Skip to main content
×
×
Home

The contribution of dementia to the disparity in family wealth between black and non-black Americans

  • Jennifer E. Kaufman (a1), William T. Gallo (a1) and Marianne C. Fahs (a1)
Abstract

The enormous economic burden of dementia in the United States of America falls disproportionately on families coping with this devastating disease. Black Americans, who are at greater risk of developing dementia than white Americans, hold on average less than one-eighth of the wealth of white Americans. This study explores whether dementia exacerbates this wealth disparity by examining dementia's effect on wealth trajectories of black versus non-black Americans over an eight-year period preceding death, using five waves of data (beginning in 2002 or 2004) on decedents in the 2012 and 2014 waves of the Health and Retirement Study (N = 2,429). Dementia is associated with a loss of 97 per cent of wealth among black Americans, compared with 42 per cent among non-black Americans, while wealth loss among black and non-black Americans without dementia did not differ substantially (15% versus 19%). Dementia appears to increase the probability of wealth exhaustion among both black and non-black Americans, although the estimate is no longer significant after adjusting for all covariates (for blacks, odds ratio (OR) = 2.04, 95% confidence interval (CI) = 0.83, 5.00; for non-blacks, OR = 1.47, 95% CI = 0.95, 2.27). Dementia has a negative association with home-ownership, and the loss or sale of a home may play a mediating role in the exhaustion of wealth among black Americans with dementia.

Copyright
Corresponding author
*Corresponding author. Email: Jennifer.Kaufman87@sphmail.cuny.edu
References
Hide All
Alzheimer's Association (2016) 2016 Alzheimer's disease facts and figures. Alzheimer's and Dementia 12, 459509.
Alzheimer's Association (2017) 2017 Alzheimer's disease facts and figures. Alzheimer's and Dementia 13, 325373.
Arora, K (2016) How does dementia onset in parents influence unmarried adult children's wealth? Social Science and Medicine 152, 156165.
Brown, TH (2016) Diverging fortunes: racial/ethnic inequality in wealth trajectories in middle and late life. Race and Social Problems 8, 2941.
Burd-Sharps, S and Rasch, R (2015) Impact of the US Housing Crisis on the Racial Wealth Gap Across Generations. Brooklyn, NY: Social Science Research Council.
Chien, S, Campbell, N, Chan, C, Hayden, O, Hurd, M, Main, R, Mallett, J, Martin, C, McCullough, C, Meijer, E, Moldoff, M, Pantoja, P, Rohwedder, S and St Clair, P (2015) RAND HRS Data Documentation. Version O. Santa Monica, CA: Labor and Population Program, RAND Center for the Study of Aging.
Chiteji, NS (2010) The racial wealth gap and the borrower's dilemma. Journal of Black Studies 41, 351366.
Chiteji, N and Stafford, F (1999) Portfolio choices of parents and their children as young adults: asset accumulation by African American families. American Economic Review 89, 377380.
Choi, H, Schoeni, RF, Martin, LG and Langa, KM (2018) Trends in the prevalence and disparity in cognitive limitations of Americans 55–69 years old. Journals of Gerontology 73B, supplement 1, S29-S37.
Colello, KJ (2017) Medicaid Financial Eligibility for Long-term Services and Supports. Washington, DC: Congressional Research Service.
Conley, D (2001) Decomposing the black–white wealth gap: the role of parental resources, inheritance, and investment dynamics. Sociological Inquiry 71, 3966.
Crimmins, EM, Saito, Y, Kim, JK, Zhang, YS, Sasson, I and Hayward, MD (2018) Educational differences in the prevalence of dementia and life expectancy with dementia: changes from 2000 to 2010. Journals of Gerontology 73B, supplement 1, S20-S28.
Delavande, A, Hurd, MD, Martorell, P and Langa, KM (2013) Dementia and out-of-pocket spending on health care services. Alzheimer's and Dementia 9, 1929.
