title: Beyond black and white: race/ethnicity and health status among older adults.
abstract: OBJECTIVE
  This study examined physical and mental health, health symptoms, sensory and functional limitations, risk factors, and multimorbidity among older Medicare managed care members to assess disparities associated with race/ethnicity.
  
  
  METHODS
  We used data on 236,289 older adults from 208 Medicare plans who completed the 2012 Medicare Health Outcomes Survey to compare 14 health indicators across non-Hispanic whites, blacks, American Indians/Alaskan Natives, Asians, Native Hawaiians/Pacific Islanders, multiracial individuals, and Hispanics. Logistic regression models that clustered on the plan estimated the risk of indicators of adverse health and functional status.
  
  
  RESULTS
  Even after controlling for key patient sociodemographic factors, race/ethnicity was significantly associated with most adverse health indicators. Except for Asians, all racial/ethnic minority groups were significantly more likely than whites to report poor mental health status, presence of most health symptoms, sensory limitations, and activities-of-daily-living disability. Important differences were observed across racial and ethnic groups.
  
  
  CONCLUSIONS
  Despite some exceptions, elders of racial/ethnic minority background are generally at higher risk than non-Hispanic whites for a broad range of adverse health and functional outcomes that are not routinely assessed. Limitations include bias related to self-reported data and respondent recall. Future research should consider ethnic subgroup variations; employing newer techniques to improve estimates for smaller groups; and prioritizing and identifying opportunities for care improvement of diverse enrollee groups by considering specific needs. To improve the health status of the elderly, service delivery targeting the needs of specific population groups, coupled with culturally appropriate care for racial/ ethnic minorities, should also be considered.
authors.affiliation: The National Committee for Quality Assurance, 1100 13th St, NW, Ste 1000, Washington, DC 20005. E-mail: ng@ncqa.org.
authors.forename: Judy H
authors.initials: JH
authors.lastname: Ng
authors.forename: Arlene S
authors.initials: AS
authors.lastname: Bierman
authors.forename: Marc N
authors.initials: MN
authors.lastname: Elliott
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Wilson
authors.forename: Chengfei
authors.initials: C
authors.lastname: Xia
authors.forename: Sarah Hudson
authors.initials: SH
authors.lastname: Scholle
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D004185:Disability Evaluation; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D008297:Male; D044469:Racial Groups / Q000706:statistics & numerical data*; D012678:Sensation Disorders / Q000453:epidemiology; D014481:United States / Q000453:epidemiology