Socioeconomic factors including work, retirement, education, income, and wealth can have a serious impact on the health and well-being of minority individuals. Economic circumstances can determine whether an individual can afford health care and proper nutrition from early life into old age. Individual and family financial resources and health care insurance can determine whether an older individual enters a nursing home or stays at home to be cared for by family and friends. We still do not fully understand the interaction of financial assets and health outcomes, particularly in different racial and ethnic groups. Similarly, the role of education in improving health behaviors and health status should be better understood.
Compared to their white counterparts, as a group, minority elders:
- Depend more heavily on Social Security
- Receive little support from private pensions
- Derive even less income from accumulated assets
- Rely on earnings from employment in old age to a large extent.
For minority elders, it is of prime importance to ensure the availability of Social Security for low-income individuals and to improve access to private pensions. Challenges for policymakers also include finding ways to encourage individual savings, including home ownership, and facilitate continued employment.
Study Population Changes and Underlying Causes of Health and Function of Elders Over Time
Many studies have identified significant risk factors for the development of chronic diseases that predate onset of symptoms by at least a decade. Population-based studies in which individuals are tracked from birth to their adult death help researchers understand the changes in health over time and the large variations in health across racial and ethnic populations. Research will continue to develop, maintain, and analyze longitudinal data sets.
Provide Information Useful for Policy
NIA is currently supporting the Health and Retirement Study, a nationally representative longitudinal data collection that examines retirement, economic, and family variables as they relate to health of the elderly. These studies provide data for researchers, policy analysts, and program planners who make major policy decisions affecting retirement, health insurance, savings, and economic well-being. Future studies will focus on health (physical, cognitive, and functional), dementia, economic and family resources, and care arrangements.
Recent findings of reduced disability among the elderly have become prominent in the public policy debate regarding Medicare and Social Security. Future research is needed to:
- Evaluate whether disability is being prevented or postponed
- Identify contributors to disability decline
- Determine the impact of changes in health care
- Examine the economic implications of reduced rates of disability.
Produce Data on Burdens and Costs of Illness, Healthy Life Expectancy, Longevity, and Mortality Trajectories
Determining the costs of specific illnesses always has been difficult due to the lack of adequate data on incidence and prevalence and the different methodologies and assumptions used by scientists in calculating direct medical costs and indirect costs such as lost wages and family and informal caregiving support. These difficulties are compounded in minority populations because of differences in the use of formal medical care and informal family caregiving. Future projections of healthy life expectancy, longevity, and mortality depend on assumptions on how cohorts of individuals will change over time, particularly as recent immigrants are assimilated into the American "melting pot." Research will provide valuable information for projecting the need for health care services for all population groups.
Monitor Population Aging and the Global Burden of Disease
Population aging is not unique to the United States. As advances in sanitation, nutrition, and medical care are spread over the world, the global burden of disease has been shifting from infectious diseases to diseases of more industrialized societies, including heart disease, hypertension, diabetes, and cancer. The perspective of international studies helps increase understanding of American population aging through comparison with that of different systems.
Although many of the disparities in adult health and life expectancy across nation, county, race, occupation, and social class are well documented, causal mechanisms are less well understood. Understanding these differences is critical for developing behavioral and public health interventions. Future research efforts will focus on developing better cross-national and subnational databases on health outcomes, risk factors, and socioeconomic status structural factors, such as societal inequality.
