Racial Disparities in Disability Among Older Adults: Finding From the Exploring Health Disparities in Integrated Communities Study

被引:22
作者
Thorpe, Roland J., Jr. [1 ,2 ]
McCleary, Rachael [1 ]
Smolen, Jenny R. [1 ]
Whitfield, Keith E. [2 ]
Simonsick, Eleanor M. [3 ,4 ]
LaVeist, Thomas [1 ]
机构
[1] Johns Hopkins Bloomberg Sch Publ Hlth, Hopkins Ctr Hlth Dispar Solut, Baltimore, MD 21205 USA
[2] Duke Univ, Ctr Biobehav Hlth Dispar Res, Durham, NC USA
[3] Johns Hopkins Sch Med, Baltimore, MD USA
[4] NIA, Baltimore, MD 21224 USA
关键词
disability; older adults; racial disparities; African Americans; EHDIC; INCIDENT MOBILITY DISABILITY; LOWER-EXTREMITY FUNCTION; BLACK-WHITE DIFFERENCES; SOCIOECONOMIC-STATUS; RESIDENTIAL SEGREGATION; RACE DISPARITIES; NEIGHBORHOOD CHARACTERISTICS; PHYSICAL FUNCTION; SOCIAL-CONTEXT; WOMENS HEALTH;
D O I
10.1177/0898264314534892
中图分类号
R4 [临床医学]; R592 [老年病学];
学科分类号
1002 ; 100203 ; 100602 ;
摘要
Objective: Persistent and consistently observed racial disparities in physical functioning likely stem from racial differences in social resources and environmental conditions. Method: We examined the association between race and reported difficulty performing instrumental activities of daily living (IADL) in 347 African American (45.5%) and Whites aged 50 or above in the Exploring Health Disparities in Integrated Communities-Southwest Baltimore, Maryland Study (EHDIC-SWB). Results: Contrary to previous studies, African Americans had lower rates of disability (women: 25.6% vs. 44.6%, p = .006; men: 15.7% vs. 32.9%; p = .017) than Whites. After adjusting for sociodemographics, health behaviors, and comorbidities, African American women (odds ratio [OR] = 0.32, 95% confidence interval [CI] = [0.14, 0.70]) and African American men (OR = 0.34, 95% CI = [0.13, 0.90]) retained their functional advantage compared with White women and men, respectively. Conclusion: These findings within an integrated, low-income urban sample support efforts to ameliorate health disparities by focusing on the social context in which people live.
引用
收藏
页码:1261 / 1279
页数:19
相关论文
共 73 条
  • [1] [Anonymous], 1998, American Apartheid: Segregation and the Making of the Underclass
  • [2] [Anonymous], 2002, SERIES CENSR
  • [3] [Anonymous], OLD AM 2008 KEY IND
  • [4] Neighborhood environment and loss of physical function in older adults: Evidence from the Alameda County Study
    Balfour, JL
    Kaplan, GA
    [J]. AMERICAN JOURNAL OF EPIDEMIOLOGY, 2002, 155 (06) : 507 - 515
  • [5] Neighborhood Characteristics and Disability in Older Adults
    Beard, John R.
    Blaney, Shannon
    Cerda, Magda
    Frye, Victoria
    Lovasi, Gina S.
    Ompad, Danielle
    Rundle, Andrew
    Vlahov, David
    [J]. JOURNALS OF GERONTOLOGY SERIES B-PSYCHOLOGICAL SCIENCES AND SOCIAL SCIENCES, 2009, 64 (02): : 252 - 257
  • [6] Beckett LA, 1996, AM J EPIDEMIOL, V143, P766
  • [7] Neighborhoods and obesity
    Black, Jennifer L.
    Macinko, James
    [J]. NUTRITION REVIEWS, 2008, 66 (01) : 2 - 20
  • [8] Social context explains race disparities in obesity among women
    Bleich, Sara N.
    Thorpe, Roland J., Jr.
    Sharif-Harris, Hamidah
    Fesahazion, Ruth
    LaVeist, Thomas A.
    [J]. JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, 2010, 64 (05) : 465 - 469
  • [9] Socioeconomic status in health research - One size does not fit all
    Braveman, PA
    Cubbin, C
    Egerter, S
    Chideya, S
    Marchi, KS
    Metzler, M
    Posner, S
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2005, 294 (22): : 2879 - 2888
  • [10] Perceived neighborhood safety and incident mobility disability among elders: the hazards of poverty
    Clark, Cheryl R.
    Kawachi, Ichiro
    Ryan, Louise
    Ertel, Karen
    Fay, Martha E.
    Berkman, Lisa F.
    [J]. BMC PUBLIC HEALTH, 2009, 9