Ethnic Disparities in Disability among Middle-Aged and Older Israeli Adults: The Role of Socioeconomic Disadvantage and Lifetime Adversity

BACKGROUND: Ethnic minorities often experience higher rates of stress and have access to fewer material resources, both of which confer a higher risk for disease and disability. Few studies have investigated ethnic health disparities among the Israeli population, even though vast ethnic differences in power, resources, and education exist. The current study examines if lifetime adversity and socioeconomic status (SES) contribute to ethnic disparities in disability among older Israeli adults. METHODS: We used data from the Israeli component of the Survey of Health, Aging and Retirement in Europe (SHARE) Wave 1 (2005\06), a nationally representative sample of Israelis aged 50 or older. The sample included respondents from the three major ethnic groups in Israel: Jewish Israelis, Arabs, and Jewish immigrants from the Former Soviet Union (FSU) (n=1547). We employed negative binomial regression to assess the risk of disability as measured by activities of daily living (ADL) and instrumental activities of daily living (IADL). RESULTS: Arab older adults (IRR=1.39; 95% CI 1.13, 1.71) and FSU older adults (IRR=1.72; 95% CI 1.30, 2.26) experienced higher risk of ADLs compared to Jewish Israelis. Similar results were found for IADLs. Greater education, higher income, and fewer lifetime adversities were associated with lower risk of ADLs and IADLs. Inclusion of these variables attenuated, but did not eliminate ethnic disparities in disability. CONCLUSIONS: Socioeconomic disadvantage among Arabs and Jewish immigrants from FSU is associated with higher levels of disability. Lifetime adversity might lead to greater socioeconomic disadvantage among ethnic minorities and intensify disparities in disability.