The Demography of Mental Health Among Mature Adults in a Low-Income,High-HIV-Prevalence Context

Very few studies have investigated mental health in sub-Saharan Africa (SSA). Using data from Malawi, this article provides a first picture of the demography of depression and anxiety (DA) among mature adults (aged 45 or older) in a low-income country with high HIV prevalence. DA are more frequent among women than men, and individuals affected by one are often affected by the other. DA are associated with adverse outcomes, such as poorer nutrition intake and reduced work efforts. DA also increase substantially with age, and mature adults can expect to spend a substantial fraction of their remaining lifetime—for instance, 52 % for a 55-year-old woman—affected by DA. The positive age gradients of DA are not due to cohort effects, and they are in sharp contrast to the age pattern of mental health that has been shown in high-income contexts, where older individuals often experience lower levels of DA. Although socioeconomic and risk- or uncertainty-related stressors are strongly associated with DA, they do not explain the positive age gradients and gender gap in DA. Stressors related to physical health, however, do. Hence, our analyses suggest that the general decline of physical health with age is the key driver of the rise of DA with age in this low-income SSA context.     

Occupational careers and mortality of elderly men

This article presents findings from an analysis of occupational differentials in mortality among a cohort of males aged 55 years and older in the United States for the period 1966-1983. Using the National Longitudinal Survey of Mature Men, we construct event histories for 3,080 respondents who reach the exact age of 55. The dynamics that characterize socioeconomic differentials in mortality are analyzed by evaluating the differential effects of occupation over the career cycle. Maximum likelihood estimates of hazard-model parameters show that the mortality of current or last occupation differs substantially from that of longest occupation, controlling for education, income, health status, and other sociodemographic factors. In particular, the rate of mortality is reduced by the substantive complexity of the longest occupation while social skills and physical and environmental demands of the latest occupation lower mortality.     

Determinants of Mortality at Older Ages: The Role of Biological Markers of Chronic Disease

Researchers have had a longstanding interest in understanding the determinants of mortality. This article examines the impact of a broad array of biological markers, together with self‐reports of physical and mental health status, on the probability of dying for older adults. The estimates are derived from logistic regression models based on data from a national survey in Taiwan. The analysis confirms previous studies demonstrating the effects of clinical measures related to metabolic syndrome on mortality and identifies detrimental effects of neuroendocrine and immune‐system markers. The results reveal that biomarkers provide independent explanatory power in the presence of self‐reported health measures. The associations between biomarkers and mortality found here provide new avenues for projecting future mortality and elucidating differences in longevity across populations.     

Domestic Harm and Neglect Among Lesbian,Gay, and Bisexual Older Adults

This study examined harm, hurt, and neglect by caregivers as well as self-neglect and physical and mental health status among 113 lesbian, gay, and bisexual (LGB) older adults aged 60–88 years, who attended community-based social and recreation programs or groups in the United States. Reporting on their experiences with caregivers, 22.1% of the participants experienced at least one type of harm, including physical, emotional, verbal, sexual, financial, and neglectful; additionally, 25.7% of the participants reported they knew LGB older adults who experienced at least one type of harm from his or her caregiver. With regard to self-neglect, 62.8% reported experiencing it; those indicating positive psychological health reported fewer experiences with self-neglect.     

Serious psychological distress,sex, and falls among the elderly

Serious psychological distress and falls are two major public health problems among the elderly. This study aims to test the hypothesis that although serious psychological distress can increase the risks of falls among the elderly, it tends to affect elderly women more than elderly men. Data of this study are from the 2011 California Health Survey Interviews (CHIS). We extracted a sample of 13,153 respondents aged 65 and older for this study, including 8,087 females and 5,066 males. We tested both unadjusted and adjusted interaction effects using bivariate and multivariate logistic regression analysis. Elderly women with serious psychological distress had the greatest likelihood of falls as compared to men with serious psychological distress and men and women without serious psychological distress. With respect to the covariates, limitations of physical activity and poor self-rated health status, Asian race, and older age were more likely to be associated with falls. This study provides further information on sex disparities of falls among the elderly such that serious psychological distress has a greater impact on falls for elderly women than elderly men. Thus, the findings of our studies suggest that mental health services and intervention can be useful to prevent falls for elderly women.     

A Comparison of Older Informal Caregivers and Non-Caregivers Living in Non-Metropolitan Areas

The primary purpose of this study was tocompare the quality of life, health, and socialsupport of caregivers and non-caregivers age 65or older. A secondary purpose was to examineage identity in these two groups. This samplewas taken from a large quality of life surveyof 875 individuals age 55 or older living incommunities in northern British Columbia,Canada (Michalos et al.,2001). We restricted our sample to (a)individuals 65 years or older because we wereparticularly interested in seniors, and (b)married individuals because preliminaryanalyses indicated that marital status was apotentially confounding variable in thecaregiver/non-caregiver comparisons. Thus, oursample consisted of 239 married,community-dwelling respondents ranging in agefrom 65 to 86 years, with an average age of71.8 years. Of these respondents, 48.5% werefemales and 26.4% were caregivers. Generallyspeaking, caregivers and non-caregivers werenot significantly different in terms of qualityof life, self-reported health, and most aspectsof social support and age identity. Seniors,whether they were caregivers or not, reportedpositive levels of quality of life and healthstatus. Caregivers and non-caregivers, however,did differ in terms of: (a) their satisfactionwith their romantic relationships, withcaregivers being less satisfied, and (b) theage they felt mentally with caregivers feelingslightly older mentally than non-caregivers.Thus, caregiver status alone does not appear toresult in lower levels of quality of life,poorer mental and physical health, lower levelsof social support, or older age identitiesoverall in older, married adults living innon-metropolitan areas.     

