TY - JOUR T1 - Intersecting Early-Life Selection Mechanisms: Socio-Historical Changes in Racially Stratified Effects of Education on Functional Limitations in the United States. JF - Journal of Aging and Health Y1 - Forthcoming A1 - Bhatta, Tirth R KW - Education KW - Intersectionality KW - later-life health inequalities KW - life course AB -

OBJECTIVE: Scant research has focused on the role of in shaping intersecting early-life selection mechanisms and their impacts on racially stratified effects of education on health across cohorts.

METHOD: Drawing from the , this study fitted negative binomial regression models to assess the impacts of childhood socioeconomic status (SES) on the relationship between education and functional limitations for Black and White adults across birth cohorts ( = 16,269, born 1931-1959).

RESULTS: The disparities between Black adults and White adults in impacts of childhood SES on both education and functional limitations were more pronounced in recent cohorts. The racial stratification in the impacts of education on functional limitations was documented across cohorts. However, after adjusting for childhood SES, this stratification narrowed considerably in recent cohorts.

DISCUSSION: This study underscores the role of a context in shaping the effects of education on health at the intersection of race and cohort.

ER - TY - JOUR T1 - Race/Ethnicity, Nativity, and Gender Disparities in Mental Health Trajectories from Mid- to Later-Life: A Life Course-Intersectional Approach. JF - Journal of Racial and Ethnic Health Disparities Y1 - Forthcoming A1 - Liu, Jingwen A1 - Lin, Zhiyong KW - Depressive symptoms KW - gender KW - Intersectionality KW - life course KW - nativity KW - Race/ethnicity AB -

BACKGROUND: Numerous studies have highlighted mental health disparities based on race/ethnicity, nativity, and gender across different life stages. However, few have investigated how the intersectionality of these factors influences mental health trajectories during midlife to late life. This study fills this gap by adopting a life course-intersectional approach, viewing mental health trajectories as dynamic processes shaped by the combined influences of race/ethnicity, nativity, and gender. It explores social, psychological, and physiological pathways contributing to these disparities.

DESIGN: Using data from the Health and Retirement Study (2006-2018; N = 38,049 observations) and growth curve models, this study examines how intra-individual trends in depressive symptoms (measured as CES-D scale, 07) are influenced by the intersection of race/ethnicity, nativity, and gender. It also investigates the impact of objective and subjective social isolation and physical health on group disparities in mental health trajectories.

RESULTS: The findings reveal that, during mid- to early late-life, most Black and Hispanic Americans experience higher levels of depressive symptoms compared to their White counterparts (disparities ranging from 0.184 to 0.463 for men and 0.117 to 0.439 for women). However, this disadvantage diminishes for US-born Hispanic men and US-born Black women (0.014-0.031 faster decrease rates compared to US-born White), while it intensifies for Hispanic immigrants (0.017-0.018 slower decrease rates compared to US-born White) in advanced ages. Mediation analysis demonstrates that both social isolation and physical health contribute to these disparities, with physical health explaining a larger portion, particularly in differences between immigrant Hispanic women and US-born Whites.

CONCLUSION: This study underscores the importance of a life course-intersectional approach in understanding mental health disparities. It emphasizes the need for improved social welfare systems and community-level interventions targeting the specific challenges faced by older Hispanic immigrants, especially women who encounter multiple forms of oppression.

ER - TY - JOUR T1 - Racial/ethnic/gender-Based Differences in Health Trajectories Among American Older Adults: 10-Year Longitudinal Evidence from the Health and Retirement Study. JF - Social Work Public Health Y1 - Forthcoming A1 - Kong, Dexia A1 - Lu, Peiyi A1 - Davitt, Joan A1 - Shelley, Mack KW - ethnicity KW - growth curve model KW - Health differences KW - Intersectionality KW - race AB -

