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CRITICAL PERSPECTIVES ON RACIAL AND ETHNIC DIFFERENCES IN HEALTH IN LATE LIFE

Norman B. Anderson, Rodolfo A. Bulatao, and Barney Cohen, Editors

Panel on Race, Ethnicity, and Health in Later Life

Committee on Population

Division of Behavioral and Social Sciences and Education

NATIONAL RESEARCH COUNCIL OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS
Washington D.C.
www.nap.edu



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Critical Perspectives on Racial and Ethnic Differences in Health in Late Life CRITICAL PERSPECTIVES ON RACIAL AND ETHNIC DIFFERENCES IN HEALTH IN LATE LIFE Norman B. Anderson, Rodolfo A. Bulatao, and Barney Cohen, Editors Panel on Race, Ethnicity, and Health in Later Life Committee on Population Division of Behavioral and Social Sciences and Education NATIONAL RESEARCH COUNCIL OF THE NATIONAL ACADEMIES THE NATIONAL ACADEMIES PRESS Washington D.C. www.nap.edu

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Critical Perspectives on Racial and Ethnic Differences in Health in Late Life THE NATIONAL ACADEMIES PRESS 500 Fifth Street, N.W. Washington, D.C. 20001 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. This study was supported by Contract No. N01-OD-4-2139, TO #78 between the National Academy of Sciences and the National Institute on Aging and a grant from the Andrew W. Mellon Foundation. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the authors and do not necessarily reflect the views of the organizations or agencies that provided support for the project. Library of Congress Cataloging-in-Publication Data Critical perspectives on racial and ethnic differences in health in late life / Norman B. Anderson, Rodolfo A. Bulatao, and Barney Cohen, editors ; Panel on Race, Ethnicity, and Health in Later Life, Committee on Population, Division of Behavioral and Social Sciences and Education. p. ; cm. Includes bibliographical references. ISBN 0-309-09211-6 (pbk.) 1. Minority older people—Health and hygiene—United States. 2. Older people—Health and hygiene—United States—Cross-cultural studies. 3. Discrimination in medical care—United States. 4. Health status indicators. [DNLM: 1. Health Status—Aged. 2. Ethnic Groups. 3. Health Behavior—Aged. 4. Socioeconomic Factors. WB 141.4 C934 2004] I. Anderson, Norman B. II. Bulatao, Rodolfo A., 1944- III. Cohen, Barney, 1959- IV. National Research Council (U.S.). Panel on Race, Ethnicity, and Health in Later Life. RA564.8.C75 2004 362.198’97’00973—dc22 2004017317 Additional copies of this report are available from the National Academies Press, 500 Fifth Street, N.W., Lockbox 285, Washington, D.C. 20055; (800) 624-6242 or (202) 334-3313 (in the Washington metropolitan area); http://www.nap.edu. Printed in the United States of America Copyright 2004 by the National Academy of Sciences. All rights reserved. Suggested citation: National Research Council. (2004). Critical Perspectives on Racial and Ethnic Differences in Health in Late Life. N.B. Anderson, R.A. Bulatao, and B. Cohen, Editors. Panel on Race, Ethnicity, and Health in Later Life. Committee on Population, Division of Behavioral and Social Sciences and Education. Washington, DC: The National Academies Press.

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Critical Perspectives on Racial and Ethnic Differences in Health in Late Life THE NATIONAL ACADEMIES Advisers to the Nation on Science, Engineering, and Medicine The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M. Alberts is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Wm. A. Wulf is president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M. Alberts and Dr. Wm. A. Wulf are chair and vice chair, respectively, of the National Research Council. www.national-academies.org

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Critical Perspectives on Racial and Ethnic Differences in Health in Late Life COMMITTEE ON POPULATION 2004 KENNETH W. WACHTER (Chair), Department of Demography, University of California, Berkeley ELLEN BRENNAN-GALVIN, School of Forestry and Environmental Studies, Yale University JANET CURRIE, Department of Economics, University of California, Los Angeles JOHN N. HOBCRAFT, Department of Social Policy, London School of Economics CHARLES B. KEELY, Walsh School of Foreign Service, Georgetown University DAVID I. KERTZER, Department of Anthropology, Brown University DAVID LAM, Population Studies Center, University of Michigan, Ann Arbor CYNTHIA B. LLOYD, Population Council, New York DOUGLAS S. MASSEY, Department of Sociology and Woodrow Wilson School of Public and International Affairs, Princeton University RUBEN G. RUMBAUT, Center for Research on Immigration, Population and Public Policy and Department of Sociology, University of California, Irvine JAMES W. VAUPEL, Max Planck Institute for Demographic Research, Rostock, Germany LINDA J. WAITE, Department of Sociology, University of Chicago ROBERT J. WILLIS, Institute for Social Research, University of Michigan, Ann Arbor BARNEY COHEN, Director

