Understanding Racial And Ethnic Differences In Health In Late Life: A Research Agenda - Softcover

Softcover

ISBN 10: 0309092477 ISBN 13: 9780309092470

Verlag: National Academies Press, 2004

Inhaltsangabe

Despite population trends, little research on the health of diverse groups has focused on the elderly. In this update of its 1997 report, Racial and Ethic Differences in the Health of Older Americans, a National Research Council panel explores factors affecting the health status of various groups. Members address methodological issues including the social construct of race. Based on some unexpected findings, they identify 18 research needs including longitudinal study of the health effects of stress and discrimination, and the use of alternative therapies by group. Annotation ©2004 Book News, Inc., Portland, OR (booknews.com)

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Rodolfo A. Bulatao and Norman B. Anderson, Editors, Panel on Race, Ethnicity, and Health in Later Life, National Research Council

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Understanding Racial and Ethnic Differences in Health in Late Life

A Research Agenda

National Academies Press

Copyright © 2004 National Academy of Sciences
All right reserved.
ISBN: 978-0-309-09247-0

Contents

EXECUTIVE SUMMARY....................................................11 THE NATURE OF RACIAL AND ETHNIC DIFFERENCES.......................7Racial and Ethnic Groups.............................................9Definitions..........................................................9Disparate Treatment..................................................11How Group Membership May Affect Health...............................13Differences in Mortality and Health in Late Life.....................14Mortality............................................................15Causes of Death......................................................18Health and Disability................................................20Diseases and Conditions..............................................21Needed Research......................................................25Why Health Differences Matter........................................282 PERSPECTIVES ON RACIAL AND ETHNIC DIFFERENCES.....................32Major Factors........................................................32Nature of the Evidence...............................................36Selection Processes..................................................39Selection Through Accession to Social Groups.........................39Selection Through Survival...........................................40Reciprocal Causation.................................................41Implications.........................................................42Needed Research......................................................443 GENETIC INFLUENCES................................................46Race in Genetic Perspective..........................................46The Nature of Genetic Influence......................................48Gene Interactions....................................................49Some Racial and Ethnic Differences...................................52Needed Research......................................................534 SOCIOECONOMIC FACTORS.............................................54The Health Gradient and Reciprocal Causation.........................54Status, Race, and Ethnicity..........................................56Mechanisms...........................................................58Needed Research......................................................595 BEHAVIOR RISK FACTORS.............................................61Behavioral Variation.................................................61Reasons for Variation................................................62Effects of Variation and Trends......................................64Other Behaviors......................................................66Needed Research......................................................676 SOCIAL AND PERSONAL RESOURCES.....................................70Social Resources.....................................................70Personal Resources...................................................73Racial and Ethnic Variation..........................................74Needed Research......................................................747 PREJUDICE AND DISCRIMINATION......................................76Correlational Studies................................................78Experimental and Physiological Studies...............................78Needed Research......................................................798 STRESS............................................................82Stress and Health....................................................82Race, Ethnicity, and Stress..........................................83Needed Research......................................................859 BIOPSYCHOSOCIAL INTERACTIONS......................................86Physiological Reactivity.............................................87Allostatic Load......................................................88Psychoneuroimmunology................................................88The Metabolic Syndrome and Psychosocial Factors......................89Neurovisceral Integration............................................89Needed Research......................................................9010 HEALTH CARE.......................................................92Insurance Coverage...................................................92Quality of Care......................................................95Geographic and Institutional Variation...............................98Stereotyping by Providers............................................99Patient Behavior.....................................................101Needed Research......................................................10211 THE LIFE COURSE...................................................104Early Health Disadvantage............................................105Pathways to Disadvantage.............................................106Needed Research......................................................10812 INTERVENTIONS.....................................................111Changing Individual Behavior.........................................111Health Promotion at Older Ages.......................................112Possible Effects on Differentials....................................113Needed Research......................................................114Social Policy........................................................115Effectiveness of Interventions.......................................115Targeted Interventions...............................................117Indirect Effects of Policy...........................................119Needed Research......................................................120REFERENCES...........................................................122APPENDIX.............................................................153BIOGRAPHICAL SKETCHES................................................156INDEX................................................................161

Chapter One

Executive Summary

An enormous amount of research has confirmed the existence of large and persistent differences in health status between various racial and ethnic groups in the United States. Most of this research has focused on black-white differences: it consistently shows that despite rising life expectancy and general improvements in the health status of the U.S. population, blacks continue to experience significantly lower life expectancy than whites.

Over the last 20 years, research on these issues has largely shifted away from straightforward descriptive studies to attempts to identify the underlying determinants of the observed differences in health status by race as a step towards developing an integrated model of causal processes. Many different disciplines have made broad theoretical and empirical contributions to the debate, but, to date, scholars have not been able to integrate these diverse contributions into a unifying model of causal processes. Interdisciplinary dialogue in this area has sometimes been difficult. A major problem is that each discipline makes contributions that focus on their particular domains of interest, uses different underlying assumptions, and applies different standards of evidence when analyzing data. Thus, it is perhaps not surprising that after decades of research in this area, there are still large and persistent differences in health by racial and ethnic groups that have not been fully...

Details zur Ausgabe

• Verlag: National Academies Press
• Erscheinungsdatum: 2004
• Sprache: Englisch
• ISBN 10: 0309092477
• ISBN 13: 9780309092470
• Einband: Taschenbuch
• Anzahl der Seiten: 169
• Herausgeber: Bulatao Rodolfo A., Anderson Norman B.
• Kontakt zum Hersteller: Nicht verfügbar
• Verantwortliche Person: Nicht verfügbar