Racial/Ethnic Differences in Mortality in Late Midlife: Have They Narrowed in Recent Years?

TitleRacial/Ethnic Differences in Mortality in Late Midlife: Have They Narrowed in Recent Years?
Publication TypeJournal Article
Year of Publication2020
AuthorsDoza, A, Jensen, GA, Tarraf, W
JournalJournal of Gerontology, Series B
Date Published2020 Oct 14
ISSN Number1758-5368
KeywordsDeath Rates, Disparities, minorities
Abstract

OBJECTIVES: Examine whether racial/ethnic differences in mortality rates have changed in recent years among adults in late midlife, and if so, how.

METHODS: We analyze Health and Retirement Study data on non-Hispanic Whites (Whites), non-Hispanic Blacks (Blacks), and English- and Spanish-speaking Hispanics (Hispanic-English and Hispanic-Spanish), ages 50-64 from two periods: 1998-2004 (P1, n=8920) and 2004-2010 (P2, n=7224). Using survey-generalized linear regression techniques we model death-by-end-of-period as a function of race/ethnicity, and sequentially adjust for a series of period-specific baseline risk factors including demographics, health status, health insurance, health behaviors, and social networks. Regression decomposition techniques are used to assess the contribution of these factors to observed racial/ethnic differences in mortality rates.

RESULTS: The odds ratio for death (ORD) was not statistically different for Blacks (vs. Whites) in P1 but was 33% higher in P2 (OR=1.33; 95% CI=1.05-1.69). The adjusted ORD among Hispanic-English (vs. Whites) was not statistically different in both periods. The adjusted ORD among Hispanic-Spanish (vs. Whites) was lower (ORD=0.36; 95% CI= 0.22-0.59) in P1 but indistinguishable in P2. In P1, 50.1% of the disparity in mortality rates among Blacks was explained by baseline health status, 53.1% was explained by financial factors. In P2, 55.8% of the disparity in mortality rates was explained by health status, 40.0% by financial factors and 16.2% by health insurance status.

DISCUSSION: Mortality rates among Blacks and Hispanic-Spanish have risen since the mid-1990s. Hispanic-Spanish, may be losing their advantageous lower risk of mortality, long known as the "Hispanic Paradox."

DOI10.1093/geronb/gbaa175
Citation Key11148
PubMed ID33053179