2013-14-10-r115.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Field AE, Robertson NA, Wang T, Havas A, Ideker T, Adams PD. DNA methylation clocks in aging: categories, causes, and consequences. Mol Cell. 2018;71(6):882–95.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Zannas AS, Arloth J, Carrillo-Roa T, Iurato S, Roh S, Ressler KJ, et al. Lifetime stress accelerates epigenetic aging in an urban, African American cohort: relevance of glucocorticoid signaling. Genome Biol. 2015;16:266. https://doi.org/10.1186/s13059-015-0828-5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Brody GH, Miller GE, Yu T, Beach SR, Chen E. Supportive family environments ameliorate the link between racial discrimination and epigenetic aging: a replication across two longitudinal cohorts. Psychol Sci. 2016;27(4):530–41. https://doi.org/10.1177/0956797615626703.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Giurgescu C, Nowak AL, Gillespie S, Nolan TS, Anderson CM, Ford JL, et al. Neighborhood environment and DNA methylation: implications for cardiovascular disease risk. J Urban Health. 2019;96(Suppl 1):23–34. https://doi.org/10.1007/s11524-018-00341-1.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Lind L, Ingelsson E, Sundstrom J, Siegbahn A, Lampa E. Methylation-based estimated biological age and cardiovascular disease. Eur J Clin Investig. 2018;48(2). https://doi.org/10.1111/eci.12872.

    Article  CAS  Google Scholar 

  42. Marioni RE, Shah S, McRae AF, Chen BH, Colicino E, Harris SE, et al. DNA methylation age of blood predicts all-cause mortality in later life. Genome Biol. 2015;16:25. https://doi.org/10.1186/s13059-015-0584-6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Perna L, Zhang Y, Mons U, Holleczek B, Saum KU, Brenner H. Epigenetic age acceleration predicts cancer, cardiovascular, and all-cause mortality in a German case cohort. Clin Epigenetics. 2016;8:64. https://doi.org/10.1186/s13148-016-0228-z.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Popejoy AB, Fullerton SM. Genomics is failing on diversity. Nature. 2016;538(7624):161–4. https://doi.org/10.1038/538161a.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Barcelona de Mendoza V, Wright ML, Agaba C, Prescott L, Desir A, Crusto CA, et al. A systematic review of DNA methylation and preterm birth in African American women. Biol Res Nurs. 2017;19(3):308–17.

    Article  CAS  PubMed  Google Scholar 

  46. Horvath S, Gurven M, Levine ME, Trumble BC, Kaplan H, Allayee H, et al. An epigenetic clock analysis of race/ethnicity, sex, and coronary heart disease. Genome Biol. 2016;17(1):171. https://doi.org/10.1186/s13059-016-1030-0.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Bressler J, Marioni RE, Walker RM, Xia R, Gottesman RF, Windham BG, et al. Epigenetic age acceleration and cognitive function in African-American adults in midlife: the atherosclerosis risk in communities study. J Gerontol A Biol Sci Med Sci. 2019. https://doi.org/10.1093/gerona/glz245.

  48. Beydoun MA, Hossain S, Chitrala KN, Tajuddin SM, Beydoun HA, Evans MK, et al. Association between epigenetic age acceleration and depressive symptoms in a prospective cohort study of urban-dwelling adults. J Affect Disord. 2019;257:64–73. https://doi.org/10.1016/j.jad.2019.06.032.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Blackburn EH, Epel ES, Lin J. Human telomere biology: a contributory and interactive factor in aging, disease risks, and protection. Science. 2015;350(6265):1193–8.

    Article  CAS  PubMed  Google Scholar 

  50. Jylhava J, Pedersen NL, Hagg S. Biological age predictors. EBioMedicine. 2017;21:29–36. https://doi.org/10.1016/j.ebiom.2017.03.046.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Herrmann M, Pusceddu I, Marz W, Herrmann W. Telomere biology and age-related diseases. Clin Chem Lab Med. 2018;56(8):1210–22. https://doi.org/10.1515/cclm-2017-0870.