Health disparity by race/ethnicity or gender has been well-documented. However, few researchers have examined health outcomes based on the intersection of individuals' race, ethnicity, and gender or investigated various health dimensions. Guided by an intersectionality framework, this study explores racial/ethnic/gender-based differences in trajectories of multiple health outcomes over a ten-year period among American older adults. Longitudinal data from the Health and Retirement Study (2004-2014) were used ( = 16,654). Older adults (65+) were stratified into six mutually-exclusive groups based on their race, ethnicity, and gender: Non-Hispanic (NH) White Men, NH White Women, NH Black Men, NH Black Women, Hispanic Men, and Hispanic Women. Growth curve models examined the trajectories of three health measures, including cognitive function, physical function limitations (i.e. activities of daily living and instrumental activities of daily living), and depressive symptoms. NH White men and women reported significantly better outcomes in cognition and physical function trajectories than racial/ethnic minority groups. Women in all racial/ethnic groups had more depressive symptoms but better cognition than men. Hispanic women reported the most depressive symptoms. Hispanic women and NH Black women had the worst physical function limitations. NH Black men/women were the most disadvantaged in cognition. Racial/ethnic/gender-based differences were stable over time in all health trajectories. Study findings highlight the utility of an intersectional framework in understanding how multiple social identities intersect to generate protective and/or risk effects on cognitive, mental, and physical health. Multilevel intervention strategies are warranted to reduce the persistent health inequity gap.

ER - TY - JOUR T1 - Aging with Incarceration Histories: An Intersectional Examination of Incarceration and Health Outcomes among Older Adults. JF - The Journals of Gerontology, Series B Y1 - 2023 A1 - Latham-Mintus, Kenzie A1 - Deck, Monica M A1 - Nelson, Elizabeth KW - health KW - incarceration KW - Intersectionality KW - life course AB -

OBJECTIVES: Experiences with incarceration are linked to poor mental and physical health across the life course. The purpose of this research is to examine whether incarceration histories are associated with worse physical and mental health among older adults. We apply an intersectionality framework and consider how the intersection of sexism and racism leads to unequal health outcomes following incarceration among women and people of color.

METHODS: We employ two measures of health (i.e., number of depressive symptoms and physical limitations) to broadly capture mental and physical health. Using data from Waves 11 and 12 of the Health and Retirement Study (HRS), we estimated a series of general linear models (GLM) to analyze differences in health by incarceration history, gender/sex, and race/ethnicity.

RESULTS: Findings suggest that experiences with incarceration are associated with a greater number of physical limitations and more depressive symptoms among older men and women, net of sociodemographic characteristics, early-life conditions, and lifetime stressful events. Formerly incarcerated women, particularly women of color, had more physical limitations and depressive symptoms, relative to other groups.

DISCUSSION: These findings suggest that incarceration histories have far-reaching health implications. Older women of color with incarceration histories experience markedly high levels of physical limitations and depressive symptoms in later life.

ER - TY - JOUR T1 - Attributions for Everyday Discrimination and All-Cause Mortality Risk Among Older Black Women: A Latent Class Analysis Approach. JF - The Gerontologist Y1 - 2023 A1 - Erving, Christy L A1 - Cobb, Ryon J A1 - Sheehan, Connor KW - African Americans KW - death index KW - Health Disparities KW - Intersectionality KW - Mortality KW - women AB -

BACKGROUND AND OBJECTIVES: This study examined the relationship between number of attributed reasons for everyday discrimination and all-cause mortality risk, developed latent classes of discrimination attribution, and assessed whether these latent classes were related to all-cause mortality risk among US older Black women.

RESEARCH DESIGN AND METHOD: Participants were from the 2006 and 2008 waves of the Health and Retirement Study (N = 1133; 335 deaths). Vital status was collected through the National Death Index through 2013 and key informant reports through 2019. Latent Class Analyses were conducted on discrimination attributions. Weighted Cox proportional hazards model were used to predict all-cause mortality. Analyses controlled for demographic characteristics, socioeconomic status, and health.

RESULTS: Reporting greater attributions for everyday discrimination was associated with higher mortality risk (HR = 1.117; 95% CI: 1.038 - 1.202; p <.01), controlling for demographic characteristics, socioeconomic status, and health as well as health behaviors. A four-class solution of the Latent Class Analysis specified the following attribution classes: No/Low Attribution; Ancestry/Gender/Race/Age; Age/Physical Disability; High on All Attributions. When compared to the No/Low Attribution class, membership in the High on All Attributions class was associated with greater mortality risk (HR = 2.809; CI: 1.458 - 5.412; p < .01).

