Understanding Racial/Ethnic Disparities in Physical Performance in Midlife Women: Findings From SWAN (Study of Women’s Health Across the Nation)

Author:

Sternfeld Barbara1,Colvin Alicia2,Stewart Andrea2,Appelhans Bradley M3,Cauley Jane A2,Dugan Sheila A3,El Khoudary Samar R2,Greendale Gail A4,Strotmeyer Elsa2,Karvonen-Gutierrez Carrie5ORCID

Affiliation:

1. Division of Research, Kaiser Permanente, Oakland, California

2. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania

3. Department of Physical Medicine and Rehabilitation for affiliation, Rush University Medical Center, Chicago, Illinois

4. Department of Gerontology, David Geffen School of Medicine at UCLA, University of California, Los Angeles

5. Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor

Abstract

Abstract Objectives Evaluate degree to which racial/ethnic differences in physical performance are mediated by sociodemographic, health, behavioral, and psychosocial factors. Methods Physical performance was evaluated using a decile score derived from grip strength, timed 4 m walk, and timed repeat chair stand in 1,855 African American, Caucasian, Chinese, Hispanic, and Japanese women, mean age = 61.8 (SD = 2.7) in the Study of Women’s Health Across the Nation. Mediators included education, financial strain, comorbidities, pain, body mass index (BMI), physical activity, and perceived stress. Structural equation models provided estimates of the total difference in physical performance between Caucasians and each race/ethnic groups and differences due to direct effects of race/ethnicity and indirect effects through mediators. Results The mean decile score for Caucasian women was 16.9 (SD = 5.6), 1.8, 2.6, and 2.1 points higher than the model-estimated scores in African Americans, Hispanics and Chinese, respectively, and 1.3 points lower than the Japanese. Differences between Caucasians and the Chinese and Japanese were direct effects of race/ethnicity whereas in African Americans and Hispanics 75% or more of that disparity was through mediators, particularly education, financial strain, BMI, physical activity, and pain. Discussion Addressing issues of poverty, racial inequality, pain, and obesity could reduce some racial/ethnic disparity in functional limitations as women age.

Funder

National Institutes of Health

National Institute on Aging

National Institute of Nursing Research

Office of Research on Women’s Health

Publisher

Oxford University Press (OUP)

Subject

Geriatrics and Gerontology,Gerontology,Clinical Psychology,Social Psychology

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