Folorunsho Sunkanmi
Department of Sociology, University of Nebraska-Lincoln, Lincoln, USA.
J Aging Soc Policy. 2025 Jul 2:1-17. doi: 10.1080/08959420.2025.2528584.
Despite extensive research on social determinants of health, gaps remain in understanding how race and disability intersect to shape health disparities among older adults. This essay examines how structural inequities, including limited access to healthcare, inadequate housing, and economic instability, contribute to poorer health outcomes for racialized older adults with disabilities. Early-life disadvantages, such as growing up in underserved neighborhoods and experiencing systemic discrimination, accumulate over the life course, increasing the risk of chronic health conditions and financial insecurity in later life. Black and Hispanic older adults with disabilities experience disproportionately higher rates of hypertension and diabetes than their White counterparts, reflecting both historical and structural inequities. This essay emphasizes the need for longitudinal research to capture the cumulative effects of social determinants of health on marginalized populations, including Black, Hispanic, Indigenous, and Asian older adults with disabilities. It calls for culturally and disability-competent healthcare systems that incorporate bilingual navigation programs, tailored interventions, and specialized training for healthcare providers. Policy recommendations include strengthening anti-discrimination laws, increasing funding for community-based services, and improving access to telemedicine with a focus on digital equity. Addressing these barriers is essential to advancing health equity and ensuring that all older adults, regardless of race or disability, can age with dignity and well-being.
尽管对健康的社会决定因素进行了广泛研究，但在理解种族和残疾如何相互交织以形成老年人健康差异方面仍存在差距。本文探讨了结构性不平等，包括获得医疗保健的机会有限、住房不足和经济不稳定，如何导致残疾的种族化老年人健康状况更差。早期生活中的不利因素，如在服务不足的社区长大和经历系统性歧视，会在生命过程中积累，增加晚年患慢性健康问题和经济不安全的风险。与白人残疾老年人相比，黑人与西班牙裔残疾老年人患高血压和糖尿病的比例要高得多，这反映了历史和结构性不平等。本文强调需要进行纵向研究，以了解健康的社会决定因素对边缘化人群，包括黑人、西班牙裔、原住民和亚裔残疾老年人的累积影响。它呼吁建立有文化能力和残疾问题处理能力的医疗保健系统，包括双语导航项目、量身定制的干预措施以及为医疗保健提供者提供专门培训。政策建议包括加强反歧视法律、增加对社区服务的资金投入，以及改善远程医疗的可及性并关注数字公平。消除这些障碍对于促进健康公平以及确保所有老年人，无论种族或残疾状况如何，都能有尊严且幸福地变老至关重要。
