UNDERSTANDING RACIAL AND ETHNIC DIFFERENCES IN HEALTH IN LATE LIFE
A RESEARCH AGENDA
Rodolfo A. Bulatao and Norman B. Anderson, Editors
THE NATIONAL ACADEMIES PRESS
Washington, D.C. www.nap.edu
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 Academies and the National Institute of Aging and by 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
Understanding racial and ethnic differences in health in late life : a research agenda / Panel on Race, Ethnicity, and Health in Later Life, Committee on Population, Division of Behavioral and Social Sciences and Education ; Rodolfo A. Bulatao and Norman B. Anderson, editors.
p. ; cm.
“This volume is the Panel”s final report. The workshop papers are available in a companion volume, Critical perspectives on racial and ethnic differences in health in late life”—Pref.
Updates work from: Racial and ethnic differences in the health of older Americans. 1997.
Includes bibliographical references and index.
ISBN 0-309-09247-7 (pbk.)
1. Minorities—Health and hygiene—United States. 2. Ethnic groups—Health and hygiene—United States. 3. Older people—Health and hygiene—United States. 4. Health services accessibility—United States. 5. Discrimination in medical care—United States. 6. Health status indicators—United States. 7. Health and race—United States. 8. Social medicine—United States.
[DNLM: 1. Continental Population Groups—United States. 2. Geriatric Assessment—United States. 3. Ethnic Groups—United States. 4. Health Services Accessibility—Aged—United States. 5. Socioeconomic Factors—Aged—United States. WT 30 U45 2004] I. Bulatao, Rodolfo A., 1944- II. Anderson, Norman B. III. National Research Council (U.S.). Panel on Race, Ethnicity, and Health in Later Life. IV. Racial and ethnic differences in the health of older Americans.
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 Academies. All rights reserved.
Suggested citation: National Research Council. (2004). Understanding Racial and Ethnic Differences in Health in Late Life: A Research Agenda. Panel on Race, Ethnicity, and Health in Later Life. Roldolfo A. Bulatao and Norman B. Anderson, editors. Committee on Population, Division of Behavioral and Social Sciences and Education. Washington, DC: The National Academies Press.
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.
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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.
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, San Antonio
JAMES S. HOUSE,
Institute of Gerontology, University of Michigan Ann Arbor
JAMES S. JACKSON,
Department of Psychology, University of Michigan Ann Arbor
John F. Kennedy School of Government, Harvard University
GERALD E. MCCLEARN,
Center for Developmental and Health Genetics, Pennsylvania State University
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, Senior Program Assistant
ANTHONY S. MANN, Senior Program Assistant
COMMITTEE ON POPULATION
KENNETH W. WACHTER (Chair),
Department of Demography, University of California, Berkeley
School of Forestry and Environmental Studies, Yale University
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
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
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 (NRC). The panel’s task was to inform the National Institute on Aging about recent research findings on racial and ethnic disparities in later 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, first 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, DC. The panel was also asked to produce a summary of the state of knowledge, based on the workshop, 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 ultimately it was decided to publish the papers and the panel report separately. This volume is the panel’s final report. The workshop papers are available in a companion volume, Critical Perspectives on Racial and Ethnic Differences in Health in Late Life.
The panel benefited greatly from the workshop papers and thanks the following individuals for their contribution to the workshop and the resulting volume: Gary D. Sandefur, Mary E. Campbell, Jennifer Eggerling-Boeck, Robert A. Hummer, Maureen R. Benjamins, Richard G. Rogers, Jennifer J.
Manly, Richard Mayeux, Clyde Hertzman, Alberto Palloni, Douglas Ewbank, Guillermina Jasso, Douglas S. Massey, Mark E. Rosenzweig, James P. Smith, Richard S. Cooper, Eileen M. Crimmins, Mark D. Hayward, Teresa E. Seeman, Carlos Mendes de Leon, Thomas A. Glass, Jeffrey D. Morenoff, John Lynch, Marilyn A. Winkleby, Catherine Cubbin, Hector F. Myers, Wei-Chin Hwang, Rodney Clark, Julian F. Thayer, Bruce H. Friedman, Amitabh Chandra, Jonathan S. Skinner, David M. Cutler, James Y. Nazroo, Debbie Bradshaw, Rosana Norman, Ria Laubscher, Michelle Schneider, Nolwazi Mbananga, and Krisela Steyn.
The panel met multiple times over the course of the project to plan and hold the workshop and to digest and interpret the presentations. This report reflects the intense deliberations of the full panel, based on the papers and the members’ own expertise.
This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the NRC’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We thank the following individuals for their review of this report: Stuart H. Altman, National Health Policy, Heller Graduate School, Brandeis University; Lisa Berkman, School of Public Health, Harvard University; Janet Currie, Department of Economics, University of California, Los Angeles; Mark D. Hayward, Social Science Research Institute, Pennsylvania State University; Judith R. Lave, Health Policy and Management, Graduate School of Public Health, University of Pittsburgh; Spero Manson, American Indian and Alaska Native Programs, University of Colorado Health Sciences Center, Aurora, CO; Kyriakos S. Markides, Division of Sociomedical Sciences, Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX; Thomas G. McGuire, Department of Health Care Policy, Harvard Medical School; Gary D. Sandefur, Department of Sociology, Institute of Poverty, University of Wisconsin–Madison; and Kenneth W. Wachter, Department of Demography, University of California, Berkeley.
Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations nor did they see the final draft of the report before its release. The review of this report was overseen by Larry Bumpass, Center for Demography and Ecology, University of Wisconsin–Madison, and Harold C. Sox, Annals of Internal Medicine, American College of Physicians of Internal Medicine, Philadelphia, PA. Appointed by the NRC, they were
responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.
The panel is grateful to the sponsors of the project, the National Institute of Aging and the Andrew W. Mellon Foundation. Besides providing funding, the representatives of these organizations were a valuable source of information and advice to the panel.
The panel was fortunate to have the services of the study director, Randy Bulatao, who worked closely with panel members to draft and edit the report. Barney Cohen, director of the Committee on Population, oversaw the work and managed the final stages of the process. Special thanks are due to Christine Covington Chen for her superb administrative and logistic support, to Eugenia Grohman for skillfully editing the manuscript, to Kirsten Sampson Snyder for navigating the report through review, and to Anthony Mann and Yvonne Wise for preparing the final manuscript for publication.
Norman B. Anderson, Chair
Panel on Race, Ethnicity, and Health in Later Life