Investigating the mechanism of marital mortality reduction: The transition to widowhood and quality of health care

While it is well known that the widowed suffer increased mortality risks, the mechanism of this survival disadvantage is still under investigation. In this article, we examine the quality of health care as a possible link between widowhood and mortality using a unique data set of 475,313 elderly couples who were followed up for up to nine years. We address whether the transition to widowhood affects the quality of care that individuals receive and explore the extent to which these changes mediate the elevated mortality hazard for the widowed. We analyze six established measures of quality of health care in a fixed-effect framework to account for unobserved heterogeneity. Caregiving and acute bereavement during the transition to widowhood appear to distract individuals from taking care of their own health care needs in the short run. However, being widowed does not have long-term detrimental effects on individuals’ ability to sustain contact with the formal medical system. Moreover, the short-run disruption does not mediate the widowhood effect on mortality. Nevertheless, long after spousal death, men suffer from a decline in the quality of informal care, coordination between formal and informal care, and the ability to advocate and communicate in formal medical settings. These findings illustrate women’s centrality in the household production of health and identify important points of intervention in optimizing men’s adjustment to widowhood.     

Mortality attributable to obesity among middle-aged adults in the united states

Obesity is considered a major cause of premature mortality and a potential threat to the longstanding secular decline in mortality in the United States. We measure relative and attributable risks associated with obesity among middle-aged adults using data from the Health and Retirement Study (1992–2004). Although class II/III obesity (BMI _ 35.0 kg/m2) increases mortality by 40% in females and 62% in males compared with normal BMI (BMI = 18.5-24.9), class I obesity (BMI = 30.0-34.9) and being overweight (BMI = 25.0-29.9) are not associated with excess mortality. With respect to attributable mortality, class II/III obesity (BMI _ 35.0) is responsible for approximately 4% of deaths among females and 3% of deaths among males. Obesity is often compared with cigarette smoking as a major source of avoidable mortality. Smoking-attributable mortality is much larger in this cohort: about 36% in females and 50% in males. Results are robust to confounding by preexisting diseases, multiple dimensions of socioeconomic status (SES), smoking, and other correlates. These findings challenge the viewpoint that obesity will stem the long-term secular decline in U.S. mortality.     

Comment: there may be compositional effects,but they do not work that way*

This analysis joins the debate on how declines in marriage have shifted the composition of the unmarried and married populations in the United States, and how compositional shifts have affected nonmarital birth rates. Gray, Stockard, and Stone (2006) presented one model for compositional effects that Ermisch (2009) challenged with alternative statistical tests. I propose an alternative model for compositional shifts based not on theory but on observed marriage and fertility patterns. The results from this alternative model are consistent with Ermisch’s findings yet support Gray et al.’s general case that compositional effects have had an important infiuence on nonmarital birth rates.     

Forced Migration and Mortality in the Very Long Term: Did Perestroika Affect Death Rates Also in Finland?

In this article, we analyze mortality rates of Finns born in areas that were ceded to the Soviet Union after World War II and from which the entire population was evacuated. These internally displaced persons are observed during the period 1971-2004 and compared with people born in the same region but on the adjacent side of the new border. We find that in the 1970s and 1980s, the forced migrants had mortality rates that were on par with those of people in the comparison group. In the late 1980s, the mortality risk of internally displaced men increased by 20% in relation to the expected time trend. This deviation, which manifests particularly in cardiovascular mortality, coincides with perestroika and the demise of the Soviet Union, which were events that resulted in an intense debate in civil society about restitution of the ceded areas. Because state actors were reluctant to engage, the debate declined after some few years, and after the mid-1990s, the death risk again approached the long-term trend. Our findings indicate that when internally displaced persons must adjust to situations for which appropriate coping behaviors are unknown, psychosocial stress might arise several decades after their evacuation.     

Revisiting das gupta: Refinement and extension of standardization and decomposition

Standardization and decomposition are established and widely used demographic techniques for comparing rates and means between groups with differences in composition. The difference in rates and means has heretofore been resolved in terms of the contribution of variables to compositional effects for each variable and an overall rate effect. This study demonstrates that the resolution of differences is attainable at the categorical level for both compositional effects and rate effects. Refinements to Das Gupta’s equations yield a complete decomposition because of the additivity of categorical compositional and rate effects. Other refinements allow the decomposition of polytomous variables. Extensions to the method provide for the decomposition of the standard deviation and the multivariate index of dissimilarity.     

Parental characteristics and the schooling progress of the children of immigrant and U.S.-born blacks

In this study, I examine disparities in schooling progress among children born to immigrant and U.S.-born blacks. I find that in one- and two-parent families, children born to black immigrants are less likely to fall behind in school than those born to U.S.-born blacks. In two-parent immigrant families, children born to two immigrant parents have a significant schooling advantage over children born to one immigrant parent. While children born to two immigrant parents in the wealthiest black immigrant families do better in the second generation than in the first, the reverse is observed among children in less wealthy families. These findings contribute in two ways to our understanding of the assimilation processes of children born to black immigrant parents. First, they show that there is a positive association between the number of immigrant parents in a family and children’s schooling performance. Second, they suggest that disparities in the assimilation patterns of the children of black immigrants are a likely product of the interaction between their parental characteristics and the socioeconomic circumstances of their families.     

