How Does the Trajectory of Multimorbidity Vary Across Black, White, and Mexican Americans in Middle and Old Age?
How Does the Trajectory of Multimorbidity Vary Across Black, White, and Mexican Americans in Middle and Old Age?
复制标题
DOI：
10.1093/geronb/gbr106
复制
发表时间：
2011-11-01
影响因子：
6.2
通讯作者：
Ye, Wen
中科院分区：
文献类型：
--
作者：
Quinones, Ana R.;Liang, Jersey;Ye, Wen
目标。这项研究调查了 51 岁及以上美国人报告的长达 11 年的多种慢性病的内部和人际差异。它重点关注白人、黑人和墨西哥裔美国人的多重发病率的变化。方法。数据来自健康与退休研究 (1995-2006) 的 17,517 名受访者，最多有 5 次重复观察。采用分层线性模型来分析报告的合并症时间变化的种族差异。结果。美国中老年人在基线时平均患有近 2 种慢性病，11 年来增加到近 3 种。美国白人在多种疾病的水平和变化率方面与黑人和墨西哥裔美国人不同。与白人相比，墨西哥裔美国人的合并症初始水平较低且积累较慢。相比之下，在整个 11 年的观察期间，黑人的多发病水平较高，尽管其变化速度相对于白人有所放缓。讨论。这些结果表明，即使调整了人口异质性，美国黑人与包括白人和墨西哥裔美国人在内的其他族裔群体之间的健康差异仍然存在于多发病的轨迹中。需要进一步研究中年之前可能发生的健康劣势和差异死亡率的影响，并探索出生的作用、自我报告疾病的性质以及种族老年人多病平均轨迹背后的异质性。
Objectives. This research examines intra- and interpersonal differences in multiple chronic conditions reported by Americans aged 51 and older for a period up to 11 years. It focuses on how changes in multimorbidity vary across White, Black, and Mexican Americans.Methods. Data came from 17,517 respondents of the Health and Retirement Study (1995-2006) with up to 5 repeated observations. Hierarchical linear models were employed to analyze ethnic variations in temporal changes of reported comorbidities.Findings. Middle-aged and older Americans have on average nearly 2 chronic diseases at the baseline, which increased to almost 3 conditions in 11 years. White Americans differ from Black and Mexican Americans in terms of level and rate of change of multimorbidity. Mexican Americans demonstrate lower initial levels and slower accumulation of comorbidities relative to Whites. In contrast, Blacks showed an elevated level of multimorbidity throughout the 11-year period of observation, although their rate of change slowed relative to Whites.Discussion. These results suggest that health differences between Black Americans and other ethnic groups including White and Mexican Americans persist in the trajectory of multimorbidity even when population heterogeneity is adjusted. Further research is needed concerning the impact of health disadvantages and differential mortality that may have occurred before middle age as well as exploring the role of nativity, the nature of self-reported diseases, and heterogeneity underlying the average trajectory of multimorbidity for ethnic elders.