Income health inequalities among older persons: the mediating role of multiple risk exposures.
OBJECTIVE
We examine whether the pervasive income gradient in health among senior citizens can be explained in part by multiple risk exposure.


METHODS
A representative sample of 457 older persons (M = 74.29 years) living independently at home were assessed in a longitudinal study. Health was assessed with a standard self-report index. Risks included loss of a loved one, caregiver burden, low housing quality, and low social integration.


RESULTS
The prospective link between income and subsequent health 2 years later is largely explained by exposure to a confluence of multiple risk factors during the 2-year period. These findings incorporate controls for negative affectivity.


CONCLUSIONS
Low-income, older persons are significantly more likely to have lost a loved one or close friend, be burdened by extensive caregiving demands for someone else, be more socially isolated, and live in lower quality housing. These risk exposures, in turn, largely account for the prospective link between income and health.
Evans
Gary W
GW
Departments of Environmental Analysis and Human Development, Cornell University, Ithaca, NY 14853-4401, USA. gwe1@cornell.edu
Wethington
Elaine
E
Coleman
Meredith
M
Worms
Margo
M
Frongillo
Edward A
EA
D000368:Aged; D017028:Caregivers; D017281:Cost of Illness; D006304:Health Status; D054625:Healthcare Disparities; D006798:Housing; D006801:Humans; D007182:Income; D008875:Middle Aged; D009518:New York; D012307:Risk Factors; D012944:Social Support; D017805:Widowhood