Race/ethnic and nativity differentials in mid-life and late-life functioning in the United States
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As the population structure of the United States continues to grow older and more diverse by race/ethnicity and nativity, the importance of understanding health differences in mid- and late-life becomes crucial for our society. Disability and functioning are strong and consistent predictors of independence and quality of life. In addition, because health is strongly associated with socioeconomic and social environmental factors, it is important to examine the extent to which the social environment at least partially explains race/ethnic and nativity differences in physical functioning and disability. Chapter 2 of this dissertation examines three measures of disability and functioning across 13 broad race/ethnic and nativity groups for adults aged 50 and above. I find that middle-aged foreign-born individuals in nearly every subgroup exhibit lower proportions of functional limitations and disability than U.S.-born whites. This pattern of immigrant advantage is generally reversed in later life and becomes a disadvantage. Moreover, most U.S.-born minority groups had significantly higher levels of disability and functional limitations than U.S.-born whites in both mid- and late life. This broad examination takes into account the demographic heterogeneity of the U.S. population and is especially timely given the rapid population aging that U.S. minority and immigration subpopulations are experiencing. In chapters 3 and 4 I use the National Health and Aging Trends Survey (NHATS) and examined race/ethnic and nativity differences in two new measures of disability: self -care and household activity limitation. I introduced a new conceptual framework of disability pathways, drew from an intersectionality approach and examined how socioeconomic status, social environmental factors, chronic health conditions, and physical capacity/functioning attenuate race/ethnic and nativity differences. My findings indicate that these key social environmental factors generally attenuate disparities, with the exception of foreign-born Hispanics. This sub-group continued to experience high rates of household and self-care limitations during their relatively long lives even net of these social environmental controls. I examine possible explanations for such striking health disadvantages. More research is needed to examine why this group has such high odds of debilitating disability, especially as they begin to enter later life in significantly large numbers.