Life course determinants of racial and ethnic disparities in functional health trajectories

Previous research has documented racial/ethnic disparities in functional health trajectories in old age, though little work has investigated the relative contribution of early and later life insults in their genesis. This paper uses two-part latent curve models to investigate the life course determinants of racial/ethnic disparities in functional health trajectories in the USA. We find that blacks and Hispanics have both a greater probability of having any limitation at baseline and more limitations on average among those who have any. Over time, there is convergence in trajectories between Hispanics and non-Hispanic whites, though the black-white gap remains constant. In addition, we find that disparities result from differential exposure to poor childhood health, early life socioeconomic deprivation, as well as adult health and socioeconomic attainment. However, the impact of childhood insults is largely mediated by more contemporaneous factors. We also find little evidence that the impact of life course factors varies across groups. (C) 2009 Elsevier Ltd. All rights reserved.