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Critical Perspectives on Racial and Ethnic Differences in Health in Late Life PANEL ON RACE, ETHNICITY, AND HEALTH IN LATER LIFE NORMAN B. ANDERSON (Chair), American Psychological Association, Washington, DC EILEEN M. CRIMMINS, Andrus Gerontology Center, University of Southern California ANGUS S. DEATON,* Woodrow Wilson School of Public and International Affairs, Princeton University DAVID V. ESPINO, Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio JAMES S. HOUSE, Institute of Gerontology, University of Michigan, Ann Arbor JAMES S. JACKSON, Department of Psychology, University of Michigan, Ann Arbor CHRISTOPHER JENCKS, John F. Kennedy School of Government, Harvard University GERALD E. MCCLEARN, Department of Biobehavioral Health, Pennsylvania State University ALBERTO PALLONI, Department of Sociology, University of Wisconsin-Madison TERESA E. SEEMAN, School of Medicine, University of California, Los Angeles JAMES P. SMITH, RAND Corporation, Santa Monica, CA EUGENIA Y.-H. WANG, School of Medicine, University of Louisville DAVID R. WILLIAMS, Department of Sociology, University of Michigan, Ann Arbor RODOLFO A. BULATAO, Study Director BARNEY COHEN, Director, Committee on Population BANGHWA LEE CASADO, Research Intern CHRISTINE COVINGTON CHEN, Project Assistant ANTHONY S. MANN, Senior Project Assistant *   Until October 2002.

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Critical Perspectives on Racial and Ethnic Differences in Health in Late Life Contributors MAUREEN R. BENJAMINS, School of Public Health, University of Illinois, Chicago DEBBIE BRADSHAW, Burden of Disease Research Unit, Medical Research Council, Tygerberg, South Africa MARY E. CAMPBELL, Department of Sociology, University of Wisconsin-Madison AMITABH CHANDRA, Department of Economics, Dartmouth College, Hanover, NH RODNEY CLARK, Department of Psychology, Wayne State University, Detroit, MI BARNEY COHEN, The National Academies, Washington, DC RICHARD S. COOPER, Department of Preventive Medicine and Epidemiology, Loyola University Stritch School of Medicine, Maywood, IL EILEEN M. CRIMMINS, Andrus Gerontology Center, University of Southern California CATHERINE CUBBIN, Stanford Prevention Research Center, Stanford University School of Medicine DAVID M. CUTLER, Department of Economics, Harvard University JENNIFER L. EGGERLING-BOECK, Department of Sociology, University of Wisconsin-Madison DOUGLAS EWBANK, Sociology Department, University of Pennsylvania BRUCE H. FRIEDMAN, Department of Psychology, Virginia Polytechnic Institute and State University

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Critical Perspectives on Racial and Ethnic Differences in Health in Late Life THOMAS A. GLASS, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health MARK D. HAYWARD, Department of Sociology, Pennsylvania State University CLYDE HERTZMAN, Center for Health Services and Policy Research, University of British Columbia, Vancouver, Canada ROBERT A. HUMMER, Population Research Center and Department of Sociology, University of Texas at Austin WEI-CHIN HWANG, Department of Psychology, University of Utah GUILLERMINA JASSO, Department of Sociology, New York University RIA LAUBSCHER, Burden of Disease Research Unit, Medical Research Council, Tygerberg, South Africa JOHN W. LYNCH, Department of Epidemiology, University of Michigan JENNIFER J. MANLY, GH Sergievsky Center and Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University DOUGLAS S. MASSEY, Department of Sociology and Woodrow Wilson School of Public and International Affairs, Princeton University RICHARD MAYEUX, GH Sergievsky Center and Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University NOLWAZI MBANANGA, Burden of Disease Research Unit, Medical Research Council, Tygerberg, South Africa CARLOS F. MENDES DE LEON, Department of Internal Medicine, Rush Presbyterian St. Luke’s Medical Center, Chicago, IL JEFFREY D. MORENOFF, Department of Sociology, University of Michigan HECTOR F. MYERS, Department of Psychology, University of California, Los Angeles JAMES Y. NAZROO, Department of Epidemiology and Public Health, University College London, England ROSANA NORMAN, Burden of Disease Research Unit, Medical Research Council, Tygerberg, South Africa ALBERTO PALLONI, Department of Sociology, University of Wisconsin-Madison RICHARD G. ROGERS, Population Program and Department of Sociology, University of Colorado at Boulder MARK R. ROSENZWEIG, John F. Kennedy School of Government, Harvard University GARY D. SANDEFUR, Department of Sociology, University of Wisconsin-Madison

