Diversity & Aging: Health Disparities by Gender, SES, and Ethnicity

May 4, 2010

Overview

Diversity in the aging population

Health disparities: Gender, SES, & Race/Ethnicity

Responding to diversity in the aging population

Figure 1.5 Population trends for minorities

Diversity of Older Adults in the U.S.

Diversity of the Aging Population

Gender

Socioeconomic status

Race/ethnicity: Diversity within ethnic groups

Each group has unique demographic structure

Gender Differences in Health

Which sex is healthier, men or women?

The answer is complicated

Gender Differences in Health

Compared to men, women:

Have higher life expectancy & lower death rates

Report poorer health, more disabilityReport more mental health problems

Health Disparities

Gender

Socioeconomic status

Race/ethnicity

Health Equity Quiz

How does the U.S. rank in terms of health equity?

What (if anything) surprised you?

Socioeconomic Status & Health

Effects on health related to accumulated advantage or disadvantage over time

Following influence SES:OccupationIncomePropertyEducation

SES & Health

Socioeconomic status does not CAUSE health

SES related to factors that influence health:

Access to & utilization of medical care & insuranceHealth behaviors (e.g., smoking, diet)Stressors & Social support

SES & Health

Poverty associated with the following:

poor nutritionsubstandard housingexposure to pollutants & violent behaviorlimited access to health care

SES & Health

Better-educated, wealthier:HealthierMore preventative health careBetter medical treatment

SES strongest determinant of whether health maintained w/increasing age

Protective Factors

Some w/low SES maintain good health

Protective factors:

Quality of social relationships Family support, religious involvement, & effective

coping skills

Health Disparities

Gender

Socioeconomic status

Race/ethnicity

Race and Ethnicity

SES differences btw racial groups largely responsible for racial disparities in health

BUT, racial health disparities persist even among those who share the same SES

Health disadvantage reflects more than racial disparities in SES

Racial/Ethnic Disparities

Research on African Americans suggests:

Lower life expectancy at all decades of life

More functional impairment from chronic disease

Less access to health care; medical technology

Racial/Ethnic Disparities

Research on Hispanic Americans suggests:

Use less formal services

Barriers (e.g., language barrier, lack of insurance)

Characterized by diversity:

Mexican Americans have health advantagePuerto Ricans have most jeopardized healthCubans have least jeopardized health

Racial/Ethnic Disparities Research on Asian Americans suggests:

Most advantaged ethnic minority group; highest SES of any minority group

Still, diversity between subgroups

Underserved by social service agencies

Expectation for family care

Racial/Ethnic Disparities

Research on Native Americans suggests:

Characterized by diversity

Lower life expectancy & disability (e.g., diabetes)

Informal support; less likely to use formal

Important role of older women

Racial/Ethnic Disparities

Disparities could be related to:

Genetics

Environment/Lifestyle

Access, utilization, & quality of health care

Effects of prejudice or discrimination

Multiple Jeopardy

Patterns of inequality reinforce one another

Multiple jeopardy:

Refers to a person in 2 or more disadvantaged groups

Related to cumulative disadvantage

Responses to Minority Group Aging

Different groups have different health & social service needs

Diversity exists within ethnic groups

May mix traditional medicine with modern treatments

Disparities in health outcomes btw genders, SES groups, and races/ethnicities

Related to access to resources (e.g., neighborhood) & knowledge (e.g., health behaviors)

Multiple jeopardy: Intersection btw gender, race, & SES

Reducing health disparities has implications for population health

Summary