Educational Differences in Self-Rated Health Trends Among Middle-Aged and Older Adults Living Alone, 1972–2018

Objectives: This study examines educational differences in living alone and in self-rated health trends among middle-aged and older adults. Methods: We used logistic regression to analyze data from the 1972–2018 National Health Interview Survey ( n = 795,239 aged 40–64; n = 357,974 aged 65–84). Results: Between 1972–1974 and 2015–2018, living alone became more prevalent, particularly among men and at lower levels of education. Self-rated health trends varied by living arrangement and education. We found self-rated health declines among middle-aged adults having no college degree and living alone, but trends in self-rated health were mostly stable or even improved among middle-aged adults living with others. Among older adults, self-rated health improved over time, but for the least-educated older Americans living alone, the probability of reporting fair or poor health increased between 1972–1974 and 2015–2018. Discussion: The findings suggest growing disparities by social class, in living arrangements and in self-rated health.

Older Americans’ Perceptions of the Federal Government’s Pandemic Response: Voices From the COVID-19 Coping Study

There is limited understanding of how older adults evaluated the federal government’s COVID-19 response, despite their increased health risks during the pandemic and their important role in politics. We conducted qualitative thematic analysis on a nationally representative subsample of respondents aged 55+ from the COVID-19 Coping Study ( N = 500) who were asked: “How do you feel about federal government responses to and handling of the COVID-19 pandemic?” Analyses identified largely negative opinions about the federal government and former President Trump’s leadership, though some were neutral or positive. Participants expressed concerns that the federal government was undermining science, and that sending mixed messages about personal protective equipment and masks was dangerous. Perspectives were divergent and reflective of the country’s polarization surrounding COVID-19 policies. Results can inform efforts to build unity between political parties and identify strategies that governments can use to better respond to future public health crises.

Peripheral edema: A common and persistent health problem for older Americans

Peripheral edema (i.e., lower limb swelling) can cause pain, weakness, and limited range of motion. However, few studies have examined its prevalence in the U.S. or its association with demographics, comorbidities, activity, or mobility. This study used data from the Health and Retirement Study, a nationally representative longitudinal survey of U.S. adults (age 51+/ N = 19,988 for 2016), to evaluate time trends and correlates of peripheral edema using weighted descriptive statistics and logistic regressions, respectively. Peripheral edema was assessed with the question “Have you had… // Persistent swelling in your feet or ankles?” The weighted prevalence of edema among older U.S. adults was 19% to 20% between 2000 and 2016. Peripheral edema was associated with older age, female sex, non-white race, low wealth, obesity, diabetes, hypertension, pain, low activity levels, and mobility limitations (odds ratios ranging from 1.2–5.6; p-values ≤0.001). This study provides the first estimates of national prevalence and correlates of peripheral edema among older Americans. Peripheral edema is common and strongly associated with comorbidities, pain, low activity levels, and mobility limitations, and disproportionately affects poorer and minority groups. Peripheral edema should be a focus of future research in order to develop novel and cost-effective interventions.

Derailed by the COVID-19 Economy? Older Adults' Paid Work by Intersections of Age, Gender, Race-Ethnicity, and Class

This paper addresses the uneven employment effects on older Americans (Boomers and Genxers, ages 50-75) of the COVID-19 pandemic. Drawing on monthly CPS data from January through December 2020 (IPUMS) with an intersectional approach, we first chart shifts in employment and non-employment for population subgroups defined by age, gender and race/ethnicity, including explanations for not working (unemployment, retired, disabled, not in the workforce for other reasons – NILF-other). We then examine uneven transitions --monthly individual-level shifts out of and into paid work for population subgroups, considering also disparities by educational level. We find increases in proportions unemployed, especially for women in their 50s, as well as increases in the proportions reporting they are NILF-Other, especially for Asian and Hispanic women, with small increases for Asian and Hispanic men as well. There is little change in age-graded reports of being retired, regardless of gender or race/ethnicity, though there are education-level effects.

Adverse Neighborhood Environments and Health Behaviors among Older Americans

Maintaining healthy lifestyle, including healthy diet and physical activity, in adverse neighborhood environments may be more difficult for older adults because of changes linked to aging, which make them more vulnerable to their environments. This study aims to investigate the association of neighborhood disorder with diet quality and physical activity in a national sample of older Americans. For this study, we used data from the Health and Retirement Study. Neighborhood disorders include vandalism, boarded houses, abandoned cars, demolished houses, trash, litter, or junk, poorly kept communal areas, homeless people, prostitution, winos or junkies, and drug use or drug dealing near residents’ housing unit (range: 0-11). Diet quality and physical activity were assessed using the Healthy Eating Index 2015 (HEI-2015; range:0-100) and the metabolic (MET) equivalent activity points (range: 0-31 in this sample). Ordinary least squares regression models were estimated to examine an association between neighborhood disorder, diet quality, and physical activity. Neighborhood disorder was associated with poor diet and physical inactivity. For one additional negative neighborhood feature, HEI-2015 scores and MET-equivalent activity points decreased by 0.55 (95% CI: -1.09. -0.01) and 0.69 (95% CI: -1.05, -0.33). Findings of this study suggest that older adults living in adverse neighborhoods are at a greater risk of poor diet and physical inactivity, which are important risk factors for poor health and chronic diseases. Promoting neighborhood environments and perceived neighborhood safety would increase access to health food, encourage healthy diet and physical activity, and support healthy aging.

Congressional Update

This popular annual session will provide cutting-edge information on what the 117th Congress has and has not accomplished to date, and what may be left for end of the First Session. Speakers will discuss key issues such as pandemic relief, Social Security, Medicare, Medicaid, and the Older Americans Act.

The Older Americans Act, the Aging Network, and the Pandemic

This session provides insights into how the pandemic challenged the capabilities and ingenuity of the Older Americans Act (OAA) programs and the aging network and what it means for in-home and community aging services now and in the future. Speakers will include key aging network stakeholders, who will discuss the overnight evolution of programs serving often isolated older adults.