Race, individual socioeconomic status, neighborhood context, and physical and mental health trajectories among older adults.

摘要

Guided by the life course theory and bioecological theory, this study examines the association between race, individual socioeconomic status (SES), neighborhood socioeconomic context, and physical health (mortality and self-rated health) and mental health (depressive symptoms) trajectories for older adults. Individual-level data are from four waves of the Americans' Changing Lives Study (ACL) (1986--2002). Neighborhood-level socioeconomic data are from 1980, 1990, and 2000 census data. Neighborhood information was linked to the neighborhood that respondents resided in at wave 1 (W1) when neighborhood context is treated as a static measure. 1980, 1990 and 2000 census data were merged to W1, W3, and W4 ACL data, respectively, when neighborhood context is treated as a dynamic measure.;Results indicated that: 1) Self-rated health and depressive symptoms improved, but then reversed and started declining; 2) Racial differences in self-rated health, mortality, and depressive symptoms between Blacks and Whites persist at older ages; 3) Higher individual income and education, and lower neighborhood socioeconomic disadvantage are associated with better self-rated health and less depressive symptoms at baseline and lower mortality rates. But they do not affect the rate of change in self-rated health and depressive symptoms; 4) After controlling for individual SES and neighborhood socioeconomic disadvantage, racial differences in self-rated health and depressive symptoms disappear. However, race crossover effects for mortality exist even after both individual SES and neighborhood socioeconomic context are controlled. Black older adults experience higher mortality rates at young old ages while they have lower mortality rates at oldest old ages, compared to White older adults. 5) A proportional change score may be a better dynamic family income measure in longitudinal studies on health; 6) Three types of neighborhood socioeconomic trajectories (improve-decline, continuously improving, and decline-improve) are related to worse depressive symptoms compared to the continuously improving neighborhoods. But they do not contribute to the rate of change in depressive symptoms.;Policy needs to better address the socioeconomic conditions of individuals over their life course, particularly the individual and neighborhood socioeconomic context of Blacks, if we want to reduce racial disparities in physical and mental health at older ages.