Timing, Accumulation, and the Black/White Disability Gap in Later Life

Abstract

Examining the Black/White disability gap among older adults, this study focuses on the role of timing in racial inequality over time. Using the Duke Established Populations for Epidemiologic Studies of the Elderly (EPESE), the author reexamines Black and White disability trajectories with attention to timing of onset. In addition, known mediators are examined for their relative impact on onset and accumulation of disability. The author finds that diverging trajectories of Black and White disability, evidence of a cumulative disadvantage argument, are fueled solely by differences in onset. A more nuanced picture of racial disparities arises when controls are included, lending support to a weathering hypothesis. Access to health care is primary in explaining the Black/White disparity. The author concludes that timing is integral to the study of health trajectories and that research using cumulative disadvantage benefits from supplemental theories with specific assertions as to timing, including weathering.