Added: Glenna Golub - Date: 04.12.2021 07:18 - Views: 17679 - Clicks: 3680
This research explores black—white differences in healthy aging and investigates whether mastery acts as a buffer against poor health for older black and white men. Using data from the Health and Retirement Study HRS —a series of binary logit models were created to assess healthy aging over a 2-year period.
Healthy aging was defined as good subjective health and free of disability at both waves. Black—white disparities in healthy aging were observed, where older black men had lower odds of healthy aging. Mastery was associated with higher odds of healthy aging, and race moderated the relationship between mastery and healthy aging. The predicted probability of healthy aging was relatively flat across all levels of mastery among black men, yet white men saw consistent gains in the probability of healthy aging with higher levels of mastery.
In race-stratified models, mastery was not a ificant predictor of healthy aging among black men. High levels of mastery are linked to positive health—often acting as a buffer against stressful life events. However, among older black men, higher levels of mastery did not necessarily equate to healthy aging. There is wealth of empirical data demonstrating black—white differences in healthy or successful aging McLaughlin et al. Older black adults typically experience poorer subjective health and more disability in later life compared with their white peers even African american male for older caucasin women controlling for socioeconomic differences Spencer et al.
This well-documented disparity may be due, in part, to differences in levels of mastery among older black and white adults, where black adults often report lower mastery Jang et al. A high sense of mastery confers important health benefits in later life Pearlin et al.
Furthermore, research suggests that black men receive fewer health benefits from high levels of mastery Jang et al. Thus, the objective of this research is to explore black—white differences in healthy aging among older men while considering the role of mastery for healthy aging.
Gerontologists have had a long vested interest in conceptualizing and in measuring healthy aging. Indeed, the majority of research that disaggregates race and gender has focused on racial differences in healthy aging among women. Individuals with high levels of mastery may evaluate stressful situations more favorably because they view themselves as having control over the situation—thus, reducing the physiological response to stress i.
Likewise, a greater sense of mastery is believed to shape health indirectly by improving health behaviors. Although mastery is viewed as a powerful predictor of health across the life course, perceptions of mastery vary by race and ethnicity. According to the stress process model Pearlin et al. The stress process model conceptualizes mastery as an important coping resource, which minimizes the harmful effects of stress on health Lincoln, Perceptions of mastery map onto objective conditions, and, accordingly, structural constraints such as limited economic opportunities diminish feelings of mastery Pearlin et al.
Compared with their white peers, older black men typically report less mastery Jang et al. Mastery is consistently shown to be associated with better mental health among older black adults Hill et al. Among black men, specifically, Watkins and colleagues observed a negative association between mastery and depressive symptoms across all stages of the adult life course.
In general, whites experience additional health benefits from higher levels of mastery Jang et al. Oates and Goode propose that mastery is a more central coping resource for white adults, whereas religiosity is a more central coping resource for black adults. When examining race and gender simultaneously, research indicates that black men experience even fewer health benefits from mastery as compared with black women Jang et al.
Less is known about the role of mastery for healthy aging and whether the protective effects of mastery extend to physical health outcomes among older black men. Based on research exploring healthy aging, mastery, and race, we have generated the following set of hypotheses:.
Hypothesis 1: Relative to older white men, older black men will be less likely to experience healthy aging. Hypothesis 2: Older black men will have lower levels of mastery compared with older white men. Hypothesis 3: Mastery will partially mediate the relationship between race and healthy aging. Hypothesis 4: Higher levels of mastery will be associated with healthy aging, regardless of race, net of numerous social and health factors.
Hypothesis 5: Higher levels of mastery will be associated with healthy aging for older black and white men; however, the effect of mastery on healthy aging will be greater for white men i. By taking a closer examination of the potential pathways linking mastery to healthy aging among older black and white men, researchers and clinicians may gain important insights about future health promotion. The HRS is a publicly available, ongoing longitudinal survey of Americans over the age of Information is collected from respondents and their spouses every 2 years. The Psychosocial and Lifestyle Questionnaire PLQ is a self-administered leave-behind questionnaire that is given to half-samples i.
The main objective of the PLQ is to collect detailed psychosocial data, and it was first distributed to the core in Because of issues related to variable concordance, this research uses years Wave 9 and Wave 10 of the PLQ. Data were pooled from the and PLQ half-samples. After restricting the pooled sample to black and white men, there were 5, respondents in the sample.
The sample was further restricted to age-eligible respondents i. Since respondents were followed across multiple waves, it was possible for respondents to have missing information because of death or attrition. Analyses were run including and excluding respondents who died between follow-up waves see Online Supplementary Text for description of sensitivity analyses. All predictors and healthy aging measures were used in the imputation process, and missing information was assumed to be missing at random.