DISCUSSION AND IMPLICATIONS: Findings underscore the importance of everyday discrimination experiences from multiple sources in shaping all-cause mortality risk among older Black women. Accordingly, this study problematizes the homogenization of Black women in aging research and suggests the need for health interventions that consider Black women's multiplicity of social statuses.

VL - 63 IS - 5 ER - TY - JOUR T1 - Life, Longevity, and the Pursuit of Happiness: The Role of Disability in Shaping Racial and Sex Disparities in Living a Long and Happy Life JF - Population Research and Policy Review Y1 - 2023 A1 - Bardo,Anthony R. A1 - Cummings,Jason L. KW - Activities of Daily Living KW - Black People KW - Black white differences KW - Black women KW - Business And Economics–Economic Situation And Conditions KW - Data quality KW - Demographers KW - Demography KW - Disability KW - Disadvantaged KW - Gender Differences KW - Happiness KW - health KW - Inequality KW - Intersectionality KW - Life Expectancy KW - Life span KW - limitations KW - Longevity KW - Marital Status KW - Men KW - Older people KW - Peers KW - Quality of Life KW - race KW - Racial differences KW - Racial inequality KW - Retirement KW - Severity KW - Sex differences KW - Subjective well-being KW - Wealth KW - women AB - Disability-free life expectancy is a common measure used by demographers to gauge quantity and quality of life. Yet, the extent to which positive dimensions of quality of life differ by disability status remains unexplored. Using data from the Health and Retirement Study (N = 16,614), we estimated happy life expectancy by age, race, sex, and severe Activities of Daily Living (ADL) limitations. First, results show that happy life expectancy differed substantially by disability status, as older adults with severe ADL limitations experienced 50–60% fewer remaining years of their life happy compared to their more able-bodied peers. Second, healthy Black women and men at age fifty can expect to live five fewer years of their remaining life happy compared to their White peers, but there were no significant race or sex differences among individuals with severe ADL limitations. Finally, the racial gap in Happy Life Expectancy between Black and White women was largely accounted for by group differences in marital status, education, and wealth, but Black men continued to be disadvantaged compared to their White peers. Implications of this study point to a need to critically examine the intersections of race and sex to develop a clearer portrait of the pattern and underlying factors associated with social disparities in longevity and quality of life. Findings highlight the importance of considering positive dimensions of quality of life alongside measures of illness, disability, or disease when determining whether we are adding life to years or just years to life. VL - 42 SN - 01675923 UR - https://proxy.lib.umich.edu/login?url=https://www.proquest.com/scholarly-journals/life-longevity-pursuit-happiness-role-disability/docview/2849184861/se-2 ER - TY - JOUR T1 - Experiences of Older Adults During the 2020 COVID-19 Pandemic in the United States: An Initial Exploration of Nationally Representative Data at the Intersection of Gender and Race. JF - Journal of Applied Gerontology Y1 - 2022 A1 - Takashi Yamashita A1 - Punksungka, Wonmai A1 - Van Vleet, Samuel A1 - Helsinger, Abigail A1 - Cummins, Phyllis KW - COVID-19 KW - gender KW - Intersectionality KW - race AB -

Little is known about the overall experiences and feelings of diverse older populations during the 2020 COVID-19 pandemic. To provide the baseline information for future research and policy, this study analyzed the 2020 Health and Retirement Study COVID-19 project data ( = 1782). More than 70% of older adults reported the following activities: watching TV (98%), reading (90%), using a computer and the internet (83%), gardening (82%), walking (75%), baking and cooking (73%), and praying (73%). Volunteering and attending community groups, which are known to benefit well-being, were unpopular (less than 8%). During the pandemic, older adults were generally satisfied with their lives, but more than half of them were concerned about their own health, family's health, and future prospects. Our study also showed the differences in the experiences and feelings by gender and race as well as the intersection of gender and race in the United States.

