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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Robert F. Schoeni, PhD, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI 48109, Vicki A. Freedman, PhD, Polisher Research Institute, Madlyn and Leonard Abramson Center for Jewish Life, 1425 Horsham Road, North Wales, PA 19454, 215-371-1886, bschoeni@isr.umich.edu, and Robert Wallace, MD, Department of Epidemiology, The University of Iowa, College of Public Health, 200 Hawkins Drive, Iowa City, IA 52242.
Racial and socioeconomic disparities in late-life disability have been well documented; yet, it remains unclear whether social inequalities exist in the disability trajectories individuals experience before death. To explore this topic, we drew upon prospective data from very large nationally representative samples of Americans who died over a 12-year period. We developed synthetic disability trajectories based on population-level experiences at various times from death and examined the following questions: 1) How does the likelihood of experiencing disability change as individuals approach death? 2) Do the chances of experiencing disability before death differ for people with different socioeconomic backgrounds? 3) If trajectories are different, why is this so? We found that even 10 years prior to death, only 60 percent of decedents were disability free. The percentage of persons who were disability free prior to death declined gradually between 60 and 12 months prior to death and declined rapidly in the last 12 months prior to death. Nevertheless, about 30% of decedents were not disabled even during the last few months of life, suggesting that a substantial portion of decedents are relatively healthy just prior to dying. We also found that, although disability differentials by income and education narrowed somewhat in the last six months of life, they remained substantial. Racial differences in disability trajectories, in contrast, were small even several years prior to death, and they did not diminish as death approached. Neither age at death nor cause of death appeared to explain the socio-economic differentials we uncovered.
Learning Objectives:
Keywords: Disability, Social Inequalities
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.