Racial disparities in disability among older adults: finding from the exploring health disparities in integrated communities study
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Roland J Thorpe1, Rachael McCleary2, Jenny R Smolen2
1Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA Center on Biobehavorial Health Disparities Research, Duke University, Durham, NC, USA rthorpe@jhu.edu.
Objective:
Persistent and consistently observed racial disparities in physical functioning likely stem from racial differences in social resources and environmental conditions.
Method:
We examined the association between race and reported difficulty performing instrumental activities of daily living (IADL) in 347 African American (45.5%) and Whites aged 50 or above in the Exploring Health Disparities in Integrated Communities-Southwest Baltimore, Maryland Study (EHDIC-SWB).
Results:
Contrary to previous studies, African Americans had lower rates of disability (women: 25.6% vs. 44.6%, p = .006; men: 15.7% vs. 32.9%; p = .017) than Whites. After adjusting for sociodemographics, health behaviors, and comorbidities, African American women (odds ratio [OR] = 0.32, 95% confidence interval [CI] = [0.14, 0.70]) and African American men (OR = 0.34, 95% CI = [0.13, 0.90]) retained their functional advantage compared with White women and men, respectively.
Conclusion:
These findings within an integrated, low-income urban sample support efforts to ameliorate health disparities by focusing on the social context in which people live.
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