    Article  CAS  PubMed  Google Scholar 

  52. Chae DH, Nuru-Jeter AM, Adler NE, Brody GH, Lin J, Blackburn EH, et al. Discrimination, racial bias, and telomere length in African-American men. Am J Prev Med. 2014;46(2):103–11. https://doi.org/10.1016/j.amepre.2013.10.020.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Cherkas LF, Aviv A, Valdes AM, Hunkin JL, Gardner JP, Surdulescu GL, et al. The effects of social status on biological aging as measured by white-blood-cell telomere length. Aging Cell. 2006;5(5):361–5. https://doi.org/10.1111/j.1474-9726.2006.00222.x.

    Article  CAS  PubMed  Google Scholar 

  54. Geronimus AT, Hicken MT, Pearson JA, Seashols SJ, Brown KL, Cruz TD. Do US black women experience stress-related accelerated biological aging? Hum Nat. 2010;21(1):19–38.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Lynch SM, Peek MK, Mitra N, Ravichandran K, Branas C, Spangler E, et al. Race, ethnicity, psychosocial factors, and telomere length in a multicenter setting. PLoS One. 2016;11(1):e0146723. https://doi.org/10.1371/journal.pone.0146723.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Drury SS, Esteves K, Hatch V, Woodbury M, Borne S, Adamski A, et al. Setting the trajectory: racial disparities in newborn telomere length. J Pediatr. 2015;166(5):1181–6.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Geronimus AT, Pearson JA, Linnenbringer E, Schulz AJ, Reyes AG, Epel ES, et al. Race-ethnicity, poverty, urban stressors, and telomere length in a Detroit community-based sample. J Health Soc Behav. 2015;56(2):199–224. https://doi.org/10.1177/0022146515582100.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Lee DB, Kim ES, Neblett EW. The link between discrimination and telomere length in African American adults. Health Psychol. 2017;36(5):458–67. https://doi.org/10.1037/hea0000450.

    Article  PubMed  Google Scholar 

  59. Brown L, Needham B, Ailshire J. Telomere length among older U.S. adults: differences by race/ethnicity, gender, and age. J Aging Health. 2017;29(8):1350–66. https://doi.org/10.1177/0898264316661390.

    Article  PubMed  Google Scholar 

  60. Levine ME. Modeling the rate of senescence: can estimated biological age predict mortality more accurately than chronological age? J Gerontol A Biol Sci Med Sci. 2013;68(6):667–74. https://doi.org/10.1093/gerona/gls233.

    Article  PubMed  Google Scholar 

  61. Beydoun HA, Huang S, Beydoun MA, Hossain S, Zonderman AB. Mediating-moderating effect of allostatic load on the association between dietary approaches to stop hypertension diet and all-cause and cause-specific mortality: 2001-2010 National Health and Nutrition Examination Surveys. Nutrients. 2019;11(10). https://doi.org/10.3390/nu11102311.

    Article  CAS  PubMed Central  Google Scholar 

  62. Gillespie SL, Anderson CM, Zhao S, Tan Y, Kline D, Brock G, et al. Allostatic load in the association of depressive symptoms with incident coronary heart disease: the Jackson Heart Study. Psychoneuroendocrinology. 2019;109:104369. https://doi.org/10.1016/j.psyneuen.2019.06.020.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Shalowitz MU, Schetter CD, Hillemeier MM, Chinchilli VM, Adam EK, Hobel CJ, Ramey SL, Vance MR, O’Campo P, Thorp JM Jr, Seeman TE, Raju TNK, Eunice Kennedy Shriver National Institute of Child Human Development Community Child Health Network. Cardiovascular and metabolic risk in women in the first year postpartum: allostatic load as a function of race, ethnicity, and poverty status. Am J Perinatol 2019;36(10):1079–1089.

