“They’re not leaving their home; this is where they were born, this is where they will die.”: Key Informant Perspectives From the U.S. Counties With the Greatest Concentration of the Oldest Old

2021 ◽  
pp. 016402752110323
Author(s):  
Carrie Henning-Smith ◽  
Megan Lahr ◽  
Jill Tanem
Keyword(s):  
Successful Aging ◽  
Resource Constraints ◽  
Oldest Old ◽  
County Level ◽  
County Commissioners ◽  
Rural Counties ◽  
Rural Environments ◽  
Key Informant ◽  
Service Areas ◽  
The U.S

The “oldest old,” age 85 and older, constitute one of the fastest growing segments of the U.S. population. Yet, surprisingly little is known about the characteristics of U.S. counties with the highest percentage of the oldest old, nearly all of which are rural. We used qualitative analysis of key informant interviews ( n = 50) with county commissioners and other county-level representatives from rural counties with the highest prevalence of the oldest old, targeting the 54 rural counties with ≥5% of the population age 85+. We found that the rural counties with the highest proportion of residents age 85+ face unique challenges to supporting successful aging among the oldest old, including resource constraints, limited services, isolated locations, and widespread service areas. Still, interviewees identified particular reasons why the oldest old remain in their counties, with many highlighting positive aspects of rural environments and community.

scholarly journals INTEREST GROUP SESSION—AGING AMONG ASIANS: RESEARCH METHODS IN AGING AMONG ASIANS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S364-S364
Author(s):  
Wenjun Li ◽  
Shantha Balaswamy ◽  
Allen Glicksman
Keyword(s):  
Interest Group ◽  
Successful Aging ◽  
Oldest Old ◽  
Lessons Learned ◽  
World Population ◽  
Participant Recruitment ◽  
Promotion Policy ◽  
Age Related ◽  
The World ◽  
The U.S

Abstract Asians are the largest and the fastest growing segment of the world population. Asian immigrants are the second largest immigrant population in the U.S. However, age-related social and health issues are understudied among late-life immigrant and the oldest old Asians. Little data exist to support public health promotion, policy studies and clinical practice in this population. To advance research into aging among Asians living in the U.S. and elsewhere in the world, sound methodologies can be adopted from those well-developed in other settings while novel methodologies are to be developed to meet the unique needs of Asian studies. This symposium brings together four abstracts that address a variety of common methodological issues in social and health studies among Asian older adults. The topics range from culturally and linguistically appropriate strategies for recruiting non-English speaking research participants, assessment of social isolation and transportation barriers using an ethnographical approach, development of a new culturally appropriate measure for successful aging among the oldest old Chinese in China, and evaluation of preventive healthcare use among faith-based first-generation Chinese immigrants using self-administered surveys in the U.S. These studies involve qualitative ethnographical analysis, mixed methods for instrument development, quantitative data analysis, use of geographic information systems and demography to plan participant recruitment, and use of staged community engagement to increase efficiency and representativeness of participant recruitment. Lessons learned from these studies are valuable to future studies on aging among Asians. This symposium is a collaborative effort of the GSA Aging Among Asians Interest Group.

scholarly journals Timing of social distancing policies and COVID-19 mortality: county-level evidence from the U.S.

2021 ◽  
Author(s):  
Catalina Amuedo-Dorantes ◽  
Neeraj Kaushal ◽  
Ashley N. Muchow
Keyword(s):  
New York ◽  
Political Ideology ◽  
Death Rate ◽  
The United States ◽  
County Level ◽  
Level Data ◽  
Level Information ◽  
Alternative Measures ◽  
The U.S ◽  
Pharmaceutical Interventions

AbstractUsing county-level data on COVID-19 mortality and infections, along with county-level information on the adoption of non-pharmaceutical interventions (NPIs), we examine how the speed of NPI adoption affected COVID-19 mortality in the United States. Our estimates suggest that adopting safer-at-home orders or non-essential business closures 1 day before infections double can curtail the COVID-19 death rate by 1.9%. This finding proves robust to alternative measures of NPI adoption speed, model specifications that control for testing, other NPIs, and mobility and across various samples (national, the Northeast, excluding New York, and excluding the Northeast). We also find that the adoption speed of NPIs is associated with lower infections and is unrelated to non-COVID deaths, suggesting these measures slowed contagion. Finally, NPI adoption speed appears to have been less effective in Republican counties, suggesting that political ideology might have compromised their efficacy.

