Work

Racial, Ethnic, Nativity, and Educational Disparities in Cognitive Impairment and Activity Limitations in the United States, 1998–2016

Year: 2023

Type: article

Abstract: Despite extensive research on cognitive impairment and limitations in basic activities of daily living, no study has investigated the burden of their co-occurrence (co-impairment). Using the Health and Retirement Study data and incidence-based multistate models, we study the population burden of co-impairment using three key indicators: mean age at onset, lifetime risk, and health expectancy. We examine patterns by gender, race, ethnicity, nativity, education, and their interactions for U.S. residents aged 50-100. Furthermore, we analyze what fractions of racial, ethnic, and nativity disparities in co-impairment are attributable to inequalities in educational attainment. Results reveal that an estimated 56% of women and 41% of men aged 50 will experience co-impairment in their remaining life expectancy. Men experience an earlier onset of co-impairment than women (74 vs. 77 years), and women live longer in co-impairment than men (3.4 vs. 1.9 years). Individuals who are Black, Latinx, and lower educated, especially those experiencing intersecting disadvantages, have substantially higher lifetime risk of co-impairment, earlier co-impairment onset, and longer life in co-impairment than their counterparts. Up to 75% of racial, ethnic, and nativity disparity is attributable to inequality in educational attainment. This study provides novel insights into the burden of co-impairment and offers evidence of dramatic disparities in the older U.S. population.

Source: Demography

DOI: 10.1215/00703370-10941414

Authors: Shubhankar Sharma, Jo Mhairi Hale, Mikko Myrskylä, Hill Kulu

Institutions: University of Helsinki, University of St Andrews, Max Planck Institute for Demographic Research

Language: English

Topic: Health disparities and outcomes

Subfield: Health

Field: Social Sciences

Domain: Social Sciences

SDGs: Reduced inequalities, Good health and well-being

Open Access status: gold

Estimated APC paid: $2,750