Black-White Differences in Disability and Morbidity in the Last Years of Life

To assess black-white differences in disability and morbidity in the last years of life, the authors analyzed data from the National Health Interview Survey from 1986 to 1994, with mortality follow-up through December 1995. A baseline household interview was conducted for 10,187 decedents aged 50 years and over within 2 years before death. Data collected included long-term limitation of activity, number of chronic conditions, number of bed days, doctor visits, and days of short hospital stay during the year preceding the interview. For both blacks and whites, educational attainment was inversely associated with disability/morbidity indices. Black decedents had greater morbidity compared with whites, and this difference was consistent across educational levels. Adjustment for education reduced the black-white difference in limitation of activity score by 32%, bed days by 59%, and hospital stay days by 40%. This study from a national representative US sample indicates that black decedents experienced greater disability/morbidity and worse quality of life through their last few months or years of life. Educational attainment was associated with morbidity before death and accounted for much of the black-white difference.