scholarly journals TESTING HEALTH DISPARITIES IN COGNITIVE AND BIOLOGICAL AGING IN OLDER ADULTS IN THE UNITED STATES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S427-S427
Author(s):  
Daniel Belsky
Keyword(s):  
Health Disparities ◽  
Cognitive Aging ◽  
Ethnic Disparities ◽  
Later Life ◽  
The United States ◽  
The Body ◽  
Biological Aging ◽  
Composite Indices ◽  
Patterns Of Aging ◽  
The Life Course

Abstract We conducted analysis to test if health disparities in cognitive aging were parallel to or different from health disparities in patterns of aging in other systems in the body, and if race/ethnicity-related disparities could be accounted for by differences in socioeconomic circumstances across the life-course. We analyzed data from more than 10,000 adults participating in the US NHANES and US Health and Retirement Study. We measured cognitive aging using neuropsychological tests of processing speed and memory. We measured aging in other systems using composite indices of biological aging based on organ-system function tests and blood chemistries. We conducted analysis to (i) quantify and compare health disparities in cognitive aging and biological aging; (ii) test if individuals exhibiting accelerated cognitive aging were also exhibiting accelerated biological aging; and (iii) test if race/ethnic disparities in cognitive and biological aging could be explained by measured socioeconomic resource differences in childhood and later life.

scholarly journals LEVERAGING ANALYTIC METHODS TO EXPAND OPPORTUNITIES IN AGING-RELATED HEALTH DISPARITIES RESEARCH

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S426-S426
Author(s):  
Igor Akushevich ◽  
Carl V Hill ◽  
Heather E Whitson
Keyword(s):  
Health Disparities ◽  
Cognitive Aging ◽  
Small Population ◽  
The Body ◽  
Process Models ◽  
Individual Level ◽  
Analytic Methods ◽  
Age Related ◽  
Patterns Of Aging ◽  
The U.S

Abstract The objective of the Symposium is to improve the understanding of how existing analytic methods and data can be leveraged to make progress in understanding the causes and mechanisms of health-related disparities in Alzheimer’s disease, related dementias and other prominent age-related diseases. Topics will cover a range of academic and administrative topics including: i) advanced analytic methods and modeling of health disparities with application to racial and geographic disparities in AD/ADRD; ii) the role of repeated anesthetic and surgical exposure in generation of disparities in AD/ADRD risk; iii) the nature of health disparities in cognitive aging as parallel to or distinct from health disparities in patterns of aging in other systems in the body; iv) recent advances in machine learning applied to large claims databases involving medical disparities; and v) geographic-related disparities in life expectancy across the U.S. A focus will be made on demonstrating how studies using established administrative data resources such as Medicare claims databases combined with innovative analytic approaches such as partitioning analyses, time-series based methods of projection and forecasting, and stochastic process models can be used to uncover previously overlooked or understudied aspects in this area of research. Analyses of such increasingly available large health datasets provides an opportunity to obtain nationally representative multiethnic results based on individual-level measures that reflect the real care-related and epidemiological processes ongoing in the U.S. healthcare system and allows the targetting of relatively rare diseases in relatively small population subgroups.

scholarly journals A Confluence of Policy Inequality: Health Disparities in Old Age Among American Indian and Alaska Native Populations

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 37-37
Author(s):  
Sadie Giles
Keyword(s):  
United States ◽  
Health Disparities ◽  
Life Course ◽  
American Indian ◽  
Old Age ◽  
Alaska Native ◽  
Political History ◽  
The United States ◽  
The Political ◽  
The Life Course

Abstract Racial health disparities in old age are well established, and new conceptualizations and methodologies continue to advance our understanding of health inequality across the life course. One group that is overlooked in many of these analyses, however, is the aging American Indian/Native Alaskan (AI/NA) population. While scholars have attended to the unique health inequities faced by the AI/NA population as a whole due to its discordant political history with the US government, little attention has been paid to unique patterns of disparity that might exist in old age. I propose to draw critical gerontology into the conversation in order to establish a framework through which we can uncover barriers to health, both from the political context of the AI/NA people as well as the political history of old age policy in the United States. Health disparities in old age are often described through a cumulative (dis)advantage framework that offers the benefit of appreciating that different groups enter old age with different resources and health statuses as a result of cumulative inequalities across the life course. Adding a framework of age relations, appreciating age as a system of inequality where people also gain or lose access to resources and status upon entering old age offers a path for understanding the intersection of race and old age. This paper will show how policy history for this group in particular as well as old age policy in the United States all create a unique and unequal circumstance for the aging AI/NA population.