  64. Matos TM, Souza-Talarico JN. How stress mediators can cumulatively contribute to Alzheimer’s disease an allostatic load approach. Dement Neuropsychol. 2019;13(1):11–21. https://doi.org/10.1590/1980-57642018dn13-010002.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Allen AM, Thomas MD, Michaels EK, Reeves AN, Okoye U, Price MM, et al. Racial discrimination, educational attainment, and biological dysregulation among midlife African American women. Psychoneuroendocrinology. 2019;99:225–35. https://doi.org/10.1016/j.psyneuen.2018.09.001.

    Article  PubMed  Google Scholar 

  66. Thomas MD, Michaels EK, Reeves AN, Okoye U, Price MM, Hasson RE, et al. Differential associations between everyday versus institution-specific racial discrimination, self-reported health, and allostatic load among black women: implications for clinical assessment and epidemiologic studies. Ann Epidemiol. 2019;35:20–8 e3. https://doi.org/10.1016/j.annepidem.2019.05.002.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Cuevas AG, Wang K, Williams DR, Mattei J, Tucker KL, Falcon LM. The association between perceived discrimination and allostatic load in the Boston Puerto Rican Health Study. Psychosom Med. 2019;81(7):659–67. https://doi.org/10.1097/PSY.0000000000000715.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Forrester S, Jacobs D, Zmora R, Schreiner P, Roger V, Kiefe CI. Racial differences in weathering and its associations with psychosocial stress: the CARDIA study. SSM Popul Health. 2019;7:003. https://doi.org/10.1016/j.ssmph.2018.11.003.

    Article  PubMed  Google Scholar 

  69. • McCrory C, Fiorito G, Ni Cheallaigh C, Polidoro S, Karisola P, Alenius H, et al. How does socio-economic position (SEP) get biologically embedded? A comparison of allostatic load and the epigenetic clock(s). Psychoneuroendocrinology. 2019;104:64–73. https://doi.org/10.1016/j.psyneuen.2019.02.018Comparison between biomarker-based and DNA based methods for measuring age acceleration.

    Article  PubMed  Google Scholar 

  70. Rodriguez JM, Karlamangla AS, Gruenewald TL, Miller-Martinez D, Merkin SS, Seeman TE. Social stratification and allostatic load: shapes of health differences in the MIDUS study in the United States. J Biosoc Sci. 2019;51(5):627–44. https://doi.org/10.1017/S0021932018000378.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Upchurch DM, Stein J, Greendale GA, Chyu L, Tseng CH, Huang MH, et al. A longitudinal investigation of race, socioeconomic status, and psychosocial mediators of allostatic load in midlife women: findings from the study of women’s health across the nation. Psychosom Med. 2015;77(4):402–12. https://doi.org/10.1097/PSY.0000000000000175.

    Article  PubMed  PubMed Central  Google Scholar 

  72. Seeman M, Stein Merkin S, Karlamangla A, Koretz B, Seeman T. Social status and biological dysregulation: the “status syndrome” and allostatic load. Soc Sci Med. 2014;118:143–51. https://doi.org/10.1016/j.socscimed.2014.08.002.

    Article  PubMed  PubMed Central  Google Scholar 

  73. Tan M, Mamun A, Kitzman H, Mandapati SR, Dodgen L. Neighborhood disadvantage and allostatic load in African American women at risk for obesity-related diseases. Prev Chronic Dis. 2017;14:E119. https://doi.org/10.5888/pcd14.170143.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Robinette JW, Charles ST, Almeida DM, Gruenewald TL. Neighborhood features and physiological risk: an examination of allostatic load. Health Place. 2016;41:110–8. https://doi.org/10.1016/j.healthplace.2016.08.003.

    Article  PubMed  PubMed Central  Google Scholar 

  75. Seeman TE, Singer BH, Rowe JW, Horwitz RI, McEwen BS. Price of adaptation--allostatic load and its health consequences. MacArthur studies of successful aging. Arch Intern Med. 1997;157(19):2259–68.