scholarly journals 694 Insufficient sleep linked with higher COVID-19 infection cases and deaths in the United States

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A271-A271
Author(s):  
Azizi Seixas ◽  
Nicholas Pantaleo ◽  
Samrachana Adhikari ◽  
Michael Grandner ◽  
Giardin Jean-Louis
Keyword(s):  
Regression Models ◽  
Negative Binomial ◽  
The United States ◽  
Poor Sleep ◽  
County Level ◽  
Infection Rates ◽  
Insufficient Sleep ◽  
Death Rates ◽  
Rural Counties ◽  
The Relationship

Abstract Introduction Causes of COVID-19 burden in urban, suburban, and rural counties are unclear, as early studies provide mixed results implicating high prevalence of pre-existing health risks and chronic diseases. However, poor sleep health that has been linked to infection-based pandemics may provide additional insight for place-based burden. To address this gap, we investigated the relationship between habitual insufficient sleep (sleep <7 hrs./24 hr. period) and COVID-19 cases and deaths across urban, suburban, and rural counties in the US. Methods County-level variables were obtained from the 2014–2018 American community survey five-year estimates and the Center for Disease Control and Prevention. These included percent with insufficient sleep, percent uninsured, percent obese, and social vulnerability index. County level COVID-19 infection and death data through September 12, 2020 were obtained from USA Facts. Cumulative COVID-19 infections and deaths for urban (n=68), suburban (n=740), and rural (n=2331) counties were modeled using separate negative binomial mixed effects regression models with logarithmic link and random state-level intercepts. Zero-inflated models were considered for deaths among suburban and rural counties to account for excess zeros. Results Multivariate regression models indicated positive associations between cumulative COVID-19 infection rates and insufficient sleep in urban, suburban and rural counties. The incidence rate ratio (IRR) for urban counties was 1.03 (95% CI: 1.01 – 1.05), 1.04 (95% CI: 1.02 – 1.05) for suburban, and 1.02 (95% CI: 1.00 – 1.03) rural counties.. Similar positive associations were observed with county-level COVID-19 death rates, IRR = 1.11 (95% CI: 1.07 – 1.16) for urban counties, IRR = 1.04 (95% CI: 1.01 – 1.06) for suburban counties, and IRR = 1.03 (95% CI: 1.01 – 1.05) for rural counties. Level of urbanicity moderated the association between insufficient sleep and COVID deaths, but not for the association between insufficient sleep and COVID infection rates. Conclusion Insufficient sleep was associated with COVID-19 infection cases and mortality rates in urban, suburban and rural counties. Level of urbanicity only moderated the relationship between insufficient sleep and COVID death rates. Future studies should investigate individual-level analysis to understand the role of sleep mitigating COVID-19 infection and death rates. Support (if any) NIH (K07AG052685, R01MD007716, R01HL142066, K01HL135452, R01HL152453

Disproportionately Overrepresented: Women in Local Elected Offices

2018 ◽  
Vol 50 (3) ◽  
pp. 165-176 ◽  
Author(s):  
Ethan M. Bernick ◽  
Brianne Heidbreder
Keyword(s):  
United States ◽  
Maximum Likelihood ◽  
Gender Norms ◽  
The United States ◽  
Census Bureau ◽  
National Association ◽  
County Level ◽  
Political Factors ◽  
Using Data ◽  
The U.S

This research examines the position of county clerk, where women are numerically disproportionately over-represented. Using data collected from the National Association of Counties and the U.S. Census Bureau, the models estimate the correlation between the county clerk’s sex and county-level demographic, social, and political factors with maximum likelihood logit estimates. This research suggests that while women are better represented in the office of county clerk across the United States, when compared to other elective offices, this representation may be because this office is not seen as attractive to men and its responsibilities fit within the construct of traditional gender norms.