Racial Health Disparities and Questions of Evidence

2016 ◽  
Author(s):  
Carolyn Moxley Rouse
Keyword(s):  
Health Disparities ◽  
Minority Groups ◽  
Ethnic Disparities ◽  
Structural Data ◽  
The United States ◽  
National Average ◽  
Healthy People ◽  
Making Sense ◽  
Socially Constructed ◽  
Healthy People 2010

The United States Healthy People 2010 initiative, designed to focus nationally funded health research and care on achieving a set of nationwide goals, was directed toward the elimination of racial and ethnic health disparities. While racial and ethnic disparities are complex (with the health of some minority groups surpassing the national average), the health of black Americans continues to fall short of the national average. By focusing on the presumptions embedded in the design of health disparities research, this chapter addresses why Healthy People 2010 largely failed to reduce racial health inequality. Importantly, in thinking about health inequalities, researchers initially failed to consider how race is socially constructed; how data collection is never value-neutral (see King, chapter 8, this volume); and, finally, the limits of randomized control trials (deductive methods) when it comes to making sense of complex behavioral and structural data. The chapter ends by describing how ethnographic insights can help complicate the assumptions and conclusions of health disparities research.

Community Efforts to Reduce Racial and Ethnic Health Disparities: Challenges and Facilitators Identified by 16 Multistakeholder Alliances

2018 ◽  
Vol 77 (1) ◽  
pp. 74-84 ◽  
Author(s):  
Jaime Hamil ◽  
Juliet Yonek ◽  
Yasmin Mahmud ◽  
Raymond Kang ◽  
Ariane Garrett ◽  
...  
Keyword(s):  
Health Care ◽  
Health Disparities ◽  
Health Care Quality ◽  
Ethnic Disparities ◽  
The United States ◽  
Care Quality ◽  
Local Health ◽  
Local Data ◽  
Federal Policies ◽  
Improve Health Care Quality

The Robert Wood Johnson Foundation’s Aligning Forces for Quality (AF4Q) program aimed to improve health care quality and reduce racial and ethnic disparities in 16 diverse communities in the United States from 2006 to 2015; yet most communities failed to make substantive progress toward advancing health care equity by the program’s end. This qualitative analysis of key stakeholder interviews aims to identify the major contributors to success versus failure in addressing local health disparities during AF4Q and identified five major themes. Three themes highlight challenges related to collecting local data on racial and ethnic health disparities and transitioning from data collection to action. Two themes capture the critical contribution of stakeholder engagement and access to technical expertise to successful efforts. The challenges and facilitators experienced by these 16 AF4Q communities may help inform the disparities reduction efforts of other communities and guide state or federal policies to reduce health disparities.

scholarly journals Unequal Protective Effects of Parental Educational Attainment on the Body Mass Index of Black and White Youth

2019 ◽  
Vol 16 (19) ◽  
pp. 3641 ◽  
Author(s):  
Assari ◽  
Boyce ◽  
Bazargan ◽  
Mincy ◽  
Caldwell
Keyword(s):  
Body Mass Index ◽  
Socioeconomic Status ◽  
Health Disparities ◽  
Educational Attainment ◽  
Body Mass ◽  
The United States ◽  
The Body ◽  
Protective Effects ◽  
White Youth ◽  
Parental Educational Attainment

Background: Parental educational attainment is shown to be protective against health problems; the Minorities’ Diminished Returns theory, however, posits that these protective effects tend to be smaller for socially marginalized groups particularly blacks than whites. Aims: To explore racial differences in the effect of parental educational attainment on body mass index (BMI) in a national sample of US adolescents. Methods: In this cross-sectional study, we used baseline data of 10,701 (8678 white and 2023 black) 12–17 years old adolescents in the Population Assessment of Tobacco and Health (PATH; 2013). Parental educational attainment was the predictor. Youth BMI (based on self-reported weight and height) was the dependent variable. Age, gender, ethnicity, and family structure were covariates. Race was the focal moderator. Results: Overall, higher parental educational attainment was associated with lower youth BMI. Race, however, moderated the effect of parental educational attainment on BMI, suggesting that the protective effect of parenting educational attainment on BMI is significantly smaller for black than white youth. Conclusions: In the United States, race alters the health gains that are expected to follow parental educational attainment. While white youth who are from highly educated families are fit, black youth have high BMI at all levels of parental educational attainment. This means, while the most socially privileged group, whites, gain the most health from their parental education, blacks, the least privileged group, gain the least. Economic, social, public, and health policymakers should be aware that health disparities are not all due to lower socioeconomic status (SES) of the disadvantaged group but also diminished returns of SES resources for them. Black–white health disparities exist across all high socioeconomic status (SES) levels.

