Public Policy,Health Care and Older Women

For the first time in history, long life has become a problem. The most serious problem facing the older generation is the availability and affordability of health care. While the life expectancy of both men and women cbntinues to increase, the older population of the U.S. is becoming increasingly feminine. In the last two decades there has been a dramatic fall in poverty among the aged, yet for many elderly persons and especially older women, Social Security benefits barely keep them above the poverty level. Access to medical care has improved with Medicaid and Medicare, but not to the extent the aging population had anticipated. Proposals for universal health care have been put forth by politicians, legislators and professional organizations, some of which acknowledge the unique health problems of aging women while others are discriminatory to the aged in general and women in particular. Many believe women must assert themselves if their health care needs are to be adequately and fairly addressed. To this end, more women than ever are becoming involved in the political process, running for and being elected to local, state and national offices. It is anticipated that these women will be sensitive to the health care needs of older women and put forth efforts to develop and implement policies which address these needs.     

Gender differences in positive and negative self-assessments of health status in a national epidemiological study of Israeli aged

The literature in subjective health appraisals frequently notes that elderly women, more so than men, generally experience a lower quality of life in all major indicators (physical health status, functional ability, perceived income adequacy, social contacts, psychological distress, and cognitive ability). The current epidemiological study, of 1,352 reporting Israeli subjects between the ages of 75-94, was undertaken in order to obtain reliable estimates of "poor" and "excellent/good" self assessments of health in a national sample of aged; to identify the most significant correlates of "poor" and "excellent/good" assessments; and to ascertain whether the models of "poor" and "good/excellent" subjective health are different for elderly men and women. While it was found that women indeed rate their health as being poorer than men, of greater theoretical interest was the finding that the pattern of variables predicting to "poor" and "good/excellent" health are different for men and women. The findings point to the fact that the simple health self-evaluation question is not a unitary construct, but rather a complex attitudinal measure which yields different structural and conceptual results when controlling for the subjective health outcome ("poor" or "good/excellent") and when analyzing gender-dichotomized models.     

Gender differences in retirement decisions in Hong Kong

The study of labor force participation at older ages and the process of retirement do not have a long tradition in Asia's newly developed societies. This study, based on telephone survey of 950 respondents, examines various socio-economic factors that would influence retirement decision among older workers in Hong Kong. The findings show that older men were more likely to participate in the labor force than older women. Interestingly, older workers, in particular older women, with pension were less likely to retire. Having a working spouse decreased the likelihood of retirement and older workers, in particular older women, living with married children were more likely to retire. Poor health also discourages the propensity to continue working at old age. These findings confirm that retirement entails much more than just a decision to stop work, and that there were gender differences in retirement decision. Finally, several policy challenges, with reference to elderly women, concerning older workers' labor force participation were discussed.     

Proximate industrial activity and psychological distress

This paper examines the role that gender, occupational status, and family status play in moderating the effect of industrial activity on the psychological well-being of nearby residents. Using a unique spatial assessment of industrial activity and an environmental risk/social stressor framework in conjunction with individual-level data from the Detroit Area Study (DAS) and demographic data from the U.S. census, we find that residents of neighborhoods in close proximity to industrial activity report elevated levels of psychological distress compared to residents of neighborhoods removed from this type of activity. These influences are more pronounced among women but gender differences are also contingent upon occupational and family statuses. We show that specific combinations of work and family statuses make persons particularly vulnerable to the influence of this environmental stressor and women are two and a half times more likely than men to have these vulnerable statuses. This study makes an important contribution to the environmental health literature because it reminds researchers of the fundamental influence of social roles when examining the link between environmental risks and mental health.     

Discrimination Against Older Women in Health Care

Growing awareness of apparent gaps in health care received by women and men raises concern over possible discrimination. This literature review examines this issue for elderly women, whose health care is obtained in a system that also may be permeated with age discrimination. Physicians tend to spend more time with women and older patients, suggesting that discrimination may not be an issue in the physician-patient relationship or may work in favor of older women. However, this may simply reflect elderly women's poorer health. Gender and age disparities in medical treatments received provide a more compelling argument that the health care system is a source of discrimination against older women, who are less likely than others to receive available treatments for cardiac, renal, and other conditions. The history of medical treatment of menopause suggests that stereotypes of older women have been advantageous for segments of the health care system. Finally, in addition to discrimination that has its source within the health care system itself, societal-wide inequities, particularly economic, are extremely detrimental to older women's health care. As we respond to the health care crisis, we must be alert to the potential to rectify those structures and tendencies that can lead to discrimination against women and the aged. Health care reform presents a unique opportunity to ensure health care equity.     

