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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