IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v62y2006i4p909-922.html
   My bibliography  Save this article

Explaining US racial/ethnic disparities in health declines and mortality in late middle age: The roles of socioeconomic status, health behaviors, and health insurance

Author

Listed:
  • Sudano, Joseph J.
  • Baker, David W.

Abstract

Pervasive health disparities continue to exist among racial/ethnic minority groups, but the factors related to these disparities have not been fully elucidated. We undertook this prospective cohort study to determine the independent contributions of socioeconomic status (SES), health behaviors, and health insurance in explaining racial/ethnic disparities in mortality and health declines. Our study period was 1992-1998, and our study population consists of a US nationally representative sample of 6286 non-Hispanic whites (W), 1391 non-Hispanic blacks (B), 405 Hispanics interviewed in English (H/E), and 318 Hispanics interviewed in Spanish (H/S), ages 51-61 in 1992 in the Health and Retirement Study. The main outcome measures were death; major decline in self-reported overall health (SROH); and combined outcome of death or major decline in SROH. Crude mortality rates over the 6-year study period for W, B, H/E and H/S were 5.8%, 10.6%, 5.8%, and 4.4%, respectively. Rates of major decline in SROH were 14.6%, 23.2%, 22.1% and 39.4%, for W, B, H/E and H/S, respectively. Higher mortality rates for B versus W were mostly explained by worse baseline health. For major decline in SROH, education, income, and net worth independently explained more of the disparities for all three minority groups as compared to health behaviors and insurance, reducing the effect for B and H/E to non-significance, while leaving a significant elevated odds ratio for H/S. Without addressing the as-yet undetermined and pernicious effects of lower SES, public health initiatives that promote changing individual health behaviors and increasing rates of insurance coverage among blacks and Hispanics will not eliminate racial/ethnic health disparities.

