8. IMPROVING HEALTH AND HEALTH CARE FOR MINORITY AND AGING POPULATIONS Explanations for racial disparities in healthcare and health range from differential treatment by the medical care system, differences in where minorities seek care, and racial differences in health behaviors such as compliance, diet and exercise. These differences contribute to disparities in obesity, chronic disease, and ultimately, disability and death. An improved understanding of the relative influence of these causes is essential for the design of policies that improve the health of elderly minority Americans. In this subproject, we apply new methods to analyze these and other explanations of racial disparities and their implications for policy changes that might close racial gaps in health. We first analyze how black-white differences in mortality and in severe disability among the elderly population have evolved over the past twenty years. To the extent that disparities have declined, we will explore the extent to which convergence in disability and mortality is caused by whites catching up to blacks in the prevalence of obesity, as opposed to outcomes for blacks improving over time. We will also measure the extent to which trends in chronic disease prevalence are responsible for the evolution of racial disparities. We then focus on disparities in healthcare. In particular, we will explore racial differences in the receipt of intensive healthcare services, how they vary across providers and over time, and whether they are a consequence of taste-based prejudice, differences in triage rules, or statistical discrimination (minoritiesreceiving lower benefit from treatment on average).

Public Health Relevance

Understanding the reasons for racial disparities in healthcare and health can inform the design of policies that improve health. This subproject explores trends in racial disparities, and some potential explanation for why racial disparities exist.

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