Gender, race, and health: the structure of health status among older adults.

A previously developed model of disease, disability, functional limitation, and perceived health was examined for race and/or gender biases. This model focuses on (a) the direct effects of three factors on perceived health status, (b) how disability, functional limitations, and self-rated health interrelate, and (c) how race and gender condition these interrelationships. The results confirm the construct validity of separate dimensions of disability and functional limitation, and indicate that their differential effects are further modified by gender. Eight significant differences in structural effects are identified, including one gender effect among both blacks and whites, and seven additional gender effects among whites. In the structural model, then, most differences are gender differences among whites. The significant racial differences within gender were found only in the measurement model. Race differences for upper body disability and perceived health are consistent across gender. Sex differences, however, in measures of basic ADLs and household ADLs are not consistent across race. The findings confirm earlier conclusions that differences in the measurement of health exist between males and females, and between blacks and whites, but that the differences in the causes of perceived health exist only between males and females.