The Methuselah Effect: The Pernicious Impact of Unreported Deaths on Old-Age Mortality Estimates

We examine inferences about old-age mortality that arise when researchers use survey data matched to death records. We show that even small rates of failure to match respondents can lead to substantial bias in the measurement of mortality rates at older ages. This type of measurement error is consequential for three strands in the demographic literature: (1) the deceleration in mortality rates at old ages; (2) the black-white mortality crossover; and (3) the relatively low rate of old-age mortality among Hispanics, often called the “Hispanic paradox.” Using the National Longitudinal Survey of Older Men matched to death records in both the U.S. Vital Statistics system and the Social Security Death Index, we demonstrate that even small rates of missing mortality matching plausibly lead to an appearance of mortality deceleration when none exists and can generate a spurious black-white mortality crossover. We confirm these findings using data from the National Health Interview Survey matched to the U.S. Vital Statistics system, a data set known as the “gold standard” (Cowper et al. 2002) for estimating age-specific mortality. Moreover, with these data, we show that the Hispanic paradox is also plausibly explained by a similar undercount.     

The Life Course,Cohort Dynamics,and International Differences in Aging Trajectories

In recent years, population health research has focused on understanding the determinants of later-life health. Two strands of that work have focused on (1) international comparisons of later-life health and (2) assessing the early-life origins of disease and disability and the importance of life course processes. However, the less frequently examined intersection of these approaches remains an important frontier. The present study contributes to the integration of these approaches. We use the Health and Retirement Study family of data sets and a cohort dynamic approach to compare functional health trajectories across 12 high-income countries and to examine the role of life course processes and cohort dynamics in contributing to variation in those trajectories. We find substantial international variation in functional health trajectories and an important role of cohort dynamics in generating that variation, with younger cohorts often less healthy at comparable ages than the older cohorts they are replacing. We further find evidence of heterogeneous effects of life course processes on health trajectories. The results have important implications for future trends in morbidity and mortality as well as public policy.     

Positive Identity Experiences of Young Bisexual and Other Nonmonosexual People: A Qualitative Inquiry

The majority of LGBTQ psychological research focuses on dysfunction. The exclusion of strengths-based perspectives in LGBTQ psychology limits the understanding of LGBTQ mental health. In this article we report experiences that young bisexual and other nonmonosexual people perceive as affirming of their sexual identity. A 28-day, daily diary study was used to investigate whether bisexual-identified participants encountered positive experiences related to their sexual identity, and which type of experiences they perceived to be positive. Using a constructivist grounded theory approach, participants’ experiences were organized according to a social ecological model. Experiences were reported at the intrapersonal, interpersonal, and institutional levels, but most positive sexual identity experiences occurred at the interpersonal level. Implications for positive health outcome research and the integration of positive psychology with LGBTQ psychology are discussed, as well as study limitations.     

“I Had to Go to the Streets to Get Love”: Pathways From Parental Rejection to HIV Risk Among Young Gay and Bisexual Men

Young, gay, and bisexual men (YGBM) are at increased risk of family rejection, which is related to HIV infection. What remains unknown is how family rejection leads to HIV risk. In this exploratory study, qualitative interviews were conducted with 21 HIV-positive YGBM aged 18 to 24. Most participants reported family rejection, which decreased instrumental and emotional support and resulted in participants using riskier ways to support themselves, such as engaging in survival sex. Conceptualizing the findings using a family systems framework, we present a tentative conceptual model to describe the potential relationships between family rejection and HIV risk for YGBM.     

Inequality and demographic response to short-term economic stress in North Orkney,Scotland, 1855–1910: Sector differences

We examine economic inequality and social differences in infant and child mortality, and fertility responses to food price changes in North Orkney, 1855–1910, using linked vital records. This small population featured a diverse occupational structure, limited land resources, and geographic isolation from mainland Scotland. Segments of Orkney’s non-agricultural working population were living so close to the margin of subsistence in normal years that an increase in food prices in bad years cost the lives of their children. Delayed childbearing, in addition to increased labour intensity, occupational diversification, and poor relief, failed to mitigate the negative effects of unfavourable prices in this group. While previous studies for Western Europe show a strong social gradient in mortality responses to food prices, and for Eastern Asia a strong household gradient, this study shows a strong sectoral gradient, indicating low standards of living for the non-agricultural working population well into the twentieth century.     

