Beyond Income: A Social Justice Approach to Assessing Poverty among Older Adults with Chronic Kidney Disease

ABSTRACT

How social workers define and assess poverty is a matter of economic and social justice. Recent conceptual and measurement advances point to a multidimensional definition of poverty which captures material, social, and political deprivations. Using data from a survey, this article describes how nephrology social workers assess poverty among older adults living with a chronic kidney disease (N = 52). Results suggest respondents already conceive of poverty as a multidimensional experience, support awareness-raising about poverty, and primarily assess poverty by employment status, income, access to transportation, and education. Opportunities to expand poverty assessment in future work are promising.     

Elder mistreatment in underserved populations: Opportunities and challenges to developing a contemporary program of research

ABSTRACT

This article provides an overview of the status of research on elder mistreatment among underserved populations in the United States, including gaps in our current knowledge base and scientific and structural barriers to growing research on the exploitation, neglect, and abuse of older people from diverse and disadvantaged ethnic/racial, geographic, sexual identity, and socioeconomic groups. High-priority areas in need of new elder mistreatment research with underserved populations are identified, and suggestions are given for how this research can be facilitated by researchers, university institutional review boards, and funding agencies.     

Lessons Learned From a Canadian Province-Wide Age-Friendly Initiative: The Age-Friendly Manitoba Initiative

The Age-Friendly Manitoba Initiative was launched in 2008. A formative evaluation we conducted in 2011 with 44 participating rural and urban communities demonstrates considerable progress, with virtually all communities having formed an Age-Friendly Committee and conducting a community assessment to identify priorities for action. The majority of communities implemented one or more age-friendly projects. Major barriers to becoming age-friendly identified by participants included lack of funding; lack of capacity, particularly in small communities; and lack of leadership or direction. The study highlights the importance of strong leadership at all levels of government (municipal, provincial, federal); the need to support communities, particularly rural ones, as they try to become more age-friendly; and the importance of ongoing promotion of age-friendliness locally and more broadly (e.g., provincially).     

Age-Friendly Portland: A University-City-Community Partnership

This article addresses the question of how creating an age-friendly city has come to be an important policy and planning issue in Portland, Oregon. In 2006, researchers from Portland State University's Institute on Aging examined the meanings of age friendliness among a broad range of participants in Portland, Oregon. The research was conducted in conjunction with the World Health Organization's (WHO) Age-Friendly Cities project and followed the completion of two earlier non–WHO-related projects. The city of Portland, through the Institute on Aging, was one of nine original members to apply for and be accepted into the WHO Global Network of Age-Friendly Cities and Communities. An Age-Friendly Portland Advisory Council was formed to guide the development of an action plan, monitor progress over time, and suggest additional research. To understand how Portland's age-friendly policy effort has developed over time, we use Kingdon's (1984) agenda-setting framework to explain how the policy problem was formulated, how solutions were developed, and the influence of local politics. The policy actors, including individuals and organizations working within and outside of government, are described. The Portland experience provides a case study that other cities, especially those with a strong commitment to community-engaged urban planning, may find useful as they develop age-friendly initiatives.     

Collaborative Partnership in Age-Friendly Cities: Two Case Studies From Quebec,Canada

This article aims to explain the collaborative partnership conditions and factors that foster implementation effectiveness within the age-friendly cities (AFC) in Quebec (AFC-QC), Canada. Based on a community-building approach that emphasizes collaborative partnership, the AFC-QC implementation process is divided into three steps: (1) social diagnostic of older adults' needs; (2) an action plan based on a logic model; and (3) implementation through collaborations. AFC-QC promotes direct involvement of older adults and seniors' associations at each of the three steps of the implementation process, as well as other stakeholders in the community. Based on two contrasting case studies, this article illustrates the importance of collaborative partnership for the success of AFC implementation. Results show that stakeholders, agencies, and organizations are exposed to a new form of governance where coordination and collaborative partnership among members of the steering committee are essential. Furthermore, despite the importance of the senior associations' participation in the process, they encountered significant limits in the capacity of implementing age-friendly environments solely by themselves. In conclusion, we identify the main collaborative partnership conditions and factors in AFC-QC.     

Prevalence estimates and correlates of elder abuse in the United States: The National Intimate Partner and Sexual Violence Survey

This study examines the prevalence and correlates of psychological abuse and physical abuse against women and men aged 70 or older. Self-report data from 2,185 respondents in the 2010 National Intimate Partner and Sexual Violence Survey (NISVS) were used to create weighted estimates for past-year experiences of abuse. Correlates were then examined using survey logistic regression models. More than 1 in 10 adults who are 70 years of age or older (14.0%) have experienced some form of abuse in the past year, with 12.1% experiencing psychological abuse and 1.7% experiencing physical abuse. One in five victims (20.8%) were abused by both intimate and nonintimate partners. Health care insecurity was the strongest correlate of past-year abuse. The odds of experiencing abuse were 4.53 times greater for those who experienced health care insecurity than for those who did not. This presents a significant challenge for identifying and helping victims of abuse.     

The Population Education Transition Curve: Education Gradients Across Population Exposure to New Health Risks

The salutary effect of formal education on health-risk behaviors and mortality is extensively documented: ceteris paribus, greater educational attainment leads to healthier lives and longevity. Even though the epidemiological evidence has strongly indicated formal education as a leading “social vaccine,” there is intermittent reporting of counter-education gradients for health-risk behavior and associated outcomes for certain populations during specific periods. How can education have both beneficial and harmful effects on health, and under which contexts do particular effects emerge? It is useful to conceptualize the influence of education as a process sensitive to the nature, timing of entry, and uniqueness of a new pleasurable and desirable lifestyle and/or product (such as smoking) with initially unclear health risks for populations. Developed herein is a hypothesis that the education gradient comprises multiple potent pathways (material, psychological, cognitive) by which health-risk behaviors are influenced, and that there can be circumstances under which pathways act in opposite directions or are differentially suppressed and enhanced. We propose the population education transition (PET) curve as a unifying functional form to predict shifting education gradients across the onset and course of a population’s exposure to new health risks and their associated consequences. Then, we estimate PET curves for cases with prior epidemiological evidence of heterogeneous education gradients with health-risk behaviors related to mass-produced cigarettes in China and the United States; saturated fats, sugar, and processed food diets in Latin America; and HIV infection in sub-Saharan Africa. Each offers speculation on interactions between environmental factors during population exposure and education pathways to health-risk behaviors that could be responsible for the temporal dynamics of PET curves. Past epidemiological studies reporting either negative or positive education gradients may not represent contradictory findings as much as come from analyses unintentionally limited to just one part of the PET process. Last, the PET curve formulation offers richer nuances about educational pathways, macro-historical population dynamics, and the fundamental cause of disease paradigm.     

Perceived social support in Chinese parents of children with attention deficit hyperactivity disorder in a Chinese context: Implications for social work practice

This article reports the results of a Hong Kong study (no. of parents = 121) which identified perceived social support (PSS), both overall and four types of support, of Chinese parents of children with attention deficit hyperactivity disorder (ADHD) and examined the impact of PSS on the interrelationship between the ADHD symptoms and parenting stress. The parents perceived support of their primary social network as more satisfactory than professionals’. Parenting stress of the high PSS group was lower than the low PSS group’s. The PSS-overall, parenting role, and the ADHD symptoms explained a significant variance of parenting stress. The results pave the way to develop a complex social work model in helping.