Double Disadvantage in the Process of Disablement: Race as a Moderator in the Association between Chronic Conditions and Functional Limitations

Abstract

Objectives: This study evaluated (a) whether the association between chronic conditions and functional limitations vary by race/ethnicity, and (b) whether socioeconomic status accounted for any observed racial variation in the association between chronic conditions and functional limitations. Method: The Health and Retirement Study data were used to assess whether race/ethnicity moderated the association between chronic conditions and functional limitations, and whether education, income, and/or wealth mediated any of the observed moderation by race/ethnicity. Results: Results from structural equation models of latent growth curves with random onset indicated that (a) the positive association between chronic conditions and functional limitations onset was larger for African Americans and Hispanics than it was for Whites, but (b) this difference largely persisted net of socioeconomic status. Discussion: African Americans and Hispanics endure a multiplicative double disadvantage in the early stages of the disablement process where they experience (a) a more rapid onset and higher levels of functional limitations, and (b) greater risk of functional limitation onset associated with chronic conditions compared to their White counterparts. Moreover, basic economic policies are unlikely to curtail the greater risk of functional limitations onset associated with chronic conditions encountered by African Americans and Hispanics.