There are many complex and interacting factors related to race, ethnicity, gender, environment, socioeconomic status, geography, place of birth and recency of immigration, and culture that can affect the health and quality of life of elderly individuals. These factors can influence work history, diet, exercise, the use of preventive health care, and the individual's role in the family and community. There also are biologic and genetic factors that can affect the course and severity of disease and disability. All of these factors must be understood to design interventions to improve health and quality of life.
Study Normal Aging Processes in Special Populations
To understand the course of disease and disability, it is necessary to understand "normal" aging, those processes that occur in the absence of disease. Investigators know the prevalence of certain diseases varies among racial and ethnic populations, but very little is known about:
- The normal processes of aging in minority populations
- The similarities and differences among racial and ethnic groups and among groups that differ on other characteristics such as geography.
Determine the Effects of Early Life Factors on Adult Health
Aging is a lifelong process in which early life events can play an important role. Differences in nutrition, education, disease incidence and health care early in life and in fetal development can impact disease and disability in later life. Because of the wide variety of racial, ethnic, and national backgrounds in the minority elderly population, we can learn much about the impact of early life events on how well these individuals age. Research into the influence of early and midlife experience on aging health also will improve our ability to predict health status of future cohorts of elders.
Develop Necessary Data Related to Health Differences and Causes
Because of the complex and interactive nature of racial, ethnic, cultural, and socioeconomic variables, there is a lack of data that adequately addresses differences in health among racial and ethnic populations. More sources of data collection on a national level and ways to analyze different smaller data collection efforts are needed. One solution could be the use of "linked data" to discover new scientific knowledge and to help in the evaluation and design of policies to deal with an aging society. Data from several sources could be linked by some common identifier and analyzed in ways not previously possible. However, the use of linked data presents a complex set of challenges to maintain the confidentiality of survey respondents.
Ongoing data collection programs, such as the Current Population Survey, the National Health Survey, and the Survey of Income and Program Participation, oversample minority persons to provide important information on living arrangements, income, health care needs, and other topics.
Other surveys focused on specific groups include:
- The Hispanic Health and Nutrition Examination Survey, sponsored by the National Center for Health Statistics in 1985
- The Hispanic Established Population for Epidemiologic Study of the Elderly
- The Health and Retirement Study
- The Assets and Health Dynamics of the Oldest-Old. T
These surveys concentrated on issues of illness and well-being. Support for these and other surveys of racial and ethnic groups will be continued and expanded to provide adequate data for researchers and public policymakers.
Promote Clear and Functional Definitions of Race, Culture, and Ethnicity
Race, culture, and ethnicity can be difficult to define as the elderly population becomes more diverse. For example, black immigrants from Africa can have different languages and cultures compared to African-Americans and blacks of Caribbean ancestry. Asians may be individuals from China, Vietnam, Japan, Korea, or other nations, each with individual languages and cultures. Hispanics, as a group, are particularly diverse with different racial and cultural heritages, including American Indian, black, and white, depending on their country of origin or region of the United States in which they live. For research purposes, it is important to have clear, consistent ways to define race, culture, and ethnicity to identify those factors that impact on health and allow comparison of data among different research studies.
Determine the Relative Influences of Race, Ethnicity, Economic Status, Education, and Work Experiences in Health
Health and quality of life, particularly in later years, are attributable to many factors, some of which influence one another. To better understand risk factors for disease and preventive factors leading to good health, research on separating the influence of each factor and how they work together is needed. Longitudinal data with a lifespan approach are particularly important to disentangle and better understand the multitude of factors that affect health and well-being.
