Heterogeneity in Healthy Aging Among U.S. Latinos: A Dual Functionality Perspective
Catherine García, Blaklee R Kemp, Courtney Boen, Marc A Garcia
The Journals of Gerontology: Series B, March 2026
Abstract
Objectives
This study examines heterogeneity in healthy aging among U.S. Latinos using a dual functionality perspective–the absence of both cognitive and physical limitations. We aim to quantify age-related changes and subgroup disparities by heritage and nativity, disaggregated by sex.
Methods
We analyzed 16 years of nationally representative data from the American Community Survey (2008–2023), including 1,902,870 Latino adults. Logistic regression models estimated age-specific probabilities of dual functionality across heritage and nativity subgroups, adjusting for sociodemographic covariates. Analyses were stratified by sex, and subgroup deviations from pan-ethnic Latino averages were calculated.
Results
Dual functionality declines with age, but subgroup differences are pronounced. At age 45, South American male and female respondents had the highest dual functionality (≥97%), whereas island-born Puerto Ricans had the lowest (≤89%). By age 85, South Americans maintained a relative advantage, while Puerto Ricans remained disadvantaged. Foreign-born Latinos generally exhibited higher dual functionality than U.S.-born peers; this advantage narrowed or reversed with age, particularly among women. Notably, U.S.-born South American men showed steep declines after age 75, in contrast to sustained advantages among foreign-born Central Americans.
Discussion
These findings reveal deep inequities in functional aging that emerge well before old age. Dual functionality offers a culturally grounded and policy-relevant metric for assessing aging equity. The persistent disadvantage among Puerto Ricans–particularly island-born–signals the enduring impact of structural inequality. Addressing these disparities requires life-course informed interventions that prioritize functional health, autonomy, and dignity in aging.
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