Using Multiple-hierarchy Stratification and Life Course Approaches to Understand Health Inequalities

Brown, Tyson H.; Richardson, Lee; Hargrove, Taylor W.; Thomas, Claudewell S.

doi:10.1177/0022146516645165

Cited by 162 publications

(156 citation statements)

References 78 publications

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“…16 We did not examine interactive effects of race, SES, and gender, and age on pain outcomes, though there is evidence that complex patterns are present in the links between these factors and health outcomes. 4 We encourage exploration of these intersections in future investigations. Last, we are unable to estimate pain prevalence among Asian Americans, a diverse and growing group of older adults.…”

Section: Discussionmentioning

confidence: 97%

Racial and Socioeconomic Disparities in Disabling Chronic Pain: Findings From the Health and Retirement Study

Janevic

McLaughlin

Heapy

et al. 2017

The Journal of Pain

170

117

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The U.S. National Pain Strategy calls for increased population research on “high impact chronic pain,” i.e., longstanding pain that substantially limits participation in daily activities. Using data from the nationally-representative Health and Retirement Study (HRS), we investigated the prevalence of high-impact chronic pain in U.S. adults over age 50 overall and within population subgroups. We also explored sociodemographic variation in pain-related disability within specific activity domains. Data are from a subsample of HRS respondents (n=1,925) who were randomly selected for a supplementary pain module in 2010. Our outcome was operationalized as pain duration of ≥7 months and a disability rating of ≥7 (0 to 10 scale) in at least one domain: family/home, leisure, social activities, work, or basic activities. Overall, 8.2% (95% C.I. = 6.7 to 10.1%) of adults over age 50 met criteria for high-impact chronic pain. This proportion rose to 17.1% (95% C.I. = 12.3 to 23.4%) among individuals in the lowest wealth quartile. Prevalence differences by education, race/ethnicity and age were not significant. Arthritis and depression were significantly associated with high-impact pain in multivariable analysis. Among adults with any chronic pain, African Americans and individuals in the lowest wealth quartile reported more pain-related disability across activity domains.

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Section: Discussionmentioning

confidence: 97%

Racial and Socioeconomic Disparities in Disabling Chronic Pain: Findings From the Health and Retirement Study

Janevic

McLaughlin

Heapy

et al. 2017

The Journal of Pain

170

117

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“…Much previous work in race/ethnicity, SES, and health outcomes has documented disparities between blacks, Hispanics, and whites . Our large and diverse sample allows us to expand those findings by documenting hypertension diagnosis disparities among Asians, American Indians/Alaskan Natives, and Native Hawaiian/other Pacific Islanders.…”

Section: Study Strengths and Limitationsmentioning

confidence: 97%

Associations of overweight/obesity and socioeconomic status with hypertension prevalence across racial and ethnic groups

Young

Fischer

Arterburn

et al. 2018

J of Clinical Hypertension

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Racial/ethnic disparities in the prevalence of diagnosed hypertension are persistent but may be partially explained by racial/ethnic differences in weight category and neighborhood socioeconomic status. The authors compared hypertension prevalence rates among 4 060 585 adults with overweight or obesity across 10 healthcare systems by weight category and neighborhood education level in geographically and racially diverse individuals. Data were obtained from electronic health records. Hypertension was defined as at least two outpatient visits or one inpatient hospitalization with a coded diagnosis. Logistic regression, adjusted for age, sex, and site, with two‐way interactions between race/ethnicity and weight category or neighborhood education, was used to examine the association between hypertension and race/ethnicity, with whites as the reference. Results documented that odds ratios for hypertension prevalence were greater for blacks, American Indians/Alaskan Natives, Asians, and Native Hawaiians/other Pacific Islanders compared with whites and lower for Hispanics in similar weight categories and neighborhood education levels. Although two‐way interactions were statistically significant, the magnitude of the odds of hypertension compared with whites did not substantially vary across weight or neighborhood education. Hypertension odds were almost double relative to whites for blacks and Native Hawaiians/other Pacific Islanders across most weight categories and all neighborhood education levels. Odds of hypertension were about 50% greater for Asians relative to whites across weight categories. Results suggest that other factors might be associated with racial/ethnic disparities in hypertension. More research is needed to understand the many factors that may contribute to variation in diagnosed hypertension across racial/ethnic groups with overweight or obesity.

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“…Research from the United States has shown that blacks are in much worse health than whites at each level of education (Brown et al 2016). Because black respondents constitute a substantial share of the U.S. sample, I estimated the models separately for blacks and whites in the United States.…”

Section: Additional Analysesmentioning

confidence: 99%

Education and Physical Health Trajectories in Later Life: A Comparative Study

Leopold

2018

Demography

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The cumulative (dis)advantage hypothesis states that health disparities between education groups increase with age. The present study examined this hypothesis in a comparative analysis of the United States, the United Kingdom, the Netherlands, and Sweden. These countries offer sharp contrasts in the social conditions that may intensify or inhibit processes of cumulative (dis)advantage. Using harmonized panel data from the HRS, ELSA, and SHARE, the study applied Poisson multilevel regression models to trace changes in the number of chronic conditions and functional limitations of people aged 50–76 (N = 16,887 individuals; 71,154 observations). The four countries showed a clear gradient in levels of physical health and in the extent to which health trajectories were shaped by education. Across all ages and cohorts, health problems were most prevalent in the United States, less prevalent in the United Kingdom and the Netherlands, and least prevalent in Sweden. A similar cross-national gradient was found for the size of health gaps between education groups and for the extent to which these gaps widened with age. Gaps were largest in the United States, smaller in the United Kingdom and in the Netherlands, and smallest in Sweden.Electronic supplementary materialThe online version of this article (10.1007/s13524-018-0674-7) contains supplementary material, which is available to authorized users.

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Using Multiple-hierarchy Stratification and Life Course Approaches to Understand Health Inequalities

Cited by 162 publications

References 78 publications

Racial and Socioeconomic Disparities in Disabling Chronic Pain: Findings From the Health and Retirement Study

Racial and Socioeconomic Disparities in Disabling Chronic Pain: Findings From the Health and Retirement Study

Associations of overweight/obesity and socioeconomic status with hypertension prevalence across racial and ethnic groups

Education and Physical Health Trajectories in Later Life: A Comparative Study

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