scholarly journals Cortisol and Racial Health Disparities Affecting Black Men in Later Life: Evidence From MIDUS II

2019 ◽  
Vol 13 (4) ◽  
pp. 155798831987096 ◽  
Author(s):  
Julie Ober Allen ◽  
Daphne C. Watkins ◽  
Linda Chatters ◽  
Arline T. Geronimus ◽  
Vicki Johnson-Lawrence
Keyword(s):  
United States ◽  
Health Disparities ◽  
Psychological Distress ◽  
Health Outcomes ◽  
Black Men ◽  
White Men ◽  
Later Life ◽  
The United States ◽  
Racial Health Disparities ◽  
Medical Morbidity

In the United States, Black men have poorer overall health and shorter life spans than most other racial/ethnic groups of men, largely attributable to chronic health conditions. Dysregulated patterns of daily cortisol, an indicator of hypothalamic–pituitary–adrenal (HPA) axis stress–response functioning, are linked to poor health outcomes. Questions remain regarding whether and how cortisol contributes to Black–White differences in men’s health. This exploratory study compared early day changes in cortisol levels (diurnal cortisol slopes from peak to pre-lunch levels) and their associations with medical morbidity (number of chronic medical conditions) and psychological distress (Negative Affect Scale) among 695 Black and White male participants in the National Survey of Midlife in the United States (MIDUS II, 2004–2009). Black men exhibited blunted cortisol slopes relative to White men (−.15 vs. −.21, t = −2.97, p = .004). Cortisol slopes were associated with medical morbidity among Black men ( b = .050, t = 3.85, p < .001), but not White men, and were unrelated to psychological distress in both groups. Findings indicate cortisol may contribute to racial health disparities among men through two pathways, including the novel finding that Black men may be more vulnerable to some negative health outcomes linked to cortisol. Further, results suggest that while cortisol may be a mechanism of physical health outcomes and disparities among older men, it may be less important for their emotional health. This study increases understanding of how race and male sex intersect to affect not only men’s lived experiences but also their biological processes to contribute to racial health disparities among men in later life.

Becoming and being gendered through the body: older women, their mothers and body image

2007 ◽  
Vol 27 (5) ◽  
pp. 701-718 ◽  
Author(s):  
LAURA HURD CLARKE ◽  
MERIDITH GRIFFIN
Keyword(s):  
Body Image ◽  
Older Women ◽  
Later Life ◽  
The Body ◽  
Structured Interviews ◽  
Theoretical Understanding ◽  
Socially Constructed ◽  
Women's Body Image ◽  
Mother Daughter Relationship ◽  
The Life Course

ABSTRACTFollowing West and Zimmerman's (1987) theoretical understanding of how gender identities are created and maintained, this paper examines the ways in which older women learned from their mothers how ‘to do gender’ through their bodies and specifically their physical appearances. Extracts from semi-structured interviews with 44 women aged 50 to 70 years have been drawn upon to identify and discuss the ways in which women perceive, manage and present their bodies using socially-constructed ideals of beauty and femininity. More specifically, three ways that women learned ‘to do gender’ are examined: from their mothers' criticisms and compliments about their appearance at different stages of the lifecourse; from their mothers' attitudes towards their own bodies when young and in late adulthood; and from the interviewees' own later-life experiences and choices about ‘beauty work’. Interpretative feminism is employed to analyse how the women exercised agency while constructing body-image meanings in a social context that judges women on their ability to achieve and maintain the prevailing ideal of female beauty. The study extends previous research into the influence of the mother-daughter relationship on young women's body image. The findings suggest that mothers are important influences on their daughters' socialisation into body-image and beauty work, and exert, or are perceived to exert, accountability across the life-course.

scholarly journals Unraveling US National COVID-19 Racial/Ethnic Disparities using County Level Data Among 328 Million Americans

