The Role of Social Determinants of Health in Shaping Racial and Disability Disparities Among Older Adults in the United States.

Abstract

Despite extensive research on social determinants of health, gaps remain in understanding how race and disability intersect to shape health disparities among older adults. This essay examines how structural inequities, including limited access to healthcare, inadequate housing, and economic instability, contribute to poorer health outcomes for racialized older adults with disabilities. Early-life disadvantages, such as growing up in underserved neighborhoods and experiencing systemic discrimination, accumulate over the life course, increasing the risk of chronic health conditions and financial insecurity in later life. Black and Hispanic older adults with disabilities experience disproportionately higher rates of hypertension and diabetes than their White counterparts, reflecting both historical and structural inequities. This essay emphasizes the need for longitudinal research to capture the cumulative effects of social determinants of health on marginalized populations, including Black, Hispanic, Indigenous, and Asian older adults with disabilities. It calls for culturally and disability-competent healthcare systems that incorporate bilingual navigation programs, tailored interventions, and specialized training for healthcare providers. Policy recommendations include strengthening anti-discrimination laws, increasing funding for community-based services, and improving access to telemedicine with a focus on digital equity. Addressing these barriers is essential to advancing health equity and ensuring that all older adults, regardless of race or disability, can age with dignity and well-being.