    Article  CAS  PubMed  Google Scholar 

  76. Johnson SC, Cavallaro FL, Leon DA. A systematic review of allostatic load in relation to socioeconomic position: poor fidelity and major inconsistencies in biomarkers employed. Soc Sci Med. 2017;192:66–73. https://doi.org/10.1016/j.socscimed.2017.09.025.

    Article  PubMed  Google Scholar 

  77. Carter SE, Ong ML, Simons RL, Gibbons FX, Lei MK, Beach SRH. The effect of early discrimination on accelerated aging among African Americans. Health Psychol. 2019;38(11):1010–3. https://doi.org/10.1037/hea0000788.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Szanton SL, Rifkind JM, Mohanty JG, Miller ER, Thorpe RJ, Nagababu E, et al. Racial discrimination is associated with a measure of red blood cell oxidative stress: a potential pathway for racial health disparities. Int J Behav Med. 2012;19(4):489–95.

    Article  PubMed  PubMed Central  Google Scholar 

  79. Goosby BJ, Heidbrink C. Transgenerational consequences of racial discrimination for African American health. Sociol Compass. 2013;7(8):630–43. https://doi.org/10.1111/soc4.12054.

    Article  PubMed  PubMed Central  Google Scholar 

  80. Cobb RJ, Parker LJ, Thorpe RJ. Self-reported instances of major discrimination, race/ethnicity, and inflammation among older adults: evidence from the Health and Retirement Study. J Gerontol Biol Med Sci. 2018.

  81. Hsu P-C, Kadlubar S, Su JL, Acheampong D, Rogers LJ, Runnells G, et al. County poverty levels influence genome-wide DNA methylation profiles in African American and European American women. Transl Cancer Res. 2019;8(2):683–92.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  82. Harris KM, Schorpp KM. Integrating biomarkers in social stratification and health research. Annu Rev Sociol. 2018;44:361–86. https://doi.org/10.1146/annurev-soc-060116-053339.

    Article  PubMed  PubMed Central  Google Scholar 

  83. Simons RL, Lei MK, Beach SR, Philibert RA, Cutrona CE, Gibbons FX, et al. Economic hardship and biological weathering: the epigenetics of aging in a US sample of black women. Soc Sci Med. 2016;150:192–200.

    Article  PubMed  Google Scholar 

  84. Cunliffe VT. The epigenetic impacts of social stress: how does social adversity become biologically embedded? Epigenomics. 2016;8(12):1653–69. https://doi.org/10.2217/epi-2016-0075.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  85. Galanter JM, Gignoux CR, Oh SS, Torgerson D, Pino-Yanes M, Thakur N, et al. Differential methylation between ethnic sub-groups reflects the effect of genetic ancestry and environmental exposures. Elife. 2017;6. https://doi.org/10.7554/eLife.20532.

  86. Campbell CM, Edwards RR. Ethnic differences in pain and pain management. Pain Manag. 2012;2(3):219–30. https://doi.org/10.2217/pmt.12.7.

    Article  PubMed  Google Scholar 

  87. Fuentes M, Hart-Johnson T, Green CR. The association among neighborhood socioeconomic status, race and chronic pain in black and white older adults. J Natl Med Assoc. 2007;99(10):1160–9.

    PubMed  PubMed Central  Google Scholar 

  88. Limaye S, Katz P. Challenges of pain assessment and management in the minority elderly population. Ann Long Term Care. 2006;14(11).

  89. Lavin R, Park J. A characterization of pain in racially and ethnically diverse older adults: a review of the literature. J Appl Gerontol. 2014;33(3):258–90. https://doi.org/10.1177/0733464812459372.

    Article  PubMed  Google Scholar 

  90. Shavers VL, Bakos A, Sheppard VB. Race, ethnicity, and pain among the U.S. adult population. J Health Care Poor Underserved. 2010;21(1):177–220. https://doi.org/10.1353/hpu.0.0255.

    Article  PubMed  Google Scholar 

  91. Tan G, Jensen MP, Thornby J, Anderson KO. Ethnicity, control appraisal, coping, and adjustment to chronic pain among black and white Americans. Pain Med. 2005;6(1):18–28. https://doi.org/10.1111/j.1526-4637.2005.05008.x.

