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Blacks, Non-Bilingual Hispanics At Higher Risk For Old-Age Disability

Armen Hareyan's picture

Although disability rates among the elderly are falling, African-Americans and Hispanics who are not fluent in English are nearly 50 percent more likely to become disabled after age 65, compared to whites and Hispanics who speak English, according to a new study.

The study, which appears in the December issue of the American Journal of Public Health, included interviews with more than 8,000 adults age 65 years or older who took part in the Health and Retirement Study. The University of Michigan conducted the study and the National Institute of Aging provided funding.

"Despite two decades where we've seen a declining trend in disability rates, we still see distressingly high rates of disability amongst older adults whose health insurance is largely covered by Medicare," said lead author Dorothy Dunlop, Ph.D., a research associate professor at Northwestern University. "Older African-Americans and Spanish-speaking Hispanics are at the greatest risk to develop disability."

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Study participants were disability-free when first interviewed -- but when contacted again six years later, nearly one-third of African-Americans (30.4 percent) and a similar proportion of Spanish-speaking Hispanics (32.7 percent) had developed a disability significant enough to prevent them from being able to perform activities of daily living without assistance. The disability rates for whites and Hispanics who researchers interviewed in English were virtually identical: 20.1 percent of whites and 20 percent of English-speaking Hispanics.

Ana Abraido-Lanza, Ph.D., an assistant professor of sociomedical sciences at Columbia University, said, "These findings contribute to the literature documenting the great gaps in health among people of different ethnic and socioeconomic characteristics in the United States." She was not involved with the study.

The results suggest that poverty is the main driver of these disparities: Where the study controlled for demographic factors and socioeconomic status, the risk of disability for Hispanics regardless of their English fluency was the same.

Lifestyle factors also have a large influence. "Weight and low levels of physical activity are strong predictors of disability even after accounting for other influential health and economic factors," Dunlop said. She continued, "Programs specific to language and cultural groups, to increase physical activity and prevent unhealthy weight gain or loss, may be effective strategies to reduce disability rates and reduce racial and ethnic disparities in disability."

Private health insurance was protective against disability -- suggesting that limited access to health care before becoming eligible for Medicare could play a role in the disparities.