Understanding Racial And Ethnic Differences In Health In Late Life: A Research Agenda

185 Pages·2004·0.51 MB·English

by  Rodolfo A. Bulatao

Panel on Race, Ethnicity, and Health in Later Life
Rodolfo A. Bulatao and Norman B. Anderson,
Editors
Committee on Population
Division of Behavioral and Social Sciences and Education
THE NATIONAL ACADEMIES PRESS • 500 Fifth Street, N.W. • Washington, D.C. 20001
NOTICE: The project that is the subject of this report was approved by the Governing Board
of the National Research Council, whose members are drawn from the councils of the Na-
tional Academy of Sciences, the National Academy of Engineering, and the Institute of Medi-
cine. The members of the committee responsible for the report were chosen for their special
competences and with regard for appropriate balance.
This study was supported by Contract No. N01-OD-4-2139, TO #71 between the National
Academies and the National Institute of Aging and by a grant from the Andrew W. Mellon
Foundation. Any opinions, findings, conclusions, or recommendations expressed in this pub-
lication are those of the authors and do not necessarily reflect the views of the organizations or
agencies that provided support for the project.
Library of Congress Cataloging-in-Publication Data
Understanding racial and ethnic differences in health in late life : a research agenda / Panel
on Race, Ethnicity, and Health in Later Life, Committee on Population, Division of Behav-
ioral and Social Sciences and Education ; Rodolfo A. Bulatao and Norman B. Anderson,
editors.
p. ; cm.
“This volume is the Panel’s final report. The workshop papers are available in a compan-
ion volume, Critical perspectives on racial and ethnic differences in health in late life”—
Pref.
Updates work from: Racial and ethnic differences in the health of older Americans. 1997.
Includes bibliographical references and index.
ISBN 0-309-09247-7 (pbk.)
1. Minorities—Health and hygiene—United States. 2. Ethnic groups—Health and hy-
giene—United States. 3. Older people—Health and hygiene—United States. 4. Health
services accessibility—United States. 5. Discrimination in medical care—United States. 6.
Health status indicators—United States. 7. Health and race—United States. 8. Social
medicine—United States.
[DNLM: 1. Continental Population Groups—United States. 2. Geriatric Assessment—
United States. 3. Ethnic Groups—United States. 4. Health Services Accessibility—Aged—
United States. 5. Socioeconomic Factors—Aged—United States. WT 30 U45 2004] I.
Bulatao, Rodolfo A., 1944- II. Anderson, Norman B. III. National Research Council (U.S.).
Panel on Race, Ethnicity, and Health in Later Life. IV. Racial and ethnic differences in the
health of older Americans.
RA448.4.U52 2004
362.1’089’00973—dc22
2004016831
Additional copies of this report are available from the National Academies Press, 500 Fifth
Street, N.W., Lockbox 285, Washington, D.C. 20055; [phone] or [phone] (in
the Washington metropolitan area); http://www.nap.edu.
Printed in the United States of America.
Copyright 2004 by the National Academies. All rights reserved.
Suggested citation: National Research Council. (2004). Understanding Racial and Ethnic
Differences in Health in Late Life: A Research Agenda. Panel on Race, Ethnicity, and Health
in Later Life. Roldolfo A. Bulatao and Norman B. Anderson, editors. Committee on Popula-
tion, Division of Behavioral and Social Sciences and Education. Washington, DC: The Na-
tional Academies Press.
