Understanding the twentieth-century decline in chronic conditions among older men

I argue that the shift from manual to white-collar jobs and reduced exposure to infectious disease were important determinants of declines in chronic disease rates among older men from the early 1900s to the 1970s and 1980s. The average decline in chronic respiratory problems, valvular heart disease, arteriosclerosis, and joint and back problems was about 66%. Occupational shifts accounted for 29% of the decline; the decreased prevalence of infectious disease accounted for 18%; the remainder are unexplained. The duration of chronic conditions has remained unchanged since the early 1900s, but when disability is measured by difficulty in walking, men with chronic conditions are less disabled now than they were in the past.     

Changes in functional limitation and survival among older Taiwanese, 1993, 1996, and 1999

Using data from the Survey of Health and Living Status of the Elderly in Taiwan, we investigate changes in difficulties in walking and climbing stairs, tasks that represent basic lower-body movements less likely to be influenced by changes in environment and social roles than are activities and instrumental activities of daily living. Results are shown for unadjusted prevalence rates and rates adjusted for changes in population composition. The findings indicate that Taiwan does not appear to be experiencing the improvements in functioning witnessed recently in the United States. Prevalence of functional limitation increased between 1993 and 1996 and between 1996 and 1999. One possible reason is the change in old-age survival, which appears to have benefited those who have functional limitations, especially in a severe form. The Universal Health Insurance programme, established in 1995, may have increased access to care and thus the survival of those in poorest health.     

Changes in functional limitation and survival among older Taiwanese, 1993, 1996, and 1999

Using data from the Survey of Health and Living Status of the Elderly in Taiwan, we investigate changes in difficulties in walking and climbing stairs, tasks that represent basic lower-body movements less likely to be influenced by changes in environment and social roles than are activities and instrumental activities of daily living. Results are shown for unadjusted prevalence rates and rates adjusted for changes in population composition. The findings indicate that Taiwan does not appear to be experiencing the improvements in functioning witnessed recently in the United States. Prevalence of functional limitation increased between 1993 and 1996 and between 1996 and 1999. One possible reason is the change in old-age survival, which appears to have benefited those who have functional limitations, especially in a severe form. The Universal Health Insurance programme, established in 1995, may have increased access to care and thus the survival of those in poorest health.     

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.     

Obesity, disease, and functional limitation in later life

Little is known about the effects of obesity late in life. Using data from the Longitudinal Study of Aging and the Assets and Health Dynamics of the Oldest Old Survey, this study finds an increased prevalence of obesity, over time, among those 70 and older. Obesity is related most strongly to limitations in activities of daily living (ADLs) for women and to activities related to mobility. One ADL, eating, has a negative association to obesity. Obesity is associated with an increased prevalence of arthritis, diabetes, and hypertension. These results are cross-sectional and are based on self-reports of height and weight; they must be interpreted cautiously.     

Differences in disability among older women and men in Egypt and Tunisia

Research on child survival and health has indicated disparities between boys and girls in selected Middle Eastern countries. Health disparities in later life are understudied in this region. In this article, we examine differences between women and men in later-life activity limitation in Egypt and Tunisia. Difficulty executing physical tasks is more common for women than for men in both study sites, although differences are smaller after adjustment for underlying illness. Differences in the difficulty of executing physical tasks also are sensitive to environmental controls in variable ways across the study sites. The findings caution against the sole use of reported disability in comparative studies of gender and aging.     

Educational attainment and transitions in functional status among older Taiwanese

Despite considerable research examining the influence of socioeconomic status on health, few studies have considered this relationship as it pertains to older adults in non-Western societies. We attempt to ascertain the influence of education on changes in physical functioning in a rapidly developing country. Data come from the 1989 Survey of Health and Living Status of the Elderly in Taiwan and a follow-up interview in 1993 (N = 4,049, age = 60+). Individuals are conceptualized to be in a state of functional independence or functional limitation at the time of origin, based on their ability to perform three physical functioning tasks. The outcome at the follow-up interview is categorized as functionally independent, limited, or dead, allowing for six probabilities, one from each state of origin to each outcome. These are calculated using a multinomial logit model, controlling for other factors often thought to be associated with health transitions. High levels of educational attainment result in a decreased incidence of functional limitation for those originating in a state of independence. Contrary to expectations, however, education has little influence on those who originate functionally limited. Thus, higher education plays a substantial role in primary prevention of morbidity, delaying the onset of disability, but other factors are more important once limitations begin. We speculate on the reasons behind these findings, including that the results may be culturally dependent.     

