Race, frailty, life and death

A recent paper circulated by the National Bureau of Economic Research https://www.nber.org/papers/w32971 constructs measures of frailty.

How does one do that? From the Health and Retirement Study, HRS, which covers adults in the US over age 50, you consider all activities of daily living like bathing, eating, walking several blocks, taking medication, grocery shopping, etc. and simply tally for each person in the sample whether that person has difficulty carrying out these activities. The ratio of activities carried out with difficulty divided by the total number of activities is the frailty index for that person. And you can calculate this index for all people in the sample and trace out this index over time as people age.

Some results:

Whites have lover frailty indices than Hispanics and Blacks. This is true for both men and women.

These differences are large: A 55-year-old Black man has the same frailty index, on average, as a 68-year-old White male, a 13 year difference. For Black and White women that difference is 20 years.

Why are such measures of frailty important? It turns out they are good predictors of future decisions, outcomes and quality of life. For example, someone in the lowest 20%ile of the frailty index is over 13% more likely to die over the next two years than someone in the highest 20%ile of that distribution.

What are the racial implications? If Black women had the same frailty index at age 55 as White women, simulations based on the estimates in the paper reveal that their life expectancy at age 55 would increase from 82.6 to 83.8, an increase of more than one year.

Some questions arise:

Why are frailty indices for Blacks and Hispanics so much higher than for whites?

To what extent are social and economic conditions contributing to this large racial gap?

Are we as a society content knowing that such large health gaps exist?

What might we do to bridge this gap?