As life expectancy increases, questions arise about the quality of the additional years of life. Data consistently shows a Hispanic mortality advantage, especially among older adults. However, despite comparatively longer life expectancy, Hispanic elders are also at high risk of disease and disability. Therefore, the first goal of the proposed research is to analyze two NIH-funded datasets to identify changes in healthy life expectancy among very old Mexican-Americans as compared to otherwise similar non- Hispanic whites. Increases in proportion of life spent without disability would be evidence of compression of morbidity, whereas decreases in proportion of life spent without disability would be evidence of expansion of morbidity. Studies show that morbidity and disability trajectories (and hence healthy life expectancy) differs significantly across sub-populations (e.g. immigrants) and are also influenced by the neighborhood context. Therefore, the second aim of this study is to do sub-group analyses. This includes analyses by specific diseases, by demographic and SES groups, and by neighborhood variables. These goals will be accomplished using data on Mexican American elders from the Hispanic Established Populations for the Epidemiologic Study of the Elderly (H-EPESE). Non-Hispanic white elders will be sampled from the Health and Retirement Study (HRS) as the comparison group. Sullivan method will be used to calculate the life expectancy of each cross-sectional cohort, and multi-level modeling will be used to determine the relative influence of individual and neighborhood level characteristics. Results from the data would allow for measurement of population health over time for a growing and vulnerable population of elders. At the same time, results would allow for targeted interventions at both individual as well as neighborhood level variables. Understanding trends in healthy life expectancy is particularly important in a country with an already overburdened health services system5 since interventions that are targeted at particularly vulnerable groups may be more effective than those aimed at the general population34.

Public Health Relevance

From both an individual and a societal level, living longer lives in good health is desirable. Recent research suggests that healthy life expectancy among very old Mexican Americans (compared to the general older population) may be on the decline. This is a growing and vulnerable population, and information about healthy life expectancy will be essential to guide public health officials as they allocate limited resources.

Agency
National Institute of Health (NIH)
Institute
National Institute on Minority Health and Health Disparities (NIMHD)
Type
Small Research Grants (R03)
Project #
5R03MD011390-02
Application #
9487292
Study Section
Social Sciences and Population Studies A Study Section (SSPA)
Program Officer
Rosario, Adelaida M
Project Start
2017-05-19
Project End
2020-01-31
Budget Start
2018-02-01
Budget End
2020-01-31
Support Year
2
Fiscal Year
2018
Total Cost
Indirect Cost
Name
University of Georgia
Department
Other Health Professions
Type
Schools of Public Health
DUNS #
004315578
City
Athens
State
GA
Country
United States
Zip Code
30602