scholarly journals Life on the Edge: Patterns of Formal and Informal Help to Older Adults in the United States and Sweden

2005 ◽  
Vol 60 (5) ◽  
pp. S281-S288 ◽  
Author(s):  
Adam Davey ◽  
Elia E. Femia ◽  
Steven H. Zarit ◽  
Dennis G. Shea ◽  
Gerdt Sundström ◽  
...  

Abstract Objectives. Our objective in this study was to compare assistance received by individuals in the United States and Sweden with characteristics associated with low, moderate, or high 1-year placement risk in the United States. Methods . We used longitudinal nationally representative data from 4,579 participants aged 75 years and older in the 1992 and 1993 waves of the Medicare Current Beneficiary Survey (MCBS) and cross-sectional data from 1,379 individuals aged 75 years and older in the Swedish Aging at Home (AH) national survey for comparative purposes. We developed a logistic regression equation using U.S. data to identify individuals with 3 levels (low, moderate, or high) of predicted 1-year institutional placement risk. Groups with the same characteristics were identified in the Swedish sample and compared on formal and informal assistance received. Results . Formal service utilization was higher in Swedish sample, whereas informal service use is lower overall. Individuals with characteristics associated with high placement risk received more formal and less informal assistance in Sweden relative to the United States. Discussion . Differences suggest formal services supplement informal support in the United States and that formal and informal services are complementary in Sweden.

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S674-S674
Author(s):  
Tamar E Shovali ◽  
Kerstin G Emerson

Abstract Nearly three million grandparents in the US serve as primary caregivers for their grandchildren. Little research on formal service use and grandfamilies exists for Black and Hispanic populations. To begin to address this gap we conducted exploratory analyses using nationally representative estimates of characteristics and service accessibility of noninstitutionalized children living with grandparents from the 2013 National Survey of Children in Nonparental Care. Our goal was to understand differences in service use as a function of grandfamily race/ethnicity. We specifically explored grandparents’ formal service count, financial services received, confidence in obtaining/using community services, and level of role preparation by race/ethnicity. We calculated descriptive statistics for these service variables for grandparents raising Hispanic, White, Black, and Other identified grandchildren (N = 892). On average, there was a minimal range for the number of formal services used (M range = 5.26 – 5.84, possible = 0 – 10 higher equals more services used), reported number of financial services (M range = 0.71 - 0.78, possible = 0 – 3 higher equals more financial services received), and confidence obtaining/using services (M range = 7.4—7.9, possible = 1 – 9 higher equal more confidence). Most prepared to take on the caregiving role were grandparents of White children (55%) followed by Black (21.6%), Other (12.3%), and Hispanic (11.1%) indicating that although grandparents in this sample report being confident and able to access formal services, grandparents of White children report being feeling more prepared to take on caregiving than grandparents of Black, Hispanic, and Other combined.


2017 ◽  
Vol 32 (5) ◽  
pp. 1228-1233 ◽  
Author(s):  
Olivier Drouin ◽  
Robert C. McMillen ◽  
Jonathan D. Klein ◽  
Jonathan P. Winickoff

Purpose: To report on adults’ recall of discussion by physicians and dentists about e-cigarettes. Design: A nationally representative cross-sectional survey (Internet and random digit dialing) in the United States. Participants: Adults who ever used e-cigarettes. Measures: Participant-reported discussion about the potential benefits and harms of e-cigarettes with their doctor, dentist, or child’s doctor in the past 12 months. Analysis: Fisher exact test for the analysis between benefits and harms for each type of provider and for rates of advice between provider types. Results: Among the 3030 adults who completed the survey, 523 (17.2%) had ever used e-cigarettes. Of those who had seen their doctor, dentist, or child’s doctor in the last year, 7.3%, 1.7%, and 10.1%, respectively, reported discussing potential harms of e-cigarettes. Conversely, 5.8%, 1.7%, and 9.3% of patients who had seen their doctor, dentist, or child’s doctor in the last year reported that the clinician discussed the potential benefits of e-cigarettes. Each clinician type was as likely to discuss harms as benefits. Rates of advice were similar between doctors and child’s doctors but lower for dentists. Rates were comparable when the analysis was limited to current e-cigarette users, participants with children, or those who reported using both e-cigarettes and combusted tobacco. Conclusions: Few physicians and dentists discuss either the harms or benefits of e-cigarettes with their patients. These data suggest an opportunity to educate, train, and provide resources for physicians and dentists about e-cigarettes and their use.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Garima Sharma ◽  
Gowtham R Grandhi ◽  
Isaac Acquah ◽  
Reed Mszar ◽  
Laxmi S Mehta ◽  
...  