Somebody has to DUST! Gender,health, and housework in older couples

This study examines the link between health and housework among older couples. For those out of the paid labor force, many of the standard arguments about relative resources and time availability no longer hold. Women spend more time on domestic tasks than men at any age; however, it is unclear how health shapes the household division of labor based on gender among older adults. This study examines the relative effect of three dimensions of health. Women’s poor health increases the chance of an equal division of labor, but the gender nature of household tasks may limit women’s ability to cut back.     

Socio-demographic Differences in Self-reported Psychological Distress Among 25- to 64-Year-Old Finns

Background Mental health problems are a major public health issue worldwide. The aim of this study was to assess the relative importance of socio-demographic characteristics associated with different domains of psychological distress in Finland. Methods Data source was a nationwide survey “Health Behaviour and Health among the Finnish Adult Population” (AVTK), from years 2002 to 2003 (N = 5425; response rate 66%). Psychological distress was measured by self-reported questions of general mental health (MHI-5), depression, insomnia and stress. Socio-demographic factors included education, employment status, partnership and children living in the household. Main analyses were conducted by multivariate logistic regression. Results Education, employment and partnership were associated with most of the psychological distress outcomes. Respondents with a lower educational level had poor mental health in both genders but less insomnia and stress in men. Those with an intermediate education had the least stress in women. The unemployed and retired were at a higher risk for poor mental health and depression. Moreover, employment status was associated with insomnia and stress in men. Respondents not having a partner showed a higher risk of psychological distress according to all measures. Not having children living in the household was associated with insomnia in women and with less stress in men. Conclusions Socio-demographic factors, such as having a partner and employment status, are associated with several measures of psychological distress indicating the importance of social and economic factors to psychological well-being. The association of education and of having children living at home varies by the domain of psychological distress measure.     

Stressors,Coping Resources,Functioning, and Role Limitations Among Older Korean Immigrants: Gender Differences

This study explored the differential impacts of stressors and coping resources on the functioning and roles of 246 older Korean immigrant men and women. Older Korean immigrant women were significantly more likely than men to have acculturation and socioeconomic stressors, physical/social functioning problems, and role limitations. English-language barriers and lack of transportation were significantly related to lower functioning and higher role limitations of older Korean women compared to those of older men. Providing social and health care services with bilingual and transportation services to older Korean immigrant women is recommended to increase their physical/social functioning and role performance.     

Gender and Intergenerational Co-residence in Egypt and Tunisia

This paper compares the levels and determinants of intergenerational co-residence among older women and men in Egypt and Tunisia. Women in both settings have higher odds than do men of living in child-headed households, largely because women more often are widowed and have fewer economic resources. In Tunisia, women have higher odds than do men of living in child-headed households partly because of their poorer health. In Egypt, the odds of living in parent- and child-headed intergenerational households for unmarried compared to married older adults are higher for women than men. Disparate needs and marital histories likely contribute to the different living arrangements of older women and men in these settings.     

Population aging raises questions for policymakers

This issue of Asia-Pacific Population and Policy examines the size of the elderly population in Asia and projections for the next 50 years. It discusses some of the characteristics of Asia's elderly population. Information is based on a study of population momentum and population aging at the East-West Center prepared by the UN for the 32 countries in East, Southeast, and South Asia with populations of 150,000 or more. Demographic analysis revealed that the population aged 65 and above are projected to increase during 2000-50 by about 3% per year; of all Asians aged 55 and older, roughly one-half are now between the ages of 55 and 64, about one-third are between 65 and 74, and almost one-sixth are 75 and above. In most countries of Asia, older women are outnumbered by older men. Among the population aged 55 and above, there are about 90 men for every 100 women and among those aged 75 and above, there are only about 70 men for every 100 women. This analysis of demographic data suggests that the elderly population will expand dramatically in Asia over the next 50 years. This changing situation poses a challenge for policy makers in the provision of personal care and financial support for Asia's growing elderly population.     

