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Journal of Aging and Health
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Income Health Inequalities Among Older Persons

The Mediating Role of Multiple Risk Exposures

Gary W. Evans, PhD

Cornell University, gwe1{at}cornell.edu

Elaine Wethington, PhD

Cornell University

Meredith Coleman, BA

Cornell University

Margo Worms, BA

Cornell University

Edward A. Frongillo, PhD

Cornell University

Objective: We examine whether the pervasive income gradient in health among senior citizens can be explained in part by multiple risk exposure. Method: A representative sample of 457 older persons (M = 74.29 years) living independently at home were assessed in a longitudinal study. Health was assessed with a standard self-report index. Risks included loss of a loved one, caregiver burden, low housing quality, and low social integration. Results: The prospective link between income and subsequent health 2 years later is largely explained by exposure to a confluence of multiple risk factors during the 2-year period. These findings incorporate controls for negative affectivity. Discussion: Low-income, older persons are significantly more likely to have lost a loved one or close friend, be burdened by extensive caregiving demands for someone else, be more socially isolated, and live in lower quality housing. These risk exposures, in turn, largely account for the prospective link between income and health.

Key Words: income • multiple risk • health disparities

This version was published on February 1, 2008

Journal of Aging and Health, Vol. 20, No. 1, 107-125 (2008)
DOI: 10.1177/0898264307309938
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