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.

Agency
National Institute of Health (NIH)
Type
Research Program Projects (P01)
Project #
5P01AG005842-28
Application #
8726250
Study Section
Special Emphasis Panel (ZAG1)
Project Start
Project End
Budget Start
Budget End
Support Year
28
Fiscal Year
2014
Total Cost
Indirect Cost
Name
National Bureau of Economic Research
Department
Type
DUNS #
City
Cambridge
State
MA
Country
United States
Zip Code
02138
(2016) Understanding Changes in Healthy Life Spans. Natl Bur Econ Res Bull Aging Health :4
Beshears, John; Choi, James J; Laibson, David I et al. (2016) Vaccination Rates are Associated With Functional Proximity But Not Base Proximity of Vaccination Clinics. Med Care 54:578-83
Deaton, Angus (2016) On Death and Money: History, Facts, and Explanations. JAMA 315:1703-5
Bordone, Valeria; de Valk, Helga A G (2016) Intergenerational support among migrant families in Europe. Eur J Ageing 13:259-270
GBD 2015 DALYs and HALE Collaborators (2016) Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 388:1603-1658
Palladino, Raffaele; Tayu Lee, John; Ashworth, Mark et al. (2016) Associations between multimorbidity, healthcare utilisation and health status: evidence from 16 European countries. Age Ageing 45:431-5
Aitken, Murray; Berndt, Ernst R; Cutler, David et al. (2016) Has The Era Of Slow Growth For Prescription Drug Spending Ended? Health Aff (Millwood) 35:1595-603
Sowa, Agnieszka; Golinowska, Stanisława; Deeg, Dorly et al. (2016) Predictors of religious participation of older Europeans in good and poor health. Eur J Ageing 13:145-157
Okbay, Aysu; Baselmans, Bart M L; De Neve, Jan-Emmanuel et al. (2016) Genetic variants associated with subjective well-being, depressive symptoms, and neuroticism identified through genome-wide analyses. Nat Genet 48:624-33
Rappange, David R; Brouwer, Werner B F; van Exel, Job (2016) Rational expectations? An explorative study of subjective survival probabilities and lifestyle across Europe. Health Expect 19:121-37

Showing the most recent 10 out of 293 publications