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.     

The Importance of Spousal Education for the Self-Rated Health of Married Adults in the United States

Education’s benefits for individuals’ health are well documented, but it is unclear whether health benefits also accrue from the education of others in important social relationships. We assess the extent to which individuals’ own education combines with their spouse’s education to influence self-rated health among married persons aged 25 and older in the United States (N = 337,846) with pooled data from the 1997–2010 National Health Interview Survey. Results from age- and gender-specific models revealed that own education and spouse’s education each share an inverse association with fair/poor self-rated health among married men and women. Controlling for spousal education substantially attenuated the association between individuals’ own education and fair/poor self-rated health and the reduction in this association was greater for married women than married men. The results also suggest that husbands’ education is more important for wives’ self-rated health than vice versa. Spousal education particularly was important for married women aged 45–64. Overall, the results imply that individuals’ own education and spousal education combine to influence self-rated health within marriage. The results highlight the importance of shared resources in marriage for producing health.     

Gender Differences in the Consequences of Divorce: A Study of Multiple Outcomes

In this study, I examined gender differences in the consequences of divorce by tracing annual change in 20 outcome measures covering four domains: economic, housing and domestic, health and well-being, and social. I used data from the German Socio-Economic Panel Study (SOEP) and fixed-effects panel regression models on a sample of N = 18,030 individuals initially observed in a marital union, N = 1,220 of whom divorced across the observation period (1984–2015). Three main findings emerged from the analysis. First, men were more vulnerable to short-term consequences of divorce for subjective measures of well-being, but postdivorce adaptation alleviated gender differences in these outcomes. Second, a medium-term view on multiple outcomes showed more similarity than differences between women and men. The medium-term consequences of divorce were similar in terms of subjective economic well-being; mental health, physical health, and psychological well-being; residential moves, homeownership, and satisfaction with housework; and chances of repartnering, social integration with friends and relatives, and feelings of loneliness. Third, the key domain in which large and persistent gender differences emerged were women’s disproportionate losses in household income and associated increases in their risk of poverty and single parenting. Taken together, these findings suggest that men’s disproportionate strain of divorce is transient, whereas women’s is chronic.     

Looking at Population Health Beyond “Male” and “Female”: Implications of Transgender Identity and Gender Nonconformity for Population Health

Looking beyond binary measurements of “male” or “female” can illuminate health inequality patterns that correspond to gender identity rather than biological sex. This study examines disparities in overall health among transgender men, transgender women, gender-nonconforming adults, and cisgender (nontransgender) men and women in the U.S. population. Behavioral Risk Factor Surveillance System (BRFSS) data from 32 U.S. states and territories between 2014 and 2016 yield an analytic sample that identifies 2,229 transgender and gender-nonconforming adults and 516,753 cisgender adults. Estimates from logistic regression models, using cisgender men as a reference group, show that gender-nonconforming respondents have significantly higher odds of reporting poor self-rated health than any other gender identity group. Transgender men also display higher odds of reporting poor health in some models, corresponding to their relative socioeconomic disadvantage. I find no apparent health disadvantage among transgender women and a persistent, if slight, disadvantage among cisgender women. Gender-nonconforming respondents’ predicted probabilities of reporting poor health remain nearly twice as high as those of cisgender men after adjustments for demographic, socioeconomic, and behavioral factors. Their persistent patterns of health-related disadvantage underscore the need for higher-quality data on gender-nonconforming respondents that account for sex assigned at birth.     

我国老年人健康自评的差异性分析——基于2002年和2005年全国老年跟踪调查数据

健康自评能反映健康状态的主观和客观的两个方面,是评价老年人健康状况的一个重要指标.本文旨在回答我国老年人健康自评的变化,从而为改善老年人的健康状况提供参考.采用2002年和2005年两次全国老年调查数据,对不同老年人群体的健康自评的差异性进行分析并进一步探究影响因素.     

Gender differences in activity of daily living of the elderly in rural China: evidence from Chaohu

Using data from a sample survey, Well-being of the elderly in Anhui province, China, this paper studies the effects of health, economic and family factors on the activities of daily living (ADLs) as measures of disability for elderly men and women. The objective is to explore reasons for gender differences in ADLs in rural China. Our results suggest that higher incidence rates of chronic diseases, lower cognitive ability, as well as heavier household and daily care burdens of females, are the main factors leading to a higher prevalence of ADL disability for the female elderly.     

