Drilling Down to the Disparity: Black-White Differences in Life Course Influences on Functional Limitations

• In Event: 499 - Section on Aging and the Life Course Roundtable Session.
  In Refereed Roundtable: Table 03. Lifetime Socioeconomic Influences on Health

Abstract

Life course studies seeking to identify the key drivers of the enduring Black-White disparities in late-life physical functioning have frequently explored the relative impact of early life, midlife, and later-life social and health circumstances. Although adult socioeconomic status and health are largely determined to be most consequential, childhood factors seem to have a residual independent effect. In this paper, we address a key limitation of this literature, namely the failure to address the endogeneity of midlife circumstances in analytic models that also include early-life circumstances as predictors. Incorporating statistical correction with the novel synthesis of endogenous treatment models with latent growth curves, we revisit the question of relative impact of factors from across the life course. Using data on Black and White adults from the Health and Retirement Study (W2 – W9), we find that the impact of childhood on functional limitations is overestimated for both groups, but more for Black adults. It is the differential selection into adult social institutions that matters more. Further, educational attainment has a stronger impact on mid-life morbidity and earnings for White adults relative to Black adults. For the same level of achieved education, Black adults get less health benefit. Taken together, our findings suggest that the origin of health disparities are not as simple as weighing the relative effect of circumstances at specific points in the life course, but their selection effects over the life course. This has important implications for the ways we test path-dependent and accumulative life course models for health disparities.

Authors

• Jessica A. Kelley-Moore, Case Western Reserve University

• Wenxuan Huang, Case Western Reserve University