VL - 41 IS - 619-627 ER - TY - JOUR T1 - The inequitable burden of the COVID-19 pandemic among marginalized older workers in the United States: an intersectional approach. JF - The Journals of Gerontology, Series B Y1 - 2022 A1 - Andrea, Sarah B A1 - Eisenberg-Guyot, Jerzy A1 - Blaikie, Kieran J A1 - Owens, Shanise A1 - Oddo, Vanessa M A1 - Peckham, Trevor A1 - Minh, Anita A1 - Hajat, Anjum KW - COVID-19 KW - Employment KW - Inequities KW - Intersectionality AB -

OBJECTIVES: The COVID-19 pandemic has profoundly affected the lives of people globally, widening longstanding inequities. We examined the COVID-19 pandemic's impact on employment conditions by race/ethnicity, gender, and educational attainment and the association between such conditions and well-being in older adults in the United States.

METHODS: Using data from the Health and Retirement Study respondents interviewed between May 2020 and May 2021 when they were ≥55 years of age, we examined intersectional patterns in COVID-19-related changes in employment conditions among 4,107 participants working for pay at the start of the pandemic. We also examined the compounding nature of changes in employment conditions and their association with financial hardship, food insecurity, and poor self-rated health.

RESULTS: Relative to non-Hispanic White men with greater than high school education (>HS), Black and Latinx men and women were more likely to experience job loss irrespective of education; among those who did not experience job loss, men with ≤HS reporting Black, Latinx, or "other" race were >90% less likely to transition to remote work. Participants who experienced job loss with decreased income or continued in-person employment with decreased income/shift changes had greater prevalence of financial hardship, food insecurity, and poor/fair self-rated health than others.

DISCUSSION: The impact of COVID-19 on employment conditions is inequitably patterned and is associated with financial hardship, food insecurity, and adverse health in older adults. Policies to improve employment quality and expand social insurance programs among this group are needed to reduce growing inequities in well-being later in life.

VL - 77 IS - 10 ER - TY - JOUR T1 - Intersectional Discrimination Attributions and Health Outcomes Among American Older Adults: A Latent Class Analysis. JF - The International Journal of Aging and Human Development Y1 - 2022 A1 - Lu, Peiyi A1 - Kong, Dexia A1 - Shelley, Mack A1 - Joan Davitt KW - Discrimination KW - Intersectionality KW - Latent Class Analysis AB -

Guided by an intersectionality framework, this study examined intersectional discrimination attributions and their associations with health outcomes. Older respondents (aged ≥50) from the Health and Retirement Study in 2014-2015 were included ( = 6286). Their reasons for discrimination (age, gender, sexual orientation, race, national origin, religion, financial status, weight, physical appearance, disability, and others) were examined. Latent class analysis examined the subgroup profiles. Six classes were identified: class 1 (54.52% of the sample) had no/minimal discrimination; Class 2 (21.89%) experienced primarily ageism; class 3 (8.81%) reported discrimination based on age/gender/national origin/race; class 4 (7.99%) attributed discrimination to financial/other reasons; class 5 (5.87%) experienced discrimination based on age/weight/physical appearance/disability; and class 6 (0.92%) perceived high discrimination. Intersectional discrimination was associated with poorer self-rated health and higher depressive symptoms compared to the no/minimal discrimination group. Multiple marginalized identities co-occur and contribute to discrimination. An intersectional approach is recommended to understand discrimination in later life.

VL - 95 IS - 3 ER - TY - RPRT T1 - Understanding cognitive impairment in the U.S. through the lenses of intersectionality and (un)conditional cumulative (dis)advantage Y1 - 2022 A1 - Jo Mhairi Hale A1 - Daniel C Schneider A1 - Neil K Mehta A1 - Mikko Myrskylä KW - cognitive impairment KW - cumulative (dis)advantage KW - Dementia KW - Education KW - Health Disparities KW - Intersectionality AB - Grounded in theories of intersectionality and cumulative (dis)advantage, we develop complementary formalizations of (dis)advantage to study disparities in cognitive impairment: Conditional Cumulative (Dis)Advantage that reflects inequalities in outcomes and Unconditional Cumulative (Dis)Advantage that additionally accounts for inequalities in opportunities. We study the properties of these formalizations and show that cumulative disadvantage does not imply cumulative advantage. Using these formalizations and incidence-based multistate models, we analyze the Health and Retirement Study to assess how racial/ethnic, nativity, gender, early-life adversity, and educational (dis)advantages accumulate into three important metrics for characterizing later-life cognitive impairment—lifetime risk, mean age at first impairment, and cognitive health expectancies. We find that the benefits and penalties of one (dis)advantage depend on positionality on the other axes of inequality. Black women and Latinas experience Conditional Cumulative Disadvantage in cognitive impairment: they are penalized more from having lower education than Whites. White men experience Conditional Cumulative Advantage: they benefit more from higher education than Blacks or Latinx. However, when accounting for racial/ethnic inequities in educational opportunities, results ubiquitously show Unconditional Cumulative Disadvantage. Our formalization provides a mathematical grounding for cumulative (dis)advantage, and the empirical results comprehensively document the multi-dimensional, intersecting axes of stratification that perpetuate inequities in cognitive impairment. JF - MPIDR Working Paper PB - Max Planck Institute ER - TY - JOUR T1 - The Association between Multiple Chronic Conditions and Depressive Symptoms: Intersectional Distinctions by Race, Nativity, and Gender. JF - Journal of Health and Social Behavior Y1 - 2021 A1 - Christy L Erving A1 - Frazier, Cleothia KW - cumulative disadvantage KW - depression KW - Intersectionality KW - Multiple Chronic Conditions AB -

