Differential effects of aging in place on disability among black and white elderly

The black health disadvantage, including old-age disability, is well-known and persists over the life course, although it is smaller in the older population. In non-metropolitan areas, as in the U.S. as a whole, health disparities between African Americans and non-Hispanic whites begin to emerge in early adulthood and continue to widen through middle age. Both race and place of residence play a role in shaping health status and disability, and some would argue that these effects are cumulative in a way that ages African Americans prematurely, resulting in greater functional limitations and disability. The aim of this paper is to analyze the differences between African Americans and non-Hispanic whites in their functional limitations and disability for persons age 65 and older. We pay special attention to place in terms of metro-nonmetro and South-non-South region. Both aspects of residency are important for examining race differentials in disability because of the historical experience of African Americans is different in the South than the remaining regions; there are also different experiences of blacks and whites in metro and nonmetro areas. The paper first reviews recent findings on the disability gap at the national level and related health black-white health differentials. We then link the “weathering” hypothesis to the emerging theory of cumulative disadvantage which will be our theoretical frame for the analysis of black-white differentials in disability. Third, we develop and test a model that first brings in race and residential characteristics in terms of region and metro status. The analysis builds on an earlier descriptive paper in which we detail the importance of metro status and region for the incidence of disability of blacks and whites, as well as the different ways those residential characteristics affect the two races. We use the disability concepts measured in the 2009 American Community Survey.