Brendan Stevenson

The effects of types of social networks, perceived social support, and loneliness on the health of older people: accounting for the social context.

Objectives: To use an ecological model of ageing (Berkman, Glass, Brissette, & Seeman, 2000) which includes upstream social context factors and downstream social support factors to examine the effects of social networks on health. Method: Postal survey responses from a representative population sample of New Zealanders aged 55 to 70 years (N = 6,662). Results: Correlations and multiple regression analyses provided support for a model in which social context contributes to social network type, which affects perceived social support and loneliness, and consequent mental and physical health. Ethnicity was related to social networks and health but this was largely accounted for by other contextual variables measuring socioeconomic status. Gender and age were also significant variables in the model. Discussion: Social network type is a useful way to assess social integration within this model of cascading effects. More detailed information could be gained through the development of our network assessment instruments for older people.

Independence, Well‐being, and Social Participation in an Aging Population

Abstract:  In 2005 the Health, Work, and Retirement (HWR) Longitudinal Study was established at Massey University in order to identify the later‐midlife factors that lay the basis for community participation, independence, and health in later life. Information was collected via postal questionnaire on physical and mental health, psychosocial factors, work and retirement attitudes, and socioeconomic and demographic indicators of a sample of 6662 community‐dwelling adults aged 55–70 years. This report provides an overview of these results, and highlights the impact that the transition from work to retirement has on the health and retirement adjustment of older people with respect to independence, well‐being, and social participation.

The impact of socio-contextual, physical and lifestyle variables on measures of physical and psychological wellbeing among Māori and non-Māori: the New Zealand Health, Work and Retirement Study

ABSTRACT This article provides an overview of the New Zealand Health, Work and Retirement Study (HWR), the focus of which is on determinants of cultural-contextual factors on physical and mental health among 6,662 New Zealand citizens, a nationally representative sample of adults between 55 and 70 years of age. The HWR was initiated in 2006 with two-year re-assessment intervals. The health and wellbeing of older Māori was a study priority as previous research has shown large health disparities between Māori and non-Māori in New Zealand. Persons of Māori origin were over-sampled to ensure adequate information for subsequent analyses. First-wave results indicated that socioeconomic status, social support and retirement status were associated with optimal ageing among older adults in New Zealand. Māori scored lower on markers of physical and mental health, which was partially explained by restrictive factors including reduced economic living standards and a propensity towards less physical activity. After controlling for multiple socio-contextual and biological variables, ethnicity continued to predict health, suggesting that there are other markers of health and wellbeing in ageing among Māori. Structural variables which restrict access to health care and predispose Māori to engage in maladaptive lifestyle behaviours combined with the distal effects of colonisation may contribute to the health disparities found between Māori and the majority population in New Zealand.

The Influence of Ethnicity and Gender on Caregiver Health in Older New Zealanders

OBJECTIVES We examined the interrelationships between ethnicity, gender, and caregiving on the health of older New Zealanders. We hypothesized that those providing higher levels of care and more care across time would have poorer health outcomes and that these relationships would be moderated by ethnicity and gender. METHOD A representative sample of participants (N = 2,155) aged 54-70 years from the first 2 waves of the New Zealand Health, Work and Retirement study completed postal surveys in 2006 and 2008. Caregiving questions were adapted from the Australian Womens Health study, and health measures were derived from the SF36 Health Survey. RESULTS Women and Māori (indigenous New Zealanders) were more likely to provide care than men and non-Māori. Respondents providing higher levels of care reported poorer mental health and this was particularly true of Māori and female caregivers. Male Māori caregivers providing the highest level of care reported the poorest mental health. Level of care was unrelated to physical health. There was minimal evidence for changes in health over time based on caregiver status. DISCUSSION The poorer health of caregivers supports previous findings on the detrimental health effects of caregiving. Caregiving may have more detrimental effects on Māori health outcomes due to existing inequalities in health, barriers to formal support services, and the multiple roles of elder Māori.

