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Educational Disparities in the Prevalence and Consequence of Physical Vulnerability

¹ Indiana University Center for Aging Research, Indianapolis.
² Regenstrief Institute, Inc., Indianapolis, Indiana.
³ Department of Medicine, Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis.
⁴ Departments of Sociology and Department of Statistics, Indiana University, Bloomington.

Address correspondence to Daniel O. Clark, PhD, Regenstrief Institute, Inc., 1050 Wishard Boulevard RG-6, Indianapolis, IN 46202. E-Mail: dclark{at}regenstrief.org

Objectives. The purpose of this study was to estimate educational differences in the prevalence and mortality consequence of physical vulnerability among older adults in the United States.

Methods. Data came from the 1998 and 2000 waves of the Health and Retirement Study, a nationally representative cross-sectional and prospective cohort study of community-based adults aged 65 and older. We created a physical vulnerability score from age, gender, and self-reported disability measures and measured socioeconomic status via educational attainment. Mortality data came from the National Death Index.

Results. In the 1998 cohort, high physical vulnerability was more than 3 times more prevalent in individuals with less than 12 years of education compared to those with 16 or more years of education. Although less educated older adults had a higher probability of death overall, evidence of educational differences in the mortality consequence of high physical vulnerability was limited. In 2000, 2.16 million older adults had high physical vulnerability, and more than one half (53%) of these adults had less than 12 years of education.

Discussion. In persons 65 years of age or older, educational differences are more apparent in the prevalence of physical vulnerability than in the mortality consequence of that vulnerability.