    Article  PubMed  Google Scholar 

  92. Anderson KO, Green CR, Payne R. Racial and ethnic disparities in pain: causes and consequences of unequal care. J Pain. 2009;10(12):1187–204.

    Article  PubMed  Google Scholar 

  93. Diaz-Venegas C, Downer B, Langa KM, Wong R. Racial and ethnic differences in cognitive function among older adults in the USA. Int J Geriatr Psychiatry. 2016;31(9):1004–12. https://doi.org/10.1002/gps.4410.

    Article  PubMed  PubMed Central  Google Scholar 

  94. • Booker SS, Herr K. The state-of-“cultural validity” of self-report pain assessment tools in diverse older adults. Pain Med. 2015;16(2):232–9. https://doi.org/10.1111/pme.12496Provides recommendations of pain in older adults who can verbally report pain. The article has implications for both clinicians and researchers who are measuring pain in older adults.

    Article  PubMed  Google Scholar 

  95. Tait RC, Chibnall JT. Racial/ethnic disparities in the assessment and treatment of pain: psychosocial perspectives. Am Psychol. 2014;69(2):131–41.

    Article  PubMed  Google Scholar 

  96. • Karcioglu O, Topacoglu H, Dikme O, Dikme O. A systematic review of the pain scales in adults: which to use? Am J Emerg Med. 2018;36(4):707–14. https://doi.org/10.1016/j.ajem.2018.01.008Systematic review of scales used to measure pain in adults. The authors discuss the validity and reliability of commonly used pain assessment scales within the literature.

    Article  PubMed  Google Scholar 

  97. Ware LJ, Epps CD, Herr K, Packard A. Evaluation of the revised Faces Pain Scale, Verbal Descriptor Scale, Numeric Rating Scale, and Iowa Pain Thermometer in older minority adults. Pain Manag Nurs. 2006;7(3):117–25. https://doi.org/10.1016/j.pmn.2006.06.005.

    Article  PubMed  Google Scholar 

  98. Cleeland CS, Ryan KM. Pain assessment: global use of the Brief Pain Inventory. Ann Acad Med Singap. 1994;23(2):129–38.

    CAS  PubMed  Google Scholar 

  99. Melzack R. The short-form McGill Pain Questionnaire. Pain. 1987;30(2):191–7. https://doi.org/10.1016/0304-3959(87)91074-8.

    Article  CAS  PubMed  Google Scholar 

  100. Revicki DA, Cook KF, Amtmann D, Harnam N, Chen WH, Keefe FJ. Exploratory and confirmatory factor analysis of the PROMIS pain quality item bank. Qual Life Res. 2014;23(1):245–55. https://doi.org/10.1007/s11136-013-0467-9.

    Article  PubMed  Google Scholar 

  101. Baker TA, Buchanan NT, Corson N. Factors influencing chronic pain intensity in older black women: examining depression, locus of control, and physical health. J Women's Health (Larchmt). 2008;17(5):869–78. https://doi.org/10.1089/jwh.2007.0452.

    Article  Google Scholar 

  102. Meghani SH, Kang Y, Chittams J, McMenamin E, Mao JJ, Fudin J. African Americans with cancer pain are more likely to receive an analgesic with toxic metabolite despite clinical risks: a mediation analysis study. J Clin Oncol. 2014;32(25):2773–9. https://doi.org/10.1200/JCO.2013.54.7992.

    Article  PubMed  PubMed Central  Google Scholar 

  103. Taylor JL, Campbell CM, Thorpe RJ Jr, Whitfield KE, Nkimbeng M, Szanton SL. Pain, racial discrimination, and depressive symptoms among African American women. Pain Manag Nurs. 2018;19(1):79–87.

    Article  Google Scholar 

  104. Khanna R, Kumar A, Khanna R. Brief pain inventory scale: an emerging assessment modality for orofacial pain. Indian J Pain. 2015;29(2):61.

