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Understanding Racial and Ethnic Differences in Health in Late Life: A Research Agenda
RACIAL AND ETHNIC VARIATION
Despite the evidence of effects of social and personal resources on health, the contribution of these effects to racial and ethnic health differences has received little systematic study. Some studies of religious involvement do suggest that its effects can be different between groups. Steffen et al. (2001) found that attempts to cope through religion (through prayer, trusting in God and seeking God’s help, and finding comfort in religion) were related to lower blood pressure during normal daily activities and during sleep for blacks but not whites. And Musick et al. (1998) determined that religious activity was linked to fewer depressive symptoms among elderly blacks with cancer but not among whites.
Culture may in some cases lead to psychological dispositions having opposite effects among different groups. A few studies suggest that, for Korean Americans in contrast with whites, a perceived external locus of control rather than higher self-efficacy is more effective at relieving psychological distress (Bjorck et al., 1997; Kim, 2002; Sastry and Ross, 1998). Whether other social and personal resources also have different implications for the health of different groups is difficult to say. And what such studies add up to—what health differences might be accounted for—has not been investigated.
The lack of research on group differences is somewhat surprising in light of occasional suggestions that such factors may explain racial and ethnic differences. For instance, a lack of social and psychological resources in poor communities may be postulated to contribute to poorer health outcomes, or, in the case of Hispanics and Asians, social cohesiveness may be postulated to lead to unexpectedly good health outcomes. Nevertheless, the vast majority of research to date on health effects of social and psychological factors does not focus on ethnicity, treating it instead as a covariate to be controlled in multivariate models. As outlined by Mendes de Leon and Glass (2004), available evidence does not point to large or systematic differences in social resources by race or ethnicity. An important caveat here is that the evidence largely involves comparisons of whites and blacks, with only minimal information on Hispanics and little or no information about other growing ethnic populations, such as Asian subgroups.
While evidence accumulates that social and psychological resources affect health in old age, their contribution to racial and ethnic differences remains largely unstudied. Though it is plausible to postulate that such resources contribute to health differences, evidence is essential for understanding and designing possible interventions.