Eiken, S, Sredl, K, Burwell, B and Saucier, P (2016) Medicaid Expenditures for Long-Term Services and Supports (LTSS) in FY 2014: Managed LTSS Reached 15 Percent of LTSS Spending. Truven Health Analytics. Available at https://www.medicaid.gov/medicaid/ltss/downloads/ltss-expenditures-2014.pdf.
Garcia, MA, Downer, B, Chiu, C-T, Saenz, JL, Rote, S and Wong, R (in press) Racial/ethnic and nativity differences in cognitive life expectancies among older adults in the United States. The Gerontologist. Available online doi:10.1093/geront/gnx142.
Gittleman, M and Wolff, EN (2000) Racial wealth disparities: is the gap closing? Jerome Levy Economics Institute, Bard College, Working Paper 311. Available at https://papers.ssrn.com/sol3/papers.cfm?abstract_id=243769.
Gittleman, M and Wolff, EN (2004) Racial differences in patterns of wealth accumulation. Journal of Human Resources 39, 193227.
Gurland, BJ, Wilder, DE, Lantigua, R, Stern, Y, Chen, J, Killeffer, EH and Mayeux, R (1999) Rates of dementia in three ethnoracial groups. International Journal of Geriatric Psychiatry 14, 481493.
Health and Retirement Study (2014) Public Use Datasets (Data files). Produced and distributed by the University of Michigan, Ann Arbor, MI.
Herring, C and Henderson, L (2016) Wealth inequality in black and white: cultural and structural sources of the racial wealth gap. Race and Social Problems 8, 417.
Hurd, MD, Martorell, P, Delavande, A, Mullen, KJ and Langa, KM (2013) Monetary costs of dementia in the United States. New England Journal of Medicine 368, 13261334.
Jackman, MR and Jackman, RW (1980) Racial inequalities in home ownership. Social Forces 58, 12211234.
Jutkowitz, E, Kane, RL, Gaugler, JE, MacLehose, RF, Dowd, B and Kuntz, KM (2017) Societal and family lifetime cost of dementia: implications for policy. Journal of the American Geriatrics Society 65, 21692175.
Keating, NC, Fast, JE, Lero, DS, Lucas, SJ and Eales, J (2014) A taxonomy of the economic costs of family care to adults. Journal of the Economics of Ageing 3, 1120.
Kelley, AS, McGarry, K, Gorges, R and Skinner, JS (2015) The burden of health care costs for patients with dementia in the last 5 years of life. Annals of Internal Medicine 163, 729736.
Kochhar, R and Fry, R (2014) Wealth Inequality Has Widened Along Racial, Ethnic Lines Since End of Great Recession. Washington, DC: Pew Research Center. Available at http://www.pewresearch.org/fact-tank/2014/12/12/racial-wealth-gaps-great-recession/.
Krivo, LJ and Kaufman, RL (2004) Housing and wealth inequality: racial-ethnic differences in home equity in the United States. Demography 41, 585605.
Kuebler, M (2013) Closing the wealth gap: a review of racial and ethnic inequalities in homeownership. Sociology Compass 7, 670685.
Langa, KM, Larson, EB, Crimmins, EM, Faul, JD, Levine, DA, Kabeto, MU and Weir, DW (2017) A comparison of the prevalence of dementia in the United States in 2000 and 2012. JAMA Internal Medicine 177, 5158.
Lines, LM, Sherif, NA and Wiener, JM (2014) Racial and Ethnic Disparities Among Individuals with Alzheimer's Disease in the United States: A Literature Review. Research Triangle Park, NC: RTI Press.
Massey, DS (2015) The legacy of the 1968 Fair Housing Act. Sociological Forum (Randolph, NJ) 30, supplement 1, 571588.
McKernan, S, Ratcliffe, C, Simms, M and Zhang, S (2014) Do racial disparities in private transfers help explain the racial wealth gap? New evidence from longitudinal data. Demography 51, 949974.
Menchik, PL and Jianakoplos, NA (1997) Black–white wealth inequality: is inheritance the reason? Economic Inquiry 35, 428442.
