Testing the double jeopardy hypothesis using health-related quality of life measures

The double jeopardy hypothesis posits that minority elderly suffer a double disadvantage to health due to the interactive effects of age and race. Previous examinations of the hypothesis have found little support that the process of aging heightens the health disadvantage for racial minorities compared to whites. This study contributes to the existing research by focusing on five major racial-ethnic groups: African-Americans, Asian and Pacific Islanders, American Indians and Alaskan Natives, the Hispanic origin population, and non-Hispanic whites. Additionally, we examine race-by-age differences using health-related quality of life measures, which have been largely overlooked in past double jeopardy analyses. The unhealthy days question relies on count data reflecting frequency of poor health experienced during a given month, not considered by standard measures of morbidity and mortality.

Using data from the 2003 and 2005 waves of the California Health Interview Survey, we find that the number of unhealthy days increases more steeply for aging African-Americans and Hispanics compared to whites. African-Americans and Hispanics ages 30 and older have significantly more unhealthy days in comparison to whites. Furthermore, the magnitude of the health difference is much larger in the elderly strata than observed between younger groups. Contrary to previous findings, we find support for the double jeopardy hypothesis using quantifiable indicators for health-related quality of life. Other measures of health used in past studies may have downplayed the race-by-age inequality. Our findings indicate the need to consider health-related quality of life when examining racial-ethnic health disparities among the elderly.