Education and Male-Female Differences in Later-Life Cognition: International Evidence From Latin America and the Caribbean

This study explores the role of early-life education for differences in cognitive functioning between men and women aged 60 and older from seven major urban areas in Latin America and the Caribbean. After documenting statistically significant differences in cognitive functioning between men and women for six of the seven study sites, I assess the extent to which these differences can be explained by prevailing male-female differences in education. I decompose predicted male-female differences in cognitive functioning based on various statistical models for later-life cognition and find robust evidence that male-female differences in education are a major driving force behind cognitive functioning differences between older men and women. This study therefore suggests that early-life differences in educational attainment between boys and girls during childhood have a lasting impact on gender inequity in cognitive functioning at older ages. Increases in educational attainment and the closing of the gender gap in education in many countries in Latin America and the Caribbean may thus result in both higher levels and a more gender-equitable distribution of later-life cognition among the future elderly in those countries.     

Concealing Concealment: The Mediating Role of Internalized Heterosexism in Psychological Distress Among Lesbian,Gay, and Bisexual Older Adults

ABSTRACT

Recent population-based studies indicate that sexual minorities aged 50 and older experience significantly higher rates of psychological distress than their heterosexual age-peers. The minority stress model has been useful in explaining disparately high rates of psychological distress among younger sexual minorities. The purpose of this study is to test a hypothesized structural relationship between two minority stressors—internalized heterosexism and concealment of sexual orientation—and consequent psychological distress among a sample of 2,349 lesbian, gay, and bisexual adults aged 50 to 95 years old. Structural equation modeling indicates that concealment has a nonsignificant direct effect on psychological distress but a significant indirect effect that is mediated through internalized heterosexism; the effect of concealment is itself concealed. This may explain divergent results regarding the role of concealment in psychological distress in other studies, and the implications will be discussed.     

Perceptions of aging among rural, midwestern senior citizens: signs of women's resiliency

This study utilized both quantitative and qualitative approaches to examine perceptions of aging among rural-dwelling senior citizens (203 women and 112 men), ages 65 and older. Quantitative results revealed that, despite no significant gender differences in the total number of medical conditions reported, women were less likely than men to report that health problems interfered with their daily functioning. Qualitative analyses revealed that women were particularly like to identify relationships, frame of mind, participating in activities, and religion/spirituality as important contributors to successful aging.     

Anticipatory caregiving anxiety among older women and men

This study, based on a sample of 221 older women and men, explores factors associated with anticipatory caregiving anxiety using a scale developed by Cicirelli (1988). Results show that even the anticipation of providing care evokes anxiety. We find that women have higher levels of anxiety than men, individuals who have served as caregivers have higher levels of anxiety than individuals who have never provided care to family members, and that individuals who are in better health and have more income have lower levels of anxiety than those with less health or income. Implications for services to support caregivers and long-term care reform are discussed.     

Gender and Aging in the Developing World: Where Are the Men?

In recent years, both population aging and gender issues have gained prominence in international forums concerned with population. It is frequently asserted or implied that older women are universally more vulnerable to social, economic, and health disadvantages than older men. The most significant manifestation of this exclusive concern with women when considering gender and aging is the Plan of Action adopted by the Second World Assembly on Aging in 2002. The assumed relative disadvantage of elderly women is commonly attributed to gender differences in earlier life experiences. But are older women truly disadvantaged globally with respect to all or most essential aspects of well‐being? The authors provide empirical evidence that clearly shows that older women are not invariably disadvantaged vis‐à‐vis men. In particular, they call into question the wisdom and equity of a virtually exclusive emphasis on the needs of women when incorporating gender concerns into policies and programs related to aging. A more balanced perspective that recognizes gender as a potential, but not necessarily central, marker of vulnerability for various aspects of well‐being in specific settings and times, and that allows for male as well as female disadvantage, would serve the current and future elderly generations far better.     

