The Contributions of Race, Individual Socioeconomic Status, and Neighborhood Socioeconomic Context on the Self-Rated Health Trajectories and Mortality of Older Adults

Abstract

Drawing on four waves of the Americans' Changing Lives Study, we examine the contributions of individual and neighborhood socioeconomic status to explain racial disparities in self-rated health trajectories over time, among Black and White older adults in the United States. Primary results of three-level growth curve analyses of self-rated health change, and multinomial logistic regression of mortality and attrition, indicate that (1) racial and socioeconomic disparities in health persist into old age, (2) Black older adults have greater declines in self-rated health over time than White older adults, and these disparities are explained by individual and neighborhood socioeconomic status (SES), (3) individual and neighborhood SES contribute to persisting self-rated health disparities at older ages, but may not contribute significantly to further declines in self-rated health at older ages, (4) Black disadvantage in mortality exists at older ages, and persists net of individual and neighborhood SES, and (5) individual SES is a significant predictor of 16-year mortality among older adults. Our results suggest that we should continue to be concerned about the existence and persistence of racial and socioeconomic disparities in self-rated health and mortality throughout old age, and the contribution of individual and neighborhood socioeconomic context in perpetuating these disparities.