Using random coefficient growth curve analysis, this study utilizes 12 waves of data from the Health and Retirement Study (1994-2016; person-waves = 145,177) to examine the association between multiple chronic conditions (MCC) and depressive symptoms among older adults. Applying cumulative disadvantage and intersectionality theories, we also test whether the association between MCC and depressive symptoms differs by race, nativity, and gender. Findings reveal that MCC prevalence is highest among U.S.-born black women, whereas depressive symptoms are highest among foreign-born Hispanic women. Compared to men, MCC has a stronger effect on women's depressive symptoms. Furthermore, the MCC-depressive symptoms association is strongest for foreign-born Hispanic women. Despite an increase in MCC in the transition from midlife to late life, all race-nativity-gender groups experience a decline in depressive symptoms as they age. The decline in depressive symptoms is steepest for U.S.-born black and foreign-born Hispanic women. Study implications are discussed.

VL - 62 IS - 4 ER - TY - JOUR T1 - Contribution of socioeconomic, lifestyle, and medical risk factors to disparities in dementia and mortality. JF - SSM - Population Health Y1 - 2021 A1 - Weiss, Jordan KW - Dementia KW - Intersectionality KW - Mortality KW - Multistate KW - Population attributable fraction AB -

Extensive literature in the United States documents racial/ethnic and gender disparities in the incidence and prevalence of dementia yet few studies have examined how race/ethnicity and gender intersect to shape inequalities in the risk of dementia. Moreover, few studies have examined heterogeneity in the contribution of known risk factors to dementia across these demographic strata while properly accounting for the semi-competing risk of death. I calculated the proportion of dementia cases attributable to socioeconomic, lifestyle, and medical risk factors across demographic subgroups using nationally representative data from the US-based Health and Retirement Study for the years 2000-2016 and a multistate framework that accounts for the semi-competing risk of death. Socioeconomic resources contributed to the largest number of dementia cases but the magnitude of this contribution varied across strata defined by race/ethnicity and gender. The greatest potential for dementia prevention was observed among non-Hispanic black and Hispanic men and women, supporting an intersectionality approach, and underscoring the need for culturally sensitive intervention and public health initiatives to address the growing burden of dementia. Taken together, work demonstrates the potential benefit of taking an intersectional approach to understanding disparities in dementia.

VL - 16 ER - TY - JOUR T1 - Intersectional trends in employment quality in older adults in the United States JF - SSM - Population Health Y1 - 2021 A1 - Sarah B. Andrea A1 - Eisenberg-Guyot, Jerzy A1 - Peckham, Trevor A1 - Vanessa M Oddo A1 - Hajat, Anjum KW - employment quality KW - Inequities KW - Intersectionality KW - Precarious employment AB - Americans' working lives have become more precarious over the past several decades. Worsening employment quality has been linked to poorer physical and mental health and may disproportionately impact marginalized working populations. We examined differences in the quality and character of worker-employer relationships among older workers in the United States (US) across intersecting gender-racial/ethnic-educational subgroups. Using longitudinal data on employment stability, material rewards, workers’ rights, working-time arrangements, unionization, and interpersonal power relations from the Health and Retirement Study (1992–2016), we used principal components analysis to construct an employment quality (EQ) score. We estimated intersectional differences in EQ, overall and over time, using generalized estimating equations. Overall, EQ was greatest for white men with college degrees and poorest for Latinx women with < high school degrees. Over time, EQ tended to remain unchanged or slightly worsen across intersectional strata; the greatest EQ reduction was for Latinx women with college degrees, while the greatest improvement was for white women with high school degrees. There are enduring and growing inequities in EQ for older marginalized adults in the US, which may contribute to growing health inequities. VL - 15 SN - 2352-8273 ER - TY - JOUR T1 - Perceived Neighborhood Characteristics and Cognitive Functioning among Diverse Older Adults: An Intersectional Approach JF - International Journal of Environmental Research and Public Health Y1 - 2021 A1 - Amy D Thierry A1 - Kyler J. Sherman-Wilkins A1 - Armendariz, Marina A1 - Allison R Sullivan A1 - Heather R. Farmer KW - cognitive functioning KW - Health Disparities KW - Intersectionality KW - Neighborhoods KW - Older Adults AB - Unfavorable neighborhood conditions are linked to health disparities. Yet, a dearth of literature examines how neighborhood characteristics contribute to cognitive health in diverse samples of older adults. The present study uses an intersectional approach to examine how race/ethnicity, gender, and education moderate the association between neighborhood perceptions and cognitive functioning in later life. We used data from adults ≥65 years old (n = 8023) in the 2010–2016 waves of the nationally representative Health and Retirement Study (HRS). We conducted race/ethnicity-stratified linear regression models where cognitive functioning, measured using the 35-point Telephone Interview Cognitive Screen (TICS), was regressed on three neighborhood characteristics—cleanliness, safety, and social cohesion. We examine whether there is heterogeneity within race/ethnicity by testing if and how the relationship between neighborhood characteristics and cognitive functioning differs by gender and education. Among White adults, worse neighborhood characteristics were associated with lower cognitive functioning among those with less education. However, for Black adults, poor perceived quality of one’s neighborhood was associated with worse cognitive functioning among those with more years of education compared to those with fewer years of education. Among Mexicans, perceived neighborhood uncleanliness was associated with lower cognitive functioning among those with less education, but higher cognitive functioning for those with higher levels of education. Thus, this study contributes to the literature on racial/ethnic disparities in cognitive aging disparities by examining neighborhood contextual factors as determinants of cognitive functioning. In particular, we find that higher education in the context of less favorable neighborhood environments does not confer the same benefits to cognitive functioning among all older adults. VL - 18 IS - 5 ER - TY - JOUR T1 - Reversing the Gains of the Civil Rights and Women’s Movements: How Housing Strain and Market Exclusion Led to Wealth Depletion During the Great Recession JF - Journal of the Society for Social Work & Research Y1 - 2021 A1 - West, Stacia A1 - Amy Castro Baker A1 - Ma, Chenyi A1 - Elliot, Stacy KW - Black women KW - gender KW - Intersectionality KW - race KW - Recession KW - Retirement KW - Wealth AB - Objective: We use feminist standpoint theory to investigate how the intersection of identity influenced wealth loss following the Great Recession among older single adults who benefitted from the social movements and legislative gains of the 1960s and 1970s. Looking back on more than a decade of recession and recovery, this study explores how intersections of race, class, and gender produced different wealth outcomes for the early baby boomer EBB cohort. Method: A sample of older baby boomers from the University of Michigan Health and Retirement Study were selected at two waves, 2004 and 2016. We used a generalized estimation equation with interaction effects to test changes in wealth over time for different race and gender groups. Results: Controlling for income and health, we found that both single Black and white women lost wealth at significantly higher rates than single white men. Poor health was associated with wealth shocks, or substantial wealth loss, for single white women, whereas the intersection of race and gender was associated with wealth loss for single Black women. Black women in this cohort ended the Great Recession with $85,000 less than their peers based on the overlapping identities of race and gender independent of health trouble. Conclusions: The policy history of women’s credit and lending access, as well as predatory targeting during the subprime lending crisis, contextualizes our findings. We discuss policy approaches to prevent future wealth erosion in households headed by Black women. VL - 12 IS - 2 ER - TY - JOUR T1 - Explaining disparities in BMI trajectories among older adults: a test of the double jeopardy and intersectionality hypotheses JF - Longitudinal and Life Course Studies Y1 - 2020 A1 - Hui-Peng Liew KW - BMI KW - double jeopardy KW - Intersectionality AB - This study aims to assess how heterogeneity in BMI trajectories differs across birth cohorts, race/ethnicity, gender and the level of education in the United States of America. Specifically, it seeks to examine whether the combined effects of race/ethnicity, sex and education on the differences in the BMI trajectories reflect the processes associated with double jeopardy and/or intersectionality. The empirical work of this study is based on the 1992–2014 Health and Retirement Study (HRS). Findings from growth curve modelling provide partial support for the intersectionality hypotheses. Findings revealed that different dimensions of inequality (such as race/ethnicity, sex and education) interact and intersect with one another to influence longitudinal change in BMI. Health programmes to reduce, prevent, delay or reverse the progression of obesity among the elderly should pay particular attention to Black people, females and