Racial and Ethnic Differences in the Health of Older Americans (1997) / Chapter Skim
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1 Introduction
1 Introduction
Pages 1-9
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Moreover, this mortality advantage, if it exists, is not necessarily associated with lower rates of morbidity and disability. At the same time, we need to better understand the health situations of older Hispanics and Asian/Pacific Islanders, and the extent to which their immigration experiences and cultural heritages are positively or negatively related to their health outcomes.
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Increased education appears to lower the risks for some chronic diseasesmost notably, coronary heart disease and, perhaps most intriguingly, organic dementias while retarding the pace of disease progression for other conditions (Snowdon et al., 1996; Feinstein, 1993~. 1 The Office of Management and Budget has issued a proposed statistical directive allowing multiple racial and ethnic classification, to replace the system set up in 1979.
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The overarching goal of the committee's 1994 workshop, which was sponsored by the National Institute on Aging, was to make progress in understanding the extent to which racial and ethnic differences reflect differences in socioeconomic status, health-promoting behaviors, access to health care, genetics, and other factors. Ideally, we would have had papers that addressed all aspects of health both total and cause-specific mortality, morbidity, and disability for each of the major ethnic and racial groups in the United States, as well as providing systematic consideration of the potential causal factors mentioned above.
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. The volume begins with papers by Irma Elo and Samuel Preston and by Kenneth Manton and Eric Stallard that assess overall differences in mortality among racial and ethnic groups of older Americans and, in particular, investigate the often-observed crossover of mortality rates of blacks and whites in late life.
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examine the use of medical care of older blacks and whites, yet another possible factor underlying differences in health outcomes. Using data from the 1987 National Medical Expenditure Survey, they analyze racial differences in total medical care expenditures (irrespective of source of payment)
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Escarce and Puffer conclude that racial differences in the quantity of medical care received by elderly people in the United States have largely disappeared, but that the care that blacks receive may not fully reflect their differential health needs. Thus, older blacks may still be underserved by health care services.
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Various measures of retention of Japanese culture were also predictive of lower risk factors, but in multivariate models of coronary heart disease that included these risk factors, the cultural measures did not have significant effects. Nor were measures of psychosocial stresses statistically significant.
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Speculation has focused on protective cultural effects, as well as selective immigration, but the authors cite conflicting evidence of effects of immigrant status on broader indicators of health and reinforce the fact noted earlier that the Hispanic advantage in mortality is not accompanied by a Hispanic advantage in disability. As a group, these nine papers increase our sophistication in thinking about racial and ethnic differences among older Americans.
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Washington, DC: Bureau of the Census. Office of Federal Statistical Policy and Standards 1978 Federal Statistical Policy Directive No.
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