Racial and ethnic differences in the health of older Americans / Linda G. Martin and Beth J. Soldo, editors ; Committee on Population, Commission on Behavioral and Social Sciences and Education, National Research Council.

Format:

Book

Contributor:

Martin, Linda G., 1947-

Soldo, Beth J.

National Research Council (U.S.). Committee on Population.

Language:

English

Subjects (All):

Minority older people--Health and hygiene--United States.

Minority older people.

Minority older people--Diseases--United States.

Physical Description:

x, 300 p. : ill.

Edition:

1st ed.

Place of Publication:

Washington, D.C. : National Academy Press, 1997.

Language Note:

English

Summary:

Older Americans, even the oldest, can now expect to live years longer than those who reached the same ages even a few decades ago. Although survival has improved for all racial and ethnic groups, strong differences persist, both in life expectancy and in the causes of disability and death at older ages. This book examines trends in mortality rates and selected causes of disability (cardiovascular disease, dementia) for older people of different racial and ethnic groups. The determinants of these trends and differences are also investigated, including differences in access to health care and experiences in early life, diet, health behaviors, genetic background, social class, wealth and income. Groups often neglected in analyses of national data, such as the elderly Hispanic and Asian Americans of different origin and immigrant generations, are compared. The volume provides understanding of research bearing on the health status and survival of the fastest-growing segment of the American population.

Contents:

Racial and Ethnic Differences in the Health of Older Americans

Copyright

Contents

Preface

1 Introduction

REFERENCES

2 Racial and Ethnic Differences in Mortality at Older Ages

INTRODUCTION

VITAL STATISTICS AND CENSUS DATA

African Americans and Whites

Hispanics

Asian Americans and Pacific Islanders

LINKED STUDIES

Social Security and Medicare Data

National Longitudinal Mortality Survey

African Americans

Subnational Studies

EXTINCT GENERATION ESTIMATES

CAUSES OF DEATH

CONCLUSIONS

3 Health and Disability Differences Among Racial and Ethnic Groups

MAJOR MORBIDITY PROCESSES AND THEIR AGE DEPENDENCE ACROSS RACIAL AND ETHNIC GROUPS

Osteoporosis and Hip Fracture

Heart Diseases and Stroke

Atherosclerosis

Diabetes Mellitus (Adult Onset)

Body Iron Stores

Hypertension

Cancers

Prostate Cancer

Breast Cancer

Cervical Cancer

Multiple Myeloma

Disease Interactions

Health Care

BLACK, HISPANIC, AND WHITE TOTAL AND CAUSE-SPECIFIC MORTALITY DIFFERENCES

WHITE-NONWHITE DIFFERENCES IN DISABILITY AND ACTIVE LIFE EXPECTANCY

SUMMARY

4 Race, Socioeconomic Status, and Health in Late Life

THE THEORY OF HEALTH PRODUCTION AND ITS RELEVANCE TO SOCIOECONOMIC STATUS-RACE-HEALTH RESEARCH

The Socioeconomic Status-Health Gradient

Measurement of Socioeconomic Status

Education

Financial Resources

Occupation

The Race Connection

The Role of Race

Measurement of Race

RACE, SOCIOECONOMIC STATUS, AND HEALTH STATUS: EXISTING EMPIRICAL EVIDENCE

Mortality

General Health Status, Functional Status, and Morbidity

RACIAL HEALTH DISPARITIES

HEALTH AND WEALTH

RISK BEHAVIORS

EMPIRICAL MODELS OF SELF-REPORTED HEALTH OUTCOMES.