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www.national-academies.org

PANEL ON RACE, ETHNICITY, AND HEALTH IN LATER LIFE
NORMAN B. ANDERSON (Chair), American Psychological Association,
Washington, DC
EILEEN M. CRIMMINS, Andrus Gerontology Center, University of
Southern California
ANGUS S. DEATON,* Woodrow Wilson School of Public and
International Affairs, Princeton University
DAVID V. ESPINO, Department of Family and Community Medicine,
University of Texas Health Science Center, San Antonio
JAMES S. HOUSE, Institute of Gerontology, University of Michigan
Ann Arbor
JAMES S. JACKSON, Department of Psychology, University of Michigan
Ann Arbor
CHRISTOPHER JENCKS, John F. Kennedy School of Government,
Harvard University
GERALD E. MCCLEARN, Center for Developmental and Health
Genetics, Pennsylvania State University
ALBERTO PALLONI, Department of Sociology, University of
Wisconsin–Madison
TERESA E. SEEMAN, School of Medicine, University of California,
LosAngeles
JAMES P. SMITH, RAND Corporation, Santa Monica, CA
EUGENIA Y.-H. WANG, School of Medicine, University of Louisville
DAVID R. WILLIAMS, Department of Sociology, University of Michigan
Ann Arbor
RODOLFO A. BULATAO, Study Director
BARNEY COHEN, Director, Committee on Population
BANGHWA LEE CASADO, Research Intern
CHRISTINE COVINGTON CHEN, Senior Program Assistant
ANTHONY S. MANN, Senior Program Assistant
*Until October 2002.
v
COMMITTEE ON POPULATION
KENNETH W. WACHTER (Chair), Department of Demography,
University of California, Berkeley
ELLEN BRENNAN-GALVIN, School of Forestry and Environmental
Studies, Yale University
JANET CURRIE, Department of Economics, University of California,
Los Angeles
JOHN N. HOBCRAFT, Department of Social Policy, London School of
Economics
CHARLES B. KEELY, Walsh School of Foreign Service, Georgetown
University
DAVID I. KERTZER, Department of Anthropology, Brown University
DAVID LAM, Population Studies Center, University of Michigan,
AnnArbor
CYNTHIA B. LLOYD, Population Council, New York
DOUGLAS S. MASSEY, Department of Sociology and Woodrow Wilson
School of Public and International Affairs, Princeton University
RUBEN G. RUMBAUT, Center for Research on Immigration, Population
and Public Policy and Department of Sociology, University of
California, Irvine
JAMES W. VAUPEL, Max Planck Institute for Demographic Research,
Rostock, Germany
LINDA J. WAITE, Department of Sociology, University of Chicago
ROBERT J. WILLIS, Institute for Social Research, University of
Michigan, Ann Arbor
BARNEY COHEN, Director
vi
Preface
The Panel on Race, Ethnicity, and Health in Later Life was established
in 2001 under the auspices of the Committee on Population of the Na-
tional Research Council (NRC). The panel’s task was to inform the
National Institute on Aging about recent research findings on racial and
ethnic disparities in later life and to help in developing a future research
agenda for reducing them. This project was a follow-up to a 1994 Com-
mittee on Population workshop, which resulted in a volume of papers
published by the National Academy Press, Racial and Ethnic Differences
in the Health of Older Americans.
The panel was asked, first to organize a 2-day workshop bringing
together leading researchers from a variety of disciplines and professional
orientations to summarize current research and to identify research
priorities. That workshop was held in March 2002 in Washington, DC.
The panel was also asked to produce a summary of the state of knowledge,
based on the workshop, and to provide recommendations for further work.
The initial plan called for the papers and the panel report to be published in
a single volume, but ultimately it was decided to publish the papers and the
panel report separately. This volume is the panel’s final report. The work-
shop papers are available in a companion volume, Critical Perspectives on
Racial and Ethnic Differences in Health in Late Life.
The panel benefited greatly from the workshop papers and thanks the
following individuals for their contribution to the workshop and the result-
ing volume: Gary D. Sandefur, Mary E. Campbell, Jennifer Eggerling-Boeck,
Robert A. Hummer, Maureen R. Benjamins, Richard G. Rogers, Jennifer J.
vii
viii PREFACE
Manly, Richard Mayeux, Clyde Hertzman, Alberto Palloni, Douglas
Ewbank, Guillermina Jasso, Douglas S. Massey, Mark E. Rosenzweig,
James P. Smith, Richard S. Cooper, Eileen M. Crimmins, Mark D.