Health profiles and profile-specific health expectancies of older women and men: The Netherlands

This study focuses on gender differences in health profiles, and examines which health profiles drive gender differences in remaining life expectancy in women and men aged 65 and over in The Netherlands. Data from the first two cycles of the Longitudinal Aging Study Amsterdam (n = 2,141 and 1,659, respectively) were used to calculate health profiles for individuals of 65-85 years. For both women and men, six profiles were found: I. cancer; II. "other" chronic diseases; III. cognitive impairment; IV. frailty or multimorbidity; V. cardiovascular diseases; and VI. good health. The further characterization of these types showed some gender differences. Remaining life expectancy for women was greater than for men in each health profile. A decomposition into health expectancies showed that both women and men could expect to live about 5 years in good health from age 66. The greatest gender differences in years spent with health problems were found for profile IV and for profile III. Their greater number of years spent in these health states have direct consequences for the type and cost of care women need.     

Double jeopardy: Interaction effects of marital and poverty status on the risk of mortality

The purpose of this paper is to examine the hypothesis that marital and poverty status interact in their effects on mortality risks beyond their main effects. This study examines the epidemiological bases for applying an additive rather than a multiplicative specification when testing for interaction between two discrete risk factors. We specifically predict that risks associated with being nonmarried and with being poor .interact to produce mortality risks that are greater than each risk acting independently. The analysis is based on men and women who were ages 25–74 during the 1971–1975 National Health and Nutrition Examination Survey I (NHANES I) and who were traced successfully in the NHANES I Epidemiologic Follow-Up Study in 1982–1984. Overall, being both poor and nonmarried places nonelderly (ages 25–64) men, but not women, at risk of mortality greater than that expected from the main effects. This study shows that for all-cause mortality, marital and poverty status interact for men but less so for women; these findings exist when interaction is assessed with either a multiplicative or an additive standard. This difference is most pronounced for poor, widowed men and (to a lesser degree) poor, divorced men. For violent/accidental deaths among men, the interaction effects are large on the basis of an additive model. Weak main and interaction effects were detected for the elderly (age 65 +).     

How We Fall Apart: Similarities of Human Aging in 10 European Countries

We analyze human aging—understood as health deficit accumulation—for a panel of European individuals, using four waves of the Survey of Health, Aging and Retirement in Europe (SHARE data set) and constructing a health deficit index. Results from log-linear regressions suggest that, on average, elderly European men and women develop approximately 2.5 % more health deficits from one birthday to the next. In nonlinear regressions (akin to the Gompertz-Makeham model), however, we find much greater rates of aging and large differences between men and women as well as between countries. Interestingly, these differences follow a particular regularity (akin to the compensation effect of mortality) and suggest an age at which average health deficits converge for men and women and across countries. This age, which may be associated with human life span, is estimated as 102 ± 2.6 years.     

Roles,race and subjective well-being: A longitudinal analysis of elderly men

The basic contention of this paper is that research on subjective well-being would benefit from an integration of theory and research from other studies of subjective states, such as mental and physical health. Toward that end, we present results of an analysis of the impact of race and social roles on subjective well-being in a nationally representative sample of elderly men. The findings demonstrate that particular role configurations have an effect on happiness and that these effects are different for blacks and whites. Theoretical implications of these findings for subjective well-being research and role accumulation theory are discussed.     

Gender Differences in Activity of Daily Living of the Elderly in Rural China: Evidence from Chaohu

ABSTRACT

Using data from a sample survey, “Well-being of the elderly in Anhui province, China,” this paper studies the effects of health, economic and family factors on the activities of daily living (ADLs) as measures of disability for elderly men and women. The objective is to explore reasons for gender differences in ADLs in rural China. Our results suggest that higher incidence rates of chronic diseases, lower cognitive ability, as well as heavier household and daily care burdens of females, are the main factors leading to a higher prevalence of ADL disability for the female elderly.     

长春市老年人口生活质量评价

针对我国老年人口生活质量的具体情况,利用国家人口和计划生育委员会与吉林大学"我国老年人生活状况及养老公共服务需求研究"长春市部分的调研数据,采用中华医学会老年医学流行病学学组会议提出的分等加权综合评分法,对长春市老年人口生活质量进行综合评价。将老年人口划分成不同年龄组及不同性别组,分别从经济生活、医疗健康生活、家庭与社会生活、精神生活方面进行老年人口生活质量评价。研究结果显示,长春市老年人口整体生活质量处于中等偏上的水平;女性老年人生活质量略低于男性老年人生活质量;老年人口的生活质量水平随年龄增大而降低。通过实证分析,综合把握长春市老年人口的生活质量现状,明确影响长春市老年人生活质量的相关因素,发现阻碍老年人口生活质量提高的不利因素,就改善长春市老年人生活质量提出对策建议。     

