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Cultural Diversity - Health

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As noted earlier, minority older adults who survive to age sixty-five and beyond tend to be in poorer health than age peers who are white (though it is important to note that some ethnic subgroups have a higher life expectancy than the undifferentiated category of whites). Minority older adults are also more likely to suffer from multiple illnesses that further complicate treatment regimens (Markides and Miranda, 1997). Yet there are some commonalities across racial and national origin groups for adults age sixty-five and older. For instance, for both men and women across all groups, heart disease and cancer are the two leading causes of death. Strokes and chronic obstructive pulmonary disease (COPD), also known as lung disease, tend to be either the third or fourth leading cause of death, with the exception of Native Americans and Hispanics, both of whom have diabetes mellitus as the fourth leading cause of death. Alzheimer's disease is the eighth leading cause of death among white men, and the sixth leading cause among white women, age sixty-five and older. Alzheimer's disease is also the tenth leading cause of death among African-American women, the ninth leading cause of death for Native American women, and the seventh leading cause death among Hispanic women.

Older adults on the lower rungs of the socioeconomic ladder often lack adequate private insurance to supplement Medicare, and do not have resources to meet out-of-pocket costs. This especially affects African-American and Hispanic older adults, who experience high rates of poverty. Without adequate resources to pay for medical care, they tend to receive inferior services. They must depend on Medicaid and hospital emergency rooms, rather than a regular physician, for care.

VIRGIL H. ADAMS III DAVID J. EKERDT

BIBLIOGRAPHY

DILWORTH-ANDERSON, P., and BURTON, L. "Critical Issues in Understanding Family Support and Older Minorities." In Full-Color Aging: Facts, Goals, and Recommendations for America's Diverse Elders. Edited by T. P. Miles. Washington, D.C.: Gerontological Society of America, 1999. Pages 93–106.

Federal Interagency Forum on Aging Related Statistics. Older Americans 2000: Key Indicators of Well-Being. Washington, D.C.: U.S. Government Printing Office, 2000.

FERRARO, K. F., and FARMER, M. M. "Double Jeopardy: Aging as Leveler, or Persistent Health Inequality? A Longitudinal Analysis of White and Black Americans." Journal of Gerontology: Social Sciences 51B (1996): S319–S328.

JACKSON, J. S.; CHATTERS, L. M.; and TAYLOR, R. J., eds. Aging in Black America. Newbury Park, Calif.: Sage, 1993.

JOHN, R. "Aging among American Indians: Income Security, Health, and Social Support Networks." In Full-Color Aging: Facts, Goals, and Recommendations for America's Diverse Elders. Edited by T. P. Miles. Washington, D.C.: Gerontological Society of America, 1999. Pages 65–92.

MARKIDES, K., and MIRANDA, M. R. Minorities, Aging, and Health. Thousand Oaks, Calif.: Sage, 1997.

PAMPEL, F. C. Aging, Social Inequality, and Public Policy. Thousand Oaks, Calif.: Pine Forge Press, 1998.

SIEGEL, J. S. "Demographic Introduction to Racial/Hispanic Elderly Populations." In Full-Color Aging: Facts, Goals, and Recommendations for America's Diverse Elders. Edited by T. P. Miles. Washington, D.C.: Gerontological Society of America, 1999. Pages 1–19.

STOLLER, E. P., and GIBSON, R. C. Worlds of Difference: Inequality in the Aging Experience, 3d ed. Thousand Oaks, Calif.: Pine Forge Press, 2000.

WILLIAMS, D. R., and WILSON, C. M. "Race, Ethnicity, and Aging." In Handbook of Aging and the Social Sciences, 5th ed. Edited by R. H. Binstock and L. K. George. San Diego: Academic Press, 2001. Pages 160–178.

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