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Racial Disparities in Disability: Recent Evidence From Self-Reported and Performance-Based Disability Measures in a Population-Based Study of Older Adults

¹ Rush Institute for Healthy Aging
² Department of Internal Medicine
³ Department of Preventive Medicine
⁴ Rush Alzheimer's Disease Center
⁵ Department of Neurological Sciences
⁶ Department of Psychology, Rush University Medical Center, Chicago, Illinois.

Address correspondence to Dr. Carlos F. Mendes de Leon, Rush Institute for Healthy Aging, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 675, Chicago, IL 60612. Email: cmendes{at}rush.edu

Objectives. Although disability levels have been declining in older adults, there is little current information on racial differences in disability.

Methods. Our data came from a longitudinal, population-based study of 6,158 Black and White adults aged 65 and older from the south side of Chicago. Data were collected during three face-to-face interviews between 1993 and 2002. We ascertained disability using three self-report measures and a performance-based measure of physical function. Using longitudinal data analysis, we examined overall racial differences in disability and the degree to which they varied by age and gender.

Results. After an average of 6 years of follow-up, Blacks reported significantly higher disability levels than Whites after adjustment for age and sex. There was a significant increase in disability during follow-up on all four measures. Racial differences in disability did not vary consistently by age at baseline or over time but were greater among women. Findings were largely similar for self-reported and performance-based measures of disability. Adjustment for socioeconomic status substantially reduced racial differences in disability, although some of the differences remained significant, especially among women.

Conclusions. Racial disparities in disability have not been eliminated, are greater among women, and have their origins earlier in adulthood.