Suggested Citation

  • Sudano, Joseph J. & Baker, David W., 2006. "Explaining US racial/ethnic disparities in health declines and mortality in late middle age: The roles of socioeconomic status, health behaviors, and health insurance," Social Science & Medicine, Elsevier, vol. 62(4), pages 909-922, February.
    • Handle: RePEc:eee:socmed:v:62:y:2006:i:4:p:909-922
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(05)00348-5
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Lynch, J. W. & Kaplan, G. A. & Salonen, J. T., 1997. "Why do poor people behave poorly? Variation in adult health behaviours and psychosocial characteristics by stages of the socioeconomic lifecourse," Social Science & Medicine, Elsevier, vol. 44(6), pages 809-819, March.
    2. House, J.S. & Lepkowski, J.M. & Williams, D.R. & Mero, R.P. & Lantz, P.M. & Robert, S.A. & Chen, J., 2000. "Excess mortality among urban residents: How much, for whom, and why?," American Journal of Public Health, American Public Health Association, vol. 90(12), pages 1898-1904.
    3. Duncan, G.J. & Daly, M.C. & McDonough, P. & Williams, D.R., 2002. "Optimal indicators of socioeconomic status for health research," American Journal of Public Health, American Public Health Association, vol. 92(7), pages 1151-1157.
    4. Abraído-Lanza, A.F. & Dohrenwend, B.P. & Ng-Mak, D.S. & Turner, J.B., 1999. "The Latino mortality paradox: A test of the 'salmon bias' and healthy migrant hypotheses," American Journal of Public Health, American Public Health Association, vol. 89(10), pages 1543-1548.
    5. Black, S.A. & Ray, L.A. & Markides, K.S., 1999. "The prevalence and health burden of self-reported diabetes in older Mexican Americans: Findings from the Hispanic Established Populations for Epidemiologic Studies of the Elderly," American Journal of Public Health, American Public Health Association, vol. 89(4), pages 546-552.
    6. Blackwell, Debra L. & Hayward, Mark D. & Crimmins, Eileen M., 2001. "Does childhood health affect chronic morbidity in later life?," Social Science & Medicine, Elsevier, vol. 52(8), pages 1269-1284, April.
    7. Nazroo, J.Y., 2003. "The structuring of ethnic inequalities in health: Economic position, racial discrimination, and racism," American Journal of Public Health, American Public Health Association, vol. 93(2), pages 277-284.
    8. Arcia, E. & Skinner, M. & Bailey, D. & Correa, V., 2001. "Models of acculturation and health behaviors among Latino immigrants to the US," Social Science & Medicine, Elsevier, vol. 53(1), pages 41-53, July.
    9. Subramanian, S.V. & Acevedo-Garcia, Dolores & Osypuk, Theresa L., 2005. "Racial residential segregation and geographic heterogeneity in black/white disparity in poor self-rated health in the US: a multilevel statistical analysis," Social Science & Medicine, Elsevier, vol. 60(8), pages 1667-1679, April.
    10. Williams, D.R., 2003. "The Health of Men: Structured Inequalities and Opportunities," American Journal of Public Health, American Public Health Association, vol. 93(5), pages 724-731.
    11. Catherine Ross & John Mirowsky, 1999. "Refining the association between education and health: The effects of quantity, credential, and selectivity," Demography, Springer;Population Association of America (PAA), vol. 36(4), pages 445-460, November.
    12. Schulz, A. & Israel, B. & Williams, D. & Parker, E. & Becker, A. & James, S., 2000. "Social inequalities, stressors and self reported health status among African American and white women in the Detroit metropolitan area," Social Science & Medicine, Elsevier, vol. 51(11), pages 1639-1653, December.
    13. Lantz, Paula M. & Lynch, John W. & House, James S. & Lepkowski, James M. & Mero, Richard P. & Musick, Marc A. & Williams, David R., 2001. "Socioeconomic disparities in health change in a longitudinal study of US adults: the role of health-risk behaviors," Social Science & Medicine, Elsevier, vol. 53(1), pages 29-40, July.
    14. Duncan, G.J. & Daly, M.C. & McDonogh, P. & Williams, D.R., 2002. "Erratum: Optimal indicators of socioeconomic status for health research (American Journal of Public Health (2002) 92 (1151-1157))," American Journal of Public Health, American Public Health Association, vol. 92(8), pages 1212-1212.
