Caregiver Mental Health Outcomes: Are There Differences Across Generations?

Abstract Informal caregivers are a critical component of support for the rapidly aging population. Previous studies have addressed the effects of caregiving on mental health. However, they have not focused on differences among generational cohorts of caregivers of older adults, i.e., Millennial (born 1981-1996), Generation X (born 1965-1980), Baby Boomer (born 1946-1964), and Silent Generation (born 1928-1945). As the Millennial caregiver population grows in parallel with older adults and their increased needs, we must better understand Millennial responses to caregiving. Millennial caregivers provide a similar intensity of care as Baby Boomers in terms of hours per week but are more likely to be fully employed (40+ hours per week or more). We used caregiver data from the nationally representative Centers for Disease Control’s Behavioral Risk Factor Surveillance System (BRFSS) survey from 2015-2017 to conduct negative binomial regression (n=50,745). Data analysis indicates that Millennial caregivers have an incidence rate ratio of 1.22 times more self-reported days of “stress, depression, and/or problems with emotions” compared to Generation X caregivers (p<0.01); 1.64 times compared to Baby Boomers (p<0.001); and 2.38 times compared to Silent Generation caregivers (p<0.001). Generational differences show that Millennial caregivers may have different needs than older generations of caregivers. Rather than assuming that the policies and interventions designed for older generations of caregivers will fit younger generations, implications of this work can help inform: 1) the design of programs to support caregivers’ mental health, and 2) policy considerations that address the unique needs of a younger caregiver population.

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The positive association between employment and self-reported mental health in the USA: a robust application of marginalized zero-inflated negative binomial regression (MZINB)

Journal of Public Health ◽

10.1093/pubmed/fdaa030 ◽

2020 ◽

Vol 42 (2) ◽

pp. 340-352

Author(s):

Chinaeke Eric ◽

Gwynn Melanie ◽

Hong Yuan ◽

Zhang Jiajia ◽

Olatosi Bankole

Keyword(s):

Mental Health ◽

Chronic Conditions ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Chronically Ill ◽

Interactive Effects ◽

Behavioral Risk ◽

Cross Sectional ◽

Binomial Regression ◽

The Impact

Abstract Background Few studies have assessed the impact of employment on mental health among chronically ill patients. This study investigated the association between employment and self-reported mental unhealthy days among US adults. Methods For this cross-sectional cohort study, we pooled 2011–2017 Behavioral Risk Factor Surveillance System (BRFSS) survey data. We examined the association between employment and mental health in nine self-reported chronic conditions using marginalized zero-inflated negative binomial regression (MZINB). All analyses were conducted using SAS statistical software 9.4. Results Respondents (weighted n = 245 319 917) were mostly white (77.16%), aged 18–64 (78.31%) and employed (57.08%). Approximately 10% of respondents reported one chronic condition. Expected relative risk of mental unhealthy days was highest for employed respondents living with arthritis (RR = 1.70, 95% CI = [1.66, 1.74]), COPD (RR = 1.45, 95% CI = [1.41, 1.49]) and stroke (RR = 1.31, 95% CI = [1.25, 1.36]) compared to unemployed respondents. Employed males had 25% lower risk of self-reported mental unhealthy days compared to females. Conclusions Results show the interactive effects of employment on self-reported mental health. Employment may significantly impact on self-reported mental health among patients suffering from chronic conditions than those without chronic conditions.

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Effect of Comorbidity Assessed by the Charlson Comorbidity Index on the Length of Stay, Costs and Mortality among Older Adults Hospitalised for Acute Stroke

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15112532 ◽

2018 ◽

Vol 15 (11) ◽

pp. 2532 ◽

Cited By ~ 7

Author(s):

Richard Ofori-Asenso ◽

Ella Zomer ◽

Ken Chin ◽

Si Si ◽

Peter Markey ◽

...

Keyword(s):