    Article  Google Scholar 

  105. Campbell LC, Robinson K, Meghani SH, Vallerand A, Schatman M, Sonty N. Challenges and opportunities in pain management disparities research: implications for clinical practice, advocacy, and policy. J Pain. 2012;13(7):611–9. https://doi.org/10.1016/j.jpain.2012.02.004.

    Article  PubMed  PubMed Central  Google Scholar 

  106. Medoc. Quantitative sensory testing technique 2019. https://medoc-web.com/about-us/about-qst/technique/. 2019.

  107. Burton EF, Suen SY, Walker JL, Bruehl S, Peterlin BL, Tompkins DA, et al. Ethnic differences in the effects of naloxone on sustained evoked pain: a preliminary study. Divers Equal Health Care. 2017;14(5):236–42. https://doi.org/10.21767/2049-5471.1000116.

    Article  PubMed  PubMed Central  Google Scholar 

  108. Wang Y, Mo X, Zhang J, Fan Y, Wang K, Peter S. Quantitative sensory testing (QST) in the orofacial region of healthy Chinese: influence of site, gender and age. Acta Odontol Scand. 2018;76(1):58–63. https://doi.org/10.1080/00016357.2017.1383511.

    Article  PubMed  Google Scholar 

  109. Campbell CM, Edwards RR, Fillingim RB. Ethnic differences in responses to multiple experimental pain stimuli. Pain. 2005;113(1–2):20–6. https://doi.org/10.1016/j.pain.2004.08.013.

    Article  PubMed  Google Scholar 

  110. Baker TA, Buchanan NT, Small BJ, Hines RD, Whitfield KE. Identifying the relationship between chronic pain, depression, and life satisfaction in older African Americans. Res Aging. 2011;33(4):426–43.

    Article  Google Scholar 

  111. Baker TA, Clay OJ, Johnson-Lawrence V, Minahan JA, Mingo CA, Thorpe RJ, et al. Association of multiple chronic conditions and pain among older black and white adults with diabetes mellitus. BMC Geriatr. 2017;17(1):255. https://doi.org/10.1186/s12877-017-0652-8.

    Article  PubMed  PubMed Central  Google Scholar 

  112. Cruz-Almeida Y, Fillingim RB. Can quantitative sensory testing move us closer to mechanism-based pain management? Pain Med. 2014;15(1):61–72. https://doi.org/10.1111/pme.12230.

    Article  PubMed  Google Scholar 

  113. Szanton SL, Johnson B, Thorpe RJ, Whitfield K. Education in time: cohort differences in educational attainment in African-American twins. PLoS One. 2009;4(10):e7664. https://doi.org/10.1371/journal.pone.0007664.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  114. Furner SE, Wallace K, Arguelles L, Miles T, Goldberg J. Factors associated with self-reported health: a twin study of older African American women. J Women Aging. 2010;22(2):83–93. https://doi.org/10.1080/08952841003716071.

    Article  PubMed  Google Scholar 

  115. Whitfield KE, Kiddoe J, Gamaldo A, Andel R, Edwards CL. Concordance rates for cognitive impairment among older African American twins. Alzheimers Dement. 2009;5(3):276–9. https://doi.org/10.1016/j.jalz.2008.09.003.

    Article  PubMed  PubMed Central  Google Scholar 

  116. Saluter A. Marital status and living arrangements: current population reports, population characteristics (series P-20, no. 461). Washington, DC: Government Printing Office; 1992.

    Google Scholar 

  117. Bryson K, editor. New Census Bureau data on grandparents raising grandchildren. 54th Annual Scientific Meeting of the Gerontological Society of America, Chicago, IL; 2001.

  118. Whitley DM, Kelley SJ, Lamis DA. Depression, social support, and mental health: a longitudinal mediation analysis in African American custodial grandmothers. Int J Aging Hum Dev. 2016;82(2–3):166–87. https://doi.org/10.1177/0091415015626550.