    15. Bassett, M.T. & Krieger, N., 1986. "Social class and Black-White differences in breast cancer survival," American Journal of Public Health, American Public Health Association, vol. 76(12), pages 1400-1403.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Jacobson, Jerry Owen & Robinson, Paul & Bluthenthal, Ricky N., 2007. "A multilevel decomposition approach to estimate the role of program location and neighborhood disadvantage in racial disparities in alcohol treatment completion," Social Science & Medicine, Elsevier, vol. 64(2), pages 462-476, January.
    2. Zeng, Di & You, Wen & Mills, Bradford & Alwang, Jeffrey & Royster, Michael & Anson-Dwamena, Rexford, 2015. "A closer look at the rural-urban health disparities: Insights from four major diseases in the Commonwealth of Virginia," Social Science & Medicine, Elsevier, vol. 140(C), pages 62-68.
    3. Shireen Assaf & Stefano Campostrini & Cinzia Di Novi & Fang Xu & Carol Gotway Crawford, 2014. "Analyzing Disparities Trends for Health Care Insurance Coverage Among Non-Elderly Adults in the US: Evidence from the Behavioral Risk Factor Surveillance System, 1993-2009," Working Papers 2014: 14, Department of Economics, University of Venice "Ca' Foscari".
    4. Megha Swami & Hugh Gravelle & Anthony Scott & Jenny Williams, 2018. "Hours worked by general practitioners and waiting times for primary care," Health Economics, John Wiley & Sons, Ltd., vol. 27(10), pages 1513-1532, October.
    5. Kathrin Roll & Tom Stargardt & Jonas Schreyögg, 2012. "Effect of Type of Insurance and Income on Waiting Time for Outpatient Care," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 37(4), pages 609-632, October.
    6. Bjornstrom, Eileen E.S. & Kuhl, Danielle C., 2014. "A different look at the epidemiological paradox: Self-rated health, perceived social cohesion, and neighborhood immigrant context," Social Science & Medicine, Elsevier, vol. 120(C), pages 118-125.
    7. Irma Elo & Hiram Beltrán-Sánchez & James Macinko, 2014. "The Contribution of Health Care and Other Interventions to Black–White Disparities in Life Expectancy, 1980–2007," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 33(1), pages 97-126, February.
    8. Krueger, Patrick M. & Saint Onge, Jarron M. & Chang, Virginia W., 2011. "Race/ethnic differences in adult mortality: The role of perceived stress and health behaviors," Social Science & Medicine, Elsevier, vol. 73(9), pages 1312-1322.
    9. Shireen Assaf & Stefano Campostrini & Cinzia Di Novi & Fang Xu & Carol Gotway Crawford, 2017. "Analyzing disparity trends for health care insurance coverage among non-elderly adults in the US: evidence from the Behavioral Risk Factor Surveillance System, 1993–2009," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(3), pages 387-398, April.
    10. Joshua C. Hall & Brad R. Humphreys & Jane E. Ruseski, 2015. "Economic Freedom, Race, and Health Disparities: Evidence from US States," Working Papers 15-43, Department of Economics, West Virginia University.
    11. Hankyung Jun & Emma Aguila, 2021. "Private Insurance and Mental Health among Older Adults with Multiple Chronic Conditions: A Longitudinal Analysis by Race and Ethnicity," IJERPH, MDPI, vol. 18(5), pages 1-15, March.
    12. Kim, Seijeoung & Dolecek, Therese A. & Davis, Faith G., 2010. "Racial differences in stage at diagnosis and survival from epithelial ovarian cancer: A fundamental cause of disease approach," Social Science & Medicine, Elsevier, vol. 71(2), pages 274-281, July.
    13. Zachary Zimmer & Heidi A. Hanson & Ken R. Smith, 2016. "Offspring Socioeconomic Status and Parent Mortality Within a Historical Population," Demography, Springer;Population Association of America (PAA), vol. 53(5), pages 1583-1603, October.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. van Hooijdonk, Carolien & Droomers, Mariël & van Loon, Jeanne A.M. & van der Lucht, Fons & Kunst, Anton E., 2007. "Exceptions to the rule: Healthy deprived areas and unhealthy wealthy areas," Social Science & Medicine, Elsevier, vol. 64(6), pages 1326-1342, March.
    2. Prus, Steven G., 2011. "Comparing social determinants of self-rated health across the United States and Canada," Social Science & Medicine, Elsevier, vol. 73(1), pages 50-59, July.
    3. Steven Prus, 2007. "Age, SES, and Health: A Population Level Analysis of Health Inequalities over the Life Course," Social and Economic Dimensions of an Aging Population Research Papers 181, McMaster University.
