Dr. Michal Engelman, University of Wisconsin-Madison, Associate Professor of Sociology
Title of Talk: Cumulative Inequality and the Dynamics of Health Trajectories in Later Life
Abstract: Cumulative inequality theory suggests that populations exposed to disadvantages early in the life course will experience poorer health throughout the life course. However, research on health and aging consistently documents widening racial and socioeconomic disparities from childhood through adulthood, followed by stabilization, convergence, or cross-overs in later life. Using a "punctuated equilibrium" framework for modeling health histories, we show how the puzzle of diminishing disparities emerges from the differential impact of social inequities on mortality and on health declines. Employing non-parametric analyses and discrete outcome multinomial logistic regressions, we find that exposures to disadvantages earlier in the life course are strongly associated with poorer functional health in midlife and with mortality. However, a higher number of functional limitations in midlife is negatively associated with the accumulation of subsequent limitations for white men and women and for Black women, but not Black men. Our findings suggest that at older ages, a higher number of functional limitations is partially a function of longer survival, a paradoxical marker of advantage. The differential dynamics of mortality for Black and white Americans thus both shape and mask persistent health inequities.
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