Measuring living standards of older people using Sen's Capability Approach: development and validation of the LSCAPE-24 (Living Standards Capabilities for Elders) and LSCAPE-6

ABSTRACT The impact of disparities in socio-economic status on the health of older people is an important issue for policy makers in the context of population ageing. As older people live in different types of economic circumstances and because, as people age, their desires and needs are different to those of younger generations, measures of living standards need to be appropriate for older people. This paper reports on the validation of a measure of living standards for older people based on Sens Capability Approach. Using this approach, living standards are conceptualised as varying from constraint to freedom rather than from hardship to comfort. Using the New Zealand Longitudinal Study of Ageing omnibus survey of 3,923 adults aged 50–87 years, the validity of the measure was assessed. The results indicate that this measure assesses what older people are able to achieve. In addition, this measure discriminates better at the higher end of the living standards spectrum than an existing measure that assesses living standards from hardship to comfort in terms of what people possess. From this, a short form of the measure has been developed which offers a conceptually based and valid measure useful for survey research with older people. This measure of living standards provides future avenues for improved understandings of socio-economic position in later life.

The effects of socioeconomic inequalities of working life on health: implications for an ageing population

Abstract This study examines suggestions that inequalities in health related to socioeconomic status (SES) will increase in older age. A representative sample of the New Zealand population aged 55–70 years (N = 6662) responded to a postal questionnaire with measures of health (SF-36), SES, and health-related behaviours. Hierarchical multiple regressions supported predictions that the SES of working life will continue to influence physical and mental health in early old age. The strongest predictor was self-reported economic living standards. This subjective measure of SES is an important construct for future investigations of health and wellbeing among older people in an ageing population.

Alcohol consumption among older adults in Aotearoa/New Zealand: a comparison of ‘baby boomers’ and ‘over-65s’

The AUDIT-C screening measure for hazardous and heavy episodic drinking was included in a 2006 postal survey of a representative population sample of New Zealanders aged 55–70 years (N = 6642) funded by the Health Research Council of New Zealand. Results from logistic regressions showed that New Zealand Europeans and Māori, males, those with higher incomes, and those with a good standard of living were significantly more likely to drink hazardously. Heavy episodic drinking was more likely among men, Māori, and those with secondary or no school qualifications. The findings warrant further research into alcohol consumption among older people as this cohort moves into retirement.

Accounting for differences in cognitive health between older adults in New Zealand and the USA.

BACKGROUND National differences in cognitive health of older adults provide an opportunity to shed light on etiological factors. We compared the cognitive health of older adults in New Zealand and the USA, and examined differences in known risk factors. METHODS Two nationally representative samples were derived from the 2010 waves of the New Zealand Longitudinal Study of Ageing (n = 953) and the US Health and Retirement Study (HRS) (n = 3,746). Data from comparable measures of cognitive function, gender, age, income, education, prevalence of cancer, diabetes, heart disease, hypertension and stroke, exercise, alcohol consumption, smoker status, depression, and self-reported health were subjected to hierarchical regression analysis to examine how national differences in cognitive function might be explained by differences in these risk factors. RESULTS The New Zealand sample scored 4.4 points higher on average than the US sample on the 43 point cognitive scale. Regression analyses of the combined samples showed that poorer cognitive health is more likely in those who are male, older, less educated, have suffered a stroke, consume alcohol less frequently, are more depressed, and report worse overall health. Controlling for age and sex reduced the mean difference to 2.6 and controlling for risk factors further reduced it to 2.3. CONCLUSIONS Older New Zealand adults displayed better cognitive function than those in a US sample. This advantage can be partially explained by age and sex differences and, to some extent, by differences in known risk factors. However, the national advantage remained even when all measured risk factors are statistically controlled.

Reconciling Work and Caregiving Responsibilities among Older Workers in New Zealand

There are 432,000 individuals in New Zealand who provide unpaid care for someone who is ill or disabled and 65% of these carers are also in paid employment. The number of older people in the paid workforce is projected to increase in the next two decades. With the median age of carers in 2013 at 49 years, the ageing of both the population and workforce suggests that many carers may still be in paid work as they themselves age. Family care is an essential part of the health care system. Informal care provides many benefits including improved patient outcomes, reduced unnecessary re-hospitalisations and residential care placements, and considerable savings in health care expenditure. However, combining paid work and informal care is problematic for many carers and can impact on their health and wellbeing, and on work-related outcomes by way of reduced work hours, absenteeism, and employment exit. Recent policy initiatives have been implemented to support family carers in New Zealand to remain in or re-enter the workforce. This paper explores the challenges presented to older New Zealanders who combine paid work with caregiving responsibilities. We provide a profile of older workers (aged 55+) who are providing care and analyse the impact of combining paid work and care on their health, wellbeing and economic living standards. Finally, we situate these findings within the policy framework in New Zealand.