Comparing Veteran and Non-veteran Racial Disparities in Mid-life Health and Well-being

Using National Longitudinal Survey of Youth 1979 data on mid-life physical health, mental health, and self-esteem, I examine inter- and intra-racial disparities in health and well-being among veteran and non-veteran men (N = 2440). After controlling for selectivity into the military via propensity weighting, I find that black veterans have higher self-esteem than white veterans and comparable black non-veterans, but white veterans have similar mid-life self-esteem as their non-veteran counterparts. I find no evidence of disparities in health for depressive symptoms and self-rated health after taking selection into military service into account. The results suggest that aspects of military service may increase blacks’ self-esteem, possibly due to less discrimination and more opportunity.     

Is the Pro-Poor Premium Exemption Policy of Ghana’s NHIS Reducing Disparities Among the Elderly?

Under the act that established the National Health Insurance Scheme (NHIS), persons 70 years of age or above are automatically enrolled in the scheme and therefore can access health services free at the point of use. This suggests that the elderly who are unable to afford the premiums of private health insurance can enrol in the NHIS thereby eliminating the possibility of disparities in health insurance coverage. Notwithstanding, few studies have examined health insurance coverage among the elderly in Ghana. The lack of studies on the elderly in Ghana may be due to limited data on this important demographic group. Using data from the Study on Global Ageing and Health and applying logit models, this paper investigates whether the pro-poor exemption policy is eliminating disparities among the elderly aged 70 years and older. The results show that disparities in insurance coverage among the elderly are based on respondents’ socio-economic circumstances, mainly their wealth status. The study underscores the need for eliminating health access disparities among the elderly and suggests that the current premium exemptions alone may not be the solution to eliminating disparities in health insurance coverage among the elderly.     

Adolescent Health in Hong Kong: Disturbing Socio-Demographic Correlates

Relationships between self-assessed health status and socio-demographic variables were examined among 4,502 Chinese adolescent secondary school students in Hong Kong, a modern society with traditional Chinese ethno-cultural origin. Health status was self-rated in four aspects: overall health, physical health, mental health, and health effects on usual activities. In both the bivariate and multivariate analyses, there was health advantage for adolescent males relative to females, and there were inverse relationships between health level and age/level of study, in all four health aspects. Family structure was an important risk factor for all health aspects. Two-parent family was associated with significantly higher health levels than those living with father only, or with no parent/single parent and other adults, but not those living with mother only. Mainland-born adolescents had higher risks of low health level than the local-born in the aspect of overall health status. Finally economically well-being was associated with lower level of mental health.     

宗教参与对我国高龄老人死亡风险的影响分析

根据中国高龄老人健康长寿跟踪调查数据(1998～2005年),利用Cox比例风险模型考察宗教参与对高龄老人死亡风险的影响机制,深入分析人口学特征、肌体健康、心理健康、健康行为及社会经济支持这五类因素在宗教参与和死亡风险关系中的交互作用,以此对西方文献中相关的4种理论模型进行实证检验。结果表明,宗教参与对死亡风险存在一定程度的影响,但是控制其他因素则会削弱这种影响,其中肌体健康因素所代表的"替代性机制"能够将两者关系的显著作用完全消除。     

The Relationship Between Physical Activity and Perceived Health Status in Older Women: Findings from the Woman’s College Alumni Study

Using data collected from the Woman’s College (WC) Alumni Study, the purpose of this study was to determine whether perceived health status is related to physical activity in older women. A multiple linear regression analysis was conducted to examine the relationship between amounts of physical activity and self-reported health status. The results of the current study reveal that the level of physical activity is significantly correlated with perceived health status. The findings of this study have implications for the assessment of older individuals’ health and may lead to interventions that are tailored to increase physical activity among older women.     

Risk Exposure in Early Life and Mortality at Older Ages: Evidence from Union Army Veterans

This study examines the relation between risk exposures in early life and hazard of mortality among 11,978 Union Army veterans aged 50 and over in 1900. Veterans' risk exposures prior to enlistment—as approximated by birth season, country of birth, residential region, city size, and height at enlistment—significantly influenced their chance of survival after 1900. These effects are robust irrespective of whether socioeconomic well‐being in 1900 has been taken into account; however, they are sensitive to the particular age periods selected for survival analysis. Whereas some of the effects such as being born in Ireland and coming from large cities became apparent in the first decade after 1900 and then dissipated over time, the effects of birth season, being born in Germany, residential region in the United States, and height at enlistment were more salient in the post‐1910 periods. Height at enlistment shows a positive association with risk of mortality in the post‐1910 periods. Compared to corresponding findings from more recent cohorts, the exceptional robustness of the effects of risk exposures prior to enlistment on old‐age mortality among the veterans highlights the harshness of living conditions early in their lives.     

