This DataBrief describes the differences in reported disability and cognitive impairment among Black, Hispanic and White older Americans.

1. Racial/Ethnic Disparities in Disability Approximately 1 out of 3 Black and Hispanic older Americans report having a disability or cognitive impairment compared to 1 out of 5 White older Americans? DataBrief Series ● February 2011 ● No. 14

3. 29.5% of Hispanics and 35% of Black Americans have a disability or cognitive impairment, compared to 20% of White Americans.1

4. Poor health status, low education levels, and low socioeconomic status contribute to the likelihood that an individual will develop a disability and require assistance in the Activities of Daily Living (ADLs) such as eating, bathing, dressing, and toileting.2

5. Rates of disability among older Americans have been declining over the last two decades, but the declines have been greatest among the well-educated and high-income populations. As a result, the disparities in disability between high and low-income groups and high and low education categories have widened. Black and Hispanic Americans, as minority populations, are more heavily represented in lower income and lower educational attainment categories, which may contribute to the higher rates of disability among these populations.3Page 2 1 Avalere analysis of the 2006 Health and Retirement Survey (HRS) data. 2 Dunlop, Dorothy et al (2007). “Racial/Ethnic Differences in the Development of Disability Among Older Adults.” American Journal of Public Health, 97(12):2209-2215. 3Robert F. Schoeni, Vicki A. Freedman, and Linda G. Martin (2008). Socioeconomic and Demographic Disparities in Trends in Old-Age Disability, ed. David M. Cutler and David A. Wise (Chicago: University of Chicago Press). DataBrief (2011) ● No. 14

6. Older Blacks and Hispanics have Higher Rates of Disability than Older Non-Hispanic Whites DataBrief (2011) ● No. 14 Page 3 Percent of Individuals Age 65 and Older with Disabilities * Cognitive impairment (CI) is another important type of disability that commonly requires intensive services and supports. 1 Total Non-Hispanic Whites n= 29,139,825. Does not sum to 100% due to rounding. 2 Total Hispanics n= 1,794,507 3 Total Blacks n= 2,545,004

7. A Clear Policy Connection The facts in this DataBrief come from the 2006 Health and Retirement Study (HRS), a longitudinal survey of a representative sample of 22,000 Americans conducted every two years. The HRS contains information on impairments in activities of daily living and cognitive impairment, by racial/ethnic group. This DataBrief compares older non-Hispanic Black Americans and all Hispanics to non-Hispanic Whites. HRS reports data for Asians and Native Americans together as “Other.” Because this data is reported in aggregate and the sample size is relatively small, this analysis does not include Asians and Native Americans. This analysis is limited to adults over age 65. Any respondent indicating a difficulty with one or more activities of daily living is considered to have a disability. . Older Black and Hispanic Americans have higher rates of disability than older non-Hispanic Whites. Although disability rates have been decreasing over the last two decades, disparities between racial and ethnic groups persist, which affect health status and associated health spending.1 Eliminating disparities in health and health care has been a central focus in the United States for a number of years. As a key quality improvement objective, improving health and health care is one of the key priorities in the Healthy People 2020 initiative and was a focus of the Affordable Care Act. However, as policymakers create programs to eliminate disparities in health and health care, they need to take into account disparities in disability as well. The Health and Human Services Office of Disability (OD) is tasked with coordinating and overseeing programs and policies aimed at improving the health and well-being of individuals with disabilities. In addition, the Office of Minority Health, reauthorized by the recently passed Affordable Care Act, is charged with improving the health of racial and ethnic minority populations. These two Offices play vital roles in coordinating efforts across the Department of Health and Human Services and will be instrumental in constructing effective policies, programs, and demonstrations to reduce disparities in disability. 1Lubitz, James et al (2003). “Health, Life Expectancy, and Health Care Spending Among the Elderly.” New England Journal of Medicine. 349(11):1048-1055. DataBrief (2011) ● No. 14 Page 4