Kahng Sang Kyoung
Department of Social Welfare, Seoul National University, Korea.
Health Soc Work. 2010 Nov;35(4):257-66. doi: 10.1093/hsw/35.4.257.
Few studies have examined to what extent racial disparities in chronic health conditions (CHCs) are attributable to racial differences in body weight (measured as body mass index [BMI]) and socioeconomic status (SES) among older adults. To address this gap, using longitudinal data from the Health and Retirement Study, the current study examined risk factors of CHC trajectory including race, BMI, and SES. The sample consists of 22,560 in 1998, 20,825 in 2000, and 19,004 in 2002. Data analysis was done through latent growth curve modeling. As expected, older adults presented an increasing trajectory of CHCs over time. Black Americans presented a significantly more negative CHC trajectory than did their white counterparts, confirming racial disparity in health over time. Consequent hierarchical analyses revealed that racial disparity in CHC trajectory can be explained by racial disparity in BMI and that racial disparity in BMI can be attributed to racial disparity in SES. Because low SES is closely related to unhealthy diet and negative health behaviors that may subsequently lead to obesity and chronic health conditions, the findings suggest that to address racial disparity in CHCs, it is important for social workers to continuously try to mitigate racial inequality in SES.
很少有研究探讨老年人慢性健康状况(CHC)方面的种族差异在多大程度上可归因于体重(以体重指数[BMI]衡量)和社会经济地位(SES)的种族差异。为了填补这一空白,本研究利用健康与退休研究的纵向数据,考察了包括种族、BMI和SES在内的CHC轨迹的风险因素。样本包括1998年的22560人、2000年的20825人和2002年的19004人。数据分析通过潜在增长曲线模型进行。正如预期的那样,随着时间的推移,老年人的CHC呈上升轨迹。与白人相比,美国黑人的CHC轨迹明显更消极,这证实了随着时间推移健康方面的种族差异。随后的分层分析表明,CHC轨迹的种族差异可以用BMI的种族差异来解释,而BMI的种族差异可归因于SES的种族差异。由于低SES与不健康饮食和负面健康行为密切相关,而这些行为可能随后导致肥胖和慢性健康状况,研究结果表明,为了解决CHC方面的种族差异,社会工作者持续努力减轻SES方面的种族不平等很重要。