title: How does the trajectory of multimorbidity vary across Black, White, and Mexican Americans in middle and old age?
abstract: OBJECTIVE
  This research examines intra- and interpersonal differences in multiple chronic conditions reported by Americans aged 51 and older for a period up to 11 years. It focuses on how changes in multimorbidity vary across White, Black, and Mexican Americans.
  
  
  METHODS
  Data came from 17,517 respondents of the Health and Retirement Study (1995-2006) with up to 5 repeated observations. Hierarchical linear models were employed to analyze ethnic variations in temporal changes of reported comorbidities.
  
  
  RESULTS
  Middle-aged and older Americans have on average nearly 2 chronic diseases at the baseline, which increased to almost 3 conditions in 11 years. White Americans differ from Black and Mexican Americans in terms of level and rate of change of multimorbidity. Mexican Americans demonstrate lower initial levels and slower accumulation of comorbidities relative to Whites. In contrast, Blacks showed an elevated level of multimorbidity throughout the 11-year period of observation, although their rate of change slowed relative to Whites.
  
  
  CONCLUSIONS
  These results suggest that health differences between Black Americans and other ethnic groups including White and Mexican Americans persist in the trajectory of multimorbidity even when population heterogeneity is adjusted. Further research is needed concerning the impact of health disadvantages and differential mortality that may have occurred before middle age as well as exploring the role of nativity, the nature of self-reported diseases, and heterogeneity underlying the average trajectory of multimorbidity for ethnic elders.
authors.affiliation: Department of Public Health and Preventive Medicine, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, USA. quinones@ohsu.edu
authors.forename: Ana R
authors.initials: AR
authors.lastname: Quiñones
authors.forename: Jersey
authors.initials: J
authors.lastname: Liang
authors.forename: Joan M
authors.initials: JM
authors.lastname: Bennett
authors.forename: Xiao
authors.initials: X
authors.lastname: Xu
authors.forename: Wen
authors.initials: W
authors.lastname: Ye
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002908:Chronic Disease / Q000208:ethnology*; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior / Q000208:ethnology*; D054624:Health Status Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*