Health Disparities in Aging includes the analyses of socioeconomic, racial/ethnic, nativity, geographic, and gender inequalities in health and mortality, including period/cohort risks and their underlying social/biological causes. The study of Health Disparities in Aging has been a core area of study at PARC from Year 1. It incorporates socioeconomic inequalities, racial/ethnic and gender differences, and variation in health outcomes by nativity and place of residence, including period and cohort risks and their underlying social and biological mechanisms. Racial/ethnic differences in the United States are sizable and persistent, vary by racial/ethnic group, gender, and by nativity status. Socioeconomic inequalities in mortality and inequalities by place of residence have also widened and U.S. life expectancy has declined, a pattern that has received widespread public attention and extensive interest from NIA. PARC researchers have, and continue to make, important contributions to improving the understanding of factors that are behind these trends and differentials, including several NIH-funded research projects that have been launched during the current grant period and that will continue to shape this integral research theme.
Classic examples of work under this theme build on long-term collaborations between Elo and Preston on racial/ethnic and socioeconomic differentials in mortality that have recently extended to the role of diabetes and obesity in US mortality trends and differentials. Under an NIA R01 (Elo, PI), their research now also incorporates the study of trends and differentials in geographic mortality inequalities and their correlates in the U.S. Boen studies how structural racism patterns psychosocial stress exposure, promotes chronic activation of bodily physiological stress response systems, and ultimately contributes to disparities in disease emergence and progression. Elo studies mortality differentials by nativity in the U.S., and, in collaboration with Guillot, similar differentials in France. In formal demography, Guillot has designed new methodologies for better understanding mortality levels and trends, and for studying their impact on population growth and aging. Park studies health disparities by educational attainment and changing economic conditions as well as how education affects living arrangements of the elderly focusing on Asian societies. He is currently collaborating with Elo and Behrman on intergenerational transmission of demographic outcomes, including mortality. Behrman and H-P Kohler use twin studies to estimate causal effects of education on health-related outcomes. Venkataramani’s research focuses on the impacts of social events and polices on health behaviors and health outcomes, and was recently awarded the Best Published Research Paper of the Year by Society of General Internal Medicine (SGIM), "Police Killings and Their Spillover Effects on the Mental Health of Black Americans: A Population-based, Quasi-experimental Study." As part of an NIH R01-funded project on Genes, Education, and Gene-Education Interactions in Obesity and Mental Health, Kohler, Behrman and Amin investigate the extent to which these gene-environment interactions contribute to health-disparities at adult and older ages, and a recent NIA R21-funded project provides RCT evidence from Malawi on the extent to which variations in perceived mortality risks at older ages are causally related to life-course behaviors and health investments, and thus health disparities at older ages (H-P Kohler, I Kohler, Behrman). In addition, several other PARC Associates incorporate the study of health disparities in their research on Health Care and Long-Term Care of Older Adults and/or Cognition and ADRD (e.g., Brown, Hubbard, Lasater, Lavizzo-Mourey, McHugh, Neuman, Perez, Werner), and others in the study of global health and aging (Atal, Hoke, Schofield, Thirumurthy, Venkataramani).