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Critical Perspectives on Racial and Ethnic Differences in Health in Late Life MICHELLE SCHNEIDER, Burden of Disease Research Unit, Medical Research Council, Tygerberg, South Africa TERESA E. SEEMAN, School of Medicine, University of California, Los Angeles JONATHAN S. SKINNER, Department of Economics, Dartmouth College, Hanover, NH JAMES P. SMITH, RAND Corporation, Santa Monica, CA KRISELA STEYN, Burden of Disease Research Unit, Medical Research Council, Tygerberg, South Africa JULIAN F. THAYER, Gerontology Research Center, National Institute on Aging, Baltimore, MD MARILYN A. WINKLEBY, Stanford Prevention Research Center, Stanford University School of Medicine

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Critical Perspectives on Racial and Ethnic Differences in Health in Late Life Preface The Panel on Race, Ethnicity, and Health in Later Life was established in 2001 under the auspices of the Committee on Population of the National Research Council. The panel’s task was to inform the National Institute on Aging about recent research findings on racial and ethnic differences in health in late life and to help in developing a future research agenda for reducing them. This project was a follow-up to a 1994 Committee on Population workshop, which resulted in a volume of papers published by the National Academy Press, Racial and Ethnic Differences in the Health of Older Americans. The panel was asked to organize a 2-day workshop, bringing together leading researchers from a variety of disciplines and professional orientations to summarize current research and to identify research priorities. That workshop was held in March 2002 in Washington, D.C. The panel also was asked to produce a summary of the state of knowledge incorporating this information and to provide recommendations for further work. The initial plan called for the papers and the panel report to be published in a single volume, but it was decided to publish the papers and the panel report separately. The papers are presented in this volume. The panel’s final report is available in a companion volume, Understanding Racial and Ethnic Differences in Health in Late Life: A Research Agenda. The papers in this volume have been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the Report Review Committee of the National Research Council. The purpose of this independent review is

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Critical Perspectives on Racial and Ethnic Differences in Health in Late Life to provide candid and critical comments that will assist the institution in making its published volume as sound as possible and to ensure that the volume meets institutional standards for objectivity, evidence, and responsiveness to the charge. The review comments remain confidential to protect the integrity of the process. We thank the following individuals for their review of one or more papers in this volume: Dolores Acevedo-Garcia, Department of Society, Human Development, and Health, Harvard School of Public Health; Norman B. Anderson, American Psychological Association, Washington, DC; Eileen M. Crimmins, Andrus Gerontology Center, University of Southern California; Angus S. Deaton, Woodrow Wilson School of Public and International Affairs, Princeton University; Troy Duster, Department of Sociology, University of California at Berkeley; Irma T. Elo, Department of Sociology, University of Pennsylvania; David V. Espino, Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio; Maria Evandrou, Age Concern Institute of Gerontology, King’s College London, England; W. Reynolds Farley, Population Studies Center, University of Michigan; Vicki A. Freedman, Polisher Research Institute, Abramson Center for Jewish Life, North Wales, PA; W. Parker Frisbie, Population Research Center, University of Texas at Austin; Lucy Gilson, Centre for Health Policy, University of Witwatersrand, Johannesburg, South Africa; Jules Harrell, Psychology Department, Howard University; James S. House, Institute of Gerontology, University of Michigan; James S. Jackson, Research Centre for Group Dynamics, University of Michigan; John Jemmott, Annenberg School for Communication, University of Pennsylvania; Christopher Jencks, John F. Kennedy School of Government, Harvard University; Elizabeth A. Klonoff, Department of Psychology, San Diego State University, California; Neal M. Krause, Institute of Gerontology, University of Michigan; Diana J. L. Kuh, Department of Epidemiology and Public Health, University College London, England; Nancy S. Landale, Department of Sociology, Pennsylvania State University; Gerald E. McClearn, Department of Biobehavioral Health, Pennsylvania State University; Alberto Palloni, Department of Sociology, University of Wisconsin-Madison; Lynda Powell, Department of Preventive Medicine, Rush University Medical Center, Chicago, IL; Thomas C. Ricketts, III, School of Public Health, University of North Carolina at Chapel Hill; Teresa E. Seeman, School of Medicine, University of California, Los Angeles; James P. Smith, RAND Corporation, Santa Monica, CA; Keith E. Whitfield, Department of Health and Human Development, Pennsylvania State University; and David R. Williams, Department of Sociology, University of Michigan, Ann Arbor. Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of any of

