Using an interdisciplinary approach, we focus on how social determinants of health affect the aging process (normal and accelerated) for middle- and older-aged adults and ask what leads to health disparities and inequities in this population.
Key Findings from Our Research:
The main determinants of osteoporosis in males and females in a sample of middle- to older-age American adults are inequalities in accessing resources (influenced by social factors), access to health care specifically, and overall health (e.g., underlying frailty; Gough et al. 2021).
Contextualizing the greater living environment (e.g., water and air quality) to look at health disparities leaves much opportunity for improvement, although the datasets included with the Health and Retirement Study are promising (Gough et al. 2022 SERG).
Continuing health inequities in the United States for middle-older adults exist years after their initial identification in the literature. We show middle-older adults identifying as Black/African American are probably still being underdiagnosed for osteoporosis, despite race/ethnicity not being a risk factor, which may also be from quality of care and a result of structural racism (Godde et al. 2022 IAGG).
Housework in males is not protective or a risk factor for high C-reactive protein (CRP), a marker of inflammation. However, in females, male-type housework appears protective over high CRP, particularly for persons identifying as White/European American women (Gough and Godde 2022 DIRC) .
Elevated CRP is not associated with short telomere length, but social determinants that influence accessing health care, as well as underlying medical conditions, appear to be related to short telomere length. Other categories of social determinants of health are not predictors of telomere length (Gough Courtney et al. 2022 Scientific Reports).
Diagnosis of osteoporosis from risk factors alone appears to lead to underdiagnosis of osteoporosis for older adults identifying as Black/African American, even in the presence of fractures. However, when patients had bone scans, underdiagnosis disappeared, which underscores the need for access to a bone scan to help with health inequities due to structural racism and sexism. Patients with Medicare and Private insurance had similar outcomes, but having a combination of these insurances led to better access to a bone scan and a diagnosis (Godde et al. JAG).
More details about our current research projects and grant support can be found on our Research and Funding page.