Geographic variation in preventable hospitalization of older women and men: implications for access to primary health care

This study demonstrates how readily available data and small area analysis can be used to identify potential problems of access to primary care services for older women and men. Gender and socioeconomic differences in rates of preventable hospitalization are examined. Using hospital discharge data, five county and twenty-four intra-county areas in Upstate New York are studied. There is significant variation in preventable hospitalization within counties. Areas having significantly higher rates of these hospitalizations tend to have higher rates for both women and men. Problems of access are associated with lower income areas for women and men.     

The morbidity compression debate: risks, opportunities, and policy options for women

The morbidity compression theory proposes that we can compress the period of illness and disability in old age into an ever smaller period at the end of life. Although recent research offers fresh support for the theory, its validity remains uncertain. This paper demonstrates the importance of the theory and recent research in this area for women. It critiques the chief proponent and opposing views of the theory, and suggests a heightened emphasis on public policies promoting healthy lifestyles. These policies would reduce long-term care needs, save health care dollars, and improve the experience of aging.     

Postcards to God: exploring spiritual expression among disabled older adults

Postcards to God was a creative method to allow individuals to express their spirituality. The purpose of this study was to examine the validity of this innovative method. At a skilled nursing facility in a geriatric residence, 19 older disabled workshop participants created collage and message "Postcards to God", and completed a brief survey. Postcard content and construction were coded and analyzed using qualitative methods around self-reports along two attitudinal dimensions: a) making a postcard to God; and b) level of religiousness. Spiritual and religious dimensions were related to postcard thematic content. Postcards were used for expressions of spirituality and prayer across all levels of self-reported religiousness. The Postcards project seems like useful way to facilitate spiritual expression. If validated in further study, this method may prove a useful way to promote spiritual expression in a variety of older and frail populations.     

Physical activity and cognitive-health content in top-circulating magazines, 2006-2008

Physical activity may promote cognitive health in older adults. Popular media play an important role in preventive health communication. This study examined articles discussing associations between physical activity and cognitive health in top-circulating magazines targeting older adults. 42,753 pages of magazines published from 2006 to 2008 were reviewed; 26 articles met inclusion criteria. Explanations regarding the link between physical activity and cognitive health were provided in 57.7% of articles. These explanations were generally consistent with empirical evidence; however, few articles included empirical evidence. Physical activity recommendations were presented in 80.8% of articles; a wide range was recommended (90-300 min of physical activity per wk). Socioeconomic status and education level were not mentioned in the text. Results suggest an opportunity for greater coverage regarding the role of physical activity in promoting cognitive health in popular media. Magazine content would benefit from including more empirical evidence, culturally sensitive content, and physical activity recommendations that are consistent with U.S. guidelines.     

Increased hospitalization risk for recently widowed older women and protective effects of social contacts

This study examines effects of recent widowhood on health for a nationally representative sample of older women in the United States. Mediating effects of social connectedness on the health of recently widowed women are also explored. Using data from the 1984-1990 Longitudinal Study of Aging and Medicare claims, discrete-time hazard models estimate the risk of hospitalization for any 30-day period for women who were married at the time of the baseline survey (n = 1,138). Compared to women who are not recently widowed, those recently widowed have a 40% higher risk of hospitalization. Social connectedness, measured by having phoned a friend/neighbor or family member in the period prior to the baseline survey, significantly decreases hospitalization risk for the recently widowed. The findings indicate that recent widowhood has a large adverse effect on the health of older women. Results highlight the need to provide additional support to recently widowed older women.     

Aging children and their older parents: the coming generation of caregiving

This study uses a data set of older children and their older parents to examine caregiving relationships. Using the 1993 Panel Study of Income Dynamics and the 1993 Health Care Burden file, we examine help given by children to their parents. We distinguish between daughters who are household heads and daughters who are wives. We find parents receive substantially more care from daughters than from sons. The caregiving role of daughters who are household heads differs notably from that of wives. An analysis of caregiving, employment, and house-work shows that children who are caregivers devote more combined hours to these activities than children who do not provide care.     

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.     

Patterns of active life among older women: differences within and between groups

This study examines the distribution of total, unimpaired, and impaired life for several groups of older women defined by race, education, and marital history. Using data from the 1984-1990 Longitudinal Study of Aging, we model transitions among functional statuses using discrete-time Markov chains, and use microsimulation to produce summary indices of active life. Remaining years of life and the proportion of remaining years with disability vary substantially, both within each group of women studied and between pairs of groups. Of all groups studied, never-married, more-educated white women live the longest, healthiest lives. Ever-married nonwhite women with low education have the shortest life expectancy, and experience the most disability. Our findings show that life expectancy is an incomplete indicator of the time women, in particular sub-groups, can expect to live with and without impairment. These findings highlight the heterogeneity of disability processes and life expectancy for older women.     

Recent perspectives on active life expectancy for older women

This article provides a critical review of recent active life expectancy literature, describing trends of special interest to women. We review findings from leading perspectives used to study life expectancy and active life expectancy, including gender, racial and socioeconomic differences, disease-specific effects, and biodemography. We examine three competing theories of population health that frame active life expectancy research-compression of morbidity, expansion of morbidity, and dynamic equilibrium-concluding there is support for both the compression of morbidity and dynamic equilibrium theories. Policy implications for women include a greater understanding of the role of education and racial and ethnic diversity in active life trends, and an increased public policy emphasis on prevention and treatment of chronic disease, together with adoption of more healthy lifestyles.