Race and Gender Differences in Correlates of Death Anxiety Among Elderly in the United States

BACKGROUND: Death anxiety among elderly is a major public health concern. Few studies, however, have been conducted on factors associated with death anxiety. OBJECTIVES: This study investigated race and gender differences in psychosocial correlates of death anxiety among elderly in the US. MATERIALS AND METHODS: With a cross-sectional design, we used data of the Religion, Aging, and Health survey. 1,074 White and Black elderly (age > 65 years, 615 women, 359 men) were entered to this study. Demographic (age, gender, and race), socio-economic (family income, perceived financial difficulty), health (number of chronic medical conditions and self-rated health), and psychological (perceived control over life) factors were measured. Death anxiety was measured using four items. We used linear regressions to determine factors associated with death anxiety based on race and gender. RESULTS: Although race and gender did not have main effects on death anxiety (P > 0.05), they altered correlates of death anxiety. Age was a predictor of death anxiety among women (B = 0.165, P = 0.002) but not men (B = 0.082, P = 0.196). Self-rated health was associated with death anxiety among Whites (B = - 0.120, P = 0.050) but not Blacks (B = - 0.077, P = 0.268). Total family income was only associated with death anxiety among White men. CONCLUSIONS: Demographic, socio-economic, health, and psychological determinants of death anxiety in United States differ based on race, gender, and their intersection. Findings advocate that geriatric psychiatrists and gerontologists who wish to reduce death anxiety among elderly people may need to tailor their interventions to race and gender.