Inequality and Disability among Older Adults: Paths to Differential Trajectories

这个项目将研究人口、健康、社会经济、行为、心理、支持、结构、

This project will examine demographic, health, socioeconomic, behavioral, psychological, support, structural, and contextual factors predicting disability and mortality differentials for blacks and whites in addition to the unique causal pathways by gender among the most disadvantaged racial group (blacks) in the United States. This project extends the study of black/white disability differentials in later life in four ways: (1) mutiple types of advanced quantitative trajectory analyses will be used to examine differential trajectories and disentangle effects on the timing of disability versus accumulation over time and reestimate models using unique approaches to handle selective mortality; (2) theoretical contributions from epidemiologic, feminist, and other literatures will be drawn on to explore differentials across race and within race by gender; (3) the role of contextual variables in addition to individual-level factors in the causal pathways to disability and mortality for blacks and whites will be examined; (4) 20-year trends in black/ white active life expectancy will be examined using Bayesian methods for life table estimation that allow the direct inclusion of covarites and thus enable direct tests of hypotheses for independent effects. My training and work experiences have provided me a substantive and methodological knowledge base in demography of aging and sociological issues. A K99 would allow me to expand this base to include a greater understanding of multidisciplinary frameworks and approaches to health disparities by race and gender and to participate in formalized training in Bayesian statistics and multilevel modeling for the testing of contextual effects. The ROO phase would allow me the time needed, as young faculty, to complete my research plan under the guidance of my mentors and consultants, and submit an R01 proposal on racial disparities in disability and mortality over the life course. Although the health of older Americans has been improving on the whole, racial/ethinic health disparities continue to grow. Eliminating health disparities, including differentials in disability, is a major focus of Healthy People 2010 and extending active life is primary to the mission of the National Institute on Aging. Understanding the causal pathways leading to disability differentials would inform research and policy addressing these goals.