Measurement of Household Resources

Changes in Health Outcomes

Long-Run Measures of Economic Resources

ACKNOWLEDGMENT

5 How Health Behaviors and the Social Environment Contribute to Health Differences Between Black and White Older Americans

THE ROLE OF ATTITUDES AND SOCIAL CONTEXT IN BEHAVIORS THAT DAMAGE OR PROMOTE HEALTH AMONG BLACKS AND WHITES

Self-Appraisal of Health and Health Behavior

Health Behaviors

Diet and Exercise

Cigarette Smoking

Alcohol Use

Health Practices of Elderly Diabetics and Hypertensives

Social Networks and Social Support

RACIAL AND SOCIOECONOMIC DIFFERENCES IN HEALTH AND SOCIAL BEHAVIORS: FINDINGS FROM THE NEW HAVEN EPESE

6 Black-White Differences in the Use of Medical Care by the Elderly: A Contemporary Analysis

DATA AND METHODS

Data and Study Sample

Variables

Utilization of Medical Care

Demographic and Socioeconomic Characteristics

Health Status

Attitudes and Beliefs

Statistical Analysis

RESULTS

Bivariate Analyses

Multivariate Analyses

DISCUSSION

7 Are Genetic Factors Involved in Racial and Ethnic Differences in Late-Life Health?

TWO SIMPLE MONOGENIC DISORDERS DIFFERING IN FREQUENCY IN BLACKS AND WHITES

DIFFERENCES IN ALLELE FREQUENCY FOR GENETIC POLYMORPHISMS IN BLACKS AND WHITES

SOME GENETICALLY COMPLEX, ENVIRONMENTALLY INFLUENCED DISORDERS DIFFERING IN FREQUENCY IN BLACKS AND WHITES

PROSPECTS FOR A BETTER UNDERSTANDING OF THE BASIS FOR DIFFERENCES IN LATE-LIFE DISEASES

8 Differences in Rates of Dementia Between Ethno-Racial Groups

EPIDEMIOLOGICAL BACKGROUND

Dementia Rates and Subtypes

Estimating Rates of Dementia

Ethno-Racial Differences in Rates of Dementia.

Putative effects of Education

METHODOLOGICAL ISSUES

The North Manhattan Aging Project and the Active Life Expectancy Study

Our Methods for Minimizing Biases in Ethno-Racial Comparisons of Dementia

Case Findings

Screening and Field Classification Techniques

Criterion Diagnosis

Biological Indicators

Longitudinal and Outcome Information

Dementia and Quality of Life

Dementia and Service Utilization

Convergence of Conclusions

Border-Zone Dementias and Nondementias

Designation of Ethno-Racial Membership

Other Socioeconomic Information

General Results

Yields from the Survey Component

Overrepresentation

Differences in Prevalence Rates of Dementia

Mislabeling

Prevalence and Other Indices of Rates

Effect of the Breadth of the Concept of Dementia

Risk Factors

Educational Associations

Subtypes of Dementia Among Ethno-Racial Groups

Other Risk Factors: Income and Immigration

Quality-of-Life Impairments

Memory Complaints

Tasks of Daily Living

Affective Suffering

Service Utilization

Nursing Homes

Home Care

Emergency Clinics

Hospitalization

Limitations of the Findings and Potential of the Methods

Ethno-Racial Variation in Prevalence Rates

Ethno-Racial Consistency in the Associations of Dementia

Working Hypotheses for the Effects of Education

Ethno-Racial Differences in Service Utilization

CONCLUSION

9 Cardiovascular Disease Among Elderly Asian Americans

METHODS

Study Population

Baseline Examination

Measures of Acculturation for the Hawaii Cohort

Follow-up Examinations and Surveillance

Definition of Cases

Age Categories

Ni-Hon-San Comparisons

Cultural Pathways to Coronary Heart Disease in the Elderly

FUTURE RESEARCH.

REFERENCES

10 Health Status of Hispanic Elderly

MORTALITY AND LIFE EXPECTANCY

EXPLAINING THE HISPANIC ADVANTAGE IN HEART DISEASE AND CANCER MORTALITY

OTHER DISEASES

FUNCTIONAL LIMITATIONS

SELF-ASSESSED HEALTH

MENTAL HEALTH

ISSUES IN MEDICAL CARE

REFERENCES.

Notes:

Revised versions of some of the papers originally presented at a workshop held Dec. 1994 in Washington.

Includes bibliographical references.

ISBN:

9786610192298

9780309175562

0309175569

9781280192296

1280192291

9780309553063

0309553067

9780585030135

0585030138

OCLC:

923266901