Disability Among Older Immigrants in the United States: Exploring Differences by Region of Origin and Gender.

Rapid aging in American society will be disproportionately concentrated among the foreign-born. Immigrants in the United States (U.S.) are a heterogeneous population, yet little is known regarding their differences in disability later in life by region of origin. We use data from the National Health Interview Survey on respondents ages 60+ (n = 313,072) and employ gender-specific logistic models to predict reports of any activity of daily living (ADL) disability. After accounting for socioeconomic factors, compared to their U.S.-born non-Hispanic (NH) White counterparts, the odds of reporting ADL disability were higher among U.S.-born respondents that are Hispanic, NH Black, and NH Multiracial as well as respondents with Mexican, Puerto Rican, Cuban, Russian/former Soviet, Middle Eastern, East Asian, and South Asian origins. Also, Dominican, African, and Southeast Asian women-and European men-reported high odds of ADL disability. Our results highlight heterogeneity in the disability profiles of foreign-born older adults in the U.S..

Increasing Education-Based Disparities in Healthy Life Expectancy Among U.S. Non-Hispanic Whites, 2000-2010.

OBJECTIVES: To examine changes in Healthy Life Expectancy (HLE) against the backdrop of rising mortality among less-educated white Americans during the first decade of the twenty-first century. METHODS: This study documented changes in HLE by education among U.S. non-Hispanic whites, using data from the U.S. Multiple Cause of Death public-use files, the Integrated Public Use Microdata Sample (IPUMS) of the 2000 Census and the 2010 American Community Survey, and the Health and Retirement Study (HRS). Changes in HLE were decomposed into contributions from: (i) change in age-specific mortality rates; and (ii) change in disability prevalence, measured via Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). RESULTS: Between 2000 and 2010, HLE significantly decreased for white men and women with less than 12 years of schooling. In contrast, HLE increased among college-educated white men and women. Declines or stagnation in HLE among less-educated whites reflected increases in disability prevalence over the study period, whereas improvements among the college educated reflected decreases in both age-specific mortality rates and disability prevalence at older ages. DISCUSSION: Differences in HLE between education groups increased among non-Hispanic whites from 2000 to 2010. In fact, education-based differences in HLE were larger than differences in total life expectancy. Thus, the lives of less-educated whites were not only shorter, on average, compared with their college-educated counterparts, but they were also more burdened with disability.

Race/ethnic differences in educational gradients in sleep duration and quality among U.S. adults.

At the population level, those with more education tend to report better sleep, mirroring the education gradient found in other health outcomes. But research has shown that higher educational attainment does not always confer the same health benefits for Non-Hispanic Black (Black) and Hispanic adults as it does for Non-Hispanic White (White) adults. It is therefore possible that the educational gradient in sleep varies across racial/ethnic groups in the United States. Using the 2004-2018 National Health Interview Survey (N = 356,048), we examined differences in self-reported sleep duration and sleep quality by level of educational attainment and race/ethnicity. Utilizing multinomial (sleep duration) and negative binomial (times in the past week with difficulty falling asleep and staying asleep) regression models, we found that, compared to their less educated counterparts, college or more educated Whites were more likely to report ideal sleep compared to short or long sleep, and also reported fewer times with difficulty falling or staying asleep. The education-sleep association was generally reversed for Black and Hispanic adults, with the worst sleep being reported by those with college-level education. These patterns remained after adjusting for health behaviors, health outcomes, and socioeconomic status. Our study suggests that education does not yield the same protective benefit for sleep among Black and Hispanic adults as it does for White adults, and that highly educated Black and Hispanic adults in particular experience a sleep disadvantage. The differential education gradient in sleep may, therefore, be an important factor underlying current racial and ethnic health disparities.

Associations of Exercise Types with All-Cause Mortality among U.S. Adults.

PURPOSE: Exercising benefits physical and mental health as well as longevity. However, the extent to which different types of exercise are differentially associated with the risk of mortality is less clear. This study examined whether 15 different types of exercise were uniquely associated with all-cause mortality in a nationally representative sample of noninstitutionalized American adults between 18 and 84 yr old. METHODS: A total of 26,727 American adults in the National Health Interview Survey who reported their exercise type(s) in 1998 were prospectively followed for all-cause mortality through the end of 2015. We applied a series of discrete time logistic models to estimate odds ratios (OR) and 95% confidence intervals (CI) for all-cause mortality. RESULTS: During 17 yr of follow-up, 4955 deaths occurred. After adjusting for total volume of other exercises and confounders (demographic factors, socioeconomic status, and health behaviors and status), walking, aerobics, stretching, weight lifting, and stair climbing were related to lower risks of mortality (OR ranged from 0.78 to 0.93). When adjusting for engagement in all exercise types and confounders, stretching (OR = 0.90, 95% CI = 0.83-0.97) and playing volleyball (OR = 0.53, 95% CI = 0.31-0.93) were uniquely associated with lower risks of mortality. CONCLUSION: These findings suggest that some types of exercise have unique benefits for longevity, but most are indistinguishable in relation to longevity. Future studies should further investigate the unique contribution of specific exercises and the joint contribution of multiple exercises and how to promote greater exercise participation.