Responding to social service and health care needs of aging women veterans

This is a study about aging women veterans who served in the military during the 1940s, 1950s and 1960s. The Veterans Administration (VA) represents a formal network of health and support services that offers a wide range of benefits for veterans. However, older women veterans may not be aware of, or benefit from, all that may be available to them. The purpose of this study was to learn about aging women veterans' knowledge and utilization of services and benefits available through the VA. Telephone interviews were conducted in April 1998 with 220 women veterans in Massachusetts who were age 60 + years. There was generally strong identification with veterans' organizations among the women surveyed. These women veterans were likely to receive medical care-a major benefit available through the VA. The benefits veterans were least likely to know about included services that may be particularly relevant and helpful to an aging veteran, such as long-term care and home adaptation services. Strategies are suggested to enhance outreach efforts to aging veterans.     

Remarriage patterns among recent widows and widowers

Remarriage is one of the most important determinants of physical and economic well-being among the widowed. The goal of this study is to estimate how hazard rates for remarriage vary among widows and widowers on the basis of both observable and unobservable characteristics. The remarriage estimates rely on nationally representative samples of widows and widowers from the Panel Study of Income Dynamics. Continuous-time hazard rate regressions indicate strong age and duration dependence effects for middle-aged widows and widowers and for older widowers. Among middle-aged widows, blacks and those with dependent children in the home have lower rates of remarriage. For middle-aged widowers, living in urbanized areas limits the prospects of remarriage. For older widowers, education and, to some extent, economic status appear to have positive effects on the remarriage rates. Overall, age and time since widowhood have the strongest and most consistent effects on remarriage rates for different widowed groups.     

The weighting of an international health status index

The major purpose of this paper is to suggest possible weights for a global index of health status. The indicators for the global index are taken from the World Health Organization's definition of health as physical, mental and social well-being. These indicators are combined with mortality indicators to arrive at a finalized index. Survey methodology is used to make initial estimates of the weighting of appropriate indicators, based upon a sample of international health scholars. Preliminary results indicate that mortality is weighted 40%, physical health (morbidity and disability) 25%, mental health 15%, and social health 20%. These results are intended as a starting point for future research.     

中国高龄老年人精神失调状况及其影响因素分析

为分析中国高龄老年人的精神失调状况,探讨中国高龄老年人是否健康的度过晚年,本文利用了2000年中国长寿老年人的健康状况的调查数据,从中随机抽取了1006个样本,用logistic回归方法进行了分析。结果显示中国高龄老年人表现出精神失调症状的占48.9%,老年人的心态,人格,婚姻状况,经济状况对老年人精神失调症状都有显著影响,并且发现年龄,性别,对精神失调的影响不显著。中国长寿老年人的精神健康状况需要引起重视。负向心态,离婚,独居和跟家人在一起对精神失调症状影响非常显著;正向心态,自评健康状况好,有偶,住养老机构相比较而言更有利于缓解长寿老人的精神失调症状。     

Responding to Social Service and Health Care Needs of Aging Women Veterans

ABSTRACT

This is a study about aging women veterans who served in the military during the 1940s, 1950s and 1960s. The Veterans Administration (VA) represents a formal network of health and support services that offers a wide range of benefits for veterans. However, older women veterans may not be aware of, or benefit from, all that may be available to them. The purpose of this study was to learn about aging women veterans' knowledge and utilization of services and benefits available through the VA. Telephone interviews were conducted in April 1998 with 220 women veterans in Massachusetts who were age 60 + years.

There was generally strong identification with veterans' organizations among the women surveyed. These women veterans were likely to receive medical care—a major benefit available through the VA. The benefits veterans were least likely to know about included services that may be particularly relevant and helpful to an aging veteran, such as long-term care and home adaptation services. Strategies are suggested to enhance outreach efforts to aging veterans.     

Joint Analysis of Health Histories,Physiological State,and Survival

Data on individual health histories, age trajectories of physiological or biological variables, and mortality allow for the study of the joint evolution of health and physiological states and their effects on mortality. Individual health and physiological trajectories are described using a stochastic process with two mutually-dependent continuous and jumping components. The parameters of this process and mortality rate are identified from the data in which the continuous component is measured in discrete times, and transitions of jumping process are observed.     

Aging behind bars:health care for older female inmates

As the numbers of women in prison have increased, so have the number of older women behind bars. These older women present unique problems for institutions trying to meet their health care needs. We report findings from our national pilot study of federal and state prisons for women. Prisons report basic services for physical and mental health care, and most report having hospice services. However, those that house larger percentages or that expect to house larger percentages of older prisoners do not significantly differ in their approaches to assessing and providing health care from their counterparts. By failing to anticipate the increase in older women, prisons may be failing to provide for many of the health needs of this vulnerable population.