Understanding how race/ethnicity and gender define age-trajectories of disability: an intersectionality approach

Revealing the shape of knowledge using an intersectionality lens: results of a scoping review on the health and health care of ethnocultural minority older adults

This paper uses an intersectionality theoretical lens to interrogate selected findings of a scoping review of published and grey literature on the health and health-care access of ethnocultural minority older adults. Our focus was on Canada and countries with similar immigrant populations and health-care systems. Approximately 3,300 source documents were reviewed covering the period 1980–2010: 816 met the eligibility criteria; 183 were Canadian. Summarised findings were presented to groups of older adults and care providers for critical review and discussion. Here we discuss the extent to which the literature accounts for the complexity of categories such as culture and ethnicity, recognises the compounding effects of multiple intersections of inequity that include social determinants of health as well as the specificities of immigration, and places the experience of those inequities within the context of systemic oppression. We found that Canada's two largest immigrant groups – Chinese and South Asians – had the highest representation in Canadian literature but, even for these groups, many topics remain unexplored and the heterogeneity within them is inadequately captured. Some qualitative literature, particularly in the health promotion and cultural competency domains, essentialises culture at the expense of other determinants and barriers, whereas the quantitative literature suffers from oversimplification of variables and their effects often due to the absence of proportionally representative data that captures the complexity of experience in minority groups.

The Intersection and Accumulation of Racial and Gender Inequality: Black Women's Wealth Trajectories

Prior research has found evidence of large racial and gender disparities in wealth, with blacks possessing less wealth than whites and women having less wealth than men. An intersectionality approach suggests that the overlapping impacts of racial and gender domination are likely to combine in a multiplicative fashion that places black women in a uniquely precarious economic position. However, little is known about the wealth holdings of black women and even less is known about whether their wealth increases, decreases or remains stable as they approach retirement age, a stage of life when savings are especially important. This study utilizes seven waves of panel data from the Health and Retirement Study (HRS) and growth curve models to estimate the wealth trajectories of black women between the ages of 51 and 73. Results reveal that black women have especially low levels of net worth and net financial assets during middle and late life, suggesting high risk of economic insecurity in later life. Consistent with political economy and intersectionality perspectives, their persistently low wealth trajectories are likely the result of state policies, discrimination, residential segregation and health disparities. Ameliorative policy prescriptions are discussed.

Trajectories of social engagement and limitations in late life

Although studies have established important links between social relations and health, much of this research does not take into account the dynamic nature of both social relations and health over time. The present study combines person-centered and variable-centered approaches and uses social integration theory within the life course framework to examine patterns of change in social engagement and how those patterns relate to trajectories of physical and cognitive limitations among older adults, using data from the Americans' Changing Lives survey, a nationally representative panel study (N = 1,667). Individuals who had trajectories of high and increasing social engagement experienced lower levels of physical and cognitive limitations over time. The findings suggest the importance of maintaining high levels of social engagement for the physical and cognitive health of older adults.

Gender, social engagement, and limitations in late life

This study examines gender differences in the pathways among social engagement, physical limitations and cognitive limitations among U.S. older adults. It improves upon previous literature by longitudinally testing both social benefit and selection hypotheses, examining gender differences in these relationships, gaining modeling advantages through structural equation modeling, and by incorporating the frequency of participation in social activities as an important source of social integration that may influence health among older adults. This study uses U.S. panel data of adults aged 60 and older from the Americans' Changing Lives survey (N = 1642) from 1986, 1989, and 1994 in a cross-lagged panel design to better understand these relationships. For women, the flow is from greater social engagement to lower levels of subsequent physical and cognitive limitations, whereas for men the flow is from greater physical and cognitive limitations to lower levels of subsequent social engagement.