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Educational status and active life expectancy among older blacks and whites.
N Engl J Med. 1993 Jul 08; 329(2):110-6.NEJM

Abstract

BACKGROUND AND METHODS

Persons of low socioeconomic status are known to have reduced life expectancy. In a study of the relation of socioeconomic status to disability-free or active life expectancy among older persons, we analyzed prospectively gathered data on 2219 blacks and 1838 whites who were 65 years of age or older in the Piedmont region of North Carolina. We defined disability as the inability to perform independently one or more basic functional activities such as walking, bathing, dressing, eating, and using the toilet. For subgroups defined by sex, race, and education, statistical models were used to estimate, for persons at each year of age, the probability of transition from not being disabled or being disabled at base line to not being disabled, being disabled, or having died one year later. These transition probabilities were then entered into increment-decrement life tables to generate estimates of total, active, and disabled life expectancy (with total life expectancy equal to active life expectancy plus disabled life expectancy).

RESULTS

Sixty-five-year-old black men had a lower total life expectancy (11.4 years) and active life expectancy (10 years) than white men (total life expectancy, 12.6 years; active life expectancy, 11.2 years), although the differences were reduced after we controlled for education. The estimates for 65-year-old black women (total life expectancy, 18.7 years; active life expectancy, 15.9 years) were similar to those for white women. Black men and women 75 years old and older had higher values for total life expectancy and active life expectancy than whites, and the differences were larger after stratification for education. Education had a substantially stronger relation to total life expectancy and active life expectancy than did race. At the age of 65, those with 12 or more years of education had an active life expectancy that was 2.4 to 3.9 years longer than the values for those with less education in all the four subgroups defined by sex and race. Overall, the subgroups with longer total life expectancy and active life expectancy also lived more years with a disability.

CONCLUSIONS

Among older blacks and whites, the level of education, a measure of socioeconomic status, has a greater effect than race on total life expectancy and active life expectancy.

Authors+Show Affiliations

Epidemiology, Demography, and Biometry Program, National Institute on Aging, Bethesda, MD 20892.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

8510687

Citation

Guralnik, J M., et al. "Educational Status and Active Life Expectancy Among Older Blacks and Whites." The New England Journal of Medicine, vol. 329, no. 2, 1993, pp. 110-6.
Guralnik JM, Land KC, Blazer D, et al. Educational status and active life expectancy among older blacks and whites. N Engl J Med. 1993;329(2):110-6.
Guralnik, J. M., Land, K. C., Blazer, D., Fillenbaum, G. G., & Branch, L. G. (1993). Educational status and active life expectancy among older blacks and whites. The New England Journal of Medicine, 329(2), 110-6.
Guralnik JM, et al. Educational Status and Active Life Expectancy Among Older Blacks and Whites. N Engl J Med. 1993 Jul 8;329(2):110-6. PubMed PMID: 8510687.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Educational status and active life expectancy among older blacks and whites. AU - Guralnik,J M, AU - Land,K C, AU - Blazer,D, AU - Fillenbaum,G G, AU - Branch,L G, PY - 1993/7/8/pubmed PY - 1993/7/8/medline PY - 1993/7/8/entrez KW - Adult KW - Age Factors KW - Aged KW - Americas KW - Blacks KW - Cultural Background KW - Demographic Factors KW - Developed Countries KW - Differential Mortality KW - Economic Factors KW - Educational Status KW - Ethnic Groups KW - Health KW - Length Of Life KW - Life Expectancy KW - Mortality KW - North America KW - Northern America KW - Population KW - Population Characteristics KW - Population Dynamics KW - Socioeconomic Factors KW - Socioeconomic Status KW - United States KW - Whites SP - 110 EP - 6 JF - The New England journal of medicine JO - N Engl J Med VL - 329 IS - 2 N2 - BACKGROUND AND METHODS: Persons of low socioeconomic status are known to have reduced life expectancy. In a study of the relation of socioeconomic status to disability-free or active life expectancy among older persons, we analyzed prospectively gathered data on 2219 blacks and 1838 whites who were 65 years of age or older in the Piedmont region of North Carolina. We defined disability as the inability to perform independently one or more basic functional activities such as walking, bathing, dressing, eating, and using the toilet. For subgroups defined by sex, race, and education, statistical models were used to estimate, for persons at each year of age, the probability of transition from not being disabled or being disabled at base line to not being disabled, being disabled, or having died one year later. These transition probabilities were then entered into increment-decrement life tables to generate estimates of total, active, and disabled life expectancy (with total life expectancy equal to active life expectancy plus disabled life expectancy). RESULTS: Sixty-five-year-old black men had a lower total life expectancy (11.4 years) and active life expectancy (10 years) than white men (total life expectancy, 12.6 years; active life expectancy, 11.2 years), although the differences were reduced after we controlled for education. The estimates for 65-year-old black women (total life expectancy, 18.7 years; active life expectancy, 15.9 years) were similar to those for white women. Black men and women 75 years old and older had higher values for total life expectancy and active life expectancy than whites, and the differences were larger after stratification for education. Education had a substantially stronger relation to total life expectancy and active life expectancy than did race. At the age of 65, those with 12 or more years of education had an active life expectancy that was 2.4 to 3.9 years longer than the values for those with less education in all the four subgroups defined by sex and race. Overall, the subgroups with longer total life expectancy and active life expectancy also lived more years with a disability. CONCLUSIONS: Among older blacks and whites, the level of education, a measure of socioeconomic status, has a greater effect than race on total life expectancy and active life expectancy. SN - 0028-4793 UR - https://www.unboundmedicine.com/medline/citation/8510687/Educational_status_and_active_life_expectancy_among_older_blacks_and_whites_ L2 - https://www.nejm.org/doi/10.1056/NEJM199307083290208?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -