Sensory Impairment and the Odds of Adverse Consequences of Unmet Needs for Care Among Older Adults

Introduction Vision and hearing impairments are highly prevalent conditions among older adults, and well-established links exist between sensory impairment and household, mobility, and self-care activity limitations. However, studies examining the impact of unmet long-term services and supports (LTSS) needs have not considered the role of vision and hearing impairment on the risk of experiencing adverse consequences, including wetting or soiling oneself. Methods Using Rounds 1 and 5 of the National Health and Aging Trends Study, a nationally-representative survey of Medicare beneficiaries aged 65 and older, we examine the association of vision and hearing impairment on the odds of experiencing an adverse consequence while accounting for other socio-demographic and health status factors. Results Among a weighted population of 49,770,947 community-living older adults with limitations in household, mobility, or self-care activities, 20.1% (95% CI: 19.2-21.0) experienced an adverse consequence as a result of unmet LTSS needs. In the full-adjusted regression, individuals with vision or hearing impairment had 96% (OR:1.96; 95% CI: 1.64-2.34) and 43% increased odds (OR:1.43; 95% CI: 1.24-1.65), respectively of experiencing any adverse consequence. Hearing impairment was associated with higher odds of household or self-care adverse consequences, while vision impairment was associated with higher odds of mobility or self-care adverse consequences. Discussion Sensory impairment may increase the risk for adverse consequences for older adults with unmet LTSS needs. Activities that support older adults living safely in the community should consider the role of sensory impairment and how to address the unique needs of those with hearing or vision impairment.

Household Mobility Dynamics among Young Adults in Established Suburban Council Rental Housing Estates in South African Cities: A Case Study of Kenneth Gardens, Durban

The household mobility dynamics of young adults are widely acknowledged as some of the central indicators of residential satisfaction and the quantitative housing deficit. Regardless of this, hardly any studies have been conducted to investigate the trend in South African neighbourhoods. This study investigated the dynamics of household mobility among young adults in the Kenneth Gardens, a subsidised council rental estate in the city of Durban, South Africa. It is based on a survey focusing on household characteristics, profiles of young adults, likely household mobility behaviour of young adults and the factors that influence the mobility of young adults. Descriptive statistical tabulations, analysis of variance (ANOVA) and cross tabulations were used in the analysis. The paper notes that established suburban council rental housing estates are multi-cultural and diverse. Likewise, household formation aspirations and mobility factors among young adults are influenced by ethnic cultural factors and cross-cultural socio-economic factors. The paper argues that the residential satisfaction of young adults and household mobility factors in diverse neighbourhoods should be differentially understood within the context of ethnic and cultural geographies. Furthermore, cross-cultural socio-economic constraints that delay the wishes of young adults to form new households must also be taken into consideration.

Cross-State Comparison of Income and Vehicle-Ownership Effects on Household Mobility

The study investigated the effects of income and vehicle ownership on household mobility (measured as trip frequency, miles traveled, and transit use) across states on the basis of the 2017 National Household Travel Survey. Bayesian multilevel (or random-effect) regression models were developed to include state-policy variables and overcome the concern of small sample sizes in some household strata. The analysis results indicated that household income levels were positively associated with vehicle ownership and mobility; however, extremely high-income households were not necessarily more likely than high-income households to own more vehicles. Owning at least one vehicle was the norm for most households, except under two conditions: when the household income was extremely low or when the state transit level of service (LOS) was high. Moreover, states with a high transit LOS exhibited similar household mobility as long as households had similar income levels and vehicle ownership rates; by contrast, household mobility in states with a low transit LOS was relatively varied. Fully equipped (at least one vehicle per driver) and car-light households (having more drivers than vehicles) exhibited a similar trip frequency number; however, the vehicle miles traveled of car-light households were significantly shorter, especially in states with a high transit LOS. These results suggest that the mobility benefits of being fully equipped are more limited than we had anticipated. Transit services can affect household vehicle ownership and mobility only when being provided above a certain LOS.

Scissors Difference of Socioeconomics, Travel and Space Consumption Behavior of Rural and Urban Households and Its Impact on Modeling Accuracy and Data Requirements

It is believed that the “scissors difference” of socioeconomics between rural and urban households in typical municipalities of China is significant. This may result in differences in their behavior and has important implications for urban land use and transportation planning policies, as well as related modeling accuracy and data requirements. However, detailed analyses regarding such “scissors differences” between rural and urban groups in China have not been done before. In this study, travel survey data collected from the City of Wuhan in 2008 is used to study if rural and urban households are statistically different in terms of household income, household size, space consumption, highest household mobility and travel distance. A set of statistical tests, such as the Kolmogorov–Smirnov test, Mann–Whitney U test and Kruskal–Wallis H test, are applied to the study data. The study results show that the “scissors difference” is found to be statistically significant in terms of household size (HS), household income (HI), building area (BA) consumed and household mobility (except for travel distance) between rural and urban households. Conversely, analyses applied to travel distance of urban and rural household subgroups (categorized by HS and HI) reveal that the urban and rural counterparts show almost exactly opposite behavior. The study results also suggest that such differences should be explicitly considered in relevant modeling exercises by separately setting up urban and rural household groups, but the number of household groups used should be determined based on a balance between modeling accuracy and data required/modeling workload.

An Analysis of Socioeconomic Stratification, Intra-Temporal and Intra Generational Household Mobility in Central Punjab, Pakistan

The study identifies the factors of intra temporal and intra generational household mobility in three districts of Central Punjab. The intra- temporal household mobility estimates the direction of transformation as disequalizing long term income. For the current analysis, three districts of Central Punjab are selected for data collection using literacy rate as prevalence rate. The results of the study show an improvement in education of head of household and other household members which may lead to upward transformation. Furthermore, geography and occupation progression contribute to inter temporal and intra generational mobility in Central Punjab. The results show big cities of central Punjab have considerable benefits of occupational movers from one sector to another as there are sufficient job opportunities available to the households and in rural areas of all the districts households are reluctant to get the benefits of occupational movement. The study concludes that most of the heads of household are educated but occupationally deprived which lead to low extent of intra generational mobility as compared to intra temporal mobility.