Hayward, Teresa E. Seeman, Carlos Mendes de Leon, Thomas A. Glass,
Jeffrey D. Morenoff, John Lynch, Marilyn A. Winkleby, Catherine Cubbin,
Hector F. Myers, Wei-Chin Hwang, Rodney Clark, Julian F. Thayer, Bruce
H. Friedman, Amitabh Chandra, Jonathan S. Skinner, David M. Cutler,
James Y. Nazroo, Debbie Bradshaw, Rosana Norman, Ria Laubscher,
Michelle Schneider, Nolwazi Mbananga, and Krisela Steyn.
The panel met multiple times over the course of the project to plan and
hold the workshop and to digest and interpret the presentations. This report
reflects the intense deliberations of the full panel, based on the papers and
the members’ own expertise.
This report has been reviewed in draft form by individuals chosen for
their diverse perspectives and technical expertise, in accordance with proce-
dures approved by the NRC’s Report Review Committee. The purpose of
this independent review is to provide candid and critical comments that will
assist the institution in making its published report as sound as possible and
to ensure that the report meets institutional standards for objectivity, evi-
dence, and responsiveness to the study charge. The review comments and
draft manuscript remain confidential to protect the integrity of the delibera-
tive process. We thank the following individuals for their review of this
report: Stuart H. Altman, National Health Policy, Heller Graduate School,
Brandeis University; Lisa Berkman, School of Public Health, Harvard Uni-
versity; Janet Currie, Department of Economics, University of California,
Los Angeles; Mark D. Hayward, Social Science Research Institute, Pennsyl-
vania State University; Judith R. Lave, Health Policy and Management,
Graduate School of Public Health, University of Pittsburgh; Spero Manson,
American Indian and Alaska Native Programs, University of Colorado
Health Sciences Center, Aurora, CO; Kyriakos S. Markides, Division of
Sociomedical Sciences, Department of Preventive Medicine and Commu-
nity Health, University of Texas Medical Branch, Galveston, TX; Thomas
G. McGuire, Department of Health Care Policy, Harvard Medical School;
Gary D. Sandefur, Department of Sociology, Institute of Poverty, Univer-
sity of Wisconsin–Madison; and Kenneth W. Wachter, Department of De-
mography, University of California, Berkeley.
Although the reviewers listed above have provided many constructive
comments and suggestions, they were not asked to endorse the conclusions
or recommendations nor did they see the final draft of the report before its
release. The review of this report was overseen by Larry Bumpass, Center
for Demography and Ecology, University of Wisconsin–Madison, and
Harold C. Sox, Annals of Internal Medicine, American College of Physicians
of Internal Medicine, Philadelphia, PA. Appointed by the NRC, they were
PREFACE ix
responsible for making certain that an independent examination of this
report was carried out in accordance with institutional procedures and that
all review comments were carefully considered. Responsibility for the final
content of this report rests entirely with the authoring committee and the
institution.
The panel is grateful to the sponsors of the project, the National Insti-
tute of Aging and the Andrew W. Mellon Foundation. Besides providing
funding, the representatives of these organizations were a valuable source
of information and advice to the panel.
The panel was fortunate to have the services of the study director,
Randy Bulatao, who worked closely with panel members to draft and edit
the report. Barney Cohen, director of the Committee on Population, over-
saw the work and managed the final stages of the process. Special thanks
are due to Christine Covington Chen for her superb administrative and
logistic support, to Eugenia Grohman for skillfully editing the manuscript,
to Kirsten Sampson Snyder for navigating the report through review, and to
Anthony Mann and Yvonne Wise for preparing the final manuscript for
publication.
Norman B. Anderson, Chair
Panel on Race, Ethnicity, and Health in Later Life