Disability among older women and men in Fiji: concerns for the future

This study examines the composition of elderly population at risk of disability and speculates the impact of disability on the quality of their lives and their longevity. Using census and survey data collected in Fiji, life table estimates of unimpaired life expectancy across time are presented for older people and the potential costs of disability, in terms of productive years of life lost. From a planning perspective, the study discusses medical and support services that may be needed to support older individuals in Fiji. The study also describes policy implications of the findings, focusing on the older women, and considers the implications for older women of other developing countries.     

Changing mortality and morbidity rates and the health status and life expectancy of the older population

This paper demonstrates the consequences of changes in mortality and health transition rates for changes in both health status life expectancy and the prevalence of health problems in the older population. A five-state multistate life table for the mid-1980s provides the baseline for estimating the effect of differing mortality and morbidity schedules. Results show that improving mortality alone implies increases in both the years and the proportion of dependent life; improving morbidity alone reduces both the years and the proportion of dependent life. Improving mortality alone leads to a higher prevalence of dependent individuals in the life table population; improving morbidity alone leads to a lower percentage of individuals with problems in functioning.     

Changing vital rates and age distributions

Abstract In a time of rapid change in birth and death rates demographers need to know the consequences of such changes for age distribution. Does the fall in death rates tend to make the age distribution older? It certainly enables individuals to grow older, but for population aggregates the effect depends on the ages at which mortality improves. Coale, Stolnitz, Schwarz, Lorimer, the United Nations and other writers have investigated trends in age-specific birth and death rates. In particular they have demonstrated that the falling mortality which is now nearly universal does not generally make the population older and sometimes makes it younger. The present article contributes a technique for further examination of this phenomenon.     

The role of education in explaining and forecasting trends in functional limitations among older Americans*

Using the Survey of Income and Program Participation, we document the importance of education in accounting for declines in functional limitations among older Americans from 1984 to 1993. Of the eight demographic and socioeconomic variables considered, education is most important in accounting for recent trends. The relationship between educational attainment and functioning has not changed measurably, but educational attainment has increased greatly during this period. Our analysis suggests, all else being equal, that future changes in education will continue to contribute to improvements in functioning, although at a reduced rate.     

Changes in the retirement process among older men in the United States: 1972–1980

Recent changes in older men's retirement patterns are investigated for the United States. The results show that labor force incumbents, particularly those in secondary occupations, experienced increases in the volume of both retirement and reentry to the labor force. In addition, although working life expectancy remained relatively stable across occupations, men in secondary occupations spent increasingly greater portions of their work lives in postretirement jobs. Finally, large increases in nonworking life expectancy occurred because of substantial increases in life expectancy. In several occupations, however, declines in working life expectancy were major contributors to increases in nonworking life expectancy.     

Gender differences in the associations of self esteem, stress and social support with functional health status among older adults with heart disease

This study explored and compared the role of self esteem, stress and social support in maintenance or improvement in physical and psychosocial functioning over 12 months in older men and women with cardiovascular disease. Data from 502 adults over 60 years of age showed that self esteem and stress were both significantly associated with functioning when demographic and clinical factors were controlled. Men were significantly more likely than women to maintain or improve in functioning. Self esteem, stress, compliance with medication regimens, and marital status were significantly associated with maintenance or improvement of functioning among women. Only age and stress were significantly associated with maintenance or improvement in functioning among men. Findings indicated that: (1) stress and self esteem were stronger predictors of functioning, especially among women, than demographic and clinical factors; and (2) women in the highest quartile of the self esteem distribution were approximately five times as likely to maintain or improve their functioning as women in the lowest quartile.     

Life with and without heart disease among women and men over 50

This article uses a demographic approach and data from the Health and Retirement Survey, a nationally representative sample of the U.S. population, to investigate sex differences in the length of life lived with heart disease and after a heart attack for persons in the United States age 50 and older. On average, women live longer than men with heart disease. At age 50 women can expect to live 7.9 years and men 6.7 years with heart disease. The average woman experiences heart disease onset three years older and heart attacks 4.4 years older than men.     

