HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2006.106047v1 97/12/2209    most recent Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Dunlop, D. D. Articles by Chang, R. W. Search for Related Content PubMed PubMed Citation Articles by Dunlop, D. D. Articles by Chang, R. W. Related Collections Aging Other Chronic Disease Disability African Americans/Blacks Hispanics/Latinos Socioeconomic Factors

Dorothy D. Dunlop, PhD, Jing Song, MS, Larry M. Manheim, PhD, Martha L. Daviglus, MD, PhD and Rowland W. Chang, MD, MPH

Dorothy D. Dunlop is with the Institute for Healthcare Studies, the Multidisciplinary Clinical Research Center in Rheumatology, and the Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Ill. Jing Song is with the Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago. Larry M. Manheim is with the Institute for Healthcare Studies, the Multidisciplinary Clinical Research Center in Rheumatology, and the Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago. Martha L. Daviglus is with the Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago. Rowland W. Chang is with the Multidisciplinary Clinical Research Center in Rheumatology, the Department of Medicine, the Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, and the Arthritis Center, Rehabilitation Institute of Chicago, Chicago.

Correspondence: Requests for reprints should be sent to Dorothy D. Dunlop, PhD, Institute for Healthcare Studies, Northwestern University, 676 N St Clair St, Suite 200, Chicago, IL 60611 (e-mail: ddunlop{at}northwestern.edu).

Objectives. We investigated differences in the development of disability in activities of daily living among non-Hispanic Whites, African Americans, Hispanics interviewed in Spanish, and Hispanics interviewed in English.

Methods. We estimated 6-year risk for disability development among 8161 participants 65 years or older and free of baseline disability. We evaluated mediating factors amenable to clinical and public health intervention on racial/ethnic difference.

Results. The risk for developing disability among Hispanics interviewed in English was similar to that among Whites (hazard ratio [HR]=0.99; 95% confidence interval [CI] = 0.6, 1.4) but was substantially higher among African Americans (HR=1.6; 95% CI=1.3, 1.9) and Hispanics interviewed in Spanish (HR=1.8; 95% CI=1.4, 2.1). Adjustment for demographics, health, and socioeconomic status reduced a large portion of those disparities (African American adjusted HR=1.1, Spanish-interviewed Hispanic adjusted HR=1.2).

Conclusions. Higher risks for developing disability among older African Americans, and Hispanics interviewed in Spanish compared with Whites were largely attenuated by health and socioeconomic differences. Language- and culture-specific programs to increase physical activity and promote weight maintenance may reduce rates of disability in activities of daily living and reduce racial/ethnic disparities in disability.