females from racial/minority groups (Black, Hispanic, Other). JO - Longitudinal and Life Course Studies ER - TY - JOUR T1 - Personal Mastery and the Medical, Financial, and Physical Cancer Burden: Gender and Race Differences Among Older Adults JF - Journal of Aging and Health Y1 - 2020 A1 - Tetyana Pudrovska A1 - Andriy Anishkin KW - Cancer KW - Health Disparities KW - Intersectionality KW - Masculinity KW - Mastery AB - Objectives: We explore how a new cancer diagnosis affects trajectories of personal mastery among non-Hispanic Black and White older adults. We estimate whether and how cancer therapy (chemotherapy, surgery, radiation), the amount and type of health care contacts, the financial burden, and the physical symptoms of cancer explain within- and between-gender differences in mastery. Method: Using the 2006–2014 data from the Health and Retirement Study, we apply matching and multiple regression models testing mediating and moderating effects. Results: White men experience a substantially more pronounced decline in mastery after a cancer diagnosis than all women and Black men. Cancer treatment disproportionately decreases White men’s mastery via exposure to health care settings. Discussion: Cultural norms of masculinity and femininity imbue cancer and its treatment with gender-specific meanings. Deference to medical authority and losses of independence, decision-making, and self-reliance are incompatible with masculinity and might affect mastery more adversely in older White men. N1 - PMID: 32242759 ER - TY - JOUR T1 - Explaining disparities in transitions among visual-functioning states JF - Longitudinal and Life Course Studies Y1 - 2019 A1 - Hui-Peng Liew KW - double jeopardy KW - Intersectionality KW - multistate life table KW - vision functioning AB - Visual impairment is one of the most common disabilities among older adults and the majority of the visually impaired and blind worldwide are those aged 50 and older. This study aims to examine whether transitions across different visual-functioning states (good and better to poor) among older adults in the United States reflect the processes associated with double-jeopardy intersectionality, cumulative advantage (disadvantage), persistent inequality and age-as-leveller. The empirical work of this study is based on the 2002–14 Health and Retirement Study (HRS). Multistate life tables are used to assess the aim of the study. Findings from multistate life tables reveal higher transition probabilities associated with vision deterioration among females, black people, Hispanic people and those with less than a four-year degree. Findings provide support for both the intersectionality hypothesis in conjunction with the cumulative advantage (disadvantage) and persistent inequality hypothesis. Targeted interventions that detect visual loss and prevent vision impairment as well as the provision of appropriate and accessible refraction and surgical services should begin early on in life and should continue to focus on the specific needs of ethnic minorities, females and those with low education. Understanding how individuals move through dierent visual-functioning states and identifying the risk factors for poor vision are relevant to many policy concerns that seek to reduce the disease burden or health consequences associated with visual impairment. VL - 10 ER - TY - THES T1 - An Intersectional Perspective on the Relationships Among Social Status, Self-reported Discrimination, and Low-grade C-Reactive Protein in the Health and Retirement Study T2 - Biobehavioral Health Y1 - 2018 A1 - Heather R. Farmer KW - C-reactive protein KW - developmental perspective KW - Gerontology KW - health KW - health discrimination KW - Intersectionality KW - Lifespan KW - Racial Disparities KW - social determinants KW - social status and health AB - A broad literature has documented social patterning of health, such that those with lower social status (e.g., racial minorities, women, and people of lower socioeconomic status) bear a disproportionate burden of morbidity and mortality relative to those with higher status. Disparities may be larger for some individuals, particularly those who are socially disadvantaged in more than one status. Variations in stress exposure, like experiences of discrimination, and resulting low-grade inflammation, may explain such disparities. A limited body of literature has examined the social distribution of low-grade inflammation, which is implicated in chronic diseases that are responsible for excess deaths in the United States. Limited work has examined how social statuses might interact to predict inflammatory markers like C-reactive protein (CRP), or tested psychosocial mechanisms responsible for the social distribution of CRP. The present study will examine the relationship between race, gender, and SES; everyday and lifetime discrimination exposure; and CRP. Aim 1 will test whether an interaction of race, gender, and SES are associated with CRP levels. Aim 2 will assess how race, gender, and SES shape exposure to lifetime and everyday discrimination, and whether this discrimination exposure mediates the relationship between race x gender x SES and CRP. Data were drawn from 5,486 respondents in the Health and Retirement Study, a nationally representative sample of midlife and older adults, to analyze the relationships between social status (e.g., race, gender, SES), everyday discrimination, lifetime discrimination, and CRP levels at baseline and after a four-year follow-up. Aim 1 study results demonstrate that race, gender, and SES interact to produce differential CRP levels at baseline and follow-up. The results suggest that there are incremental benefits for each additional level of SES for all race and gender groups except Black women. Significant three-way interactions of race, gender, and SES also indicate that Black women experience higher CRP levels with increases in SES, and that Black men with low SES are have the highest levels of CRP. Aim 2 study results show that everyday and lifetime discrimination exposure varies across social status groups. However, there were no significant interactions among race, gender, and SES on discrimination exposure. Further, results showed that both everyday and lifetime exposure to discrimination were significantly associated with CRP levels at baseline but not with change in CRP over four years. In clarifying the complexity inherent in disparities in low-grade inflammation, as well as potential psychosocial mechanisms responsible for these mechanisms, this work will contribute to a greater understanding of the factors underlying major causes of excess morbidity and mortality in the United States, and may identify potential intervention points for addressing health disparities. JF - Biobehavioral Health PB - The Pennsylvania State University CY - State College, PA VL - Doctor of Philosophy UR - https://etda.libraries.psu.edu/catalog/15539hrc117 ER - TY - JOUR T1 - Psychosocial Mechanisms Underlying Older Black Men's Health. JF - Journals of Gerontology, Series B: Psychological Sciences & Social Sciences Y1 - 2018 A1 - Tyson H Brown A1 - Taylor W. Hargrove KW - Depressive symptoms KW - Discrimination KW - Intersectionality KW - Racial/ethnic differences AB -

