Jack Noone

Men, masculine identities, and health care utilisation

Seeking medical help early is critical for recovery, yet evidence indicates that men do not utilise general practitioner services as often as women. This paper draws on Connells (1995) theory of hegemonic masculinity to critically examine how mens under-utilisation of medical services may be influenced by the social construction of masculine identities. Interviews with seven older rural men about their help-seeking behaviour, used a movie extract and hypothetical scenarios to stimulate discussion. Transcribed data were analysed using discourse analysis, which showed that in this particular social context, the men faced a dilemma when identifying with two conflicting subject positions: the virtuous regular health care user, and the masculine infrequent user of health care services. They solved this dilemma by positioning women as frequent and trivial users of health care and themselves as legitimate users of health care. By using biomedical and morality discourses in this way the men could maintain a masculine identity whilst also identifying as virtuous users of health care services. These results support the utility of hegemonic masculinity as a theoretical basis for examining the construction and maintenance of gendered identities by highlighting the complexity of multiple masculine identities.

Preretirement Planning and Well-Being in Later Life: A Prospective Study

Cross-sectional and retrospective research has identified a reliable relationship between preretirement planning and later-life well-being. Although it seems intuitive that retirement planning leads to more positive retirement outcomes, limited longitudinal analysis has confirmed the directionality of this relationship or clarified its complexities. The Health and Retirement Study, a prospective survey of American workers and retirees from 1992 to the present, can help illuminate this relationship. Data signifying the preretirement activities of employed individuals from the 1992 wave were compared with their postretirement ratings of retirement satisfaction and subjective physical and emotional health in 2004. An ordinal regression analysis indicated that those who had discussed retirement with their spouses and had retirement superannuation or savings plans in 1992 reported greater well-being in 2004 (controlling for health status, the reason for retirement, and income in 1992). These results confirm the importance of preretirement preparation and provide a rationale for developing more comprehensive, theory-driven measures of retirement planning.

Do Men and Women Differ in Their Retirement Planning? Testing a Theoretical Model of Gendered Pathways to Retirement Preparation

Previous literature has situated retirement and retirement planning within the male’s domain by positioning women as unconcerned and therefore ill prepared for retirement. However, women’s increasing representation in the workforce requires a reexamination of their retirement plans and the factors that enable them. In this study, a subsample of 2,277 working men and women from the New Zealand Health, Work, and Retirement Survey provides the basis for a structural equation model examining the effects of socioeconomic status, work involvement, and retirement perceptions on retirement planning. This model also tests for gender differences to assess the extent to which women are disadvantaged in terms of their retirement planning and the factors that may affect retirement plans. Results indicated that perceptions of retirement and economic living standards were associated with financial preparedness. However, women were still economically disadvantaged compared to men and this impacted negatively on their financial preparations. Retirement and retirement planning is now of greater concern for women. Future promotional initiatives should be aimed at these groups to assist their financial preparations for the future.

The Process of Retirement Planning Scale (PRePS): Development and validation

Although a substantial proportion of the western population is approaching retirement age, little is known about how they are preparing for the future. Much attention has been paid to the consumption of educational material and retirement wealth in the present literature, but the process of retirement planning has been ignored. S. L. Friedman and E. K. Scholnicks (1997) theoretical model provided the basis for a comprehensive measure of retirement planning. According to their process theory, individuals develop an understanding of the problem, set goals, make a decision to start preparing, and finally undertake the behaviors needed to fulfill their goals. Fifty-two items were developed to assess each stage of the planning process for financial, health, lifestyle, and psychosocial retirement planning. These were tested on a population sample of 1,449 New Zealanders aged 49-60. Confirmatory factor analysis, bivariate correlations, and hierarchical regression provided support for the valid use of the measure. Necessary antecedents, such as the tendency to look to the future, and locus of control were significantly related to the Process of Retirement Planning Scale (PRePS). The PRePS also outperformed retirement planning measures used in the Health and Retirement Study (F. T. Juster & R. Suzman, 1995) after controlling for socioeconomic and psychological variables. This measure will enable social policy makers to determine which stages of retirement planning require support and intervention. The PRePS will also help to determine which domains of retirement planning predict well-being in later life and the factors which differentiate those who are planning from those who are not.

