scholarly journals Examining the Association of Pain and Financial Hardship Among Older Men by Race in the United States

2021 ◽  
Vol 15 (5) ◽  
pp. 155798832110496
Author(s):  
Chiho Song ◽  
Gillian L. Marshall ◽  
Alyssa Reed ◽  
Tamara A. Baker ◽  
Roland J. Thorpe

Pain associated with financial hardship among older men varies by race. The purpose of this study was to examine the association of financial hardship with the presence of pain in men 50 years and older by race. Using the Health and Retirement Study (HRS) 2010 wave, bivariate and multivariate logistic regression models were used to assess the association between four financial hardship indicators and total financial hardship as a composite score, and the presence of pain by race. Among White men, the association between the presence of pain and hardship controlling for demographic factors was statistically significant across four indicators and one composite score: ongoing financial hardship (OR = 1.29, 95% CI [1.02, 1.64]), food insecurity (OR = 2.55, 95% CI [1.51, 4.31]), taking less medication due to cost (OR = 2.12, 95% CI [1.40, 3.22]), difficulty paying bills (OR = 1.36, 95% CI [1.07, 1.73]), and total financial hardship (OR = 1.27, 95% CI [1.12, 1.44]). Among African American men, the association between the presence of pain and taking less medication due to cost (OR = 2.99, 95% CI [1.31, 6.85]) was significant. With increasing comorbidities among older adults, particularly African Americans, it is imperative to fully understand the mechanisms of this underexplored area in both the pain and financial hardship literature.

2020 ◽  
pp. 1-19
Author(s):  
Erin G. Grinshteyn ◽  
Judith A. Sugar

Abstract Previous research shows the benefits of volunteerism to individuals and communities. The purpose of this study was to determine whether lower perceived neighbourhood safety is associated with reduced volunteerism and whether this association differs by sex. Data from the 2008 Health and Retirement Study in the United States of America were used (N = 13,009 adults 60 years and older). Multivariate logistic regression models were estimated to assess the association between perceived neighbourhood safety and volunteerism while controlling for potential confounders. Perceived neighbourhood safety was associated with volunteering. The odds of volunteering were higher for those rating their perceived neighbourhood safety as excellent compared with those rating their perceived neighbourhood safety as fair/poor. Those rating their perceived neighbourhood safety as very good also had greater odds of volunteering than those rating their perceived neighbourhood safety as fair/poor. Results differed somewhat by gender. Men who perceived their neighbourhood safety as excellent had increased odds of volunteering. The association of neighbourhood safety with volunteerism was significant for women rating their perceived neighbourhood safety as excellent or very good. Among men, being married was associated with increased odds of volunteering; being completely or partly retired was associated with increased odds of volunteering among women. Initiatives aimed at improving older adults’ perceptions of safety would help improve volunteerism, which is beneficial to both older adults and communities.


2019 ◽  
Vol 76 (1) ◽  
pp. 209-218
Author(s):  
Jennifer C Cornman ◽  
Dana A Glei ◽  
Maxine Weinstein

Abstract Objectives This study compares estimates and determinants of within-individual changes in mobility across surveys of older U.S. adults. Methods Data come from the Health and Retirement Study (HRS) and the Midlife in the United States (MIDUS) study. Measures of mobility comprise self-reported level of difficulty with walking several blocks, going up several flights of stairs, lifting and carrying 10 pounds, and stooping. Predictors include sociodemographic characteristics and indicators of health and health behaviors. We pool the datasets and estimate weighted lagged dependent variable logistic regression models for each activity, assessing cross-study differences using interaction terms between a survey indicator and relevant variables. Results Estimates of declines in mobility differ substantially across surveys for walking, lifting and carrying, and stooping, but there are no between-survey differences in the probability of (not) recovering from a limitation. With the exception of age, determinants of change are similar between studies. For lifting/carrying and stooping, the age-related increase in developing limitations is less steep at younger ages for HRS respondents than MIDUS respondents, but steeper at older ages. Discussion To compare estimates of mobility change across surveys, mobility measures would need to be harmonized. Determinants of mobility change, however, are more comparable.


