Although gerontologists have long embraced the concept of heterogeneity in theories and models of aging, recent research reveals the importance of racial and ethnic diversity on life course processes leading to health inequality. This article examines research on health inequality by race and ethnicity and identifies theoretical and methodological innovations that are transforming the study of health disparities. Drawing from cumulative inequality theory, we propose greater use of life course analysis, more attention to variability within racial and ethnic groups, and better integration of environmental context into the study of accumulation processes leading to health disparities.

The relationship between childhood exposures and adult HGS varied by the type of misfortune, but there was no evidence that the relationship varied by race/ethnicity. The significant and enduring Hispanic disadvantage in HGS warrants greater attention in gerontology.

Objective To examine the effect of five childhood misfortune domains—parental behavior, socioeconomic status, infectious diseases, chronic diseases, and impairments—on all-site and selected site-specific cancer prevalence and all-site cancer incidence. Method Panel data from the Health and Retirement Study (2004–2012) were used to investigate cancer risk among adults above the age of 50. Results Risky parental behavior and impairment in childhood were associated with higher odds of all-site cancer prevalence, and childhood chronic disease was associated with prostate cancer, even after adjusting for adult health and socioeconomic factors. Moreover, having one infectious disease in childhood lowered the odds of colon cancer. Cancer trends varied by race and ethnicity, most notably, higher prostate cancer prevalence among Black men and lower all-site cancer among Hispanic adults. Discussion These findings underscore the importance of examining multiple domains of misfortune because the type and amount of misfortune influence cancer risk in different ways.

The authors examine how state policy contexts may have contributed to unfavorable adult health in recent decades, using merged individual-level data from the 1993–2016 Behavioral Risk Factor Surveillance System ( n = 2,166,835) and 15 state-level policy domains measured annually on a conservative-to-liberal continuum. The authors examine associations between policy domains and health among adults 45 to 64 years old and assess how much of the associations are accounted for by adults’ socioeconomic, behavioral and lifestyle, and family factors. A more liberal version of the civil rights domain was associated with better health. It was disproportionately important for less educated adults and women, and its association with adult health was partly accounted for by educational attainment, employment, and income. Environment, gun safety, and marijuana policy domains were, to a lesser degree, predictors of health in some model specifications. In sum, health improvements require a greater focus on macro-level factors that shape the conditions in which people live.

The positive association between educational attainment and adult health (“the gradient”) is stronger in some areas of the United States than in others. Explanations for the geographic pattern have not been rigorously investigated. Grounded in a contextual and life-course perspective, the aim of this study is to assess childhood circumstances (e.g., childhood health, compulsory schooling laws) and adult circumstances (e.g., wealth, lifestyles, economic policies) as potential explanations. Using data on U.S.-born adults aged 50 to 59 years at baseline ( n = 13,095) and followed for up to 16 years across the 1998 to 2014 waves of the Health and Retirement Study, the authors examined how and why educational gradients in morbidity, functioning, and mortality vary across nine U.S. regions. The findings indicate that the gradient is stronger in some areas than others partly because of geographic differences in childhood socioeconomic conditions and health, but mostly because of geographic differences in adult circumstances such as wealth, lifestyles, and economic and tobacco policies.