Widening the View: Capturing “Unobserved” Heterogeneity in Studies of Age and the Life Course

Kelley‐Moore, Jessica A.; Lin, Jielu

doi:10.1007/978-1-4419-7374-0_4

Cited by 28 publications

(19 citation statements)

References 69 publications

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“…We, as have most prior studies using similar methods (e.g., Haas, 2008; Kahng et al, 2004; Kim & Durden, 2007; Liang et al, 2008), have left unexamined how heterogeneous age-trajectories of disability are within-groups (Kelley-Moore & Lin, 2011). Indeed, the social construction of race/ethnicity and gender (see endnote 1) results in the presumption of homogeneity within these socially meaningful racial/ethnic/gender groups (Calasanti, 1996; Williams et al, 1994).…”

Section: Discussionmentioning

confidence: 99%

Understanding how race/ethnicity and gender define age-trajectories of disability: An intersectionality approach

Warner

Brown

2011

Social Science & Medicine

315

275

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A number of studies have demonstrated wide disparities in health among racial/ethnic groups and by gender, yet few have examined how race/ethnicity and gender intersect or combine to affect the health of older adults. The tendency of prior research to treat race/ethnicity and gender separately has potentially obscured important differences in how health is produced and maintained, undermining efforts to eliminate health disparities. The current study extends previous research by taking an intersectionality approach (Mullings & Schulz, 2006), grounded in life course theory, conceptualizing and modeling trajectories of functional limitations as dynamic life course processes that are jointly and simultaneously defined by race/ethnicity and gender. Data from the nationally representative 1994–2006 US Health and Retirement Study and growth curve models are utilized to examine racial/ethnic/gender differences in intra-individual change in functional limitations among White, Black and Mexican American Men and Women, and the extent to which differences in life course capital account for group disparities in initial health status and rates of change with age. Results support an intersectionality approach, with all demographic groups exhibiting worse functional limitation trajectories than White Men. Whereas White Men had the lowest disability levels at baseline, White Women and racial/ethnic minority Men had intermediate disability levels and Black and Hispanic Women had the highest disability levels. These health disparities remained stable with age—except among Black Women who experience a trajectory of accelerated disablement. Dissimilar early life social origins, adult socioeconomic status, marital status, and health behaviors explain the racial/ethnic disparities in functional limitations among Men but only partially explain the disparities among Women. Net of controls for life course capital, Women of all racial/ethnic groups have higher levels of functional limitations relative to White Men and Men of the same race/ethnicity. Findings highlight the utility of an intersectionality approach to understanding health disparities.

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Section: Discussionmentioning

confidence: 99%

Understanding how race/ethnicity and gender define age-trajectories of disability: An intersectionality approach

Warner

Brown

2011

Social Science & Medicine

315

275

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“…79 Furthermore, in a study where researchers examined risk factors of disability and gender disparities among adults (n=1,348) over the age of 60, they identified that women reported osteoarthritis and osteoporosis more often than men (p<.001), and women were more likely to be disabled than the men (p<.001). 80 More research is needed in order to understand the causes and potential points of intervention of these gendered differences, particularly in African Americans.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Chronic Conditions and Disability in African American Men and Women

Thorpe

Wynn

Walker

et al. 2016

Journal of the National Medical Association

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Background Race differences in chronic conditions and disability are well established; however, little is known about the association between specific chronic conditions and disability in African Americans. This is important because African Americans have higher rates and earlier onset of both chronic conditions and disability than white Americans. Methods We examined the relationship between chronic conditions and disability in 602 African Americans aged 50 years and older in the Baltimore Study of Black Aging. Disability was measured using self-report of difficulty in activities of daily living (ADL). Medical conditions included diagnosed self-reports of asthma, depressive symptoms, arthritis, cancer, diabetes, cardiovascular disease (CVD), stroke, and hypertension. Results After adjusting for age, high school graduation, income, and marital status, African Americans who reported arthritis (women: odds ratio (OR)=4.87; 95% confidence interval(CI): 2.92–8.12; men: OR=2.93; 95% CI: 1.36–6.30) had higher odds of disability compared to those who did not report having arthritis. Women who reported major depressive symptoms (OR=2.59; 95% CI: 1.43–4.69) or diabetes (OR=1.83; 95% CI: 1.14–2.95) had higher odds of disability than women who did not report having these conditions. Men who reported having CVD (OR=2.77; 95% CI: 1.03–7.41) had higher odds of disability than men who did not report having CVD. Conclusions These findings demonstrate the importance of chronic conditions in understanding disability in African Americans and how it varies by gender. Also, these findings underscore the importance of developing health promoting strategies focused on chronic disease prevention and management to delay or postpone disability in African Americans. Publication Indices Pubmed, Pubmed Central, Web of Science database

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“…With the rapidly expanding use of trajectory modeling, often only the average health trajectory is of central analytic and substantive concern (e.g., Alley, Suthers, & Crimmins, 2007;Brown, O'Rand, & Adkins, 2012;Herd, 2006;Liang et al, 2005;Shuey & Willson, 2008;Spence, Adkins, & Dupre, 2011;Yang & Lee, 2009). An unintended consequence of the typical application of trajectory modeling is that intraindividual variability over time, that is, the deviation of each panel assessment from individual mean, is relegated to random errors, or "noise," around the averaged individual trajectories (Kelley-Moore & Lin, 2011;Singer & Willett, 2003). As a result, many studies characterize observed fluctuations in health outcomes as "random error" (Liang et al, 2005), "random within-person error" (Yang & Lee, 2009), "within-individual residual" (Spence et al, 2011), or "model residual" (Brown et al, 2012), without recognizing them as a theoretically interesting and substantively important aspect of health and aging.…”

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confidence: 99%

From Noise to Signal: The Age and Social Patterning of Intra-Individual Variability in Late-Life Health

Lin

Kelley‐Moore

2015

GERONB

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Objectives: Despite a long tradition of attending to issues of intra-individual variability in the gerontological literature, large-scale panel studies on late-life health disparities have primarily relied on average health trajectories, relegating intra-individual variability over time to random error terms, or "noise." This article reintegrates the systematic study of intra-individual variability back into standard growth curve modeling and investigates the age and social patterning of intra-individual variability in health trajectories. Method: Using panel data from the Health and Retirement Study, we estimate multilevel growth curves of functional limitations and cognitive impairment and examine whether intra-individual variability in these two health outcomes varies by age, gender, race/ethnicity, and socioeconomic status, using level-1 residuals extracted from the adjusted growth curve models. Results: For both outcomes, intra-individual variability increases with age. Racial/ethnic minorities and individuals with lower socioeconomic status tend to have greater intra-individual variability in health. Relying exclusively on average health trajectories may have masked important "signals" of life course health inequality. Discussion: The findings contribute to scientific understanding of the source of heterogeneity in late-life health and highlight the need to further investigate specific life course mechanisms that generate the social patterning of intra-individual variability in health status.

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Widening the View: Capturing “Unobserved” Heterogeneity in Studies of Age and the Life Course

Cited by 28 publications

References 69 publications

Understanding how race/ethnicity and gender define age-trajectories of disability: An intersectionality approach

Understanding how race/ethnicity and gender define age-trajectories of disability: An intersectionality approach

Relationship Between Chronic Conditions and Disability in African American Men and Women

From Noise to Signal: The Age and Social Patterning of Intra-Individual Variability in Late-Life Health

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