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Understanding Racial and Ethnic Differences in Health in Late Life: A Research Agenda
greater distress, than whites in a variety of domains (Myers and Hwang, 2004). In some studies, though not all, minorities, especially blacks, react with greater psychological distress than whites to unpleasant events (Mirowsky and Ross, 1990; Myers et al., 2002; Ulbrich et al., 1989; Warheit et al., 1973).
Differences in exposure to stress are partly attributable to group differences in socioeconomic status (Neff, 1984; Warheit et al., 1975). However, race may also interact with socioeconomic status in producing levels of distress. Kessler and Neighbors (1986) found such a race-by-class interaction, such that low-status blacks reported higher levels of distress than high-status blacks or whites of any status. In contrast, after controlling for status, older blacks in the recent Macarthur Study of Successful Aging reported lower levels of distress than older whites. In particular, low-status blacks had lower levels of distress than low-status whites (Kubzansky et al., 2000). Thus, although race and socioeconomic status appear to interact in affecting stress responses, the direction of this interaction is far from clear. In addition, exposure to and the experience of stress for some minority groups may be lower than for whites. In one study (Uppaluri et al., 2001), for instance, Asian Indians and Koreans reported lower levels of stress response over a 2-week period than whites, and immigrants who had lived in the United States less than 1 year reported significantly lower stress response levels than those who had lived in the United States for at least 15 years.
Some stressors may decline in importance for older people; others may become more significant. Retrospective reports of discrimination decline with age. Nevertheless, for current generations of minority older adults, stress due to racism and discrimination may be especially important, given that their life histories extend back to earlier periods when civil rights received less attention. Minority older adults may also have greater exposure than younger cohorts to potential stressors related to acculturative stress, spousal and family caregiving, and raising grandchildren (which can of course also be emotionally rewarding; Myers and Hwang, 2004). However, it is unclear, with regard to family responsibilities, whether minority older adults feel as burdened as their white counterparts. Black and Hispanic grandparents care for grandchildren more often than whites do, but the subjective burden they experience may be less (Myers and Hwang, 2004).
In addition to stress, there may be other psychological factors that are predictive of health outcomes and important for racial and ethnic health differences. For instance, depression, anxiety, and anger or hostility have all been prospectively linked with increased cardiovascular or all-cause mortality (Rozanski et al., 1999). Interestingly, each of these psychological factors is believed to be triggered by stressful life experiences. Few if any