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Suggested Citation:"Front Matter." National Research Council. 1997. Racial and Ethnic Differences in the Health of Older Americans. Washington, DC: The National Academies Press. doi: 10.17226/5237.
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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

NATIONAL ACADEMY PRESS
Washington, D.C.
1997

Suggested Citation:"Front Matter." National Research Council. 1997. Racial and Ethnic Differences in the Health of Older Americans. Washington, DC: The National Academies Press. doi: 10.17226/5237.
×

NATIONAL ACADEMY PRESS
2101 Constitution Avenue, NW Washington, D.C. 20418

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 report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

This workshop was supported by funds from the National Institute on Aging through grant No. SES 9116694 by the National Science Foundation to the National Academy of Sciences for activities of the Committee on Population, and by Contract No. N01-0D-4-2139 between the National Academy of Sciences and the National Institute on Aging. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

Library of Congress Cataloging-in-Publication Data

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.

p. cm.

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

Includes bibliographical references.

ISBN 0-309-05489-3 (pbk.)

1. Minority aged—Health and hygiene—United States. 2. Minority aged—Diseases—United States. I. Martin, Linda G. II. Soldo, Beth J. III. National Research Council (U.S.). Committee on Population.

RA408.M54R33 1997

613'.0438'08900973—dc21 97-33731

This book is available for sale from the
National Academy Press,
2101 Constitution Avenue, N.W., Box 285, Washington, D.C. 20418. Call 800-624-6242 or 202-334-3313 (in the Washington Metropolitan Area).
This report is also available on line at http://www.nap.edu

Printed in the United States of America

Copyright 1997 by the National Academy of Sciences. All rights reserved.

Suggested Citation:"Front Matter." National Research Council. 1997. Racial and Ethnic Differences in the Health of Older Americans. Washington, DC: The National Academies Press. doi: 10.17226/5237.
×

COMMITTEE ON POPULATION

RONALD D. LEE (Chair),

Demography and Economics, University of California, Berkeley

CAROLINE H. BLEDSOE,

Department of Anthropology, Northwestern University

JOSÉ LUIS BOBADILLA,*

Inter-American Development Bank, Washington, D.C.

JOHN BONGAARTS,

The Population Council, New York

JOHN B. CASTERLINE,

The Population Council, New York

LINDA G. MARTIN, RAND,

Santa Monica, California

JANE MENKEN,

University of Pennsylvania

ROBERT A. MOFFITT,

Department of Economics, Johns Hopkins University

MARK R. MONTGOMERY,

The Population Council, New York

W. HENRY MOSLEY,

Department of Population Dynamics, Johns Hopkins University School of Hygiene and Public Health

ALBERTO PALLONI,

Department of Sociology, University of Wisconsin, Madison

JAMES P. SMITH, RAND,

Santa Monica, California

BETH J. SOLDO,

Department of Demography, Georgetown University

MARTA TIENDA,**

Population Research Center, University of Chicago

AMY O. TSUI,**

Carolina Population Center, University of North Carolina, Chapel Hill

JOHN HAAGA, Director

BARNEY COHEN, Program Officer

TRISH DeFRISCO, Senior Project Assistant

KAREN FOOTE, Program Officer (through May 1996)

JOEL ROSENQUIST, Senior Project Assistant

*  

deceased October 1996

**  

through October 1996

Suggested Citation:"Front Matter." National Research Council. 1997. Racial and Ethnic Differences in the Health of Older Americans. Washington, DC: The National Academies Press. doi: 10.17226/5237.
×

CONTRIBUTORS

RONALD J. ANGEL,

Department of Sociology, University of Texas at Austin

LISA F. BERKMAN,

Departments of Health and Social Behavior and Epidemiology, Harvard School of Public Health, Harvard University

JIMING CHEN,

Columbia University Center for Geriatrics and Gerontology in the Faculty of Medicine and New York State Psychiatric Institute

PETER CROSS,

Columbia University Center for Geriatrics and Gerontology in the Faculty of Medicine and New York State Psychiatric Institute

IRMA T. ELO,

Population Studies Center, University of Pennsylvania

JOSÉ J. ESCARCE, RAND,

Santa Monica, CA

DAVID V. ESPINO,

Department of Family Practice, University of Texas Health Science Center at San Antonio

BARRY GURLAND,

Columbia University Stroud Center in the Faculty of Medicine and New York State Psychiatric Institute

ELOISE KILLEFFER,

Columbia University Center for Geriatrics and Gerontology in the Faculty of Medicine and New York State Psychiatric Institute

RAYNARD S. KINGTON, RAND,

Santa Monica, CA

RAFAEL LANTIGUA,

Columbia University College of Physicians & Surgeons

KENNETH G. MANTON,

Center for Demographic Studies, Duke University

KYRIAKOS S. MARKIDES,

Center on Aging and Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston

LINDA G. MARTIN, RAND,

Santa Monica, CA

RICHARD MAYEUX,

Departments of Neurology and Psychiatry and Gertrude H. Sergievsky Center, Columbia University College of Physicians & Surgeons

JEWEL M. MULLEN,

Department of Epidemiology and Public Health, School of Medicine, Yale University

