Ben Lennox Kail

Do Higher Levels of Resilience Buffer the Deleterious Impact of Chronic Illness on Disability in Later Life

PURPOSE OF THE STUDY In examining the ability of resilience, or the ability to navigate adversity in a manner that protects well-being, to buffer the impact of chronic disease onset on disability in later life, the authors tested 2 hypotheses: (a) People with greater levels of resilience will have lower levels of disability and (b) resilience will moderate the association between the onset of a new chronic condition and subsequent disability. DESIGN AND METHODS This study used a sample of 10,753 Americans between the ages of 51 and 98, derived from 3 waves of the Health and Retirement Study (2006-2010). Ordinary least squares regression was used to estimate the impact of resilience on changes in disability (measured as difficulty with activities of daily living [ADLs] and instrumental activities of daily living [IADLs]) over a 2-year period using a simplified resilience score. RESULTS Resilience protects against increases in ADL and IADL limitations that are often associated with aging. Resilience mitigates a considerable amount of the deleterious consequences related to the onset of chronic illness and subsequent disability. IMPLICATIONS Our results support our hypotheses and are consistent with claims that high levels of resilience can protect against the negative impact of disability in later life.

Outside the Mainstream: Social Movement Organization Media Coverage in Mainstream and Partisan News Outlets

Purpose – Although scholars have long been interested in how social movements use mass media to forward their goals, sociological research almost exclusively focuses on the ability of activist groups to get their ideas and organizations in general audience, mainstream media coverage. This paper contributes to a more systematic understanding of media coverage outcomes by broadening the range of outlets considered relevant to political discourse. In addition to mainstream venues, we consider conservative and liberal/left outlets in our analysis of social movement organization media coverage. Method – Using negative binomial regression, we analyze how organizational characteristics, organizational frames, political elites, and event type affect the rates of social movement organization media coverage in mainstream and partisan news venues. Findings – We find that the independent variables play very different roles in mainstream and partisan media coverage outcomes. Specifically, while organizational characteristics and frames often enhance the media coverage outcomes of activist groups in mainstream venues, political elites have no effect at all. In contrast, organizational characteristics and frames do not affect social movement media coverage in partisan outlets, whereas political elites and event type do. Originality of the paper – Conceptually, this research broadens how scholars think about the relationship between social movement groups and mass media as well as the factors that influence media outcomes.

The Influence of Unpaid Work on the Transition Out of Full-Time Paid Work

PURPOSE Continued employment after retirement and engagement in unpaid work are both important ways of diminishing the negative economic effects of the retirement of baby boomer cohorts on society. Little research, however, examines the relationship between paid and unpaid work at the transition from full-time work. Using a resource perspective framework this study examines how engagement in unpaid work prior to and at the transition from full-time work influences whether individuals partially or fully retire. DESIGN AND METHODS This study used a sample of 2,236 Americans between the ages 50 and 68, who were interviewed between 1998 and 2008. Logistic regression was used to estimate transitioning into partial retirement (relative to full retirement) after leaving full-time work. RESULTS We found that the odds of transitioning into part-time work were increased by continuous volunteering (78%) and reduced by starting parental (84%), grandchild (41%), and spousal (90%) caregiving and unaffected by all other patterns of engagement in unpaid work. IMPLICATIONS Our findings suggest that volunteering is complementary with a transition to part-time work, and starting a new caregiving role at this transitioncreates a barrier to continued employment. In order to provide workers the opportunity to engage in the work force longer at the brink of retirement, it may be necessary to increase the support mechanisms for those who experience new caregiving responsibilities.

Cumulative Inequality and Racial Disparities in Health: Private Insurance Coverage and Black/White Differences in Functional Limitations

OBJECTIVES To test different forms of private insurance coverage as mediators for racial disparities in onset, persistent level, and acceleration of functional limitations among Medicare age-eligible Americans. METHOD Data come from 7 waves of the Health and Retirement Study (1996-2008). Onset and progression latent growth models were used to estimate racial differences in onset, level, and growth of functional limitations among a sample of 5,755 people aged 65 and older in 1996. Employer-provided insurance, spousal insurance, and market insurance were next added to the model to test how differences in private insurance mediated the racial gap in physical limitations. RESULTS In baseline models, African Americans had larger persistent level of limitations over time. Although employer-provided, spousal provided, and market insurances were directly associated with lower persistent levels of limitation, only differences in market insurance accounted for the racial disparities in persistent level of limitations. DISCUSSION Results suggest private insurance is important for reducing functional limitations, but market insurance is an important mediator of the persistently larger level of limitations observed among African Americans.

Reciprocity Between Depressive Symptoms and Physical Limitations Pre- and Postretirement Exploring Racial Differences

Objectives: This study assesses (a) the reciprocity between mental and physical health pre- and postretirement, and (b) the extent to which these associations vary by race. Method: Data are from the 1994 to 2008 waves of the Health and Retirement Study. Results: Analyses based on structural equation modeling reveal that depression and physical health exert reciprocal effects for Whites pre- and postretirement. For Blacks preretirement, physical limitations predict changes in depression but there is no evidence of the reverse association. Further, the association between physical limitations and changes in depressive symptoms among Blacks is no longer significant after retirement. Discussion: The transition into retirement alleviates the translation of physical limitations into depressive symptoms for Blacks only. The findings underscore the relevance of retirement for reciprocity between mental and physical health and suggest that the health implications associated with this life course transition vary by race.

