New Estimates of Racial/Ethnic Differences in Life Expectancy with Chronic Morbidity and Functional Loss: Evidence from the National Health Interview Survey

Abstract

This study documents the mortality, chronic morbidity and physical functioning experiences of U.S. Hispanics, non-Hispanic whites, and non-Hispanic blacks 50 years of age and older in the United States. Hispanics are classified by nativity to better assess an important source of heterogeneity in population health within that population. Drawing on mortality and morbidity data from the National Health Interview Survey, demographic models of healthy life expectancy are used to derive estimates of life expectancy, life expectancy with and without chronic morbidity conditions, and life expectancy with and without functional limitations. The results not only highlight the mortality advantages of foreign-born Hispanics, but also document their health advantages in terms of morbidity and physical functioning beyond age 50. Nativity is a highly important factor differentiating the health and mortality experiences of Hispanics: U.S.-born Hispanics have a health profile more indicative of their minority status while foreign-born Hispanics have much more favorable mortality and health profiles. Differences in smoking across racial/ethnic/nativity groups is suggested as an important reason behind the apparent health advantages of foreign-born Hispanics relative to whites as well as relative to their U.S.-born counterparts.

Prevalence and Trends in Morbidity and Disability Among Older Mexican Americans in the Southwestern United States, 1993–2013

“…Longer disabled life expectancies may be a result of longer life expectancy, higher prevalence of disability, or a combination of both. Research shows that foreign-born Hispanics have longer life expectancies than their U.S.-born counterparts (Cantu, Hayward, Hummer, & Chiu, 2013; Garcia et al, 2015; Hayward et al, 2014; Lariscy, Hummer, & Hayward, 2015); however, more research on differences in the prevalence of disability by nativity for Hispanics is needed.…”

Daily and Nondaily Smoking Varies by Acculturation among English-Speaking, US Latino Men and Women

“…Although English proficiency among US Latinos has risen to a majority of 68% 52 and greater acculturation is linked with greater health risk behaviors, [33][34][35] it will be important that future work is conducted in both Spanish and English to validate the present findings. Additionally, participants' country of origin was diverse which addresses a limitation of previous research conducted with a predominant or exclusive sample of Mexican Americans, 6 but the sample size was not large enough to examine the research question by national origin.…”

“…29 Relatedly, US Latino adults who speak primarily English (a marker of greater acculturation) have been shown to experience greater health risks compared with those who speak primarily Spanish. [33][34][35] However, the direction of the relationship between acculturation and smoking behavior varies by sex. In most studies, higher levels of acculturation are associated with higher smoking prevalence and/ or quantity (CPD) among women, with little effect on men's smoking behavior.…”

Future Demand For Long-Term Care Workers Will Be Influenced By Demographic And Utilization Changes

“…26 Compared with older nonHispanic whites, older non-Hispanic blacks and older US-born Hispanics generally have higher disability rates, but older immigrant Hispanics have lower rates. 27 However, future disability rates within these groups may change as a result of changes in socioeconomic characteristics or in health behaviors such as smoking. 27,28 There has been little assessment of whether and how the growing diversity of the US elderly population and policies that support greater use of home and community-based services might affect demand for long-term care workers, with respect to either the number of people in or the occupational composition of that workforce.…”

“…27 However, future disability rates within these groups may change as a result of changes in socioeconomic characteristics or in health behaviors such as smoking. 27,28 There has been little assessment of whether and how the growing diversity of the US elderly population and policies that support greater use of home and community-based services might affect demand for long-term care workers, with respect to either the number of people in or the occupational composition of that workforce. This study used national surveys to estimate the present use of long-term care and employment related to long-term care use, develop projections of future demand for long-term care services and workers, and assess how these projections would vary if utilization patterns changed.…”