    Article  PubMed  Google Scholar 

  119. • Hayslip B Jr, Fruhauf CA, Dolbin-MacNab ML. Grandparents raising grandchildren: what have we learned over the past decade? Gerontologist. 2017;57(6):1196. https://doi.org/10.1093/geront/gnx124Review of how the family structure, with regard to grandparents raising grandchildren, has changed. Explains changing demographics and what needs to be done to support these families.

    Article  PubMed  Google Scholar 

  120. Szinovacz ME. Grandparents today: a demographic profile. The Gerontologist. 1998;38(1):37–52.

    Article  CAS  PubMed  Google Scholar 

  121. Fuller-Thomson E, Minkler M, Driver D. A profile of grandparents raising grandchildren in the United States. The Gerontologist. 1997;37(3):406–11.

    Article  CAS  PubMed  Google Scholar 

  122. Simmons T, Dye JL. Grandparents living with grandchildren: 2000. Census 2000 Brief. 2003.

  123. Grandchildren GR. Frontier education center-issues brief. 2004.

  124. Kropf NP, Robinson MM. Pathways into caregiving for rural custodial grandparents. J Intergenerational Relationships. 2004;2(1):63–77.

    Article  Google Scholar 

  125. Clottey E, Scott A, Alfonso ML. Grandparent caregiving among rural African Americans in a community in the American South: challenges to health and wellbeing. Rural Remote Health. 2015;15(3).

  126. Rodriguez-Srednicki O. The custodial grandparent phenomenon: a challenge to schools and school psychology. NASP Communiqué. 2002;31(1):41–2.

    Google Scholar 

  127. Bullock K. The changing role of grandparents in rural families: the results of an exploratory study in southeastern North Carolina. Fam Soc. 2004;85(1):45–54.

    Article  Google Scholar 

  128. Whitfield KE, Wiggins S. The influence of social support and health on everyday problem solving in adult African Americans. Exp Aging Res. 2003;29(1):1–13.

    Article  PubMed  Google Scholar 

  129. • Forrester SN, Gallo JJ, Whitfield KE, Thorpe RJ. A framework of minority stress: from physiological manifestations to cognitive outcomes. Gerontologist. 2019;59(6):1017–23. https://doi.org/10.1093/geront/gny104A review that provides a framework for udnerstanding how stress in aging minorities affects cognitive outcomes through biological pathways.

    Article  PubMed  Google Scholar 

  130. Whitfield KE, Brandon DT, Wiggins S, Vogler G, McClearn G. Does intact pair status matter in the study of African American twins? The Carolina African American Twin Study of Aging. Exp Aging Res. 2003;29(4):407–23.

    Article  PubMed  Google Scholar 

Download references

Funding

SNF is supported by the UMASS Center for Clinical and Translational Science Clinical Research Scholar Award (KL2). JLT is supported by the Robert Wood Johnson Harold Amos Medical Faculty Program. KEW is supported by NIA-AG054363. RJT is supported by the NIH grants K02AG059140, R01AG054363, and U54MD000214.

Author information

Authors and Affiliations

  1. Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA

    Sarah N. Forrester

  2. Johns Hopkins School of Nursing, Baltimore, MD, USA

    Janiece L. Taylor

  3. Psychology Department, Wayne State University, Detroit, MI, USA

    Keith E. Whitfield

  4. Program for Research on Men’s Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD, 21205, USA

    Roland J. Thorpe Jr

Authors
  1. Sarah N. Forrester
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Janiece L. Taylor
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Keith E. Whitfield
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Roland J. Thorpe Jr
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Roland J. Thorpe Jr.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Epidemiology of Aging

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Forrester, S.N., Taylor, J.L., Whitfield, K.E. et al. Advances in Understanding the Causes and Consequences of Health Disparities in Aging Minorities. Curr Epidemiol Rep 7, 59–67 (2020). https://doi.org/10.1007/s40471-020-00234-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40471-020-00234-5

Keywords

Search

Navigation