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5 How Health Behaviors and the Social Environment Contribute to Health Differences Between Black and White Older Americans
Pages 163-182

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From page 163...
... For instance, during the last 30 years, life expectancy at age 65 increased 2.4 years for white males and only 1.5 years for black males. The corresponding increases for women are 3.1 years for white women and 2.5 years for black women (U.S.
From page 164...
... . In that section, we examine both traditional health behaviors and cardiovascular risk factors as well as social conditions related to social networks and socioeconomic status.
From page 165...
... social networks and support. We selected these risk factors because of the recognition that their effects on many chronic diseases, especially cardiovascular and cerebrovascular disease, are interrelated.
From page 166...
... Whites were more likely to maintain their desired body weight, but there were no significant racial differences in smoking, exercising, alcohol intake, or maintenance of social networks. Thus, these studies would suggest, albeit not conclusively, that blacks, especially older blacks, are concerned about chronic disease, appraise their health status as worse than whites, and place an equal or higher value on health-protective behaviors.
From page 167...
... Comparisons of activity levels in elderly racial groups have more often included examination of the effects of socioeconomic status than have studies of dietary patterns (Folsom et al., 1990; Sheridan et al., 1993; Kaplan et al., 1987~. Numerous studies have shown that blacks exercise less than whites and engage is less leisure time physical activity (Burke et al., 1992; Washburn et al., 1992; Heath and Smith, 1994~: 19 percent of black versus 29.9 percent of white women over age 65 exercise or play sports regularly.
From page 168...
... , which show that in 1987, 30 percent of elderly black men were smokers, compared with 16 percent of white men. Whereas 13.9 percent of older white women in that survey smoked, only 11.7 percent of black women did.
From page 169...
... II, showed that racial differences in the risk for non-insulin-dependent diabetes could not be explained by differences in social status but were strongly correlated with obesity. In a descriptive study of the health behaviors of a small sample of elderly black diabetics in San Francisco, Reid (1992)
From page 170...
... Black respondents were less likely than whites to know their own blood pressure or cholesterol level or to accurately indicate what the desirable levels of these risk factors were. These racial differences persisted after adjustment for educational attainment.
From page 171...
... Among men, 38 percent of blacks and 32 percent of whites score in the top two categories of isolation, and 46 percent of black women compared with 44 percent of white women score in the same range. Of more interest are variations within subcategories of the index.
From page 172...
... In one of the most thorough and insightful reviews of social networks and support among older black Americans, Taylor (1988) provides both a theoretical overview of a model of family support relationships and a review of non-kin sources of support.
From page 173...
... The overall response rate was 82 percent. Table 5-1 shows the distribution of a broad range of risk factors, including both standard risk factors such as smoking, alcohol consumption, and prevalence of chronic diseases (e.g., diabetes and hypertension)
From page 174...
... Among black women, only 21 percent report any alcohol consumption compared with 49 percent of white women and 50 percent and 67 percent of black and white men, respectively. This lower prevalence of alcohol consumption and, to a lesser extent, cigarette consumption among black Americans, especially women, in part reflects the strong cultural value placed on abstinence in that older generation.
From page 175...
... In the New Haven EPESE study, the prevalence of diabetes and hypertension among black and white men is similar, but black women have a higher prevalence than all other groups. The prevalence of self-reports of physician-diagnosed hypertension is 68 percent among black women compared with 47 percent among white women (p 2 .001~.
From page 176...
... The availability of social networks and social support patterns are consistent with earlier bivariate analyses. While there are no significant differences in the level of social ties when we look at the summary measure, there are differences in the specific domains even after adjustment for age and educational level.
From page 177...
... for High-Risk Health and Social Behaviors for Black and White Older Men and Women (Results of Weighted Multiple Logistic Regressions, New Haven EPESE Baseline, 1982, Data) 177 Black Versus White Men Black Versus White Women High-Risk Characteristic OR 95% CI OR 95% CI Cigarette smoking Age adjusted 0.72 0.42,1.25 0.58 0.39,0.88 Age and education adjusted 0.62 0.35,1.09 0.71 0.45,1.11 Alcohol consumption Age adjusted 0.48 0.38,0.61 0.27 0.18,0.40 Age and education adjusted 0.53 0.41,0.70 0.32 0.22,0.47 Hypertensive Age adjusted 1.02 0.75,1.40 2.34 1.52,3.60 Age and education adjusted 1.08 0.79,1.48 2.18 1.39,3.42 Diabetic Age adjusted 1.30 0.83,2.04 1.70 0.91,3.18 Age and education adjusted 1.08 0.69,1.70 1.57 0.82,3.00 Body mass index 2 28% Age adjusted 0.85 0.55,1.31 2.22 1.60,311 Age and education adjusted 0.68 0.42,1.08 1.80 1.27,2.57 Social ties of 0-1 (0-4 scale)
From page 178...
... Overall, we find inconsistent patterns, with blacks' having a higher prevalence of some behaviors and chronic conditions and a lower prevalence of other conditions. With regard to social networks and support, while there are differences in the degree to which older black Americans maintain some type of ties when compared with whites, there are no overall differences in summary measures of social ties or social support.
From page 179...
... In addition, differences in the extent to which blacks and whites maintain close and effective social ties are minimal. Other conditions more closely linked to social class and environmental exposures, as well as stressful experiences related to discnm~nation, are worthy of serious investigation.
From page 180...
... Jacobs 1990 Differences in leisure time physical activity levels between blacks and whites in population-based samples: The Minnesota Heart Survey. Journal of Behavioral Medicine 14(1)
From page 181...
... Guralnik 181 1987 Mortality among the elderly in the Alameda County Study: Behavioral and demographic risk factors. American Journal of Public Health 77(3)
From page 182...
... Keil 1994 Attitudes toward body size and dieting: Differences between elderly black and white women. American Journal of Public Health 84(8)


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