Changes in Tonsillectomy Rates Associated With Feedback and Review

PEDIATRICS ◽  
1977 ◽  
Vol 59 (6) ◽  
pp. 821-826 ◽  
Author(s):  
John E. Wennberg ◽  
Lewis Blowers ◽  
Robert Parker ◽  
Alan M. Gittelsohn
Keyword(s):  
Review Process ◽  
Peer Review Process ◽  
Average Rate ◽  
Population Based ◽  
Medical Society ◽  
Clinical Practices ◽  
National Rate ◽  
Service Areas ◽  
The Relationship ◽  
The U.S

Among 13 Vermont Hospital Service Areas, tonsillectomy rates decreased over a five-year period. In 1969, the rates in seven areas exceeded the estimated United States national rate; by 1973, the average rate for all areas had declined 46% and only one area remained above the U.S. rate. Much of the change occurred after feedback of data to the Vermont State Medical Society demonstrating 1969 variations. In 12 of the 13 areas, the relationship between feedback and change in clinical practices could not be documented; however, physicians in the area with the highest rate reviewed the indications for tonsillectomy and adopted a second opinion procedure for reviewing candidates for the surgery. The experience suggests that feedback of population-based data on incidence of procedures may be a valuable tool for the peer review process.

Other Challenges

2018 ◽  
pp. 328-370
Author(s):  
Steven Brint
Keyword(s):  
Higher Education ◽  
Low Income ◽  
Education System ◽  
Resource Constraints ◽  
Low Income Students ◽  
Higher Education System ◽  
Underrepresented Groups ◽  
The U.S

This chapter discusses other major challenges to the U.S. higher education system: rising costs, online competition, and controversies over permissible speech. These challenges can be interpreted as problems of growth in the context of resource constraints. Cost problems were largely attributable to universities' requirements for sufficient revenues to support larger staffs and new responsibilities within the context of state disinvestment. Online competition was a result of the search for market alternatives to traditional, high-cost residential campuses within the context of an expanding system that included many low-income students. And the conflicts over speech were, in most cases, the by-product of tensions between students from comparatively privileged backgrounds and those from underrepresented groups.

Understanding Michigan's Electoral Competitiveness: Swing Counties 1976-2018

2021 ◽  
Vol 47 (2) ◽  
pp. 173-201
Author(s):  
JOHN S. KLEMANSKI ◽  
DAVID A. DULIO ◽  
DOUGLAS A. CARR
Keyword(s):  
Voting Behavior ◽  
Barack Obama ◽  
County Level ◽  
Major Focus ◽  
Donald Trump ◽  
Media Attention ◽  
Election Results ◽  
Gubernatorial Election ◽  
The U.S ◽  
Electoral Competitiveness

ABSTRACT Considerable media attention was given to the so-called “pivot counties” in the U.S. and in Michigan that flipped from supporting Barack Obama twice to voting for Donald Trump in 2016. We first summarize theories of voting behavior and speculate about why Michigan has been consistently competitive over the years. We explore 40 years' worth of county-level presidential and gubernatorial election results in Michigan to determine how frequently counties have flipped across a large number of elections. We find that a number of Michigan counties frequently flip between elections, but the number of competitive Michigan counties has substantially declined in recent decades. Turnout in larger counties can affect election outcomes, and large counties that swing have been key bellwethers in past elections, and should be a major focus of research on future elections in Michigan.

scholarly journals Genes related to maintenance of autophagy and successful aging

2018 ◽  
Vol 76 (12) ◽  
pp. 831-839
Author(s):  
Carolina Fioroto Chaves ◽  
Diego Robles Mazzotti ◽  
Maysa Seabra Cendoroglo ◽  
Luiz Roberto Ramos ◽  
Sergio Tufik ◽  
...  
Keyword(s):  
Cell Survival ◽  
Differentially Expressed Genes ◽  
Expression Profile ◽  
Peripheral Blood ◽  
Successful Aging ◽  
Oldest Old ◽  
Enrichment Analysis ◽  
Differentially Expressed ◽  
Expression Of Genes ◽  
Transcriptional Process

ABSTRACT Considering aging as a phenomenon in which there is a decline in essential processes for cell survival, we investigated the autophagic and proteasome pathways in three different groups: young, older and oldest old male adults. The expression profile of autophagic pathway-related genes was carried out in peripheral blood, and the proteasome quantification was performed in plasma. No significant changes were found in plasma proteasome concentrations or in correlations between proteasome concentrations and ages. However, some autophagy- and/or apoptosis-related genes were differentially expressed. In addition, the network and enrichment analysis showed an interaction between four of the five differentially expressed genes and an association of these genes with the transcriptional process. Considering that the oldest old individuals maintained both the expression of genes linked to the autophagic machinery, and the proteasome levels, when compared with the older group, we concluded that these factors could be considered crucial for successful aging.

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