2018 ◽  
Vol 31 (10) ◽  
pp. 1748-1769 ◽  
Author(s):  
Connor Sheehan ◽  
Benjamin W. Domingue ◽  
Eileen Crimmins

Objectives: Measures of disability depend on health and social roles in a given environment. Yet, social roles can change over time as they have by gender. We document how engagement in Instrumental Activities of Daily Living (IADLs) is shifting by gender and birth cohort among older adults, and the challenges these shifts can create for population-level estimates of disability. Method: We used the Health and Retirement Study ( N = 25,047) and multinomial logistic regression models with an interaction term between gender and birth cohort to predict limitation and nonperformance relative to no difficulty conducting IADLs. Results: Nonperformance of IADLs have significantly decreased among younger cohorts. Women in younger cohorts were more likely to use a map, whereas men in younger cohorts were more likely to prepare meals and shop. Discussion: Failing to account for gender and cohort changes in IADL, performance may lead to systematic bias in estimates of population-level disability.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 76-76
Author(s):  
Kylie Meyer ◽  
Zachary Gassoumis ◽  
Kathleen Wilber

Abstract Caregiving for a spouse is considered a major stressor many Americans will encounter during their lifetimes. Although most studies indicate caregiving is associated with experiencing diminished health outcomes, little is known about how this role affects caregivers’ use of acute health services. To understand how spousal caregiving affects the use of acute health services, we use data from the Health and Retirement Study. We apply fixed effects (FE) logistic regression models to examine odds of experiencing an overnight hospitalization in the previous two years according to caregiving status, intensity, and changes in caregiving status and intensity. Models controlled for caregiver gender, age, race, ethnicity, educational attainment, health insurance status, the number of household residents, and self-assessed health. Overall, caregivers were no more likely to experience an overnight hospitalization compared to non-caregivers (OR 0.92; CI 0.84 to 1.00; p-value=0.057). However, effects varied according to the intensity of caregiving and the time spent in this role. Compared to non-caregivers, for example, spouses who provided care to someone with no need for assistance with activities of daily living had lower odds of experiencing a hospitalization (OR 0.77; CI 0.66 to 0.89). In contrast, caregivers who provided care to someone with dementia for 4 to <6 years had 3.29 times the odds of experiencing an overnight hospitalization (CI 1.04 to 10.38; p-value=0.042). Findings indicate that, although caregivers overall appear to use acute health services about as much as non-caregivers, large differences exist between caregivers. Results emphasize the importance of recognizing diversity within caregiving experiences.


2018 ◽  
Vol 12 (5) ◽  
pp. 1439-1449 ◽  
Author(s):  
Gillian L. Marshall ◽  
Tamara A. Baker ◽  
Chiho Song ◽  
David B. Miller

To better understand the health status of men in the United States, this study aimed to assess the association of hardship on the presence of and pain severity among men 50 years of age and older. Cross-sectional multivariate logistic regression analyses were conducted using the 2010 wave of the Health and Retirement Study ( N = 3,174) to assess the association between four hardship indicators and the presence of pain and pain severity among this sample of older men. Results suggest that the association between the presence of pain and hardship was statistically significant across all four indicators: ongoing financial hardship (CI [1.05, 1.63], p < .05), difficulty paying bills (CI [1.42, 3.02], p < .001), food insecurity (CI [1.46, 3.15], p < .001), and not taking medication due to cost (CI [1.06, 1.66], p < .05), even after adjusting for all demographic factors. The associations between pain severity and ongoing financial strain (CI [1.23, 2.83], p < .01) and difficulty paying bills (CI [1.02, 3.18], p < .05) were statistically significant. Results also indicate that education was a buffer at all levels. In addition, the interactive effect of hardship and Medicare insurance coverage on pain severity was significant only for ongoing financial strain (CI [1.74, 14.33], p > .001) and difficulty paying bills (CI [1.26, 7.05], p < .05). The evidence is clear that each hardship indicators is associated with the presence of pain and across some of the indicators in pain severity among men aged 50 and older. In addition, these findings stress the importance that Medicare insurance plays in acting as a buffer to alleviate some of the hardships experienced by older men. These findings also highlight the association between the presence of pain and pain severity for the overall quality of life, health outcomes, and financial position of men in later life.


2017 ◽  
Vol 31 (2) ◽  
pp. 231-255
Author(s):  
Rocío Calvo ◽  
Dawn C. Carr ◽  
Christina Matz-Costa

Objective: This study investigated nativity disparities in life satisfaction among ethnoracial groups of older adults in the United States and the factors associated with such disparities. Method: Cross-sectional data from 7,348 respondents aged 60 and older from the 2012/2014 waves of the Health and Retirement Study (HRS) were used to estimate linear regression models. Results: Older immigrants experienced higher levels of life satisfaction than comparable native-born individuals. This “happiness advantage” was particularly salient for Hispanic immigrants, who reported the highest levels of life satisfaction of all groups included in the study. With increasing education, life satisfaction increased for White and “Other Race” groups, regardless of nativity. However, for both Black groups and native-born Hispanics, higher levels of education were associated with lower life satisfaction. Discussion: Findings suggest that the “happiness paradox” may not only be a matter of Hispanic ethnicity, but that it may also extend to immigrants from other ethnoracial backgrounds.


2018 ◽  
Vol 28 (5) ◽  
pp. 526-531 ◽  
Author(s):  
Anthony A Laverty ◽  
Eszter Panna Vamos ◽  
Christopher Millett ◽  
Kiara C-M Chang ◽  
Filippos T Filippidis ◽  
...  