Coverage or Costs: The Role of Health Insurance in Labor Market Reentry Among Early Retirees

OBJECTIVES This study evaluated the impact of insurance coverage on the odds of returning to work after early retirement and the change in insurance coverage after returning to work. METHOD The Health and Retirement Study was used to estimate hierarchical linear models of transitions to full-time work and part-time work relative to remaining retired. A chi-square test was also used to assess change in insurance coverage after returning to work. RESULTS Insurance coverage was unrelated to the odds of transitioning to full-time work. However, relative to employer-provided insurance, private nongroup insurance increased the odds of transitioning to part-time work, whereas public insurance reduced the odds of making this transition. Additionally, after returning to work, insurance coverage increased among those who were without employer-provided insurance in retirement. DISCUSSION Results indicated that source of coverage may be more useful in explaining returns to part-time work than simply whether people have coverage at all. In other words, the mechanism underlying the positive relationship between insurance and returning to work appeared to be limited to those who return to work because of the cost of private nongroup insurance. Among these people, however, there was some evidence that they are able to secure new coverage once they return to work.

Successful Aging in the Context of the Disablement Process: Working and Volunteering as Moderators on the Association Between Chronic Conditions and Subsequent Functional Limitations

Objectives This study evaluated the successful aging model by assessing the impact of two forms of productive engagement-working and volunteering-as potential interventions in the process of disablement. Method The Health and Retirement Study was used to (a) estimate two-stage selection equations of (i) currently working part time and full time and (ii) currently volunteering less than 100 hours and volunteering 100 hours or more per year (net of chronic health problems) and (b) assess whether, net of selection, working, and volunteering moderate the association between chronic conditions and subsequent functional limitations. Results Chronic conditions were associated with elevated levels of subsequent functional limitations, whereas both working and volunteering were associated with lower levels of subsequent functional limitations. Moreover, workers and volunteers of less than 100 hours per year experienced a reduction in the association of chronic conditions on subsequent functional limitations. Discussion This research highlights the role of productive engagement as a key element in successful aging. Not only do work and volunteering have direct associations with health outcomes themselves, but they also act as potential interventions in the process of disablement by attenuating the way in which chronic conditions are translated into subsequent functional limitations. This suggests that (a) future research should apply successful aging models to health processes as well as health outcomes and (b) policy makers should support social institutions that foster late-life productive engagement.

Marital Status as a Moderating Factor in the Process of Disablement.

Objective: To test current marital status as a moderator on the influence of depressive symptoms and chronic conditions on subsequent functional limitations. Method: Data come from the Health and Retirement Study (HRS; 1998-2010). Hierarchal linear modeling models tested differences in functional limitations among a sample of 20,215 people. Results: At baseline, married people suffered from fewer subsequent functional limitations than the unmarried. Moreover, limited evidence suggests the influence of depressive symptoms was greater for the married than the unmarried; however, the influence of chronic conditions was consistently attenuated for married people. Accounting for differences in prior health, work, socioeconomic status, and health behaviors did not explain the moderating influence of marital status on the associations between symptoms of depression and chronic conditions with functional limitations. Discussion: This research highlights the need to identify potential modifiers that may help disrupt the process of disablement among both the married and the unmarried alike.

Service-Related Exposures and Physical Health Trajectories Among Aging Veteran Men

PURPOSE OF THE STUDY We examined the association of military service-related exposures (SREs) with physical health trajectories to establish whether combat and other hazards have lasting connections to health in later life. We also examined potential confounders and mechanisms to further understand the associations. DESIGN AND METHODS We used the 2013 HRS Veterans Mail Survey linked to the longitudinal Health and Retirement Study (HRS) to examine military service experiences and health over a decade (2000-2010) among veteran men. We employed latent class analysis to disaggregate trajectories of health in later life. RESULTS Most veteran men experienced good health over the decade. Although we found a connection between combat and later health, it was driven primarily by hazardous or traumatic exposures. Service-related disability, current health behaviors, and mental health were not likely explanations for these associations. IMPLICATIONS The measurement of service experiences is primary in understanding health implications of military service and projecting the health service needs of aging veterans. SREs are varied and complex and have differential connections to health. These connections remain unexplained by current behaviors and mental health, suggesting the need to examine earlier life course pathways and mechanisms.

The Impacts of Service Related Exposures on Trajectories of Mental Health Among Aging Veterans

Objectives Drawing on life-course perspective and cumulative advantage theory, we examined whether service related exposures (SREs)-combat and exposure to death-have lasting impacts on depressive symptom and psychiatric problem trajectories of aging veterans. Methods The Health and Retirement Study and linked 2013 Veterans Mail Survey were used to examine SREs and mental health among older veterans between 2002 and 2012 (N = 1,662). Latent growth curves were used to measure how individuals vary from average mental health trajectories based on SREs and other important covariates. Results Exposure to death had a significant and lasting effect on depressive symptoms for veterans in late life but was reduced to nonsignificance when physical health trajectories were included. Combat and exposure to death had independent and robust impacts on psychiatric problems, which were robust in final models. Discussion SREs presented varied and significant impacts, suggesting that combat does not work alone in driving poor mental health trajectories, and that exposure to death is a more robust risk marker for later outcomes.