Estimating older hazardous and binge drinking prevalence using AUDIT-C and AUDIT-3 thresholds specific to older adults

BACKGROUND This study aimed to provide hazardous and binge drinking prevalence, odds and risk attributable to specific demographic correlates in community dwelling older adults using both the standard and new older-specific AUDIT-C thresholds. METHODS Hazardous drinking was assessed using the AUDIT-C in a cross-sectional postal survey of 6662 New Zealanders aged 55-70 years old (m=60.94, SD=4.70) randomly selected from the New Zealand Electoral Roll. Prevalence data is presented for whole sample and stratified by key demographic correlates using standard and older-specific threshold scores on the AUDIT-C. Hazardous drinking prevalence using the standard AUDIT-C threshold was 56.01%, as compared to 42.28% and 50.20% under two older-specific thresholds. RESULTS Being younger, male, and wealthy were consistent drinking predictors across thresholds but the older-specific thresholds substantially altered the prevalence and risk for females, Asians, and poorer people. Past-month binge prevalence of 18.18% was considerably lower than the past-year prevalence of 33.51%, but change from past-month to past-year binge threshold had no significant effect on the demographic composition of binge drinkers. The standard AUDIT-C threshold over-estimates hazardous drinking prevalence in older adults by up to 33%, but even the most conservative rates in this study are cause for concern regarding the level of drinking by older people in New Zealand. CONCLUSION Older hazardous drinkers are predominantly younger, wealthier, white, partnered males, whichever threshold is used, but binge drinkers are more likely to be rural, Māori, and lack tertiary education. Further efforts are needed to determine factors underpinning hazardous drinking, especially in older Māori.

Adapting data collection methods in the Australian Life Histories and Health Survey: a retrospective life course study

Objective Ideally, life course data are collected prospectively through an ongoing longitudinal study. We report adaptive multimethod fieldwork procedures that gathered life history data by mail survey and telephone interview, comparable with the face-to-face methods employed in the English Longitudinal Study on Ageing (ELSA). Design The Australian Life Histories and Health (LHH) Survey was a substudy of the Australian 45 and Up Study, with data collection methods modified from the ELSA Study. A self-complete questionnaire and life history calendar were completed by the participants, followed by a computer-assisted telephone interview recording key life events. Results The LHH survey developed and tested procedures and instruments that gathered rich life history data within an ongoing Australian longitudinal survey on ageing. Data collection proved to be economical. The use of a self-complete questionnaire in conjunction with a life history calendar and coordinated computer-assisted telephone interview was successful in collecting retrospective life course information, in terms of being thorough, practical and efficient. This study has a diverse collection of data covering the life course, starting with early life experiences and continuing with socioeconomic and health exposures and outcomes during adult life. Conclusions Mail and telephone methodology can accurately and economically add a life history dimension to an ongoing longitudinal survey. The method is particularly valuable for surveying widely dispersed populations. The results will facilitate understanding of the social determinants of health by gathering data on earlier life exposures as well as comparative data across geographical and societal contexts.

Socioeconomic, psychological and demographic determinants of Australian baby boomers' financial planning for retirement

Aim:  Research from around the Western World has shown that psychological, socioeconomic and demographic factors can influence levels of financial planning. This study aims to determine how these factors interrelate to predict planning outcomes.

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.

Upstream and Downstream Correlates of Older People's Engagement in Social Networks: What are Their Effects on Health over Time?

This study tested the effects of social network engagement and social support on the health of older people moving into retirement, using a model which includes social context variables. A prospective survey of a New Zealand population sample aged 54–70 at baseline (N = 2,282) was used to assess the effects on mental and physical health across time. A structural equation model assessed pathways from the social context variables through network engagement to social support and then to mental and physical health 2 years later. The proposed model of effects on mental health was supported when gender, economic living standards, and ethnicity were included along with the direct effects of these variables on social support. These findings confirm the importance of taking social context variables into account when considering social support networks. Social engagement appears to be an important aspect of social network functioning which could be investigated further.

Enhancing the Health and Employment Participation of Older Workers

The ageing of the Australian workforce has raised concerns about economic sustainability and prompted government polices to encourage longer working lives. However, the effectiveness of these policies is limited by a focus on individual workers rather than the organisations employing them. This chapter examines the strengths of older workers, the specific challenges they face and the implications of both for policy reform. It demonstrates that challenges concerning mental health, training and the ‘design of work’ demand stronger policy intervention if employment is to be effectively prolonged. The concept of ‘work ability’ is introduced as a framework for incorporating organisational considerations into policy development.