    4. Kim, Jae-Hyun & Lee, Sang Gyu & Shin, Jaeyong & Park, Eun-Cheol, 2014. "Impact of the gap between socioeconomic stratum and subjective social class on depressive symptoms: Unique insights from a longitudinal analysis," Social Science & Medicine, Elsevier, vol. 120(C), pages 49-56.
    5. Joseph Wolfe, 2015. "The Effects of Socioeconomic Status on Child and Adolescent Physical Health: An Organization and Systematic Comparison of Measures," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 123(1), pages 39-58, August.
    6. Jaffe, Dena H. & Eisenbach, Zvi & Neumark, Yehuda D. & Manor, Orly, 2006. "Effects of husbands' and wives' education on each other's mortality," Social Science & Medicine, Elsevier, vol. 62(8), pages 2014-2023, April.
    7. Vanessa Tan & Cynthia Chen & Reshma Aziz Merchant, 2022. "Association of social determinants of health with frailty, cognitive impairment, and self-rated health among older adults," PLOS ONE, Public Library of Science, vol. 17(11), pages 1-18, November.
    8. McNeill, Lorna Haughton & Kreuter, Matthew W. & Subramanian, S.V., 2006. "Social Environment and Physical activity: A review of concepts and evidence," Social Science & Medicine, Elsevier, vol. 63(4), pages 1011-1022, August.
    9. Theodossiou, I. & Zangelidis, A., 2009. "The social gradient in health: The effect of absolute income and subjective social status assessment on the individual's health in Europe," Economics & Human Biology, Elsevier, vol. 7(2), pages 229-237, July.
    10. Terje A Eikemo & Rasmus Hoffmann & Margarete C Kulik & Ivana Kulhánová & Marlen Toch-Marquardt & Gwenn Menvielle & Caspar Looman & Domantas Jasilionis & Pekka Martikainen & Olle Lundberg & Johan P Mac, 2014. "How Can Inequalities in Mortality Be Reduced? A Quantitative Analysis of 6 Risk Factors in 21 European Populations," PLOS ONE, Public Library of Science, vol. 9(11), pages 1-1, November.
    11. Kino, Shiho & Jang, Soong-nang & Takahashi, Shuko & Ebner, Daniel K. & Kawachi, Ichiro, 2020. "Socioeconomic disparities in self-rated health in two East Asian countries: Comparative study between Japan and Korea," Social Science & Medicine, Elsevier, vol. 253(C).
    12. Mathieu Ichou & Matthew Wallace, 2019. "The Healthy Immigrant Effect: The role of educational selectivity in the good health of migrants," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 40(4), pages 61-94.
    13. Klara Gurzo & Bitte Modin & Pekka Martikainen & Olof Östergren, 2022. "Pathways from Childhood Economic Conditions to Adult Mortality in a 1953 Stockholm Cohort: The Intermediate Role of Personal Attributes and Socioeconomic Career," IJERPH, MDPI, vol. 19(12), pages 1-15, June.
    14. Alaina N. English & Jennifer A. Bellingtier & Shevaun D. Neupert, 2019. "It’s “the Joneses”: the influence of objective and subjective socioeconomic status on subjective perceptions of aging," European Journal of Ageing, Springer, vol. 16(1), pages 121-128, March.
    15. Wolfe, Joseph D. & Thomeer, Mieke Beth & Reczek, Rin, 2023. "Age at first birth and women's midlife health: Cohort and race differences across the 20th century," Social Science & Medicine, Elsevier, vol. 331(C).
    16. Garbarski, Dana, 2010. "Perceived social position and health: Is there a reciprocal relationship?," Social Science & Medicine, Elsevier, vol. 70(5), pages 692-699, March.
    17. Cunningham, Colleen M. & Hanley, Gillian E. & Morgan, Steve, 2010. "Patterns in the use of benzodiazepines in British Columbia: Examining the impact of increasing research and guideline cautions against long-term use," Health Policy, Elsevier, vol. 97(2-3), pages 122-129, October.
    18. Samir KC & Harold Lentzner, 2010. "The effect of education on adult mortality and disability: a global perspective," Vienna Yearbook of Population Research, Vienna Institute of Demography (VID) of the Austrian Academy of Sciences in Vienna, vol. 8(1), pages 201-235.
    19. Cleon Tsimbos, 2010. "An assessment of socio-economic inequalities in health among elderly in Greece, Italy and Spain," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 55(1), pages 5-15, February.
    20. Smith, Kimberly V. & Goldman, Noreen, 2007. "Socioeconomic differences in health among older adults in Mexico," Social Science & Medicine, Elsevier, vol. 65(7), pages 1372-1385, October.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:62:y:2006:i:4:p:909-922. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.