Reuters, November 13, 2007: Socioeconomics key factor in disability disparities

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NEW YORK (Reuters Health) – Older African Americans are more likely to become disabled than whites, but most of this discrepancy is due to socioeconomic status and differences in health, a new study shows.

The researchers also found that while Hispanics who chose to be interviewed in Spanish had a greater risk of becoming disabled than whites, those interviewed in English had a risk equal to that of whites.

Culture-specific programs to boost physical activity and stabilize weight “may prove to be efficient strategies not only for reducing rates of disability in activities of daily living but also for lowering racial/ethnic disparities in disability,” Dr. Dorothy D. Dunlop of Northwestern University in Chicago and colleagues conclude.

Minorities represent the fastest-growing sector of the US elderly population, Dunlop and her team note in the American Journal of Public Health.

To compare disability among whites, blacks and Hispanics, the researchers looked at a nationally representative group of 8,161 men and women 65 years of age or older, none of whom were disabled at the study’s outset.

During the 6-year follow-up, the researchers found that blacks were 60 percent more likely to become disabled than whites were, while Hispanics interviewed in Spanish had an 80 percent greater risk of disability compared with whites. However, the disability risk for whites and Hispanics interviewed in English was not significantly different.

When the researchers accounted for the substantial differences in socioeconomic status among the groups, as well as health behaviors such as exercising regularly, the disability disparities almost disappeared.

Dunlop and her team found that health behaviors had more influence on health disparities than chronic illness did. Most importantly, exercise and maintaining a healthy weight protected individuals from becoming disabled regardless of racial or ethnic factors. However, these behaviors were less common among blacks and Hispanics interviewed in Spanish.

Having private health insurance supplemental to Medicare also protected people from disability, the researchers found, but minority individuals were less likely than whites to have this insurance. Based on this finding, they note: “The lack of private insurance in the years prior to Medicare eligibility is especially problematic given the lack of wealth, income resources, and public insurance available to minority populations prior to age 65.”

SOURCE: American Journal of Public Health, December 2007.

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