Evidence map›Paper›PMID 36519710›Full record

ArticleJournal of the American Geriatrics Society2023

Racial inequality in functional trajectories between Black and White U.S. veterans.

Josephine C Jacobs, Christopher Barrett Bowling, Tyson Brown, Valerie A Smith, Kasey Decosimo, Sarah M Wilson, Susan Nicole Hastings, Megan Shepherd-Banigan, Kelli Allen, Courtney Van Houtven

Abstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Josephine C JacobsHealth Economics Resource Center, VA Palo Alto Health Care System, Menlo Park, California, USA.
Christopher Barrett BowlingDurham Geriatrics Research Education and Clinical Center, Durham VA Medical Center, Durham, North Carolina, USA.
Tyson BrownDepartment of Sociology, Duke University, Durham, North Carolina, USA.
Valerie A SmithDurham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, North Carolina, USA.
Kasey DecosimoDurham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, North Carolina, USA.
Sarah M WilsonDurham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, North Carolina, USA.
Susan Nicole HastingsDurham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, North Carolina, USA.
Megan Shepherd-BaniganDurham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, North Carolina, USA.
Kelli AllenDurham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, North Carolina, USA.
Courtney Van HoutvenDurham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, North Carolina, USA.

Funding

Functional limitations during the transition to older ageR01AG062502 · NIA · DUKE UNIVERSITY · PI Christopher Barrett Bowling · 2020 to 2026
$3.4M
A Personalized mHealth Approach to Smoking Cessation for Veterans Living with HIVIK2HX002398 · VA · DURHAM VA MEDICAL CENTER · PI WILSON, SARAH MOSHER · 2018 to 2022
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Increasing mental health services use through enabling resources & family supportIK2HX002591 · VA · DURHAM VA MEDICAL CENTER · PI SHEPHERD-BANIGAN, MEGAN ELIZABETH · 2019 to 2024
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Helping VA optimize its long-term care servicesIK2HX002860 · VA · VETERANS ADMIN PALO ALTO HEALTH CARE SYS · PI JOSEPHINE JACOBS · 2020 to 2026
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HSR&D Senior Research Career Scientist AwardIK6HX002838 · VA · DURHAM VA MEDICAL CENTER · PI Kelli D. Allen · 2020 to 2026
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HSR&D Merit Review Research Career Scientist AwardIK6HX003396 · VA · DURHAM VA MEDICAL CENTER · PI VAN HOUTVEN, COURTNEY HAROLD · 2021 to 2025
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HSRD VA IK2 HX002398HSRD VA IK2 HX002591HSRD VA IK2 HX002860HSRD VA IK6 HX002838HSRD VA IK6 HX003396NIA NIH HHS R01 AG062502
6 · The paper itself

Abstract

backgroundRacial inequality in functional trajectories has been well documented in the U.S. civilian population but has not been explored among Veterans. Our objectives were to: (1) assess how functional trajectories differed for Black and White Veterans aged ≥50 and (2) explore how socioeconomic, psychosocial, and health-related factors altered the relationship between race and function.

methodsWe conducted a prospective, longitudinal analysis using the 2006-2016 Health and Retirement Study. The study cohort included 3700 Veterans who self-identified as Black or White, responded to baseline psychosocial questionnaires, and were community-dwelling on first observation. We used stepwise and stratified linear mixed effects models of biannually assessed functional limitations. The outcome measure was as a count of functional limitations. Race was measured as respondent self-identification as Black or White. Demographic measures included gender and age. Socioeconomic resources included partnership status, education, income, and wealth. Psychosocial stressors included exposure to day-to-day and major discrimination, traumatic life events, stressful life events, and financial strain. Health measures included chronic and mental health diagnoses, smoking, rurality, and use of Veterans Affairs services.

resultsBlack Veterans developed functional limitations at earlier ages and experienced faster functional decline than White Veterans between the ages of 50 and 70, with convergence occurring at age 85. Once we accounted for economic resources and psychosocial stressors in multivariable analyses, the association between race and the number of functional limitations was no longer statistically significant. Lower wealth, greater financial strain, and traumatic life events were significantly associated with functional decline.

conclusionsHealth systems should consider how to track Veterans' function earlier in the life course to ensure that Black Veterans are able to get timely access to services that may slow premature functional decline. Providers may benefit from training about the role of economic resources and psychosocial stressors in physical health outcomes.

Indexed as

Health Status DisparitiesPhysical Functional PerformanceVeteransAgedAged, 80 and overBlack or African AmericanHumansProspective StudiesSurveys and QuestionnairesWhitefunctional limitationsHealth and Retirement Studypsychosocial stressorsracial inequityveterans

Identifiers

PMID36519710
PMCPMC10089950

What OpenQuestion holds

Textmetadata
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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.