Income Health Inequalities Among Older Persons

Income Health Inequalities Among Older Persons - Journal of...

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http://jah.sagepub.com Journal of Aging and Health DOI: 10.1177/0898264307309938 2008; 20; 107 originally published online Dec 18, 2007; J Aging Health Edward A. Frongillo Gary W. Evans, Elaine Wethington, Meredith Coleman, Margo Worms and Role of Multiple Risk Exposures Income Health Inequalities Among Older Persons: The Mediating http://jah.sagepub.com/cgi/content/abstract/20/1/107 The online version of this article can be found at: Published by: http://www.sagepublications.com can be found at: Journal of Aging and Health Additional services and information for http://jah.sagepub.com/cgi/alerts Email Alerts: http://jah.sagepub.com/subscriptions Subscriptions: http://www.sagepub.com/journalsReprints.nav Reprints: http://www.sagepub.com/journalsPermissions.nav Permissions: http://jah.sagepub.com/cgi/content/refs/20/1/107 Citations at CORNELL UNIV on February 24, 2010 http://jah.sagepub.com Downloaded from
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Income Health Inequalities Among Older Persons The Mediating Role of Multiple Risk Exposures Gary W. Evans, PhD Elaine Wethington, PhD Meredith Coleman, BA Margo Worms, BA Edward A. Frongillo, PhD Cornell University Objective: We examine whether the pervasive income gradient in health among senior citizens can be explained in part by multiple risk exposure. Method: A representative sample of 457 older persons ( M = 74.29 years) living independently at home were assessed in a longitudinal study. Health was assessed with a standard self-report index. Risks included loss of a loved one, caregiver burden, low housing quality, and low social integration. Results: The prospective link between income and subsequent health 2 years later is largely explained by exposure to a confluence of multiple risk factors during the 2-year period. These findings incorporate controls for negative affectivity. Discussion: Low-income, older persons are significantly more likely to have lost a loved one or close friend, be burdened by extensive caregiving demands for someone else, be more socially isolated, and live in lower quality housing. These risk exposures, in turn, largely account for the prospective link between income and health. Keywords: income; multiple risk; health disparities I ncome-related health inequalities are both substantial and ubiquitous. This has led to numerous attempts to account for health inequalities, with varying success. To date, no single mechanism has been uncovered that pro- vides a satisfactory accounting of health inequalities. An essential reason for this is that health inequalities likely have a complex, multivariate foun- dation that includes, at a minimum, biological inheritance, health behaviors (e.g., smoking, diet), psychological characteristics (e.g., depression, hostility), Journal of Aging and Health Volume 20 Number 1 February 2008 107-125 © 2008 Sage Publications 10.1177/0898264307309938 http://jah.sagepub.com hosted at http://online.sagepub.com 107 at CORNELL UNIV on February 24, 2010 http://jah.sagepub.com Downloaded from
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access to health care, social exclusion or relative deprivation, and elevated physical (e.g., substandard housing) and psychosocial (e.g., interpersonal conflict) risk exposure. In this article, after briefly reviewing the evidence
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Income Health Inequalities Among Older Persons - Journal of...

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