Academic journal article Generations

Aging, Minority Status, and Disability

Academic journal article Generations

Aging, Minority Status, and Disability

Article excerpt

Racial and ethnic health disparities are socioeconomic, and there are great variances in health between countries of origin, reasons for immigration, and length of time spent in the United States.

The rise in the number of Americans from ethnic minority backgrounds has been accompanied by an increased interest in disparities that characterize the health status and healthcare needs of the U.S. population. Much of the literature has focused on African Americans' health disadvantages, which persist. Increasing interest also has been paid to the health of the Hispanic/Latino population, which currently is the largest minority population. Less attention has been paid to the health of the Asian-origin population, the fastest growing minority population, or to the Native American population.

This article presents an overview of current research and knowledge on health trends in middle-age and older people of ethnic-minority background in the United States, focusing primarily on ethnic differences in disability rates, which provide a useful global measure of the health of older people. We begin with a brief overview of mortality and life expectancy data that suggest a complex picture with unexpected and paradoxical findings.

Ethnic-Minority Status, Aging, and Mortality

Hummer and colleagues (2014) recently published an analysis and overview of mortality and longevity in non-Hispanic blacks, Hispanics/ Latinos, Asian Americans, and Pacific Islanders, American Indians and Alaska Natives, and non-Hispanic whites. It shows that blacks experience considerably higher mortality rates than the general population. However, after age 85, their mortality rates drop below those of non-Hispanic whites. This evidence provides support for the long-observed (and debated) racial mortality crossover, which likely results from selective mortality earlier in life for blacks, and subsequent better health of African Americans living to very advanced ages. The latest evidence suggests the crossover is a birthcohort phenomenon, with more recent cohorts of African Americans less likely to experience a crossover in the future (Masters, 2012).

The evidence also strongly suggests a disadvantage in Native Americans, with respect to mortality, once we take into account misclas- sification of ethnicity on death certificates (Arias, 2010). Mortality rates for Hispanic/ Latinos and Asian Americans, on the other hand, are lower than those for non-Hispanic whites and non-Hispanic blacks at every age (Hummer et al., 2014). While the Asian-origin advantage can be attributed to overall advantaged socioeconomic conditions, the Hispanic/Latino advantage has been considered paradoxical given the population's overall socioeconomic disadvantage. The so-called Hispanic Paradox has been primarily attributed to a healthy migrant effect (Markides and Eschbach, 2011), which also is observed in other immigrant populations in the United States, as well as in Canada and Australia (Markides and Gerst, 2011).

Ethnic Minority Status, Aging, and Disability Rates

The first comprehensive attempt to examine race and ethnic differences in disability among Americans ages 65 and older was conducted by Markides and colleagues (2007), using 2000 United States Census data. The authors used several items intended to measure sensory disability (blindness, deafness, or a severe vision or hearing impairment); physical disability (a long-lasting condition that limits one or more basic activities); mental disability (difficulty learning, remembering, or concentrating); self-care disability (difficulty in dressing or bathing); and, going-outside-the-home disability (unable to shop or visit a doctor alone) (Stern, 2004). The relatively large sample size of the 2000 Census enabled data analysis on all major ethnic groups, including by type of Hispanic origin as well as by nativity status.

Older African Americans and Native Americans had the highest disability rates, followed by older Latinos. …

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