The Comparative Inclusive Human Development of Globalisation in Africa

This study examines the impact of globalisation on inclusive human development in 51 African countries for the period 1996–2011 with particular emphasis on income levels (low income vs. middle income), legal origins (English common law vs. French civil law), resource wealth (oil-rich vs. oil-poor), landlockedness (landlocked vs. unlandlocked), religious domination (Christianity vs. Islam) and political stability (stable vs. unstable). The empirical evidence is based on instrumental variable panel Fixed effects and Tobit regressions in order to control for the unobserved heterogeneity and limited range in the dependent variable. Political, economic, social and general globalisation variables are used. Six main hypotheses are investigated. The findings broadly show that middle income, English common law, oil-poor, unlandlocked, Christian-oriented and politically-stable countries are associated with comparatively higher levels of globalisation-driven inclusive human development. Puzzling findings are elucidated and policy implications discussed.     

Explaining Accessibility and Satisfaction Related to Healthcare: A Mixed-Methods Approach

Accessibility and satisfaction related to healthcare services are conceived as multidimensional concepts. These concepts can be studied using objective and subjective measures. In this study, we created two indices: a composite healthcare accessibility index (CHCA) and a composite healthcare satisfaction index (CHCS). To calculate the CHCA index we used three indicators based on three components of multidimensional healthcare accessibility: availability, acceptability and accessibility. In the indicator based on the component of accessibility, we included an innovative perceived time-decay parameter. The three indicators of the CHCA index were weighted through the application of a principal components analysis. To calculate the CHCS index, we used three indicators: the waiting time after the patient arrives at the healthcare service, the quality of the healthcare, and the healthcare service supply. These three indicators making up the CHCA index were weighted by applying an analytical hierarchy process. Three kinds of regressions were subsequently applied in order to explain the CHCA and CHCS indices: namely the Linear Least Squares, Ordinal Logistic, and Random Forests regressions. In these regressions, we used different independent social and health-related variables. These variables represented the predisposing, enabling, and need factors of people´s behaviors related to healthcare. All the calculations were applied to a study area: the city of Quito, Ecuador. Results showed that there are health-related inequalities in regard to healthcare accessibility and healthcare satisfaction in our study area. We also identified specific social factors that explained the indices developed. The present work is a mixed-methods approach to evaluate multidimensional healthcare accessibility and healthcare satisfaction, incorporating a pluralistic perspective, as well as a multidisciplinary framework. The results obtained can also be considered as tools for healthcare and urban planners, for more integrative social analyses that can improve the quality of life in urban residents.     

Assessing Changes in Household Socioeconomic Status in Rural South Africa, 2001–2013: A Distributional Analysis Using Household Asset Indicators

Understanding the distribution of socioeconomic status (SES) and its temporal dynamics within a population is critical to ensure that policies and interventions adequately and equitably contribute to the well-being and life chances of all individuals. This study assesses the dynamics of SES in a typical rural South African setting over the period 2001–2013 using data on household assets from the Agincourt Health and Demographic Surveillance System. Three SES indices, an absolute index, principal component analysis index and multiple correspondence analysis index, are constructed from the household asset indicators. Relative distribution methods are then applied to the indices to assess changes over time in the distribution of SES with special focus on location and shape shifts. Results show that the proportion of households that own assets associated with greater modern wealth has substantially increased over time. In addition, relative distributions in all three indices show that the median SES index value has shifted up and the distribution has become less polarized and is converging towards the middle. However, the convergence is larger from the upper tail than from the lower tail, which suggests that the improvement in SES has been slower for poorer households. The results also show persistent ethnic differences in SES with households of former Mozambican refugees being at a disadvantage. From a methodological perspective, the study findings demonstrate the comparability of the easy-to-compute absolute index to other SES indices constructed using more advanced statistical techniques in assessing household SES.     

Body image,aging, and identity in women over 50: The Gender and Body Image (GABI) study

We conducted a qualitative study of 1,849 women over age 50 to capture the thoughts, feelings, and attitudes that women at middle age have about their bodies and the experience of aging. Via an open-ended question online survey, four primary themes emerged: (a) the physical and psychological experience of aging; (b) the injustices, inequities, and challenges of aging; (c) the importance of self-care; and (d) a plea for recognition of the need to maintain a contributory role in society. Results highlight the complexities of women’s psychological and physical aspects of aging and point toward important topics worthy of further study in this growing population.