title: Cumulative inequality and racial disparities in health: private insurance coverage and black/white differences in functional limitations.
abstract: OBJECTIVE
  To test different forms of private insurance coverage as mediators for racial disparities in onset, persistent level, and acceleration of functional limitations among Medicare age-eligible Americans.
  
  
  METHODS
  Data come from 7 waves of the Health and Retirement Study (1996-2008). Onset and progression latent growth models were used to estimate racial differences in onset, level, and growth of functional limitations among a sample of 5,755 people aged 65 and older in 1996. Employer-provided insurance, spousal insurance, and market insurance were next added to the model to test how differences in private insurance mediated the racial gap in physical limitations.
  
  
  RESULTS
  In baseline models, African Americans had larger persistent level of limitations over time. Although employer-provided, spousal provided, and market insurances were directly associated with lower persistent levels of limitation, only differences in market insurance accounted for the racial disparities in persistent level of limitations.
  
  
  CONCLUSIONS
  Results suggest private insurance is important for reducing functional limitations, but market insurance is an important mediator of the persistently larger level of limitations observed among African Americans.
authors.affiliation: Department of Sociology and Gerontology Institute, Georgia State University, Atlanta. bkail@gsu.edu.
authors.forename: Ben Lennox
authors.initials: BL
authors.lastname: Kail
authors.affiliation: Department of Sociology, Pepper Institute for Aging and Public Policy, Florida State University, Tallahassee.
authors.forename: Miles G
authors.initials: MG
authors.lastname: Taylor
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D001741:Black or African American / Q000208:ethnology / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies / Q000191:economics; D005260:Female; D054624:Health Status Disparities; D006630:Hispanic or Latino / Q000208:ethnology / Q000523:psychology; D006801:Humans; D019458:Insurance Coverage / Q000191:economics* / Q000639:trends; D007348:Insurance, Health / Q000191:economics* / Q000639:trends; D008137:Longitudinal Studies / Q000191:economics; D008297:Male; D006278:Medicare / Q000191:economics / Q000639:trends; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology
keywords: Cumulative inequality; Functional limitations; Insurance; Private insurance.