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Active Life Expectancy In The Older US Population, 1982-2011: Differences Between Blacks And Whites Persisted.

ABSTRACT: Understanding long-range trends in longevity and disability is useful for projecting the likely impact of the baby-boom generation on long-term care utilization and spending. We examine changes in active life expectancy in the United States from 1982 to 2011 for white and black adults ages sixty-five and older. For whites, longevity increased, disability was postponed to older ages, the locus of care shifted from nursing facilities to community settings, and the proportion of life at older ages spent without disability increased. In contrast, for blacks, longevity increases were accompanied by smaller postponements in disability, and the percentage of remaining life spent active remained stable and well below that of whites. Older black women were especially disadvantaged in 2011 in terms of the proportion of years expected to be lived without disability. Public health measures directed at older black adults-particularly women-are needed to offset impending pressures on the long-term care delivery system as the result of population aging.

SUBMITTER: Freedman VA

PROVIDER: S-EPMC5240930 | biostudies-literature | 2016 Aug

REPOSITORIES: biostudies-literature

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Active Life Expectancy In The Older US Population, 1982-2011: Differences Between Blacks And Whites Persisted.

Freedman Vicki A VA Spillman Brenda C BC

Health affairs (Project Hope) 20160801 8

Understanding long-range trends in longevity and disability is useful for projecting the likely impact of the baby-boom generation on long-term care utilization and spending. We examine changes in active life expectancy in the United States from 1982 to 2011 for white and black adults ages sixty-five and older. For whites, longevity increased, disability was postponed to older ages, the locus of care shifted from nursing facilities to community settings, and the proportion of life at older ages ...[more]

PMID: 27503957

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Project description:ObjectivesMaterial well-being, beliefs, and emotional states are believed to influence one's health and longevity. In this paper, we explore racial differences in self-rated health, happiness, trust in others, feeling that society is fair, believing in God, frequency of sexual intercourse, educational attainment, and percent in poverty and their association with mortality.Study designsAge-period-cohort (APC) study.MethodsUsing data from the 1978-2014 General Social Survey-National Death Index (GSS-NDI), we conducted APC analyses using generalized linear models to quantify the temporal trends of racial differences in our selected measures of well-being, beliefs, and emotional states. We then conducted APC survival analysis using mixed-effects Cox proportional hazard models to quantify the temporal trends of racial differences in survival after removing the effects of racial differences in our selected measures.ResultsFor whites, the decline in happiness was steeper than for blacks despite an increase in high school graduation rates among whites relative to blacks over the entire period, 1978-2010. Self-rated health increased in whites relative to blacks from 1978 through 1989 but underwent a relative decline thereafter. After adjusting for age, sex, period effects, and birth cohort effects, whites, overall, had higher rates of self-rated health (odds ratio [OR] = 1.88; 95% confidence interval [CI] = 1.63, 2.16), happiness (OR = 2.05; 1.77, 2.36), and high school graduation (OR = 2.88; 2.34, 3.53) compared with blacks. Self-rated health, happiness, and high school graduation also mediated racial differences in survival over time.ConclusionsWe showed that some racial differences in survival could be partly mitigated by eliminating racial differences in health, happiness, and educational attainment. Future research is needed to analyze longitudinal clusters and identify causal mechanisms by which social, behavioral, and economic interventions can reduce survival differences.

Dataset Information

Active Life Expectancy In The Older US Population, 1982-2011: Differences Between Blacks And Whites Persisted.

Publications

Active Life Expectancy In The Older US Population, 1982-2011: Differences Between Blacks And Whites Persisted.

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