Older Adults ◽

Length Of Stay ◽

Acute Stroke ◽

Charlson Comorbidity Index ◽

Negative Binomial ◽

Cox Regression ◽

Negative Binomial Regression ◽

Tertiary Hospital ◽

Hospital Death ◽

Comorbidity Index

The burden of comorbidity among stroke patients is high. The aim of this study was to examine the effect of comorbidity on the length of stay (LOS), costs, and mortality among older adults hospitalised for acute stroke. Among 776 older adults (mean age 80.1 ± 8.3 years; 46.7% female) hospitalised for acute stroke during July 2013 to December 2015 at a tertiary hospital in Melbourne, Australia, we collected data on LOS, costs, and discharge outcomes. Comorbidity was assessed via the Charlson Comorbidity Index (CCI), where a CCI score of 0–1 was considered low and a CCI ≥ 2 was high. Negative binomial regression and quantile regression were applied to examine the association between CCI and LOS and cost, respectively. Survival was evaluated with the Kaplan–Meier and Cox regression analyses. The median LOS was 1.1 days longer for patients with high CCI than for those with low CCI. In-hospital mortality rate was 18.2% (22.1% for high CCI versus 11.8% for low CCI, p < 0.0001). After controlling for confounders, high CCI was associated with longer LOS (incidence rate ratio [IRR]; 1.35, p < 0.0001) and increased likelihood of in-hospital death (hazard ratio [HR]; 1.91, p = 0.003). The adjusted median, 25th, and 75th percentile costs were AUD$2483 (26.1%), AUD$1446 (28.1%), and AUD$3140 (27.9%) higher for patients with high CCI than for those with low CCI. Among older adults hospitalised for acute stroke, higher global comorbidity (CCI ≥ 2) was associated adverse clinical outcomes. Measures to better manage comorbidities should be considered as part of wider strategies towards mitigating the social and economic impacts of stroke.

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Time Allocation Behavior of Twentieth-Century American Generations: GI Generation, Silent Generation, Baby Boomers, Generation X, and Millennials

Transportation Research Record Journal of the Transportation Research Board ◽

10.1177/0361198118794710 ◽

2018 ◽

Vol 2672 (49) ◽

pp. 69-80 ◽

Cited By ~ 2

Author(s):

Annesha Enam ◽

Karthik C. Konduri

Keyword(s):

Baby Boomers ◽

Generation X ◽

Time Use ◽

Time Allocation ◽

Structural Changes ◽

Demographic Variables ◽

Silent Generation ◽

Two Generations ◽

American Heritage ◽

Using Data

In recent years, time engagement behaviors of two generations, namely Baby Boomers and Millennials have sparked much interest because these generations constitute the bulk of the American population today and they also exhibit “atypical” activity–travel patterns compared with other generations. The objective of the current research is to conduct a systematic study of the time engagement behaviors of five American generations: the GI Generation (birth year: 1901–1924), the Silent Generation (birth year: 1925–1943), Baby Boomers (birth year: 1944–1964), Generation X (birth year: 1965–1981), and Millennials (birth year: 1982–2000). Particularly, the study aims at isolating heterogeneity in behaviors associated with structural changes in the society from those associated with inherent generational characteristics. Using data from four waves (1965, 1985, 2005, and 2012) of the American Heritage and Time Use Study, the analysis explores the time engagement behaviors while accounting for the age, period, and cohort effects in addition to different socioeconomic and demographic variables. The analysis reveals that Millennials have generally delayed participation in life-changing events such as marriage and workforce entry, and have exhibited prolonged student status compared with previous generations. Millennials show lower participation in work and higher participation in discretionary activities compared with individuals of the same age group from previous generations. On the other hand, Baby Boomers clearly exhibited increased travel engagement compared with the previous generations at different stages of their lives.

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Baby Boomers Who Provide Informal Care for People Living with Dementia in the Community

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18189694 ◽

2021 ◽

Vol 18 (18) ◽

pp. 9694

Author(s):

Christina E. Miyawaki ◽

Erin D. Bouldin ◽

Christopher A. Taylor ◽

Lisa C. McGuire

Keyword(s):

Mental Health ◽

Baby Boomers ◽

Baby Boomer ◽

Well Being ◽

The United States ◽

Health Condition ◽

Behavioral Risk ◽

Physical And Mental Health ◽

Chi Square ◽

Weighted Estimates

One in four Baby Boomers fills the informal caregiver role in the United States. The objectives of this study were to estimate the prevalence of Baby Boomers who are informal caregivers for people living with dementia and compare their physical and mental health status to caregivers for persons with conditions other than dementia using 2015–2018 Behavioral Risk Factor Surveillance System data (N = 10,602). We identified caregiving status (assisting a family member/friend with a long-term illness or disability in the past month, managing personal care, and not caring for a child/grandchild) and whether the care recipient’s major health condition was dementia. We calculated weighted estimates and used chi-square tests and log-binomial regression for comparisons of selected characteristics. Among Baby Boomer caregivers, 15.4% were caring for someone with dementia. Dementia caregivers were more likely to be female, caring for a parent/parent-in-law, and providing care longer than caregivers for persons without dementia. After adjusting for sociodemographic and caregiving characteristics, the prevalence of fair/poor health, frequent mental distress, and chronic conditions were similar across types of caregivers. Although no differences in caregiver’s physical and mental health by care recipient’s dementia status were found, we should underscore the importance of maintaining Baby Boomer caregivers’ health and well-being.

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Would You Accept a Facebook Friend Request from Your Boss?

