CRITICAL PERSPECTIVES ON RACIAL AND ETHNIC DIFFERENCES IN HEALTH IN LATE LIFE
Norman B. Anderson, Rodolfo A. Bulatao, and Barney Cohen, Editors
THE NATIONAL ACADEMIES PRESS
Washington D.C.
www.nap.edu
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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 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,
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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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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
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
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
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
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
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
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
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.
Contents
Introduction |
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Racial and Ethnic Identification, Official Classifications, and Health Disparities |
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Racial and Ethnic Disparities in Health and Mortality Among the U.S. Elderly Population |
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Ethnic Differences in Dementia and Alzheimer’s Disease |
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SECTION II: TWO KEY CONCEPTUAL AND METHODOLOGICAL CHALLENGES |
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The Life-Course Contribution to Ethnic Disparities in Health |
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Selection Processes in the Study of Racial and Ethnic Differentials in Adult Health and Mortality |
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ACCESS TO HEALTH CARE |
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Geography and Racial Health Disparities |
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SECTION IV: THE CHALLENGE OF IDENTIFYING EFFECTIVE INTERVENTIONS |
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Behavioral Health Interventions: What Works and Why? |
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Ethnic Disparities in Aging Health: What Can We Learn from the United Kingdom? |
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An Exploratory Investigation into Racial Disparities in the Health of Older South Africans |