The August issue of the journal Health Affairs featured a study on the racial gap in health outcomes between elderly African-Americans and white Americans. The study, called “Active Life Expectancy In The Older US Population, 1982–2011: Differences Between Blacks And Whites Persisted,” revealed that elderly black people are more likely to live with disabilities than are older white people.
The lead author of the study, Vicki Freedman, is a research professor with the University of Michigan’s Institute for Social Research. She commented to the Chicago Tribune: “In 2011, at age 65, whites could expect to be free of disability for 15 out of their nearly 20 remaining years of life — about three-fourths of the time.” In contrast, “blacks could expect to live 12 out of 18 years — or about two-thirds of remaining years of life — without disability. The gap was a similar size in 1982.”
The study did not clarify why the difference exists or entirely explain why it persists. Elderly African-American women appear to be most at risk.
“The gaps persisted in part because of the lack of progress for older black women in gaining years of active life,” Freedman said. “Why this group has lost ground is not clear. A better understanding of the root causes occurring earlier in life, particularly those that disadvantage black women, is needed.”
The study included only participants who were 65 or older. They answered questions about how health problems and disabilities kept them from completing everyday activities like getting up, eating, bathing, dressing, using the toilet, and managing their finances without assistance.
For all participants in the study, lifespan rose between 1982 and 2011; lifespan was defined as the predicted number of years the people would live beyond age of 65. However, in that time period the years lived without disabilities was different for blacks and whites. From 1982 to 2011, blacks gained about 2.2 disability-free years of life, while whites gained almost three such years.
The more prominent gap between blacks and whites existed in terms of the difference in the number of years without disabilities and the number of years expected total. In 1982, whites could expect 74 percent of their remaining years to be lived disability-free, while blacks could expect 65 percent of their years to be disability-free.
In 2011, the results were very similar: 76 percent for whites and 67 percent for blacks. This correlates to the fact that about 22 percent of whites age 65 and over were disabled in 2011, while 32 percent of blacks in the same age group were disabled. Notably, these numbers did not explore levels of disability, so it is possible that these gaps are wider than reported.
The study used data from studies and surveys taken at three different times. The 1982 data included approximately 18,000 whites and more than 1,500 blacks. The 2004 data included information from approximately 14,000 whites and more than 1,000 blacks. The 2011 data included information from almost 6,000 whites and 2,000 blacks.
The Chicago Tribune also elicited comments from Dr. Marshall Chin of the University of Chicago, a professor of Healthcare Ethics, who had seen the results of the study: “These disparities reflect a lifetime of disadvantage,” Chin said. “Compared to whites, African-Americans have worse education, lower income and fewer social ties, all leading to worse health.
“African-Americans are more likely to lack health insurance, and even when they do receive care, it is more likely to be of inferior quality. Finally, for older people, the U.S. health system puts its money into treating diseases, rather than keeping people healthy and strong,” he added.