Five Generations and Only One Workforce ◽

10.4018/978-1-7998-0437-6.ch007 ◽

2020 ◽

pp. 123-147

Author(s):

Katherine A. Karl ◽

Richard S. Allen ◽

Charles S. White ◽

Joy Van Eck Peluchette ◽

Douglas E. Allen

Keyword(s):

Social Media ◽

Baby Boomers ◽

Generation X ◽

Generational Differences ◽

Significant Interaction ◽

Close Relationships ◽

Future Research ◽

Open Communication ◽

Self Disclosure ◽

Main Effect

Because Millennials and Generation X tend to desire close relationships with their leaders, expect frequent and open communication, and integrate their personal and professional contacts via social media, it was predicted they would be more likely than Baby Boomers to accept a Facebook friend request from their boss. Although no main effect was found for generational differences, a significant interaction between self-disclosure and generation was found, such that self-disclosure was positively related to acceptance of a friend request from one's boss for Baby Boomers and Generation X, but negatively related for Millennials. Implications and directions for future research are discussed.

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Perceived Discrimination Trajectories and Depressive Symptoms Among Middle-Aged and Older Black Adults

Innovation in Aging ◽

10.1093/geroni/igaa041 ◽

2020 ◽

Vol 4 (5) ◽

Cited By ~ 1

Author(s):

Kellee White ◽

Bethany A Bell ◽

Shuo J Huang ◽

David R Williams

Keyword(s):

Mental Health ◽

Older Adults ◽

Depressive Symptoms ◽

Racial Discrimination ◽

Repeated Measures ◽

Negative Binomial ◽

Perceived Discrimination ◽

Sensitivity Analyses ◽

Middle Aged ◽

Time Point

Abstract Background and Objectives Perceived discrimination is a risk factor for poor mental health. However, most studies measure discrimination at one time point, which does not account for heterogeneity in the cumulative patterning of exposure to discrimination. To address this gap, we examine the association between discrimination trajectories and depressive symptoms among black middle-aged and older adults. Research Design and Methods Data were analyzed from a subsample of black Health and Retirement Study respondents (2006–2018, N = 2926, older than 50 years). General discrimination and racial discrimination trajectories were constructed based on the Everyday Discrimination Scale using repeated measures latent profile analyses. We examined the extent to which the association between discrimination trajectories are differentially associated with depressive symptoms (8-item Center for Epidemiological Studies-Depression scale) using negative binomial regression models adjusted for potential confounders. Effect modification by age and gender was tested. Results Individuals in the persistently high (incident rate ratio [IRR]: 1.70; 95% confidence interval [CI]: 1.49–1.95) and moderate general discrimination trajectories (IRR: 1.19; 95% CI: 1.06–1.33) were more likely to have elevated depressive symptoms in comparison to those in the persistently low trajectory. This relationship was strongest among older adults aged older than 65 years. Respondents in the persistently high racial discrimination trajectory (IRR: 1.50; 95% CI: 1.29–1.73) had a higher risk of elevated depressive symptoms in comparison to respondents in the persistently low trajectory. Sensitivity analyses indicated that there was an independent association between persistently high racial discrimination trajectory class and elevated depressive symptoms, after adjusting for racial discrimination measured at a single time point. Discussion and Implications Characterizing longitudinal patterns of perceived discrimination may facilitate the stratification of mental health risk and vulnerability among black middle-aged and older adults. Trajectories of racial discrimination may inform risk of worse depressive symptoms more accurately than a single assessment of discrimination.

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Fire Incidents in a Mental Health Setting: Effects of Implementing Smokefree Polices and Permitting the Use of Different Types of E-Cigarettes

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17238951 ◽

2020 ◽

Vol 17 (23) ◽

pp. 8951

Author(s):

Debbie Robson ◽

Gilda Spaducci ◽

Ann McNeill ◽

Mary Yates ◽

Melissa Wood ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

False Alarm ◽

Negative Binomial ◽

Positive Impact ◽

Negative Binomial Regression ◽

Smoke Detector ◽

False Alarms ◽

Health Care Settings ◽

Smokefree Policy

Comprehensive smokefree policies in health care settings can have a positive impact on patients’ smoking behaviour, but implementation is impeded by concern that surreptitious smoking may increase fire incidents. We investigated the incidence of routinely reported fire and false alarm incidents in a large mental health organisation in England over an 81-month period when different elements of a smokefree policy were implemented. We used negative binomial regression models to test associations between rates of fire and false alarm incidents and three hospital smokefree policy periods with mutual adjustment for occupied bed days: (1) an indoor policy which allowed disposable e-cigarettes; (2) a comprehensive policy which allowed disposable e-cigarettes; and (3) a comprehensive policy with all e-cigarette types allowed. We identified 90 fires and 200 false alarms. Fires decreased (incidence rate ratio (IRR): 0.35, 95% CI: 0.17–0.72, p = 0.004) and false alarms increased (IRR: 1.67, 95% CI: 1.02–2.76, p = 0.043), each by approximately two-thirds, when all e-cigarette types were allowed, after adjusting for bed occupancy and the comprehensive smokefree policy. Implementation of smokefree policies in mental health care settings that support use of all types of e-cigarettes may reduce fire risks, though measures to minimise effects of e-cigarette vapour on smoke detector systems may be needed to reduce false alarm incidents.