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Critical Perspectives on Racial and Ethnic Differences in Health in Late Life the papers nor did they see the final version of any paper before this publication. The review of this volume was overseen by Charles B. Keely, Georgetown University. Appointed by the National Research Council, he was responsible for making certain that an independent examination of the papers was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this volume rests entirely with the authors.

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Critical Perspectives on Racial and Ethnic Differences in Health in Late Life Contents 1   Introduction Barney Cohen   1 SECTION I:   THE NATURE OF RACIAL AND ETHNIC DIFFERENCES     2   Racial and Ethnic Identification, Official Classifications, and Health Disparities Gary D. Sandefur, Mary E. Campbell, and Jennifer Eggerling-Boeck   25 3   Racial and Ethnic Disparities in Health and Mortality Among the U.S. Elderly Population Robert A. Hummer, Maureen R. Benjamins, and Richard G. Rogers   53 4   Ethnic Differences in Dementia and Alzheimer’s Disease Jennifer J. Manly and Richard Mayeux   95 SECTION II:   TWO KEY CONCEPTUAL AND METHODOLOGICAL CHALLENGES     5   The Life-Course Contribution to Ethnic Disparities in Health Clyde Hertzman   145 6   Selection Processes in the Study of Racial and Ethnic Differentials in Adult Health and Mortality Alberto Palloni and Douglas C. Ewbank   171

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Critical Perspectives on Racial and Ethnic Differences in Health in Late Life 7   Immigrant Health: Selectivity and Acculturation Guillermina Jasso, Douglas S. Massey, Mark R. Rosenzweig, and James P. Smith   227 SECTION III:   THE SEARCH FOR CAUSAL PATHWAYS         GENETIC FACTORS     8   Genetic Factors in Ethnic Disparities in Health Richard S. Cooper   269     ECONOMIC AND SOCIAL RISK FACTORS     9   Race/Ethnicity, Socioeconomic Status, and Health Eileen M. Crimmins, Mark D. Hayward, and Teresa E. Seeman   310 10   The Role of Social and Personal Resources in Ethnic Disparities in Late-Life Health Carlos F. Mendes de Leon and Thomas A. Glass   353 11   What Makes a Place Healthy? Neighborhood Influences on Racial/Ethnic Disparities in Health over the Life Course Jeffrey D. Morenoff and John W. Lynch   406     BEHAVIORAL RISK FACTORS     12   Racial/Ethnic Disparities in Health Behaviors: A Challenge to Current Assumptions Marilyn A. Winkleby and Catherine Cubbin   450     BIOBEHAVIORAL FACTORS     13   Cumulative Psychosocial Risks and Resilience: A Conceptual Perspective on Ethnic Health Disparities in Late Life Hector F. Myers and Wei-Chin Hwang   492 14   Significance of Perceived Racism: Toward Understanding Ethnic Group Disparities in Health, the Later Years Rodney Clark   540 15   A Neurovisceral Integration Model of Health Disparities in Aging Julian F. Thayer and Bruce H. Friedman   567

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Critical Perspectives on Racial and Ethnic Differences in Health in Late Life     ACCESS TO HEALTH CARE     16   Geography and Racial Health Disparities Amitabh Chandra and Jonathan S. Skinner   604 SECTION IV:   THE CHALLENGE OF IDENTIFYING EFFECTIVE INTERVENTIONS     17   Behavioral Health Interventions: What Works and Why? David M. Cutler   643 SECTION V:   TWO INTERNATIONAL COMPARISONS     18   Ethnic Disparities in Aging Health: What Can We Learn from the United Kingdom? James Y. Nazroo   677 19   An Exploratory Investigation into Racial Disparities in the Health of Older South Africans Debbie Bradshaw, Rosana Norman, Ria Laubscher, Michelle Schneider, Nolwazi Mbananga, and Krisela Steyn   703

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