Education Inequalities in Dual-Function Life Expectancy in the United States

Shawn Bauldry , Purdue University
Patricia A. Thomas, Purdue University
Madison Sauerteig-Rolson, Purdue University
Kenneth Ferraro, Purdue University

Background: This study investigates gender- and education-based inequalities in dual functionality, a new concept that captures a combination of physical and cognitive functioning, both of which are important for independent living and quality of life. Methods: Using data from the Health and Retirement Study and the National Health Interview Study Linked Mortality Files, we define a measure of dual functionality based on the absence of limitations in activities of daily living and dementia. We estimate dual-function rates (percent free of limitations) and age-50 dual-function expectancy (2FLE) by gender and education. Results: In their early 50s, only about 65 percent of women with less than a high school degree manifest dual functionality as compared with over 90 percent of women with at least a four-year college degree. A similar pattern holds among men. These education-based gaps in dual functionality remain across later life, even as dual-function rates decline at older ages. The lower dual-function rates among women and men with less education translate into inequalities of 11.6 to 12.9 years in age-50 2FLE between older adults with at least a four-year college degree compared to older adults with less than a high school degree. Discussion: Older adults, particularly women, with less than a high school degree are estimated to live a smaller percentage of their remaining years with dual functionality compared with older adults with at least a college degree. These inequalities have implications for the distribution of caregiving resources of individuals, family members, and the broader health care community.

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 Presented in Session 110. Social Inequalities in Health, Wellbeing and Morbidity