Depression in Later Life: The Role of Adult Children's College Education for Older Parents' Mental Health in the United States.

OBJECTIVES: Research on the socioeconomic gradient in mental health links disadvantaged family background with subsequent symptoms of depression, demonstrating the "downstream" effect of parental resources on children's mental health. This study takes a different approach by evaluating the "upstream" influence of adult children's educational attainment on parents' depressive symptoms. METHODS: Using longitudinal data from the U.S. Health and Retirement Study (N = 106,517 person-years), we examine whether children's college attainment influences their parents' mental health in later life and whether this association increases with parental age. We also assess whether the link between children's college completion and parents' depression differs by parents' own education. RESULTS: Parents with children who completed college have significantly lower levels of depressive symptoms than parents without college-educated children, although the gap between parents narrows with age. In addition, at baseline, parents with less than a high school education were more positively affected by their children's college completion than parents who themselves had a college education, a finding which lends support to theories of resource substitution. DISCUSSION: Offspring education is an overlooked resource that can contribute to mental health disparities among older adults in a country with unequal access to college educations.

Black/white differences in mortality among veteran and non-veteran males.

U.S. military veterans are a large and racially heterogeneous population. There are reasons to expect that racial disparities in mortality among veterans are smaller than those for non-veterans. For example, blacks are favorably selected into the military, receive relatively equitable treatment within the military, and after service accrue higher socioeconomic status and receive health and other benefits after service. Using the 1997-2009 National Health Interview Survey (N = 99,063) with Linked Mortality Files through the end of 2011 (13,691 deaths), we fit Cox proportional hazard models to estimate whether racial disparities in the risk of death are smaller for veterans than for non-veterans. We find that black/white disparities in mortality are smaller for veterans than for non-veterans, and that this is explained by the elevated socioeconomic resources of black veterans relative to black non-veterans. Leveraging birth cohort differences in military periods, we document that the smaller disparities are concentrated among All-Volunteer era veterans.

Adult children's education and changes to parents' physical health in Mexico.

The well-being of older adults is frequently tied to support from their adult children. Here, we assess whether the education of adult offspring is associated with changes to older parents' short- and long-term health in Mexico, a rapidly aging context with historically limited institutional support for the elderly. Educational expansion over the past half century, however, provides older adults with greater resources to rely on via the education of their children. Using longitudinal data from the Mexican Health and Aging Study (2001-2012), we find that offspring education is not associated with short-term changes in parents' physical functioning, but is associated with increased parental longevity, net of children's financial status and transfers. In addition, we find that mothers' longevity is more sensitive to offspring education than fathers. Our findings add to a growing body of literature that urges policy-makers to consider the multi-generational advantages of expanding educational opportunities in Mexico.

Adult Children's Education and Parents' Functional Limitations in Mexico.

This article asks how adult children's education influences older parents' physical health in Mexico, a context where older adults often lack access to institutional resources and rely on kin, primarily children, as a main source of support. Using logistic and negative binomial regression models and data from the first wave of the Mexican Health and Aging Study (N = 9,661), we find that parents whose children all completed high school are less likely to report any functional limitations as well as fewer limitations compared to parents with no children who completed high school. This association remains significant even after accounting for parent and offspring-level characteristics, including parents' income that accounts for children's financial transfers to parents. Future research should aim to understand the mechanisms that explain the association between adult children's education and changes to parents' health over time.

Duty, Honor, Country, Disparity: Race/Ethnic Differences in Health and Disability among Male Veterans.

Given their unique occupational hazards and sizable population, military veterans are an important population for the study of health. Yet veterans are by no means homogeneous, and there are unanswered questions regarding the extent of, and explanations for, racial and ethnic differences in veterans' health. Using the 2010 National Survey of Veterans, we first documented race/ethnic differences in self-rated health and limitations in Activities of Daily Living among male veterans aged 30-84. Second, we examined potential explanations for the disparities, including socioeconomic and behavioral differences, as well as differences in specific military experiences. We found that Black, Hispanic, and other/multiple race veterans reported much worse health than White veterans. Using progressively adjusted regression models, we uncovered that the poorer self-rated health and higher levels of activity limitations among minority veterans compared to Whites was partially explained by differences in their socioeconomic status and by their military experiences. Minority veterans are a vulnerable population for poor health; future research and policy efforts should attempt to better understand and ameliorate their health disadvantages relative to White veterans.

Migration, business formation, and the informal economy in urban Mexico.

Although the informal economy has grown rapidly in several developing nations, and migration and informality may be related to similar types of credit constraints and market failures, previous research has not systematically attempted to identify if migrant households are more likely to start informal and formal businesses alike and if this association varies across local contexts. We examine the relationship between prior US migration and the creation of both formal and informal businesses in urban Mexico using several criteria to indirectly assess sector location. We use data from 56 communities from the Mexican Migration Project to estimate multilevel survival and nonmultilevel competing risk models predicting the likelihood of informal, formal, and no business formation. The recent return migration of the household head is strongly associated with informal business creation, particularly in economically dynamic areas. On the other hand, migrants are only marginally more likely to start formal businesses in highly economically dynamic sending areas.