JAMES V. NEEL,

Department of Human Genetics (Medical School), University of Michigan

SAMUEL H. PRESTON,

Population Studies Center, University of Pennsylvania

FRANK W. PUFFER,

Department of Economics, Clark University

DWAYNE REED,

Buck Center for Research in Aging, Novato, CA

LAURA RUDKIN,

Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston

JAMES P. SMITH, RAND,

Santa Monica, CA

BETH J. SOLDO,

Department of Demography, Georgetown University

ERIC STALLARD,

Center for Demographic Studies, Duke University

Suggested Citation:"Front Matter." National Research Council. 1997. Racial and Ethnic Differences in the Health of Older Americans. Washington, DC: The National Academies Press. doi: 10.17226/5237.
×

YAAKOV STERN,

Gertrude H. Sergievsky Center, Columbia University College of Physicians & Surgeons

DAVID WILDER,

Columbia University Center for Geriatrics and Gerontology in the Faculty of Medicine and New York State Psychiatric Institute

KATSUKIKO YANO,

Honolulu Heart Program, Honolulu, HI

Suggested Citation:"Front Matter." National Research Council. 1997. Racial and Ethnic Differences in the Health of Older Americans. Washington, DC: The National Academies Press. doi: 10.17226/5237.
×

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. William 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. Kenneth I. Shine 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. William A. Wulf are chairman and vice chairman, respectively, of the National Research Council.

Suggested Citation:"Front Matter." National Research Council. 1997. Racial and Ethnic Differences in the Health of Older Americans. Washington, DC: The National Academies Press. doi: 10.17226/5237.
×

Contents

Page viii Cite
Suggested Citation:"Front Matter." National Research Council. 1997. Racial and Ethnic Differences in the Health of Older Americans. Washington, DC: The National Academies Press. doi: 10.17226/5237.
×

7

 

ARE GENETIC FACTORS INVOLVED IN RACIAL AND ETHNIC DIFFERENCES IN LATE-LIFE HEALTH?
James V. Neel

 

210

8

 

DIFFERENCES IN RATES OF DEMENTIA BETWEEN ETHNO-RACIAL GROUPS
Barry Gurland, David Wilder, Rafael Lantigua, Richard Mayeux, Yaakov Stern, Jiming Chen, Peter Cross, and Eloise Killeffer

 

233

9

 

CARDIOVASCULAR DISEASE AMONG ELDERLY ASIAN AMERICANS
Dwayne Reed and Katsukiko Yano

 

270

10

 

HEALTH STATUS OF HISPANIC ELDERLY
Kyriakos S. Markides, Laura Rudkin, Ronald J. Angel, and David V. Espino

 

285

Suggested Citation:"Front Matter." National Research Council. 1997. Racial and Ethnic Differences in the Health of Older Americans. Washington, DC: The National Academies Press. doi: 10.17226/5237.
×

Preface

The Committee on Population was established in 1983 to bring the knowledge and methods of the population sciences to bear on major issues of science and public policy. The committee's work has increasingly dealt with the demography and health of aging populations. Together with the Committee on National Statistics and the Division of Health Promotion and Disease Prevention of the Institute of Medicine, the committee sponsored a Workshop on Forecasting Survival, Health, and Disability in 1992. In December 1992, the committee organized a Workshop on Demography of Aging, which led to the publication of a volume of edited papers (Preston and Martin, 1995) that covered a range of topics, from household and family demography, to work and retirement, intergenerational transfers, and health. Two chapters in that volume, in particular, Medical Demography (Kenneth G. Manton and Eric Stallard) and Socioeconomic Differences in Adult Mortality and Health Status (Samuel H. Preston and Paul Taubman), pointed to the need for more in-depth analysis of racial and ethnic differences in health at older ages. This concern prompted the Committee, with funding from the National Institute on Aging (NIA), to organize a workshop, held in Washington in December 1994, at which scholars from diverse health disciplines could present and discuss analyses and reviews. This volume includes revised versions of some of the papers originally presented at the workshop. They have benefited both from the discussion at the original workshop, for which we thank all the participants, and from later review, for which we thank the generous scholars who must remain anonymous.

The committee was very fortunate to have two members, Linda Martin and Beth Soldo, who devoted time and energy to planning the workshop, guiding authors in their revisions, and editing this volume.

Suggested Citation:"Front Matter." National Research Council. 1997. Racial and Ethnic Differences in the Health of Older Americans. Washington, DC: The National Academies Press. doi: 10.17226/5237.
×

We want to thank our colleagues who helped develop the 1994 workshop: Ronald Abeles (NIA), Jacob Feldman (National Center for Health Statistics), Samuel Preston (the immediate past chair of the committee), Burton Singer (Princeton University), Richard Suzman (NIA), and David Willis (NIA). Thanks also are due Robert Moffitt and James Smith, members of the committee who assisted with the review of the papers. We also appreciate the contributions of Michael McGinniss and Michael Stoto. Beyond his role on the organizing group, Richard Suzman was a catalyst, both intellectually and financially, and we are grateful to him and the National Institute on Aging for their support.

Finally, the staff of the Committee on Population were essential to this endeavor. Karen Foote was diligent and thorough in handling the organization of the workshop and the review process. Joel Rosenquist ably handled all the administrative tasks for the workshop and manuscript production. John Haaga, the committee director, provided supervision throughout and critical insight in the final stages of the project. Barbara White gave a helpful and thorough copyediting of the report.

Most of all, of course, we appreciate the contributions of the authors.

Ronald Lee

Chair, Committee on Population

Suggested Citation:"Front Matter." National Research Council. 1997. Racial and Ethnic Differences in the Health of Older Americans. Washington, DC: The National Academies Press. doi: 10.17226/5237.
×

Racial and Ethnic Differences in the Health of Older Americans

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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.

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