Objectives: To evaluate the psychosocial mechanisms underlying older Black men's self-rated health, we examined: (a) the individual, cumulative, and collective effects of stressors on health; (b) the direct effects of psychosocial resources on health; and (c) the stress-moderating effects of psychosocial resources.

Method: This study is based on a nationally representative sample of Black men aged 51-81 (N = 593) in the Health and Retirement Study (HRS). Ordinary least squares (OLS) regression models of the psychosocial determinants of self-rated health draw on data from the HRS 2010 and 2012 Core datasets and Psychosocial Modules.

Results: Each of the six measures of stressors as well as a cumulative measure of stressors are predictive of worse self-rated health. However, when considered collectively, only two stressors (chronic strains and traumatic events) have statistically significant effects. Furthermore, two of the five psychosocial resources examined (mastery and optimism) have statistically significant protective effects, and prayer moderates the harmful effects of traumatic events on self-rated health.

Discussion: Conventional measures of stressors and coping resources-originally developed to account for variance in health outcomes among predominantly white samples-may not capture psychosocial factors most salient for older Black men's health. Future research should incorporate psychosocial measures that reflect their unique experiences.

VL - 73 IS - 2 U1 - http://www.ncbi.nlm.nih.gov/pubmed/28977648?dopt=Abstract ER -