Understanding how race/ethnicity and gender define age-trajectories of disability: An intersectionality approach

Abstract

A number of studies have demonstrated wide disparities in health among racial/ethnic groups and by gender, yet few have examined how race/ethnicity and gender intersect or combine to affect the health of older adults. The tendency of prior research to treat race/ethnicity and gender separately has potentially obscured important differences in how health is produced and maintained, undermining efforts to eliminate health disparities. The current study extends previous research by taking an intersectionality approach (Mullings & Schulz, 2006), grounded in life course theory, conceptualizing and modeling trajectories of functional limitations as dynamic life course processes that are jointly and simultaneously defined by race/ethnicity and gender. Data from the nationally representative 1994–2006 US Health and Retirement Study and growth curve models are utilized to examine racial/ethnic/gender differences in intra-individual change in functional limitations among White, Black and Mexican American Men and Women, and the extent to which differences in life course capital account for group disparities in initial health status and rates of change with age. Results support an intersectionality approach, with all demographic groups exhibiting worse functional limitation trajectories than White Men. Whereas White Men had the lowest disability levels at baseline, White Women and racial/ethnic minority Men had intermediate disability levels and Black and Hispanic Women had the highest disability levels. These health disparities remained stable with age—except among Black Women who experience a trajectory of accelerated disablement. Dissimilar early life social origins, adult socioeconomic status, marital status, and health behaviors explain the racial/ethnic disparities in functional limitations among Men but only partially explain the disparities among Women. Net of controls for life course capital, Women of all racial/ethnic groups have higher levels of functional limitations relative to White Men and Men of the same race/ethnicity. Findings highlight the utility of an intersectionality approach to understanding health disparities.

Associação entre cor/raça, obesidade e diabetes em idosos da comunidade: dados do Estudo FIBRA

“…that must be analyzed together, given their interrelations, which influence disparities and create vulnerabilities to health risks. The higher obesity among diabetic black elderly women found in our study may have been influenced by unfavorable conditions faced by this group over their lives 15,47 , even in cases in which they reached higher levels of schooling 17 , due to reduced opportunities for upward social mobility, in addition to differences and worse care in health services, a reflex of racial discrimination and social exclusion 20,47 . Cunningham et al 48 showed that, over an eight year period, there was a significant increase in WC and BMI among black women who reported greater racial discrimination (the same was not found for black and white men or for white women).…”

“…Racial differences associated with higher morbity 19,46,47 , obesity 9,15,22,29 and disability 16,28 are largely explained by unfavorable socioeconomic conditions, with lead to an accumulation of unhealthy behaviors and lifestyle, due to lower access to information, quality education and health services. According to Chor 20 , race, socioeconomic status and gender are crucial variables Table 4 Effect of race on body fat among diabetic elderly individuals according to gender, adjusted by schooling and family income.…”

Death of family members as an overlooked source of racial disadvantage in the United States

“…Again, bereavement is a known risk factor for mental and physical health (20), and childhood through early adulthood may be a period of the life course during which bereavement is especially likely to have lasting consequences (14)(15)(16)(17)(18). Although the United States has made progress in recent decades in reducing the life expectancy gap between blacks and whites, significant racial differences persist (5, 6), with important implications for surviving family members.…”

Hospitalization-Associated Disability in Adults Admitted to a Safety-Net Hospital

“…5,8,[12][13][14][37][38][39][40] Socioeconomic factors (e.g., poverty and education) have been shown to be associated with prevalent functional disability but not HAD. 11,12 The distribution of HAD suggests that there may also be different factors contributing to susceptibility for or poor recovery from HAD within each age group.…”