Racial Health Disparities in Elderly Teased Out

Article excerpt

SAN FRANCISCO -- Several analyses of data from a longitudinal study of 3,075 elderly African American and white patients have helped identify some of the causes of health disparities between races in older adults, sometimes with surprising results.

Investigators presented their findings in a joint session at the annual meeting of the Gerontological Society of America. The results can inform the clinical care of older African Americans, several speakers said.

For example, depression was strongly associated with widespread bodily pain in African American men, but not in white men. Socioeconomic status played a big role in racial disparities in death rates. Lung function did not seem to influence racial differences seen in physical performance, contrary to expectations.

All of the studies analyzed data from the Health, Aging, and Body Composition (Health ABC) study of 3,075 well-functioning, community-dwelling adults aged 70-79 years at baseline in 1997-1998. The cohort was 42% African American and 48% female and resided in Memphis or Pittsburgh. They were followed with annual clinic visits and interim 6-month phone calls for the first 6 years.

Widespread pain was present in 8% of women regardless of race and in 3% of African American men and 4% of white men after controlling for factors including osteoporosis, arthritis, and depression, reported Gregory H. Hicks, Ph.D., of the University of Delaware, Newark. He analyzed data on 2,423 patients in the Health ABC study who had appropriate records.

African Americans were significantly less likely than whites (28% vs. 53%) to report widespread pain, after accounting for the effects of demographics, socioeconomic status, psychosocial factors, health status, and biological factors.

Depressive symptoms increased the risk of widespread pain ninefold in African Americans, but did not significantly affect risk in whites. Feeling fearful quadrupled the odds for widespread pain in whites, but not for African Americans.

Osteoporosis was associated with a threefold increase in the risk of widespread pain in whites and an eightfold increase in African Americans. Arthritis was associated with a 10-fold increase in the risk of widespread pain in whites and a 13-fold increase in African Americans.

"So from a clinical perspective, it may be that addressing depression may be more important in African Americans, addressing fear may be more important in whites, and addressing osteoporosis is important in both" in order to manage widespread pain, Dr. …