Cumulative Inequality at the End of Life?: Racial Disparities in Impairment in the Time Before Death.
Cumulative Inequality at the End of Life?: Racial Disparities in Impairment in the Time Before Death.
复制标题
生命终结时的累积不平等？：死亡前时间损伤的种族差异。
DOI：
10.1093/geronb/gby129
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Reid,KeshiaM
中科院分区：
文献类型：
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作者：
Taylor,MilesG;Min,StellaN;Reid,KeshiaM
目的 借鉴累积不平等（CI）理论，当前的研究检查了个体接近死亡时损伤的种族差异，以确定所提出的假设的促进或减少晚年种族差异的机制是否在个体化寿命结束时发挥作用。方法根据北卡罗来纳州老年人流行病学研究人口（EPESE）的数据，使用潜在增长曲线分析死者之间的黑人与白人差异（N = 1,926）。结果与之前的文献一致，功能差异中的种族不平等在晚年逐渐减少。然而，随着老年人临近死亡，显着的黑人与白人之间的差异出现，并且在死亡前的两年内呈指数级增长。此外，这些差异并不完全由社会经济地位调节。讨论结果证实，健康结果中的 CI 在个体寿命的晚年是可以观察到的，这表明死亡前后的几年可能是健康不平等特别脆弱的时期。未来的研究应该研究优势地位如何转化为更多获得健康相关资源的机会，从而有助于在生命的最后阶段保持更大的功能独立性。
ObjectivesDrawing from cumulative inequality (CI) theory, the current study examined racial disparities in impairment as individuals approached death to determine whether proposed mechanisms hypothesized to fuel or diminish racial disparities at late ages were at work at the end of individualized life spans.MethodBlack–white disparities were analyzed among decedents using latent growth curves based on the data from the North Carolina Established Populations for Epidemiologic Studies of the Elderly (EPESE) (N= 1,926).ResultsConsistent with previous literature, racial inequalities in functional disparities diminish at late ages. However, significant black–white disparities emerge as older adults approach death, exponentially increasing within the 2 years immediately preceding death. Further, these disparities are not fully mediated by socioeconomic status.DiscussionThe results confirm that CI in health outcomes is observable in late life among individual life spans, suggesting the years surrounding death may be a particularly vulnerable period for health inequality. Future research should examine how advantaged statuses translate to increased access to health-related resources that aid in maintaining greater functional independence until the last stage of life.