MetLife Mature Market Institute (2011) The MetLife Study of Caregiving Costs to Working Caregivers: Double Jeopardy for Baby Boomers Caring for Their Parents. Westport, CT: MetLifeMature Market Institute. Available at https://www.caregiving.org/wp-content/uploads/2011/06/mmi-caregiving-costs-working-caregivers.pdf.
MetLife Mature Market Institute (2012) Market Survey of Long-term Care Costs: The 2012 MetLife Market Survey of Nursing Home, Assisted Living, Adult Day Services, and Home Care Costs. New York, NY: MetLife Mature Market Institute.
Oliver, ML and Shapiro, T (2006) Black Wealth/White Wealth: A New Perspective on Racial Inequality, 2nd Edn. New York, NY: Routledge.
Pfeffer, FT, Danziger, S and Schoeni, RF (2013) Wealth disparities before and after the Great Recession. Annals of the American Academy of Political and Social Science 650, 98123.
Plassman, BL, Langa, KM, Fisher, GG, Heeringa, SG, Weir, DR, Ofstedal, MB, Burke, JR, Hurd, MD, Potter, GG, Rodgers, WL, Steffens, DC, Willis, RJ and Wallace, RB (2007) Prevalence of dementia in the United States: the Aging, Demographics, and Memory Study. Neuroepidemiology 29, 125132.
RAND (2015) RAND HRS Data. Version O (Data file). Santa Monica, CA: RAND Center for the Study of Aging.
Rote, SM and Moon, H (in press) Racial/ethnic differences in caregiving frequency: does immigrant status matter? Journals of Gerontology. Available online doi:10.1093/geronb/gbw106.
Satizabal, CL, Beiser, AS, Chouraki, V, Chene, G, Dufouil, C and Seshadri, S (2016) Incidence of dementia over three decades in the Framingham Heart Study. New England Journal of Medicine 374, 523532.
Shapiro, T, Meschede, T and Osoro, S (2013) The Roots of the Widening Racial Wealth Gap: Explaining the Black–White Economic Divide. Waltham, MA: Institute on Assets and Social Policy, Brandeis University. Available at https://iasp.brandeis.edu/pdfs/Author/shapiro-thomas-m/racialwealthgapbrief.pdf.
Steenland, K, Goldstein, FC, Levey, A and Wharton, W (2016) A meta-analysis of Alzheimer's disease incidence and prevalence comparing African-Americans and Caucasians. Journal of Alzheimer's Disease 50, 7176.
Taylor, P, Kochhar, R, Fry, R, Velasco, G and Motel, S (2011) Wealth Gaps Rise to Record Highs Between Whites, Blacks and Hispanics. Washington, DC: Pew Research Center.
Thomas, ME, Moye, R, Henderson, L and Hayward, DH (2018) Separate and unequal: the impact of socioeconomic status, segregation, and the great recession on racial disparities in housing values. Sociology of Race and Ethnicity 4, 229244.
US Department of Housing and Urban Development (2015) HUD and Associated Bank Reach Historic $200 Million Settlement of ‘Redlining’ Claim (Press release). Available at https://archives.hud.gov/news/2015/pr15-064b.cfm.
US Department of Justice (2017) Justice Department Sues KleinBank for Redlining Minority Neighborhoods in Minnesota. Available at https://www.justice.gov/opa/pr/justice-department-sues-kleinbank-redlining-minority-neighborhoods-minnesota.
Vincent, GK and Velkoff, VA (2010) The Next Four Decades – The Older Population in the United States: 2010 to 2050. Washington, DC: US Department of Commerce, Economics and Statistics Administration, Bureau of the Census.
Yaffe, K, Falvey, C, Harris, TB, Newman, A, Satterfield, S, Koster, A, Ayonayon, H and Simonsick, E (2013) Effect of socioeconomic disparities on incidence of dementia among biracial older adults: prospective study. BMJ (Clinical Research) 347, f7051.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Ageing & Society
  • ISSN: 0144-686X
  • EISSN: 1469-1779
  • URL: /core/journals/ageing-and-society
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed