Explaining US Racial/Ethnic Disparities in Health Declines and Mortality in Late Middle Age: The roles of socioeconomic status, health behaviors, and health insurance

TitleExplaining US Racial/Ethnic Disparities in Health Declines and Mortality in Late Middle Age: The roles of socioeconomic status, health behaviors, and health insurance
Publication TypeJournal Article
Year of Publication2006
AuthorsSudano, JJ, Baker, DW
JournalSocial Science and Medicine
Volume62
Issue4
Pagination909
Call Numberpubs_2006_SudanoSSM.pdf
KeywordsDemographics, Health Conditions and Status, Medicare/Medicaid/Health Insurance, Women and Minorities
Abstract

Pervasive health disparities continue to exist among racial/ethnic minority groups, but the factors related to these disparities have not been fully elucidated. We undertook this prospective cohort study to determine the independent contributions of socioeconomic status (SES), health behaviors, and health insurance in explaining racial/ethnic disparities in mortality and health declines. Our study period was 1992 1998, and our study population consists of a US nationally representative sample of 6286 non-Hispanic whites (W), 1391 non-Hispanic blacks (B), 405 Hispanics interviewed in English (H/E), and 318 Hispanics interviewed in Spanish (H/S), ages 51 61 in 1992 in the Health and Retirement Study. The main outcome measures were death; major decline in self-reported overall health (SROH); and combined outcome of death or major decline in SROH. Crude mortality rates over the 6-year study period for W, B, H/E and H/S were 5.8 , 10.6 , 5.8 , and 4.4 , respectively. Rates of major decline in SROH were 14.6 , 23.2 , 22.1 and 39.4 , for W, B, H/E and H/S, respectively. Higher mortality rates for B versusWwere mostly explained by worse baseline health. For major decline in SROH, education, income, and net worth independently explained more of the disparities for all three minority groups as compared to health behaviors and insurance, reducing the effect for B and H/E to non-significance, while leaving a significant elevated odds ratio for H/S. Without addressing the as-yet undetermined and pernicious effects of lower SES, public health initiatives that promote changing individual health behaviors and increasing rates of insurance coverage among blacks and Hispanics will not eliminate racial/ethnic health disparities.

URLhttp://authors.elsevier.com/JournalDetail.html?PubID=315andPrecis=DESC
Endnote Keywords

Racial disparities/Health Behaviors/Health Insurance/Hispanics

Endnote ID

15720

Citation Key7072