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Racial-ethnic disparities in static levels of health are well documented. Less is known about racial-ethnic differences in age trajectories of health. The few studies on this topic have examined only single health outcomes and focused on black-white disparities. This study extends prior research by using a life course perspective, panel data from the Health and Retirement Study, and multilevel growth curve models to investigate racial-ethnic differences in the trajectories of serious conditions and functional limitations among blacks, Mexican Americans, and whites. We test three hypotheses on the nature of racial-ethnic disparities in health across the life course (aging-as-leveler, persistent inequality, and cumulative disadvantage). Results controlling for mortality selection reveal that support for the hypotheses varies by health outcome, racial-ethnic group, and life stage. Controlling for childhood socioeconomic status, adult social and economic resources, and health behaviors reduces but does not eliminate racial-ethnic disparities in health trajectories. (Contains 3 tables and 2 figures.)

Researchers have long documented the impact of social inequalities on family life. Most family research has focused on inequalities at the individual and family levels, and extant studies on macro‐level conditions have primarily examined economic conditions and specific family‐focused social policies. Yet, an emerging body of largely conceptual research suggests that structural inequities also have enormous power to shape families. Structural racism, structural sexism, and structural sexual and gender minority oppression, and other forms of structural injustice operate across various levels (macro, meso, and micro) and systems (e.g., educational, economic, political, criminal‐legal, etc.), to influence individuals' social environments and everyday lives in ways that may impact how, when, and where people form families. Structural oppression, moreover, may influence relationship quality, caregiving patterns, child outcomes, and various other aspects of family life. Yet, the consequences of these structural forces for families have not yet been thoroughly examined. In this article, we (1) develop a conceptual framework linking structural oppression to family characteristics and outcomes, (2) outline innovative approaches for conceptualizing and measuring structural oppression and describe how incorporating these approaches can move the field of family science forward, and (3) make several recommendations regarding best practices and fruitful avenues for future research. [ABSTRACT FROM AUTHOR]

Background: Perceptions of the US healthcare system can impact individuals' healthcare utilization, including vaccination intentions. This study examined the association between perceived racial-ethnic inequities in COVID-19 healthcare and willingness to receive the COVID-19 vaccine. Methods: This study used data from REACH-US, a nationally representative online survey of a large, diverse sample of U.S. adults (N=5145 January 26, 2021-March 3, 2021). Confirmatory factor and regression analyses examined a latent factor of perceived racial-ethnic inequities in COVID-19 healthcare, whether the factor was associated with willingness to receive the COVID-19 vaccine, and whether associations varied across racial-ethnic groups reported as probit estimates (B) and 95% confidence intervals (CIs). Results: Perceived racial-ethnic inequities in COVID-19 healthcare were highest among Black/African American adults (mean latent factor score: 0.65 ± 0.43) and lowest among White adults (mean latent factor score: 0.04 ± 0.67). Black/African American (B = -0.08; 95% CI = -0.19, 0.03) and Native Hawaiian/Pacific Islander (B = -0.08; 95% CI = -0.23, 0.07) adults who perceived greater racial-ethnic inequities in COVID-19 healthcare were less willing than participants who perceived lower inequities. In contrast, American Indian/Alaska Native (B = 0.15; 95% CI = -0.01, 0.30), Asian (B = 0.20; 95% CI = 0.08, 0.31), Hispanic/Latino (English language preference) (B = 0.22; 95% CI = 0.01, 0.43), Multiracial (B = 0.23; 95% CI = 0.09, 0.36), and White (B = 0.31; 95% CI = 0.19, 0.43) adults who perceived greater racial-ethnic inequities in COVID-19 healthcare were more willing to receive the COVID-19 vaccine than participants perceiving higher inequities. Conclusions: Greater perceived racial-ethnic inequities in COVID-19 healthcare were associated with less willingness to receive the COVID-19 vaccine among Black/African American and Native Hawaiian/Pacific Islander adults. [ABSTRACT FROM AUTHOR]

Less than 1% of studies on racialized health inequities have empirically examined their root cause: structural racism. Moreover, there has been a disconnect between the conceptualization and measurement of structural racism. This study advances the field by (1) distilling central tenets of theories of structural racism to inform measurement approaches, (2) conceptualizing U.S. states as racializing institutional actors shaping health, (3) developing a novel latent measure of structural racism in states, (4) using multilevel models to quantify the association between structural racism and five individual-level health outcomes among respondents from the Health and Retirement Study (N = 9,020) and the Behavioral Risk Factor Surveillance System (N = 308,029), and (5) making our measure of structural racism publicly available to catalyze research. Results show that structural racism is consistently associated with worse health for Black people but not White people. We conclude by highlighting this study's contributions (theoretical, methodological, and substantive) and important avenues for future research on the topic. [ABSTRACT FROM AUTHOR]