Caregiving and Care-Receiving:

Many aspects of aging are women's issues. Yet research on aging has, until recently, focussed little attention of gender differences in the experience of growing old. Older women are more likely than older men to be poor, widowed, living alone in poor health, receiving assistance from both formal and informal supports, as well as being institutionalized in long-term care facilities. This secondary analysis of data from the 1982 Survey of the Elderly in the Waterloo Region attempts to address a gap in our knowledge concerning gender differences in the giving and receiving of social support in later years. Gender differences in (1) need for social support, (2) turning to formal assistance, (3) amount of formal assistance used, and (4) amount of informal assistance received were examined using analysis of variance and logistic regression procedures. The profile of social support that emerged suggests both similarities and differences in the way elderly men and women experience the giving and receiving of social support. Older women in this sample were found to be disadvantaged in the areas of income, health, years lived alone, and loneliness, relative to older men. Low-income was related to formal service use for older women, but not for older     

健康冲击、基本医疗保险与老年人“退而不休”

在我国进入深度老龄化、劳动力供给不足的背景下,探究健康以及基本医疗保险对老年人退而不休的影响对未来合理有效开发老年人力资源具有重要意义。本文使用四期CHARLS数据将健康冲击、医疗保险与老年人退而不休放在一个统一的分析框架中,分别考察了健康冲击、新农合以及城镇职工医疗保险对老年人退而不休的影响,并进一步探究了医疗保险对老年人退而不休影响的健康异质性。结果表明:健康冲击对老年人退而不休意愿和劳动时间均有显著正向促进效应,且对劳动时间的影响有明显城乡差异,对农村地区影响更大。新农合会明显激励农村老年人选择退而不休,发生比率提高为未参合时的3.59倍,但会降低劳动时间,全年平均减少了21.21天;而城镇职工医疗保险对老年人退而不休意愿没有显著影响,但会增加劳动时间,全年平均增加了13.92天,且对劳动时间供给更多的个体,其激励效应逐渐减弱。同时,医疗保险对老年人退而不休的影响还存在性别差异,其中新农合对女性退而不休意愿影响更大,但对劳动时间并没有显著的性别差异;而职工医疗保险对女性退而不休意愿、对男性劳动时间影响更大。此外,本文还发现医疗保险对老年人退而不休的影响存在健康异质性,对健康变差的群体影响更大。     

Elderly women show neither a shortage of strategies nor an overreliance on drugs in handling aging and in dealing with minor health problems

Women 65 years old and over make up the fastest growing population segment in North America. They are, particularly among the underprivileged, known to be heavy consumers of prescribed and over-the-counter drugs. The objective of this study was to identify the role of medication in underprivileged elderly women's strategies for aging well and dealing with minor health problems. A qualitative study was conducted among 40 women aged 65 to 75. Results show that elderly women seldom mention resorting to medication to "age well" although they report using this strategy to deal with minor health problems. Overall, the elderly women mentioned a wide range of strategies to cope with aging and minor health problems, which suggests that they are well equipped to face the challenges of aging.     

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.     

Gender differences in poverty among single people in Denmark

This study — based on data from the Danish Welfare Survey of 1986, covering 461 single women and 319 single men — showns that single women have a potential higher risk than single men of becoming poor even when the sexes are categorized by household status, age and relationship to the labour market. These results suggest that the most important reason for higher risk of poverty among women than among single men is not — as often supposed — whether women are single, with or without children, but that gender as such discriminates as to poverty via the different ways men and women are linked to the labour market, This would apparently confirm that which, indirectly, was indicated by previous research on poverty.     

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.     

Living Arrangements and the Well-Being of Single Mothers in Japan

The goal of this study is to evaluate the extent to which the well-being of single mothers in Japan is related to coresidence with other adults. Using data from a representative survey of households headed by single mothers, we examine two measures of subjective well-being: perceived economic circumstances and self-rated health. One-fourth of the single mothers surveyed were coresiding with another adult(s) and it is clear that these women fare significantly better than their non-coresiding counterparts on both measures of well-being. Net of several theoretically relevant sociodemographic, family, and employment characteristics, single mothers living with others were significantly less likely to report somewhat difficult/difficult economic circumstances or fair/poor health. Efforts to account for potential endogeneity between well-being and living arrangements suggested that self-rated health, but not subjective economic well-being, is related to selection into coresidence. Single mothers in fair/poor health appear more likely to coreside with others and, accounting for this selection, intergenerational coresidence appears to be very beneficial for self-rated health. We discuss the implications of these findings for processes of stratification in Japan in light of the limited public income support available to single mothers.