Healthy aging was measured using two indicators i. Disability status was measured using a combination of activities of daily living ADLrepresenting essential self-care tasks, and instrument activities of daily living IADLrepresenting tasks required for independent living. Respondents were asked to report difficulty related to persistent i. Respondents who reported they did not do the task for reasons other than health-related difficulty were classified as having no difficulty with that task.
Mastery was measured using a 5-item scale. The mastery scale was created by averaging the scores across all five items. Respondents missing three or more items were African american male for older caucasin women as missing for the final value. Because mastery is shaped by sociodemographic characteristics and socioeconomic status SESage, marital status, and SES were included in the analyses as controls. Age was measured in years and assessed at baseline either or Four measures of SES were included in the analyses as controls: 1 educational attainment; 2 household income; 3 household wealth; and 4 health insurance coverage.
A three-category measure of educational attainment was created, where less than high school education, high school education or equivalent referenceand more than high school education were the. Both the household income and wealth quartiles were created using baseline unweighted information among black and white men who had completed the PLQ. The bottom quartile was used as the referent category for both measures. A trichotomous measure of health insurance was created, where private insurance coverage either from the respondent or spousepublic insurance coverage, and no insurance were the.
Respondents with both private and public insurance were classified as having private insurance so that the public insurance category represented public-only insurance coverage. Private insurance was used as the reference category. Four health behaviors were included in the analyses: 1 sedentary behavior, 2 obesity, 3 tobacco smoking status, and 4 health care utilization. Sedentary behavior was measured using a dichotomous indicator.
Respondents who reported never participating in physical activity i. A trichotomous measure of smoking status was created with nonsmoker i. Finally, health care utilization was measured using two dichotomous variables: 1 doctors visit and 2 hospitalization.
Both measures referred to the past 2 years. Morbidity status was also included in the analysis. While healthy aging is the main outcome, we conceptualized healthy aging to be in good subjective health and to be free of disability; however, respondents could experience both of these indications while having a chronic condition or functional limitation. Therefore, both measures i. The of chronic conditions ranged from 0 to 8 and included high blood pressure, diabetes, cancer, lung disease, heart disease, stroke, psychiatric disorders, and arthritis.
The of functional limitations ranged from 0 to 4 and was based on difficulty related to large muscle functioning i. A large set of psychosocial factors were incorporated in the analyses including additional coping resources e. Moreover, these factors may influence feelings of mastery. By including these measures, this research can investigate whether mastery has an independent effect on healthy aging among older black and white men.
Two additional coping resources were included in the analyses: 1 social support and 2 religiosity. To capture multiple dimensions of social support including quantity and quality of ties, four measures were employed: 1 composition of social network, 2 of close ties, 3 perceived positive social support, and 4 frequency of meeting up with friends and family see Online Supplementary Text for more detail.
Religiosity was measured using a 4-item scale. The scale ranged from 1 to 6 with higher scores representing more religiosity. A 3-item pessimism scale was created from the following statements: 1 If something can go wrong for me it will; 2 I hardly ever expect things to go my way; and 3 I rarely count on good things happening to me.
Responses ranged from 1 strongly disagree to 6 strongly agree with high scores reflecting more dispositional pessimism. Social stressors included neighborhood disorder, loneliness, everyday discrimination, lifetime traumas, and recent stressful events see Online Supplementary Text for more detail. All of the psychosocial measures from the PLQ have been ly validated and are widely accepted instruments used by researches from a variety of disciplines Smith et al.
To assess our hypotheses, we first examined bivariate associations among the focal variables i. Next, a series of binary logistic regression models were created. The first model included race and mastery adjusted for age. The second model further adjusted for sociodemographic characteristics and SES.
The third model introduced health behaviors, morbidity status, and psychosocial factors. Models 1—3 were used to investigate whether mastery exerts an independent effect on healthy aging, net of numerous covariates associated with both mastery and healthy aging. The fourth and final model introduced an interaction term i. Interaction analysis allowed for an investigation of whether the effect of mastery on healthy aging varied by race. Finally, to further explore the role of mastery for older black and white men, we stratified the analyses by race.
This enabled us to consider whether mastery influenced healthy aging via social and health pathways and whether those pathways differed for black and white men. Table 1 presents descriptive statistics for the sample along with a comparison of the raw and imputed data. The majority of the sample experienced healthy aging i. In general, there was high mastery reported with an average score of 4. The household income and wealth quartiles reflect the raw distribution of all black and white men who had completed the PLQ in either or Small discrepancies in the household income quartiles reflect weighted differences related to mortality i.
Analyses were weighted using the and HRS personal-level weight. Table 2 displays the bivariate associations among focal variables by race. Looking at healthy aging and each indicator i. In general, compared with older white men, older black men had lower rates of healthy aging.African american male for older caucasin women
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