IntroductionEngland introduced a tobacco display ban for shops with >280 m2 floor area (‘partial ban’) in 2012, then a total ban in 2015. This study assessed whether these were linked to child awareness of and access to cigarettes.MethodsData come from the Smoking, Drinking and Drug Use survey, an annual survey of children aged 11–15 years for 2010–2014 and 2016. Multivariate logistic regression models assessed changes in having seen cigarettes on display, usual sources and ease of access to cigarettes in shopsResultsDuring the partial display ban in 2012, 89.9% of children reported seeing cigarettes on display in the last year, which was reduced to 86.0% in 2016 after the total ban (adjusted OR 0.58, 95% CI 0.50 to 0.66). Reductions were similar in small shops (84.1% to 79.3%)%) and supermarkets (62.6% to 57.3%)%). Although the ban was associated with a reduction in the proportion of regular child smokers reporting that they bought cigarettes in shops (57.0% in 2010 to 39.8% in 2016), we did not find evidence of changes in perceived difficulty or being refused sale among those who still did.DiscussionTobacco point-of-sale display bans in England reduced the exposure of children to cigarettes in shops and coincided with a decrease in buying cigarettes in shops. However, children do not report increased difficulty in obtaining cigarettes from shops, highlighting the need for additional measures to tackle tobacco advertising, stronger enforcement of existing laws and measures such as licencing for tobacco retailers.


Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Cheng-Yang Hsieh ◽  
Sheng-Feng Sung

Introduction: Whether weekend admission is associated with increased stroke mortality in Taiwan remains uncertain, partly because of an inadequate case-mix adjustment in other studies using an insurance claims databases. Hypothesis: Adding the 7-item claims-based stroke severity index (SSI) to a multivariate logistic regression model might alter the analysis of the effect of weekend admission on 30-day stroke mortality. Methods: We identified, in the Taiwan Longitudinal Health Insurance Database, which is linked with the National Death Registry, patients hospitalized for acute ischemic stroke between 2001 and 2013. The primary outcome was mortality 30 days post-admission. In base logistic regression models with and without the SSI, we tested the odds ratio (OR) of 30-day mortality in patient admitted on weekends using the covariates of age, sex, year of admission, Charlson’s comorbidity index, brain surgery, physician specialty and surgical volume, hospital ownership, accreditation, and patient volume. Results: We analyzed 46,007 consecutive hospitalized stroke patients (mean age: 68.8 ± 12.0 years; male: 59%), with an SSI of 7.5 ± 5.3 (range: 4.1-27.1), 23.0% were admitted on the weekend, and 4.2% died within 30 days. Patients who died within 30 days were more likely to have been admitted on a weekend (4.9% vs. 4.0%, p < 0.001). Nevertheless, patients admitted on a weekend had a higher SSI than those admitted on a weekday (7.8 vs. 7.4, p < 0.001). In multivariate logistic regression models, weekend admission was associated with 30-day mortality (OR: 1.22, 95% CI: 1.10-1.35) in the base model but not in the base model plus SSI (OR: 1.07, 95% CI: 0.95-1.20). Conclusions: We confirmed that, after stroke severity had been adjust by adding the SSI, weekend admission did not increase the 30-day mortality of stroke patients in Taiwan. A case-mix adjustment in comparative outcome studies of stroke patients is important when using an insurance claims database.


2018 ◽  
Vol 28 (2) ◽  
pp. 69
Author(s):  
Tony N. Brown ◽  
Julian Culver ◽  
Asia Bento

<p> <strong>Objective: </strong>To build upon research that inves­tigates the health significance of familial and former incarceration with special emphasis on obesity risk among native-born Black (ie, African American) men.</p><p><strong>Methods: </strong>We analyzed data from the 2001-2003 National Survey of American Life (NSAL), focusing on native-born Black men (n=1140), the demographic group that bears the brunt of mass incarceration. The out­come of interest was obesity as measured by body mass index (BMI)&gt;30. Principal predic­tors were familial and former incarceration, and their statistical interaction.</p><p><strong>Results: </strong>In survey-adjusted binomial logistic regression models, familial incarceration ap­peared an unimportant predictor; whereas, former incarceration associated with a lower risk of obesity. However, former incarceration modifies the association between familial incarceration and obesity, such that native-born Black men experiencing both familial and former incarceration were significantly more likely to be obese.</p><p><strong>Conclusions: </strong>Public health researchers should treat former incarceration with greater care in studies including native-born Black men because time spent incarcerated has lingering physical health significance.</p><p><em>Ethn Dis. </em>2018;28(2):69-74; doi:10.18865/ ed.28.2.69.</p>


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