Racism drives population health inequities by shaping the unequal distribution of key social determinants of health, such as socioeconomic resources and exposure to stressors. Research on interrelationships among race, socioeconomic resources, stressors, and health has proceeded along two lines that have largely remained separate: one examining differential effects of socioeconomic resources and stressors on health across racialized groups (moderation processes), and the other examining the role of socioeconomic resources and stressors in contributing to racial inequities in health (mediation processes). We conceptually and analytically integrate these areas using race theory and a novel moderated mediation approach to path analysis to formally quantify the extent to which an array of socioeconomic resources and stressors--collectively and individually--mediate racialized health inequities among a sample of older adults from the Health and Retirement Study. Our results yield theoretical contributions by showing how the socioeconomic status-health gradient and stress processes are racialized (24% of associations examined varied by race), substantive contributions by quantifying the extent of moderated mediation of racial inequities (approximately 70%) and the relative importance of various social factors, and methodological contributions by showing how commonly used simple mediation approaches that ignore racialized moderation processes overestimate--by between 5% and 30%--the collective roles of socioeconomic status and stressors in accounting for racial inequities in health. [ABSTRACT FROM AUTHOR]

While health inequalities related to race/ethnicity, nativity, and age are well documented, it remains unclear how these axes of stratification combine to shape health trajectories, especially in middle and late life. This study addresses gaps in the literature by drawing on both life course and intersectionality perspectives to understand inequalities in morbidity trajectories. Using growth curve models applied to data from the Health and Retirement Study, I examine the life course patterning of health inequalities among US- and foreign-born non-Hispanic whites, non-Hispanic blacks, and Mexican Americans between the ages of 51 and 80 (N = 16,265). Findings are consistent with premature aging and cumulative disadvantage processes: US- and foreign-born blacks and Mexican Americans experience earlier health deterioration than US-born whites, and they also tend to exhibit steeper health declines with age. Moreover, contrary to the common assumption of monolithic healthy immigrant and erosion processes, results show that these processes are contingent on both race/ethnicity and age: compared with US-born whites, white immigrants have a persistent health advantage, while black and Mexican American immigrants experience a health disadvantage that increases with age. These results suggest that among nonwhite immigrants, the immigrant health advantage may be offset by cumulative exposure to racialized immigrant incorporation processes. A wide array of health-related factors including socioeconomic resources, health behaviors, and medical care account for some, but not all, group differences in morbidity trajectories. Findings highlight the utility of life course and intersectionality perspectives for understanding health inequalities. [ABSTRACT FROM AUTHOR]

Objective: Previous research has documented a relationship between childhood socioeconomic conditions and adult health, but less is known about racial/ethnic differences in this relationship, particularly among men. This study utilizes a life course approach to investigate racial/ethnic differences in the relationships among early and later life socioeconomic circumstances and health in adulthood among men.Design: Panel data from the Health and Retirement Study and growth curve models are used to examine group differences in the relationships among childhood and adult socioeconomic factors and age-trajectories of self-rated health among White, Black and Mexican American men aged 51-77 years (N=4147).Results: Multiple measures of childhood socioeconomic status (SES) predict health in adulthood for White men, while significantly fewer measures of childhood SES predict health for Black and Mexican American men. Moreover, the health consequences of childhood SES diminish with age for Black and Mexican American men. The childhood SES-adult health relationship is largely explained by measures of adult SES for White men.Conclusions: The life course pathways linking childhood SES and adult health differ by race/ethnicity among men. Similar to arguments that the universality of the adult SES-health relationship should not be assumed, results from our study suggest that scholars should not assume that the significance and nature of the association between childhood SES and health in adulthood is similar across race/ethnicity among men. [ABSTRACT FROM AUTHOR]

Abstract: 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 (), 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. [Copyright &y& Elsevier]

Although older Black women experience disproportionately high rates of morbidity, relatively little is known about the psychosocial mechanisms underlying their health. This study advances the field by drawing on stress processes and intersectionality frameworks to understand the health consequences of psychosocial factors among a nationally representative sample of Black women over the age of 50. We take a broad and systematic approach to analyzing relationships among psychosocial stressors and resources and health among older Black women to address three research questions. First, how do stressors (discrimination, chronic stressors, traumatic events, and financial strains) individually and collectively influence health? Second, are psychosocial resources (social support, mastery, optimism, religiosity, and prayer) protective of health? Third, to what extent do psychosocial resources moderate relationships between stressors and health? To address these questions, we utilize data from the Health and Retirement Survey (HRS) Core Data and Psychosocial Modules (N = 1,263) and nested multivariate regression analyses. We focus on measures of global health and functional health, which have previously established relationships with stress processes. Results highlight the utility of examining the health consequences of stressors collectively rather than individually in order to avoid biased estimates. Findings also indicate that several of the psychosocial resources examined are protective of older Black women's health; we find no evidence that these resources moderate the impacts of stressors on their self-rated health or functional limitations. We conclude by discussing the theoretical, substantive, and methodological implications of these findings. [ABSTRACT FROM AUTHOR]