title: Black-white disparity in disability among U.S. older adults: age, period, and cohort trends.
abstract: OBJECTIVE
  This study delineates activities of daily living (ADL) and instrumental activities of daily living (IADL) black-white disparity trends by age, period, and cohort (APC) and explores sociodemographic contributors of cohort-based disparity trends.
  
  
  METHODS
  We utilized multiple cross-sectional waves of National Health Interview Survey data (1982-2009) to describe APC trends of ADL and IADL disparities using a cross-classified random effect model. Further, we decomposed the cohort-based disparity trends using Fairlie's decomposition method for nonlinear outcomes.
  
  
  RESULTS
  The crossover ADL and IADL disparities (whites > blacks) occurring at age 75 increased with age and reached a plateau at age of 80, whereas period-based ADL and IADL disparities remained constant for the past 3 decades. The cohort disparity trends for both disabilities showed a decline with each successive cohort except for ADL disparity among women.
  
  
  CONCLUSIONS
  We examined the role of aging on racial disparity in disability and found support for the racial crossover effect. Further, the racial disparity in disability will disappear should the observed pattern of declining cohort-based ADL and IADL disparities persist. Although education, income, and marital status are important sociodemographic contributors to cohort disparity trends, future studies should investigate individual behavioral health determinants and cohort-specific characteristics that explain the cohort-based racial difference in ADL and IADL disabilities.
authors.affiliation: Institute for Behavioral and Community Health (IBACH) and Center for Health Equity Research and Policy, San Diego State University, California. slin@mail.sdsu.edu.
authors.forename: Shih-Fan
authors.initials: SF
authors.lastname: Lin
authors.affiliation: Institute for Behavioral and Community Health (IBACH) and Center for Health Equity Research and Policy, San Diego State University, California.
authors.forename: Audrey N
authors.initials: AN
authors.lastname: Beck
authors.affiliation: Department of Sociology, USC Population Research Center, Center for Economic and Social Research, University of Southern California, Los Angeles. Graduate School of Public Health, Center for Health Equity Research and Policy, San Diego State University, California.
authors.forename: Brian K
authors.initials: BK
authors.lastname: Finch
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D001741:Black or African American; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000208:ethnology* / Q000502:physiology; D015331:Cohort Studies; D003430:Cross-Sectional Studies / Q000639:trends; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D014481:United States / Q000453:epidemiology; D044465:White People
keywords: Age-period-cohort model; Black–white disparity; Disability; Older adults.