Black/White Differences in Health Status and Mortality Among the Elderly

Grade of membership (GOM) representations are used to characterize and compare the health status of a very heterogeneous sample of blacks and whites in an elderly cohort of 2,806 noninstitutionalized men and women living in New Haven, Connecticut. They were interviewed in 1982 as part of the Established Populations for the Epidemiologic Study of the Elderly (EPESE). Ideal profiles based on functional disabilities, chronic diseases, and selected biomedical and behavioral risk factors are constructed empirically. Each individual in the sample is represented by a set of GOM scores, interpreted as degrees of similarity of his or her health record to each of the profiles. Four profiles emerge from GOM analyses: healthy elderly, elderly with cognitive impairment, elderly with impairment in mobility function and physical performance and with selected chronic conditions, and elderly with major limitations in activities of daily living and multiple chronic conditions. Although elderly blacks and whites generally have similar configurations of profiles, there are important differences, especially when chronic conditions are related to specific types of functional impairments. Questions about and claims for black/white mortality crossovers at older ages, usually addressed with aggregate data, are examined conditional on GOM scores that correspond to diverse combinations of disabilities (or lack thereof) together with housing characteristics of cohort members (e.g., whether they live in public housing for the elderly or in owned or rented housing in the community).     

The project coordinator's problem

A project coordinator has a set of activities with known durations and values which are available for scheduling within a given horizon. There may be both precedence and corequisite restrictions (two activities are corequisites if scheduling one implies the other must be scheduled). The project coordinator's problem is to select the activities to be scheduled, and their start times, so as to maximize the net value of the project when there is no penalty for failing to schedule an activity. An efficient solution procedure is developed and illustrated and several generalizations are discussed.     

Advance Directives Among Korean American Older Adults: Knowledge,Attitudes, and Behavior

The study objective was to explore knowledge, attitudes, and behavior about advance directives and how cultural values influence these beliefs. Three focus groups with 23 Korean American older adults were conducted. Advance directives were seen as helpful for ensuring that preferences for unwanted end-of-life treatment are honored and for relieving the decision-making burden on family members. However, some viewed completing advance directives as contrary to focusing on living. Culturally competent education about advance directives for Korean American older adults is necessary to help them make informed decisions about end-of-life care and informing family and health care providers of these preferences.     

Mortality and physical functioning in epidemiologic studies of three older populations

Mortality experienced in the first three years of follow-up for three Established Populations for Epidemiologic Studies of the Elderly (EPESE) is examined in relation to the participants' self-reported functional ability. In East Boston, Massachusetts (N = 3,812), Iowa and Washington Counties, Iowa (N = 3,673), and New Haven, Connecticut (N = 2,812), noninstitutionalized persons aged 65 and older were asked a series of questions to determine their functional status. These measures, used in logistic regression analyses of the mortality data, showed that an increased number of reported disabilities significantly increased the risk of mortality over and above the effects of the age and sex of the participant, or the methodological differences among the sites. Disabilities in gross mobility (e.g., ability to walk a half mile, climb stairs, or perform heavy work around the house) were more strongly related to mortality than were measures of activities of daily living.     

Where is the market failure? A review of OSHA’s economic analysis for its proposed ergonomics standard

conclusion OSHA justifies its proposed regulation on the basis of “market failures in employ-ment and insurance markets. However, the Administration's own analysis demonstrates that about half of the benefits of the proposed regulation accrue directly to industry. It appears that the marginal social costs and marginal private benefits of achieving OSHA's desired level of workplace safety are approximately equal, implying no need for further government intervention. Our analysis demonstrates the following points: • When the total costs and benefits of OSHA's proposed standard are com-pared across all industries, no significant market failure is evident — the benefits to industry are approximately equal to the costs — indicating that government intervention is unnecessary. The authors thank Michael Liu and Alison Pan for their excellent research assistance on this project.     

Trends in Work–Family Context Among U.S. Women by Education Level, 1976 to 2011

This study compares trends in work–family context by education level from 1976 to 2011 among U.S. women. The major aim is to assess whether differences in work–family context by education level widened, narrowed, or persisted. We used data from the 1976–2011 March Current Population Surveys on women aged 25–64 (n = 1,597,914). We compare trends in four work–family forms by education level within three race/ethnic groups. The work–family forms reflect combinations of marital and employment status among women with children at home. Trends in the four work–family forms exhibited substantial heterogeneity by education and race/ethnicity. Educational differences in the work–family forms widened mainly among white women. Compared with more-educated peers, white women without a high school credential became increasingly less likely to be married, to be employed, to have children at home, and to combine these roles. In contrast, educational differences in the work–family forms generally narrowed among black women and were directionally mixed among Hispanic women. Only one form—unmarried and employed with children at home—became more strongly linked to a woman’s education level within all three race/ethnic groups. This form carries an elevated risk of work–family conflict and its prevalence increased moderately during the 35-year period. Taken together, the trends underscore recent calls to elevate work–family policy on the national agenda.     

Conservation of Resources theory in the context of multiple roles: an analysis of within- and cross-role mediational pathways

Based on the Conservation of Resources theory, we used data from the National Survey of Midlife Development in the United States (MIDUS I, 1995–1996; N=1779) to estimate by covariance structure analysis the direct and indirect effects of work and family demands, resources, and support on psychological distress. In a new application of the theory, we estimated six within-role mediational pathways linking work-related predictors to psychological distress through work interfering with family (WIF) and family-related predictors to psychological distress through family interfering with work (FIW). Finally, in a departure from previous work–family research, we estimated six cross-role mediational pathways linking work-related predictors to psychological distress through FIW and family-related predictors to psychological distress through WIF. Ten of the 12 hypothesized mediational effects were significant and another was marginally significant, supporting the mediational role of work–family conflict within Conservation of Resources theory.