Changing identification among American Indians and Alaska natives

The census-enumerated American Indian population dispersed rapidly between 1930 and 1990. Changes in ethnic classification account for most of the change. In the 1980 count, 10 states with historically large Indian populations account for 53% of births of Indians between the ages of 10 and 80, compared with 72% of the first enumerations of the same cohorts. Migration further reduced the share of these states to 46% of Indian residents in these cohorts. Study of the dispersal of the Indian population should focus primarily on the new emergence of the expression of Indian identity, rather than on migration from former population centers.     

Navigating Islam and same-sex liaisons among men in Turkey

This study reports the experiences of 20 Turkish men in having sex with men in an Islamic society. As part of a broader study on Turkish homosexualities, the article analyzes responses to the question, "What joys and difficulties have you experienced regarding your sexual orientation in relation to Islam?" to elicit responses on how Islam and homosexuality might coexist in everyday life.     

Changing cultural and social environments: implications for older East Asian women

The world is aging and the trend is towards a global feminization of aging. In the Asia Pacific region, which already contains approximately 50% of the world's population over age 60, the number of older women exceeds that of older men in most countries. This article explores the changes that are occurring in East Asian social and cultural traditions for aging and discusses the implications of those changes for women who aged in that culture. In the traditional culture, Chinese, Japanese, and Korean families are influenced by values of family centrality and collective orientation to life that are mostly rooted in Confucian values and ethics. In those traditions, older women assume and maintain a valued status within the family and community through respected roles and productive contributions. However, various factors, such as migration to urban areas and demographic shifts, have precipitated modernization of these societies and alterations of traditional culture. These cultural shifts are relevant to the United States where, according to the 2000 U.S. Census, 71.0% of Asian and Pacific Islander-Americans over the age 65 are foreign-born. Immigration can prompt an immediate cultural shift and create a fast forward insight into the slower cultural evolution currently occurring in East Asian societies.     

Gender differences in physical activity and walking among older adults

Older women are generally more sedentary and less active than older men, but little is known about the specific factors underlying the differences between the genders in physical activity (PA). The purpose of this study was to compare men and women regarding their household leisure time PA, walking activity, and personal and environmental factors related to physical activity. Self-administered questionnaires were completed by 276 older adults recruited from senior centers. Findings revealed that women were less active overall but more involved in household activities. The women's personal and environmental factors represented poor conditions for PA, and as a result they engaged in lower levels of PA than men.     

Gender differences in body esteem among older adults

Ninety-five adults aged 60-91 completed measures of Body-as-Object Esteem (BOE) (i.e., appearance) and Body-as-Process Esteem (BPE) (i.e., function) to explore gender differences in body esteem among older adults. As hypothesized, a significant age by gender interaction revealed that men become more disparaging of the appearance and function of their bodies in their last decades of life, while women do not. Level of physical disability was negatively correlated with BOE, particularly for disabled women. Furthermore, as is seen across the lifespan, self-esteem is a significant predictor of BOE. Disabled participants who were older than 74 years had disproportionately low BPE scores and similarly poor global self-esteem. Whether working with older adults or studying body esteem in this population, it is vital that both dimensions of body esteem are assessed along with the impact of disability status, gender, self-esteem, and age.     

Sexual activity among never-married men in northern Thailand

We use data collected in 1991 to investigate sexual activity among never-married men in Thailand, with a focus on age at first intercourse, characteristics of sexual partners, and conditions under which men visit prostitutes. We sampled men from a broad spectrum of northern Thai society, including university undergraduates, soldiers, and semiskilled/unskilled workers. We found that except for the students, the majority of each subsample is sexually experienced; prostitutes are the most common type of sexual partner for all groups. Alcohol consumption is associated with several measures of sexual activity. Condom use with prostitutes varies among the subsamples. Among men who have both prostitute and nonprostitute partners, the majority of those who do not use condoms with prostitutes also do not use condoms with their nonprostitute partners. We consider the implications of these results for the AIDS epidemic in Thailand.