2020 ◽  
Author(s):  
Daniel Li ◽  
Sheila M. Gaynor ◽  
Corbin Quick ◽  
Jarvis T. Chen ◽  
Briana J.K. Stephenson ◽  
...  
Keyword(s):  
Health Disparities ◽  
Social Determinants ◽  
Ethnic Disparities ◽  
The United States ◽  
Vulnerable Groups ◽  
County Level ◽  
Racial And Ethnic Disparities ◽  
Racial Health Disparities ◽  
Personal Protection Equipment ◽  
Level Data

ABSTRACTRacial and ethnic disparities in COVID-19 outcomes reflect the unequal burden experienced by vulnerable communities in the United States (US). Proposed explanations include socioeconomic factors that influence how people live, work, and play, and pre-existing comorbidities. It is important to assess the extent to which observed US COVID-19 racial and ethnic disparities can be explained by these factors. We study 9.8 million confirmed cases and 234,000 confirmed deaths from 2,990 US counties (3,142 total) that make up 99.8% of the total US population (327.6 out of 328.2 million people) through 11/8/20. We found national COVID-19 racial health disparities in US are partially explained by various social determinants of health and pre-existing comorbidities that have been previously proposed. However, significant unexplained racial and ethnic health disparities still persist at the US county level after adjusting for these variables. There is a pressing need to develop strategies to address not only the social determinants but also other factors, such as testing access, personal protection equipment access and exposures, as well as tailored intervention and resource allocation for vulnerable groups, in order to combat COVID-19 and reduce racial health disparities.

scholarly journals PROVIDING AND RECEIVING FAMILY CARE ACROSS THE LIFE COURSE: INSIGHTS FROM THE OLDEST OLD

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S612-S613
Author(s):  
Taylor Patskanick ◽  
Julie Miller ◽  
Chaiwoo Lee ◽  
Lisa D’Ambrosio
Keyword(s):  
Life Course ◽  
New Technologies ◽  
Oldest Old ◽  
Panel Study ◽  
Later Life ◽  
The United States ◽  
Household Composition ◽  
Extensive Experience ◽  
Living Situation ◽  
The Life Course

Abstract Unprecedented longevity comes with an increased need for providing and receiving care. A 2015 report estimated 39.8 million adults in the United States provided unpaid care to an adult in 2014 (NAC & AARP). Previous research has focused disproportionately on experiences of providing care to older adults, but little has explored experiences of providing care and receiving care among the oldest old. Adults aged 85 and older are likely to have provided care to an adult family member at some point in their lives, but now may be receiving care themselves. The presentation will report on findings from a mixed methods study investigating the experiences of providing and receiving care across the life course among a sample of the “oldest old.” Data draw from focus groups and a survey with the MIT AgeLab Lifestyle Leaders, a bimonthly panel study of adults ages 85 and older. Findings suggest the Lifestyle Leaders had extensive experience providing care, particularly in older age. They most often cared for family members with long-term physical or cognitive conditions. Opinions on learning new technologies to help with caregiving and robot caregivers were mixed. The majority of the Lifestyle Leaders received regular help with at least one care task regardless of household composition or living situation. Many reported help had improved their health, but they felt like a burden to their caregivers. Even in later life, the Lifestyle Leaders had few ideas about who might take care of them if they needed care in the future.

scholarly journals A Longitudinal Study of Allostatic Load in Later Life: The Role of Sex, Birth Cohorts, and Risk Accumulation

2018 ◽  
Vol 41 (5) ◽  
pp. 419-442 ◽  
Author(s):  
Ioana van Deurzen ◽  
Bram Vanhoutte
Keyword(s):  
Longitudinal Study ◽  
Life Course ◽  
Allostatic Load ◽  
Later Life ◽  
The Body ◽  
Life Course Perspective ◽  
Birth Cohorts ◽  
Wear And Tear ◽  
The Life Course

Are challenging life courses associated with more wear and tear on the biological level? This study investigates this question from a life-course perspective by examining the influence of life-course risk accumulation on allostatic load (AL), considering the role of sex and birth cohorts. Using biomarker data collected over three waves (2004, 2008, and 2012) of the English Longitudinal Study of Ageing ( N = 3,824) in a growth curve framework, AL trajectories over a period of 8 years are investigated. Our results illustrate that AL increases substantially in later life. Men have higher AL than women, but increases are similar for both sexes. Older cohorts have both higher levels and a steeper increase of AL over time. Higher risk accumulation over the life course goes hand in hand with higher AL levels and steeper trajectories, contributing to the body of evidence on cumulative (dis)advantage processes in later life.

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