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Journal of Aging and Health
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Article

Income Health Inequalities Among Older Persons: The Mediating Role of Multiple Risk Exposures

Gary W. Evans, PhD1*, Elaine Wethington, PhD2, Meredith Coleman, BA2, Margo Worms, BA2, and Edward A. Frongillo, PhD3

1 Cornell University, Design and Enviromental Analysis, Human Development
2 Cornell University, Human Development
3 Cornell University, Division of Nutritional Sciences

* To whom correspondence should be addressed. E-mail: gwe1{at}cornell.edu.


   Abstract
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.

First published on December 18, 2007, doi:10.1177/0898264307309938

Journal of Aging and Health 2008;20:107.

A more recent version of this article appeared on February 1, 2008


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