Social Harmony in Hong Kong: Level,Determinants and Policy Implications

This study aims at ascertaining how Hong Kong people perceive Hong Kong as a harmonious society. It also identifies the elements that are most conducive to social harmony in Hong Kong, so that the government could take reference when formulating new policies. 1,062 adults residents were asked to rate their perceived level of social harmony and their satisfaction with 36 items (divided into three dimensions: public governance, society, and economy, family and work) for which the research team believes would be influencing the perceived level of social harmony. Results show that the average rating of social harmony was 5.57 (out of 10), delineating a moderate level of social harmony. Subsequent multivariate factor analysis and regression analysis show that the four extracted factors (from the three dimensions) had significant impacts on the level of social harmony. These were, in order of significance: (a) public governance, (b) social solidarity and respect, (c) economy/family/work and, (d) social tolerance and progressiveness. According to the factor loadings of each significant factor, we identified four core values which we hope the government would consider when formulating new policies, as follows: (1) A Justice Government with Sincerity on Communication, (2) Mutual Support and Respect with Integrity and Dedication, (3) Dedication to One’s Job and Community by Helping the Needed and, (4) Creativity and Progressiveness with Tolerance. Implications for policy making are discussed. The study was conducted under the direction and guidance of the Fostering Social Harmony Task Force of the Hong Kong Professionals and Senior Executives Association (HKPASEA). The authors acknowledge the kind support and assistance provided by the Council Members of HKPASEA and staff members of the Centre for Corporate Governance and Financial Policy at Hong Kong Baptist University. We are also grateful to Prof. Alex Michalos and Prof. P. K. Ip for their comments and suggestions given at the International Conference on National Well-Being held in November 2006 at the National Central University, Taiwan.     

An Examination of the Dual Model of Perfectionism and Adolescent Athlete Burnout: A Short-Term Longitudinal Research

The dual model of perfectionism (Slade and Owens, Behav Modificat 22(3):372–390, 1998) is adopted to examine the influence of adaptive and maladaptive perfectionism on adolescent athlete burnout in Taiwan. Participants were 188 high school adolescent student-athletes (M = 16.48, SD = .59). They were administered the Multidimensional Inventory of Perfectionism in Sport (Stoeber et al., Pers Individ Dif 43(1):131–141, 2007) and the Chinese Athlete Burnout Questionnaire (ABQ) (Lu et al., Phys Educ J 39(3):83–94, 2006). A field longitudinal design was used. In cross-sectional analyses, hierarchical multiple regressions indicated that adaptive perfectionism negatively predicted athlete burnout while maladaptive perfectionism had an inverse relationship with burnout. However, after controlling for the initial scores of burnout, neither adaptive nor maladaptive perfectionism significantly predicted athlete burnout after a three month interval. Possible mechanisms of this relation, limitations, and practical implications are discussed.     

The Performance of the World Health Organization’s WHOQOL-BREF in Assessing the Quality of Life of Thai College Students

The purpose of this study was to examine the performance of the Thai-version of WHOQOL-BREF in assessing the quality of life (QoL) among Thai college students. The psychometric properties of WHOQOL-BREF were assessed in this study. The self-administered WHOQOL-BREF questionnaire was applied. A total of 407 Thai college students (male age = 20.5 ± 1.2; female age = 20.5 ± 1.2) participated in this study. Item-response distributions, internal consistency reliability, discriminant validity, criterion-related validity and construct validity through confirmatory analysis were analyzed. The findings indicate that the WHOQOL-BREF had acceptable internal consistency (α = 0.73–0.83 across four domains), all items highly correlated with corresponding domain scores (r = 0.53–0.80), the indices of a two-order confirmatory factor analysis (CFA) demonstrate that the data fit the model well with allowing covary of error variances of some items, all items had good property of criterion-related validity and item discrimination and, all three domain scores except the social relationship domain had significant associations with overall QoL or general health. The results suggest that the WHOQOL-BREF was reliable and valid to health professionals in the assessment of the QoL of college-based Thai youth, but some unsuitable items may be deleted in future studies.     

Parallels Between Objective Indicators and Subjective Perceptions of Quality of Life: A Study of Metropolitan and County Areas in Taiwan

This study explores the consistency between objective indicators and subjective perceptions of quality of life in a ranking of survey data for cities and counties in Taiwan. Data used for analysis included the Statistical Yearbook of Hsiens and Municipalities and the Survey on Living Conditions of Citizens in Taiwan, both given for the year 2000. The Quality of life was examined in seven domains: medical services, domestic finances, work, education, leisure, public safety, and environmental quality. Subjective and objective rankings for each domain of quality of life for 23 areas (some areas are cities and some are counties) are compared. Analysis by means of nonparametric correlation coefficients indicates that there is no significant correlation between objective indicators and subjective perceptions, except in Education and Environmental Quality. Objective indicators of Environmental Quality (air pollution and garbage) are positively correlated with subjective satisfaction with residential environment. But inexplicably, higher levels of literacy and educational achievement are negatively correlated with satisfaction with the educational system. It may be considered that disparity in either average objective conditions or in average subjective perceptions may not adequately depict quality of life differences.