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Exploring the Self-Reported Long-Distance Travel Frequency of Millennials and Generation X in California

Transportation Research Record Journal of the Transportation Research Board ◽

10.1177/0361198118798478 ◽

2018 ◽

Vol 2672 (47) ◽

pp. 208-218 ◽

Cited By ~ 6

Author(s):

Rosaria M. Berliner ◽

Lisa Aultman-Hall ◽

Giovanni Circella

Keyword(s):

Generation X ◽

Online Survey ◽

Negative Binomial ◽

New Technologies ◽

Age Groups ◽

Negative Binomial Regression ◽

Long Distance ◽

Brick And Mortar ◽

Distance Travel ◽

Long Distance Travel

Long-distance travel research is limited because of the lack of robust data and the complexity of defining a long-distance trip. The patterns of infrequent long-distance trips are poorly understood especially compared with the better studied (and understood) local daily travel patterns. This study contributes to filling that gap by investigating the factors that affect the frequency of long-distance trips of Californian millennials (18–34 years old, in 2015) and members of the preceding Generation X (35–50 years old, in 2015). Data collected with an online survey administered in fall 2015 are used to study the mobility of these age groups. The survey collected information on several travel-related variables, including the number of long-distance trips (defined as trips longer than 100 miles, one way) made by various modes during the previous 12 months. The authors estimate six negative binomial regression models of long-distance travel separated by purpose ( business or leisure) and mode ( overall travel versus air). The study explores the relationship of long-distance trip formation with several sociodemographic, land use, and attitudinal variables. Consistent with expectations, individual income positively affects the number of long-distance trips made by each individual. Among the attitudinal variables, the individuals who are adventurers, have higher “variety seeking” attitudes and are more interested in adopting new technologies are found to make a larger number of long-distance trips. However, those who prefer to shop in brick-and-mortar stores rather than online are found to have lower levels of long-distance travel.

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Racial Variation in Mental Health Court Experiences and the Associations of These Experiences With Recidivism

Criminal Justice and Behavior ◽

10.1177/0093854820921886 ◽

2020 ◽

Vol 47 (7) ◽

pp. 808-828

Author(s):

Woojae Han ◽

Jason Matejkowski ◽

Sungkyu Lee

Keyword(s):

Mental Health ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Mental Health Court ◽

Life Change Events ◽

Life Change ◽

Life Changes ◽

Racial Variation ◽

Program Satisfaction ◽

Binomial Regression

Little is known about how mental health court (MHC) experiences (including satisfaction and sanctioning, incentivizing, and life change events) differ by race and how this variation affects recidivism among MHC participants. This study examined how MHC experiences and recidivism differ between White ( n = 170) and Black ( n = 132) participants from four different MHCs in the United Sates. Negative binomial regression models, conducted separately for the two groups, indicated that life changes were associated with decreased arrests and that court sanctions were associated with increased number of arrests for both White and Black participants. Higher program satisfaction was positively associated with recidivism among Black participants only. To provide equitable services for people convicted of a crime with mental illness, professionals should acknowledge racial variation in the experiences of MHC participants (both within the MHC and the communities in which they are situated) and how these experiences relate to recidivism.

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Generational Perceptions: Workers And Consumers

Journal of Business & Economics Research (JBER) ◽

10.19030/jber.v7i10.2344 ◽

2011 ◽

Vol 7 (10) ◽

Author(s):

A.J. Nicholas

Keyword(s):

Baby Boomers ◽

Generation X ◽

Generation Y ◽

Generational Differences ◽

Work Ethic ◽

The Other ◽

Font Size ◽

Generational Perceptions

Today’s workers and consumers consist of four generations of individuals raised with very different technologies and lifestyles. How does this affect attracting and retaining individuals as workers or consumers? Generational differences of Traditionalists, Baby Boomers, Generation X and Generation Y may influence their values and preferences.   Why will understanding these dissimilar perceptions be important? According to Murphy (2007), “different perspectives on issues like work ethic, leadership, and authority can cause conflict, frustration, and misunderstanding if not managed well” (p.18).  In a recent “World of Work Survey” (2008), the older and younger generations noted little or no interaction with the other. This is not conducive to a cooperative environment where working with and learning from one another can be vital. Understanding what appeals to the generations as consumers is also critical for organizations.  Targeting specific generations for their preferences and reaching them through media that is suitable to their style is an important marketing trend (Marconi, 2001).  Customizing for these dissimilar cohorts will require knowledge of their particular attitudes and inclinations.  Understanding these different perceptions will enable improved communications for the workforce and the consumer. This paper seeks to clarify some of these differences.

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