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
Reference47 articles.
1. Pinpointing the sources of the Asian mortality advantage in the USA;Acciai;Journal of Epidemiology and Community Health,2015
2. U.S. disparities in health: Descriptions, causes, and mechanisms;Adler;Annual Review of Public Health,2008
3. Evaluation of the Kaiser Physical Activity Survey in women;Ainsworth;Medicine and Science in Sports and Exercise,2000
4. Comparison of performance-based measures among native Japanese, Japanese-Americans in Hawaii and Caucasian women in the United States, ages 65 years and over: A cross-sectional study;Aoyagi;BMC Geriatrics,2001
5. Racial differences in the association of education with physical and cognitive function in older blacks and whites;Barnes;The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences,2011