The color of hospitalization over the adult life course: cumulative disadvantage in black and white?
OBJECTIVE
Drawing from cumulative disadvantage theory, this research addresses the following questions: Do hospital admission and discharge rates differ for White and Black adults? If yes, do the differences amplify in later life?


METHODS
This study made use of hospital records abstracted from a long-term prospective study of adults in the National Health and Nutrition Examination Survey I: Epidemiologic Follow-up Study (N = 6,833). Semi-Markov models were specified to examine the likelihood of hospital admission and discharge for Black and White adults aged 25 to 74 years old at baseline.


RESULTS
Black adults were less likely than White adults to be admitted to the hospital, but they had longer lengths of stay. The risk of death in the hospital was greater for both Black men and women than for White men and women. In addition, the observed racial differences in hospitalization experiences amplified in later life.


CONCLUSIONS
Health inequality in America is manifest in how White and Black adults enter and exit hospitals. The findings demonstrate growing heterogeneity in later life by race.
Ferraro
Kenneth F
KF
Center on Aging and the Life Course, Department of Sociology, Purdue University, West Lafayette, IN 47907-2108, USA. ferraro@purdue.edu
Thorpe
Roland J
RJ
McCabe
George P
GP
Kelley-Moore
Jessica A
JA
Jiang
Zhen
Z
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D017052:Hospital Mortality; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D018570:Risk Assessment; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D035862:Vulnerable Populations / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data*