Social disparities in physical functioning by race, ethnicity, and immigration status

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Project Summary / Abstract Although foreign-born Latinos have significantly higher life expectancy than non-Latino whites in the U.S., they are more likely to spend those additional years of life with a disability. Socioeconomic variations among race and ethnic groups cannot alone account for race/ethnic differences in disability. Previous research on the causes of these inequalities has primarily focused on explanations such as differential access to health care, early life conditions, environmental exposures, personal health behaviors, and stress. We investigate another potential mechanism: race and ethnic differences in work – i.e., the cumulative effects of physical and psychosocial conditions experienced as work throughout life. The US occupational structure is highly stratified by race/ethnicity and gender and extensive research on occupational health has demonstrated a strong relationship between physical and psychosocial work conditions and health outcomes. Our goal is to determine whether racial and ethnic differences in work conditions over the life course can account, in part, for significantly higher limitations in physical functioning among middle aged and older Latinos compared to whites. We use data from the Health and Retirement Study (HRS) and match employment histories from this survey with data on work conditions by occupational code for respondents' jobs from the Occupational Information Network (O*NET). The analysis is based on growth curve and hazard models of limitations in physical functioning and mortality as a function of histories of work conditions and other variables. Reduced physical functioning can significantly diminish quality of life at older ages and greatly increase health care expenditures. Functional limitations are more common among social groups, including Latinos and particularly Latino immigrants, who have the fewest resources to cope with these limitations. The results of this study will significantly advance our knowledge of the role occupational segregation and work conditions in leading to higher rates of functional limitations among the Latino population.