Introduction: Cardiovascular health (CVH) and social determinants of health (SDOH) have a significant impact on maternal morbidity and mortality. We assessed the association and cumulative effects of SDOH on CVH among a nationally representative sample of pregnant women in the United States. Methods: We included cross-sectional data of pregnant women aged 18 to 49 years from the National Health Interview Survey (2013-2017). We ascertained CVH based on the following CV risk factors: hypertension, diabetes mellitus, dyslipidemia, smoking, obesity, and physical activity; classifying participants into optimal (0-1) and suboptimal (≥2) CVH. For each individual, SDOH risk score was calculated that represents the cumulative number of distinct variables (present vs absent) identified on 39 sub-components for 6 domains (economic stability, neighborhood and physical environment, community and social context, food, education, and healthcare system access). SDOH risk score was aggregated and divided into 4 quartiles. Results: Among 1,433 (3.3%, representing 2.2 million) pregnant women in US, one third (33%) of pregnant women (mean age: 33 years, 13% non-Hispanic black) had suboptimal CVH. The prevalence of hypertension, smoking, obesity and physical inactivity across the increasing SDOH quartiles were noted. Overall, 52% pregnant women with unfavorable (4 th quartile) vs 27% with favorable (1 st quartile) SDOH had suboptimal CVH. In multivariable analyses, accounting for demographics and co-morbid conditions, pregnant women with unfavorable SDOH in 4 th quartile had nearly 3-fold higher odds of suboptimal CVH. (Figure). Conclusions: Aggregate SDOH risk score provides significant discrimination of CVH in pregnant women. In pregnant women, suboptimal CVH is common and more than 1 in 2 women with highest risk of SDOH inequities have suboptimal CVH, highlighting the public health urgency for intervention in young high risk women.


2008 ◽  
Vol 22 (4) ◽  
pp. 256-263 ◽  
Author(s):  
Kenneth Jacob Steinman ◽  
Athe Bambakidis

Purpose. Estimate the prevalence of and identify characteristics associated with religious congregations' collaboration with health agencies. Design. Cross-sectional analyses of self-report data from the National Congregations Study, a random sample of religious congregations generated from the 1998 General Social Survey. Setting. United States. Subjects. Key informants from 1236 congregations. Each respondent described a single congregation. Measures. Respondents provided open-ended descriptions of congregational programs. Researchers coded program descriptions by content (e.g., domestic violence) and whether the program involved collaboration with a secular agency. Other congregational characteristics (e.g., denomination) were measured by validated measures and linked census tract data. Results. Overall, 11.1% of congregations participated in faith-health collaboration (FHC). Logistic regression analyses found that FHC was more common among congregations with more members, with a small proportion of congregants under 35 years, and with a senior pastor with a graduate degree. Other effects were conditional; for instance, denominational differences varied depending on urban/suburban/rural location and the proportion of low-income members. Conclusion. This study provides the first national estimates of the prevalence of FHC. Such collaborative efforts may require different approaches in different areas. These results can help practitioners identify congregations that may be more willing to collaborate.


Author(s):  
Sericea Stallings-Smith ◽  
Taylor Ballantyne

E-cigarette use among adolescents is well-documented, but less is known about adult users of e-cigarettes. The purpose of this study was to examine associations between sociodemographic factors and e-cigarette use in a nationally representative sample of adults in the United States. Cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) for years 2015-2016 were analyzed to assess e-cigarette use among 5989 adults aged ≥18 years. Multivariable logistic regression was conducted to examine associations between the sociodemographic exposures of age, sex, race, marital status, education level, employment status, and poverty-income ratio and the outcome of e-cigarette use. The weighted prevalence of ever use of e-cigarettes was 20%. Compared with adults aged ≥55 years, odds of e-cigarette use were 4.77 times (95% confidence interval [CI] = 3.63-6.27) higher among ages 18 to 34 years and 2.16 times (95% CI = 1.49-3.14) higher among ages 35 to 54 years. Higher odds of e-cigarette use were observed among widowed/divorced/separated participants compared with those who were married/living with a partner, among participants with less than high school (odds ratio [OR] = 1.47; 95% CI = 1.08-2.00) or high school/general educational development (GED) education (OR=1.41; 95% CI = 1.12-1.77) compared with those with college degrees/some college, and among those with incomes below the poverty level (OR=1.31; 95% CI = 1.01-1.69) compared with above the poverty level. For non-smokers of conventional cigarettes, higher odds of e-cigarette use were observed among males compared with females, Mexican Americans/Other Hispanics compared with non-Hispanic whites, and non-working participants compared with those who were working. Overall findings indicate that individuals who are widowed/divorced/separated, individuals with lower education, and with incomes below the poverty level are likely to report ever use of e-cigarettes. As increasing evidence demonstrates negative health consequences, e-cigarette initiation may ultimately contribute to additional smoking-related health inequalities even among non-smokers of conventional cigarettes.


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