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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
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Copyright 1997 by the National Academy of Sciences. All rights reserved.
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
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
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Contents
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INTRODUCTION |
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RACIAL AND ETHNIC DIFFERENCES IN MORTALITY AT OLDER AGES |
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HEALTH AND DISABILITY DIFFERENCES AMONG RACIAL AND ETHNIC GROUPS |
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RACE, SOCIOECONOMIC STATUS, AND HEALTH IN LATE LIFE |
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HOW HEALTH BEHAVIORS AND THE SOCIAL ENVIRONMENT CONTRIBUTE TO HEALTH DIFFERENCES BETWEEN BLACK AND WHITE OLDER AMERICANS |
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BLACK-WHITE DIFFERENCES IN THE USE OF MEDICAL CARE BY THE ELDERLY: A CONTEMPORARY ANALYSIS |
ARE GENETIC FACTORS INVOLVED IN RACIAL AND ETHNIC DIFFERENCES IN LATE-LIFE HEALTH? |
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DIFFERENCES IN RATES OF DEMENTIA BETWEEN ETHNO-RACIAL GROUPS |
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CARDIOVASCULAR DISEASE AMONG ELDERLY ASIAN AMERICANS |
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HEALTH STATUS OF HISPANIC ELDERLY |
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.
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
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