Media Stereotyping: A Comparison of the Way Elderly Women and Men Are Portrayed on Prime-Time Television

This content analysis of 139 programs and 2,211 characters updates and extends previous research on the way elderly people, and especially elderly women, are presented on prime-time television. Findings indicate that females and the elderly continue to be significantly underrepresented. Comparisons of elderly men and women showed patterns of traditional stereotypes, with men more likely to be depicted positively on 7 of 9 desirable traits and women more likely to be depicted negatively on 6 of the 7 undesirable traits which showed a gender difference. However, the proportional differences for specific characteristics typically were neither large nor statistically significant, suggesting that there has been some change in television's portrayal of the elderly during the 1980s. It also was noted that television appears to be more accepting and open to the portrayal of older middle-aged men than women in the same age category.     

Perceptions of Aging Among Rural,Midwestern Senior Citizens: Signs of Women's Resiliency

ABSTRACT

This study utilized both quantitative and qualitative approaches to examine perceptions of aging among rural-dwelling senior citizens (203 women and 112 men), ages 65 and older. Quantitative results revealed that, despite no significant gender differences in the total number of medical conditions reported, women were less likely than men to report that health problems interfered with their daily functioning. Qualitative analyses revealed that women were particularly like to identify relationships, frame of mind, participating in activities, and religion/spirituality as important contributors to successful aging.     

Psychological distress in pregnancy and postpartum

PurposeDepression, stress, and anxiety, termed ‘psychological distress,’ are common in pregnancy and postpartum periods. However, it is unclear whether prenatal psychological distress predicts postpartum psychological distress. We studied the prevalence, comorbidity and associations of maternal depression, stress, and anxiety in the prenatal period in relation to the occurrence of these same measures in the postpartum period.MethodsData originated from the MotherToBaby study of pregnant women residing in the U.S or Canada (2016–2018). Risk ratios and 95% Confidence Intervals using modified-Poisson regression models were used to investigate associations between prenatal psychological distress and postpartum psychological distress.ResultsOf the 288 women in the analysis, 21.2% and 26.7% of women had evidence of prenatal and postnatal psychological distress, respectively. Among those with prenatal psychological distress, 43 (70.5%) also had postpartum psychological distress. Twenty-five (41%) of those with prenatal and 46 (60%) of those with postpartum psychological distress had comorbidity of at least two of the measures. Prenatal measures independently predicted the same postnatal measures; prenatal anxiety also independently predicted postpartum stress. Participants who experienced more types of prenatal psychological distress were at higher risk for postpartum depression, stress, and anxiety.ConclusionDepression, stress, and anxiety are common in pregnant women and often occur together. Prenatal psychological distress measures are associated with postnatal psychological distress measures, with stronger associations among women with more than one type of psychological distress in pregnancy. Interventions during pregnancy may reduce the risk of postpartum psychological distress.     

Older women and family care in Hong Kong: differences in filial expectation and practices

Cultural aspects of aging have great importance on how older women and men are being treated, in particular in Asia where patriarchal practices dominate. Further, changes in the structure of the Chinese family alter this supportive function, and changes in traditional values affect the nature of the care and support provided to older women and men. This proposition was investigated by a quantitative study involving a survey of 390 older persons in Hong Kong. There are great discrepancies in informal support for older women and men. Older women are less likely to live with adult children; more likely to need financial assistance; and more likely to receive poor informal support. There is evidence that informal support for the elderly is changing in Hong Kong, and older women are being disadvantaged, experiencing insufficient and unavailability of informal support.     

Gender differences in psychosocial predictors of self-perceived health status in the elderly: Evidence from a Brazilian community study

ABSTRACT

This article aims to identify the psychosocial factors associated with self-perceived health status in the Brazilian elderly population and to present differences related to gender. The data were collected by questionnaire, including sociodemographic and behavioral questions, and scales for psychological dimensions. Self-perceived health status is related to level of education, physical activity, and self-efficacy in the total population. Regarding gender differences, self-rated health status among men is related to education level and self-efficacy and in women to level of education, physical activity, social support, and self-efficacy. These results can inform future health promotion interventions.